2022 Medicare Part D Plan Formulary Information |
Blue Medicare Advantage PPO (PPO) (H5900-001-0)
Benefit Details
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage PPO (PPO). This function does not email the formulary drug list.](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
The Blue Medicare Advantage PPO (PPO) (H5900-001-0) Formulary Drugs Starting with the Letter P in Adair County, IA: CMS MA Region 19 which includes: IA
|
Drugs Starting with Letter P
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
PACERONE 100MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PACERONE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
PACERONE 200 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PACERONE 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
PACERONE 400 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PACERONE 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
PALIPERIDONE ER 1.5 MG TABLET ER 24 [Invega] ![Compare how all Medicare Part D PDP plans in IA cover PALIPERIDONE ER 1.5 MG TABLET ER 24 [Invega].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:30 /30Days |
PALIPERIDONE ER 3 MG TABLET ER 24 [Invega] ![Compare how all Medicare Part D PDP plans in IA cover PALIPERIDONE ER 3 MG TABLET ER 24 [Invega].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:30 /30Days |
PALIPERIDONE ER 6 MG TABLET ER 24 [Invega] ![Compare how all Medicare Part D PDP plans in IA cover PALIPERIDONE ER 6 MG TABLET ER 24 [Invega].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:60 /30Days |
PALIPERIDONE ER 9 MG TABLET ER 24 [Invega] ![Compare how all Medicare Part D PDP plans in IA cover PALIPERIDONE ER 9 MG TABLET ER 24 [Invega].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:30 /30Days |
PANRETIN 0.1% GEL ![Compare how all Medicare Part D PDP plans in IA cover PANRETIN 0.1% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:60 /30Days |
PANTOPRAZOLE SOD DR 20 MG TAB ![Compare how all Medicare Part D PDP plans in IA cover PANTOPRAZOLE SOD DR 20 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
PANTOPRAZOLE SOD DR 40 MG TABLET DR [Protonix] ![Compare how all Medicare Part D PDP plans in IA cover PANTOPRAZOLE SOD DR 40 MG TABLET DR [Protonix].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PANZYGA 10% (1 G/10 ML) VIAL ![Compare how all Medicare Part D PDP plans in IA cover PANZYGA 10% (1 G/10 ML) VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
PANZYGA 10% (10 G/100 ML) VIAL ![Compare how all Medicare Part D PDP plans in IA cover PANZYGA 10% (10 G/100 ML) VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
PANZYGA 10% (2.5 G/25 ML) VIAL ![Compare how all Medicare Part D PDP plans in IA cover PANZYGA 10% (2.5 G/25 ML) VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
PANZYGA 10% (20 G/200 ML) VIAL ![Compare how all Medicare Part D PDP plans in IA cover PANZYGA 10% (20 G/200 ML) VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
PANZYGA 10% (30 G/300 ML) VIAL ![Compare how all Medicare Part D PDP plans in IA cover PANZYGA 10% (30 G/300 ML) VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
PANZYGA 10% (5 G/50 ML) VIAL ![Compare how all Medicare Part D PDP plans in IA cover PANZYGA 10% (5 G/50 ML) VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
PARICALCITOL 1 MCG CAPSULE [Zemplar] ![Compare how all Medicare Part D PDP plans in IA cover PARICALCITOL 1 MCG CAPSULE [Zemplar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
PARICALCITOL 2 MCG CAPSULE [Zemplar] ![Compare how all Medicare Part D PDP plans in IA cover PARICALCITOL 2 MCG CAPSULE [Zemplar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
PARICALCITOL 4 MCG CAPSULE [Zemplar] ![Compare how all Medicare Part D PDP plans in IA cover PARICALCITOL 4 MCG CAPSULE [Zemplar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
PAROMOMYCIN 250 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover PAROMOMYCIN 250 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
PAROXETINE ER 12.5 MG TABLET ER 24H [Paxil CR] ![Compare how all Medicare Part D PDP plans in IA cover PAROXETINE ER 12.5 MG TABLET ER 24H [Paxil CR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PAROXETINE ER 25 MG TABLET ER 24H [Paxil CR] ![Compare how all Medicare Part D PDP plans in IA cover PAROXETINE ER 25 MG TABLET ER 24H [Paxil CR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:60 /30Days |
PAROXETINE ER 37.5 MG TABLET ER 24H [Paxil CR] ![Compare how all Medicare Part D PDP plans in IA cover PAROXETINE ER 37.5 MG TABLET ER 24H [Paxil CR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:60 /30Days |
PAROXETINE HCL 10 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PAROXETINE HCL 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $16.00 | None |
PAROXETINE HCL 10 MG/5 ML ORAL SUSPENSION [Paxil] ![Compare how all Medicare Part D PDP plans in IA cover PAROXETINE HCL 10 MG/5 ML ORAL SUSPENSION [Paxil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P Q:900 /30Days |
PAROXETINE HCL 20 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PAROXETINE HCL 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $16.00 | None |
PAROXETINE HCL 30 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PAROXETINE HCL 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $16.00 | None |
PAROXETINE HCL 40 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PAROXETINE HCL 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $16.00 | None |
PASER GRANULES 4GM PACKET ![Compare how all Medicare Part D PDP plans in IA cover PASER GRANULES 4GM PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
PAXIL ORAL SUSPENSION 10 MG/5ML ![Compare how all Medicare Part D PDP plans in IA cover PAXIL ORAL SUSPENSION 10 MG/5ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P Q:900 /30Days |
PEDVAXHIB VACCINE VIAL ![Compare how all Medicare Part D PDP plans in IA cover PEDVAXHIB VACCINE VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PEG 3350-ELECTROLYTE SOLUTION RECON [TriLyte] ![Compare how all Medicare Part D PDP plans in IA cover PEG 3350-ELECTROLYTE SOLUTION RECON [TriLyte].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $16.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PEG-3350 AND ELECTROLYTES SOLUTION SOLUTION RECON ![Compare how all Medicare Part D PDP plans in IA cover PEG-3350 AND ELECTROLYTES SOLUTION SOLUTION RECON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $16.00 | None |
Pegasys 180ug/0.5mL 1 PACKET in 1 BOX / 4 SYRINGE, GLASS in 1 PACKET / 0.5 mL in 1 SYRINGE, GLASS ![Compare how all Medicare Part D PDP plans in IA cover Pegasys 180ug/0.5mL 1 PACKET in 1 BOX / 4 SYRINGE, GLASS in 1 PACKET / 0.5 mL in 1 SYRINGE, GLASS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
PEGASYS INJECTION ![Compare how all Medicare Part D PDP plans in IA cover PEGASYS INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
PEMAZYRE 13.5 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PEMAZYRE 13.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
PEMAZYRE 4.5 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PEMAZYRE 4.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
PEMAZYRE 9 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PEMAZYRE 9 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
PENICILLAMINE 250 MG TABLET [Depen] ![Compare how all Medicare Part D PDP plans in IA cover PENICILLAMINE 250 MG TABLET [Depen].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
PENICILLIN G POTASSIUM 2MMUNITS/50ML ISO-OSM ![Compare how all Medicare Part D PDP plans in IA cover PENICILLIN G POTASSIUM 2MMUNITS/50ML ISO-OSM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
PENICILLIN G POTASSIUM 3MMUNITS/50ML ISO-OSM ![Compare how all Medicare Part D PDP plans in IA cover PENICILLIN G POTASSIUM 3MMUNITS/50ML ISO-OSM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
PENICILLIN G PROCAINE 1200000UNT 2ML CTG ![Compare how all Medicare Part D PDP plans in IA cover PENICILLIN G PROCAINE 1200000UNT 2ML CTG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
Penicillin G Sodium 5000000[iU]/1 10 VIAL per CARTON / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL ![Compare how all Medicare Part D PDP plans in IA cover Penicillin G Sodium 5000000[iU]/1 10 VIAL per CARTON / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PENICILLIN GK 20 MILLION UNIT ![Compare how all Medicare Part D PDP plans in IA cover PENICILLIN GK 20 MILLION UNIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
PENICILLIN V POTASSIUM 250MG/5ML LIQUID ![Compare how all Medicare Part D PDP plans in IA cover PENICILLIN V POTASSIUM 250MG/5ML LIQUID.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $16.00 | None |
PENICILLIN VK 125 MG/5 ML SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover PENICILLIN VK 125 MG/5 ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $16.00 | None |
PENICILLIN VK 250 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PENICILLIN VK 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
PENICILLIN VK 500 MG TABLET [Veetids] ![Compare how all Medicare Part D PDP plans in IA cover PENICILLIN VK 500 MG TABLET [Veetids].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
PENTACEL VIAL KIT ![Compare how all Medicare Part D PDP plans in IA cover PENTACEL VIAL KIT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PENTAMIDINE 300 MG INHAL POWDER VIAL-NEB [NebuPent] ![Compare how all Medicare Part D PDP plans in IA cover PENTAMIDINE 300 MG INHAL POWDER VIAL-NEB [NebuPent].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
PENTAMIDINE 300 MG VIAL [Pentam] ![Compare how all Medicare Part D PDP plans in IA cover PENTAMIDINE 300 MG VIAL [Pentam].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
PENTOXIFYLLINE 400MG TABLET SA ![Compare how all Medicare Part D PDP plans in IA cover PENTOXIFYLLINE 400MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $16.00 | None |
PERINDOPRIL ERBUMINE 2 MG TAB ![Compare how all Medicare Part D PDP plans in IA cover PERINDOPRIL ERBUMINE 2 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
PERINDOPRIL ERBUMINE 4 MG TAB ![Compare how all Medicare Part D PDP plans in IA cover PERINDOPRIL ERBUMINE 4 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PERINDOPRIL ERBUMINE 8 MG TAB ![Compare how all Medicare Part D PDP plans in IA cover PERINDOPRIL ERBUMINE 8 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
PERIOGARD 0.12% ORAL RINSE MOUTHWASH [Perisol] ![Compare how all Medicare Part D PDP plans in IA cover PERIOGARD 0.12% ORAL RINSE MOUTHWASH [Perisol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
PERMETHRIN 5% CREAM (G) [Elimite] ![Compare how all Medicare Part D PDP plans in IA cover PERMETHRIN 5% CREAM (G) [Elimite].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | Q:60 /30Days |
PERPHENAZINE 16 MG TABLET [Trilafon] ![Compare how all Medicare Part D PDP plans in IA cover PERPHENAZINE 16 MG TABLET [Trilafon].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PERPHENAZINE 2 MG TABLET [Trilafon] ![Compare how all Medicare Part D PDP plans in IA cover PERPHENAZINE 2 MG TABLET [Trilafon].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PERPHENAZINE 4 MG TABLET [Trilafon] ![Compare how all Medicare Part D PDP plans in IA cover PERPHENAZINE 4 MG TABLET [Trilafon].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PERPHENAZINE 8 MG TABLET [Trilafon] ![Compare how all Medicare Part D PDP plans in IA cover PERPHENAZINE 8 MG TABLET [Trilafon].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PERSERIS ER 120 MG SYRINGE KIT SUSER SYKT ![Compare how all Medicare Part D PDP plans in IA cover PERSERIS ER 120 MG SYRINGE KIT SUSER SYKT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:1 /30Days |
PERSERIS ER 90 MG SYRINGE KIT SUSER SYKT ![Compare how all Medicare Part D PDP plans in IA cover PERSERIS ER 90 MG SYRINGE KIT SUSER SYKT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:1 /30Days |
PHENELZINE SULFATE 15 MG TABLET [Nardil] ![Compare how all Medicare Part D PDP plans in IA cover PHENELZINE SULFATE 15 MG TABLET [Nardil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
Phenobarbital 100mg/1 ![Compare how all Medicare Part D PDP plans in IA cover Phenobarbital 100mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PHENOBARBITAL 15 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PHENOBARBITAL 15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | P |
PHENOBARBITAL 16.2 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PHENOBARBITAL 16.2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | P |
PHENOBARBITAL 20 MG/5 ML ELIX ELIXIR ![Compare how all Medicare Part D PDP plans in IA cover PHENOBARBITAL 20 MG/5 ML ELIX ELIXIR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
PHENOBARBITAL 30 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PHENOBARBITAL 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | P |
PHENOBARBITAL 32.4 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PHENOBARBITAL 32.4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | P |
Phenobarbital 60mg/1 ![Compare how all Medicare Part D PDP plans in IA cover Phenobarbital 60mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | P |
PHENOBARBITAL 64.8 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PHENOBARBITAL 64.8 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | P |
PHENOBARBITAL 97.2 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PHENOBARBITAL 97.2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | P |
PHENYTEK 200 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover PHENYTEK 200 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
PHENYTEK 300 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover PHENYTEK 300 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
PHENYTOIN 125 MG/5 ML ORAL SUSPENSION [Dilantin] ![Compare how all Medicare Part D PDP plans in IA cover PHENYTOIN 125 MG/5 ML ORAL SUSPENSION [Dilantin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PHENYTOIN 50 MG CHEWABLE TABLET [Dilantin] ![Compare how all Medicare Part D PDP plans in IA cover PHENYTOIN 50 MG CHEWABLE TABLET [Dilantin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PHENYTOIN SOD EXT 100 MG CAP ![Compare how all Medicare Part D PDP plans in IA cover PHENYTOIN SOD EXT 100 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PHENYTOIN SOD EXT 200 MG CAP ![Compare how all Medicare Part D PDP plans in IA cover PHENYTOIN SOD EXT 200 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PHENYTOIN SOD EXT 300 MG CAPSULE [Phenytek] ![Compare how all Medicare Part D PDP plans in IA cover PHENYTOIN SOD EXT 300 MG CAPSULE [Phenytek].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PIFELTRO 100 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PIFELTRO 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
PILOCARPINE 1% EYE DROPS [Pilocar] ![Compare how all Medicare Part D PDP plans in IA cover PILOCARPINE 1% EYE DROPS [Pilocar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PILOCARPINE 2% EYE DROPS [Pilocar] ![Compare how all Medicare Part D PDP plans in IA cover PILOCARPINE 2% EYE DROPS [Pilocar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PILOCARPINE 4% EYE DROPS [Pilocar] ![Compare how all Medicare Part D PDP plans in IA cover PILOCARPINE 4% EYE DROPS [Pilocar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PILOCARPINE HCL 5 MG TABLET [Salagen] ![Compare how all Medicare Part D PDP plans in IA cover PILOCARPINE HCL 5 MG TABLET [Salagen].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PILOCARPINE HCL 7.5 MG TABLET [Salagen] ![Compare how all Medicare Part D PDP plans in IA cover PILOCARPINE HCL 7.5 MG TABLET [Salagen].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PIMOZIDE 1 MG TABLET [Orap] ![Compare how all Medicare Part D PDP plans in IA cover PIMOZIDE 1 MG TABLET [Orap].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PIMOZIDE 2 MG TABLET [Orap] ![Compare how all Medicare Part D PDP plans in IA cover PIMOZIDE 2 MG TABLET [Orap].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
PIMTREA 28 DAY TABLET ![Compare how all Medicare Part D PDP plans in IA cover PIMTREA 28 DAY TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PINDOLOL 10 MG TABLET [Visken] ![Compare how all Medicare Part D PDP plans in IA cover PINDOLOL 10 MG TABLET [Visken].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PINDOLOL 5 MG TABLET [Visken] ![Compare how all Medicare Part D PDP plans in IA cover PINDOLOL 5 MG TABLET [Visken].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PIOGLITAZONE HCL 15 MG TABLET [Actos] ![Compare how all Medicare Part D PDP plans in IA cover PIOGLITAZONE HCL 15 MG TABLET [Actos].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | Q:30 /30Days |
PIOGLITAZONE HCL 30 MG TABLET [Actos] ![Compare how all Medicare Part D PDP plans in IA cover PIOGLITAZONE HCL 30 MG TABLET [Actos].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | Q:30 /30Days |
PIOGLITAZONE HCL 45 MG TABLET [Actos] ![Compare how all Medicare Part D PDP plans in IA cover PIOGLITAZONE HCL 45 MG TABLET [Actos].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | Q:30 /30Days |
PIPERACIL-TAZOBACT 2.25 GM VIAL [Zosyn] ![Compare how all Medicare Part D PDP plans in IA cover PIPERACIL-TAZOBACT 2.25 GM VIAL [Zosyn].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
PIPERACIL-TAZOBACT 3.375 GM VIAL [Zosyn] ![Compare how all Medicare Part D PDP plans in IA cover PIPERACIL-TAZOBACT 3.375 GM VIAL [Zosyn].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
PIPERACIL-TAZOBACT 4.5 GM VIAL [Zosyn] ![Compare how all Medicare Part D PDP plans in IA cover PIPERACIL-TAZOBACT 4.5 GM VIAL [Zosyn].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
PIPERACIL-TAZOBACT 40.5 GRAM VIAL [Zosyn] ![Compare how all Medicare Part D PDP plans in IA cover PIPERACIL-TAZOBACT 40.5 GRAM VIAL [Zosyn].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PIQRAY 200 MG DAILY DOSE TABLET ![Compare how all Medicare Part D PDP plans in IA cover PIQRAY 200 MG DAILY DOSE TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
PIQRAY 250 MG DAILY DOSE TABLET ![Compare how all Medicare Part D PDP plans in IA cover PIQRAY 250 MG DAILY DOSE TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
PIQRAY 300 MG DAILY DOSE TABLET ![Compare how all Medicare Part D PDP plans in IA cover PIQRAY 300 MG DAILY DOSE TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
PIRFENIDONE 267 MG TABLET [ESBRIET] ![Compare how all Medicare Part D PDP plans in IA cover PIRFENIDONE 267 MG TABLET [ESBRIET].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:270 /30Days |
PIRFENIDONE 801 MG TABLET [ESBRIET] ![Compare how all Medicare Part D PDP plans in IA cover PIRFENIDONE 801 MG TABLET [ESBRIET].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:90 /30Days |
PIRMELLA 1-35 28 TABLET ![Compare how all Medicare Part D PDP plans in IA cover PIRMELLA 1-35 28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $16.00 | None |
PIROXICAM 10 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover PIROXICAM 10 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PIROXICAM 20 MG CAPSULE [Feldene] ![Compare how all Medicare Part D PDP plans in IA cover PIROXICAM 20 MG CAPSULE [Feldene].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PLASMA-LYTE 148 IV SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover PLASMA-LYTE 148 IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
PLASMA-LYTE A PH 7.4 SOLUTION 37;368; MG/100ML; ![Compare how all Medicare Part D PDP plans in IA cover PLASMA-LYTE A PH 7.4 SOLUTION 37;368; MG/100ML;.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
PLENAMINE 15% SOLUTION IV SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover PLENAMINE 15% SOLUTION IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PLENVU POWDER PACKETS SQ ![Compare how all Medicare Part D PDP plans in IA cover PLENVU POWDER PACKETS SQ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
PODOFILOX 0.5% TOPICAL SOLUTION [Condylox] ![Compare how all Medicare Part D PDP plans in IA cover PODOFILOX 0.5% TOPICAL SOLUTION [Condylox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | Q:7 /28Days |
POLYMYXIN B-TMP EYE DROPS ![Compare how all Medicare Part D PDP plans in IA cover POLYMYXIN B-TMP EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
POMALYST 1 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover POMALYST 1 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:21 /21Days |
POMALYST 2 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover POMALYST 2 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:21 /21Days |
POMALYST 3 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover POMALYST 3 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:21 /28Days |
POMALYST 4 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover POMALYST 4 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:21 /28Days |
PORTIA 0.15-0.03 TABLET ![Compare how all Medicare Part D PDP plans in IA cover PORTIA 0.15-0.03 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $16.00 | None |
POSACONAZOLE DR 100 MG TABLET [Noxafil] ![Compare how all Medicare Part D PDP plans in IA cover POSACONAZOLE DR 100 MG TABLET [Noxafil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:93 /30Days |
Potassium Chloride in Dextrose 5; 150g/100mL; mg/100mL 1000 mL in 1 BAG ![Compare how all Medicare Part D PDP plans in IA cover Potassium Chloride in Dextrose 5; 150g/100mL; mg/100mL 1000 mL in 1 BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
Potassium Chloride in Dextrose and Sodium Chloride 5; 300; 900g/100mL; mg/100mL; mg/100mL 1000 mL i ![Compare how all Medicare Part D PDP plans in IA cover Potassium Chloride in Dextrose and Sodium Chloride 5; 300; 900g/100mL; mg/100mL; mg/100mL 1000 mL i.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
POTASSIUM CITRATE ER 10 MEQ TB ![Compare how all Medicare Part D PDP plans in IA cover POTASSIUM CITRATE ER 10 MEQ TB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
POTASSIUM CITRATE ER 15 MEQ TABLET ![Compare how all Medicare Part D PDP plans in IA cover POTASSIUM CITRATE ER 15 MEQ TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
POTASSIUM CITRATE ER 5 MEQ TAB ![Compare how all Medicare Part D PDP plans in IA cover POTASSIUM CITRATE ER 5 MEQ TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
POTASSIUM CL 10 MEQ/100 ML SOL PIGGYBACK ![Compare how all Medicare Part D PDP plans in IA cover POTASSIUM CL 10 MEQ/100 ML SOL PIGGYBACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
POTASSIUM CL 10% (20 MEQ/15ML) LIQUID [Kay Ciel] ![Compare how all Medicare Part D PDP plans in IA cover POTASSIUM CL 10% (20 MEQ/15ML) LIQUID [Kay Ciel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
POTASSIUM CL 20 MEQ PACKET [Klor-Con] ![Compare how all Medicare Part D PDP plans in IA cover POTASSIUM CL 20 MEQ PACKET [Klor-Con].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
POTASSIUM CL 20 MEQ-0.45% NACL IV SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover POTASSIUM CL 20 MEQ-0.45% NACL IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
POTASSIUM CL 20 MEQ/100 ML SOL PIGGYBACK ![Compare how all Medicare Part D PDP plans in IA cover POTASSIUM CL 20 MEQ/100 ML SOL PIGGYBACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
POTASSIUM CL 20% (40 MEQ/15ML) LIQUID [Kaon-CL] ![Compare how all Medicare Part D PDP plans in IA cover POTASSIUM CL 20% (40 MEQ/15ML) LIQUID [Kaon-CL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
POTASSIUM CL 40 MEQ/100 ML SOL PIGGYBACK ![Compare how all Medicare Part D PDP plans in IA cover POTASSIUM CL 40 MEQ/100 ML SOL PIGGYBACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
POTASSIUM CL 40 MEQ/20 ML CONC VIAL [PROAMP] ![Compare how all Medicare Part D PDP plans in IA cover POTASSIUM CL 40 MEQ/20 ML CONC VIAL [PROAMP].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
POTASSIUM CL 60 MEQ/30 ML CONC VIAL [PROAMP] ![Compare how all Medicare Part D PDP plans in IA cover POTASSIUM CL 60 MEQ/30 ML CONC VIAL [PROAMP].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
POTASSIUM CL ER 10 MEQ CAPSULE ER [Micro-K Extencaps] ![Compare how all Medicare Part D PDP plans in IA cover POTASSIUM CL ER 10 MEQ CAPSULE ER [Micro-K Extencaps].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
POTASSIUM CL ER 10 MEQ TABLET [Klotrix] ![Compare how all Medicare Part D PDP plans in IA cover POTASSIUM CL ER 10 MEQ TABLET [Klotrix].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $16.00 | None |
POTASSIUM CL ER 10 MEQ TABLET ER PRT [Klotrix] ![Compare how all Medicare Part D PDP plans in IA cover POTASSIUM CL ER 10 MEQ TABLET ER PRT [Klotrix].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $16.00 | None |
POTASSIUM CL ER 15 MEQ TABLET ER PRT [Klor-Con M15] ![Compare how all Medicare Part D PDP plans in IA cover POTASSIUM CL ER 15 MEQ TABLET ER PRT [Klor-Con M15].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
Potassium cl er 20 meq tablet ![Compare how all Medicare Part D PDP plans in IA cover Potassium cl er 20 meq tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $16.00 | None |
POTASSIUM CL ER 20 MEQ TABLET ER PRT [Klor-Con M20] ![Compare how all Medicare Part D PDP plans in IA cover POTASSIUM CL ER 20 MEQ TABLET ER PRT [Klor-Con M20].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $16.00 | None |
POTASSIUM CL ER 8 MEQ CAPSULE ER [Micro-K Extencaps] ![Compare how all Medicare Part D PDP plans in IA cover POTASSIUM CL ER 8 MEQ CAPSULE ER [Micro-K Extencaps].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
POTASSIUM CL ER 8 MEQ TABLET [Slow-K] ![Compare how all Medicare Part D PDP plans in IA cover POTASSIUM CL ER 8 MEQ TABLET [Slow-K].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $16.00 | None |
PRADAXA 110 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover PRADAXA 110 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:120 /30Days |
PRADAXA 150 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover PRADAXA 150 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PRADAXA 75 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover PRADAXA 75 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:60 /30Days |
PRALUENT 150 MG/ML PEN INJCTR ![Compare how all Medicare Part D PDP plans in IA cover PRALUENT 150 MG/ML PEN INJCTR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | P |
PRALUENT 75 MG/ML PEN INJCTR ![Compare how all Medicare Part D PDP plans in IA cover PRALUENT 75 MG/ML PEN INJCTR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | P |
PRAMIPEXOLE 0.125 MG TABLET [Mirapex] ![Compare how all Medicare Part D PDP plans in IA cover PRAMIPEXOLE 0.125 MG TABLET [Mirapex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
PRAMIPEXOLE 0.25 MG TABLET [Mirapex] ![Compare how all Medicare Part D PDP plans in IA cover PRAMIPEXOLE 0.25 MG TABLET [Mirapex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
PRAMIPEXOLE 0.5 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PRAMIPEXOLE 0.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
PRAMIPEXOLE 0.75 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PRAMIPEXOLE 0.75 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
PRAMIPEXOLE 1 MG TABLET [Mirapex] ![Compare how all Medicare Part D PDP plans in IA cover PRAMIPEXOLE 1 MG TABLET [Mirapex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
PRAMIPEXOLE 1.5 MG TABLET [Mirapex] ![Compare how all Medicare Part D PDP plans in IA cover PRAMIPEXOLE 1.5 MG TABLET [Mirapex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
PRAMIPEXOLE ER 0.375 MG TABLET ER 24H [Mirapex ER] ![Compare how all Medicare Part D PDP plans in IA cover PRAMIPEXOLE ER 0.375 MG TABLET ER 24H [Mirapex ER].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
PRAMIPEXOLE ER 0.75 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PRAMIPEXOLE ER 0.75 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PRAMIPEXOLE ER 1.5 MG TABLET ER 24H [Mirapex ER] ![Compare how all Medicare Part D PDP plans in IA cover PRAMIPEXOLE ER 1.5 MG TABLET ER 24H [Mirapex ER].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
PRAMIPEXOLE ER 2.25 MG TABLET ER 24H [Mirapex ER] ![Compare how all Medicare Part D PDP plans in IA cover PRAMIPEXOLE ER 2.25 MG TABLET ER 24H [Mirapex ER].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
PRAMIPEXOLE ER 3 MG TABLET ER 24H [Mirapex ER] ![Compare how all Medicare Part D PDP plans in IA cover PRAMIPEXOLE ER 3 MG TABLET ER 24H [Mirapex ER].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
PRAMIPEXOLE ER 3.75 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PRAMIPEXOLE ER 3.75 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
PRAMIPEXOLE ER 4.5 MG TABLET ER 24H [Mirapex ER] ![Compare how all Medicare Part D PDP plans in IA cover PRAMIPEXOLE ER 4.5 MG TABLET ER 24H [Mirapex ER].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
PRASUGREL 10 MG TABLET [Effient] ![Compare how all Medicare Part D PDP plans in IA cover PRASUGREL 10 MG TABLET [Effient].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PRASUGREL 5 MG TABLET [Effient] ![Compare how all Medicare Part D PDP plans in IA cover PRASUGREL 5 MG TABLET [Effient].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PRAVASTATIN SODIUM 10 MG TABLET [Pravachol] ![Compare how all Medicare Part D PDP plans in IA cover PRAVASTATIN SODIUM 10 MG TABLET [Pravachol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | Q:30 /30Days |
PRAVASTATIN SODIUM 20 MG TAB ![Compare how all Medicare Part D PDP plans in IA cover PRAVASTATIN SODIUM 20 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | Q:30 /30Days |
PRAVASTATIN SODIUM 40 MG TABLET [Pravachol] ![Compare how all Medicare Part D PDP plans in IA cover PRAVASTATIN SODIUM 40 MG TABLET [Pravachol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | Q:30 /30Days |
PRAVASTATIN SODIUM 80 MG TABLET [Pravachol] ![Compare how all Medicare Part D PDP plans in IA cover PRAVASTATIN SODIUM 80 MG TABLET [Pravachol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PRAZIQUANTEL 600 MG TABLET [Biltricide] ![Compare how all Medicare Part D PDP plans in IA cover PRAZIQUANTEL 600 MG TABLET [Biltricide].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
PRAZOSIN 1 MG CAPSULE [Minipress] ![Compare how all Medicare Part D PDP plans in IA cover PRAZOSIN 1 MG CAPSULE [Minipress].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PRAZOSIN 2 MG CAPSULE [Minipress] ![Compare how all Medicare Part D PDP plans in IA cover PRAZOSIN 2 MG CAPSULE [Minipress].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PRAZOSIN 5 MG CAPSULE [Minipress] ![Compare how all Medicare Part D PDP plans in IA cover PRAZOSIN 5 MG CAPSULE [Minipress].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PREDNISOLONE 15 MG/5 ML SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover PREDNISOLONE 15 MG/5 ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $16.00 | P |
PREDNISOLONE 5 MG/5 ML SOLUTION [Pediapred] ![Compare how all Medicare Part D PDP plans in IA cover PREDNISOLONE 5 MG/5 ML SOLUTION [Pediapred].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | P |
PREDNISOLONE AC 1% EYE DROP ![Compare how all Medicare Part D PDP plans in IA cover PREDNISOLONE AC 1% EYE DROP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PREDNISOLONE SOD 1% EYE DROP ![Compare how all Medicare Part D PDP plans in IA cover PREDNISOLONE SOD 1% EYE DROP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PREDNISOLONE SOD PH 25 MG/5 ML SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover PREDNISOLONE SOD PH 25 MG/5 ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | P |
PREDNISONE 1 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PREDNISONE 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $16.00 | P |
PREDNISONE 10 MG TABLET [Sterapred DS] ![Compare how all Medicare Part D PDP plans in IA cover PREDNISONE 10 MG TABLET [Sterapred DS].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $16.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PREDNISONE 10 MG TABLET DOSE PACK ![Compare how all Medicare Part D PDP plans in IA cover PREDNISONE 10 MG TABLET DOSE PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PREDNISONE 10 MG TABLET DOSE PACK ![Compare how all Medicare Part D PDP plans in IA cover PREDNISONE 10 MG TABLET DOSE PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PREDNISONE 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PREDNISONE 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $16.00 | P |
PREDNISONE 20 MG TABLET [Predone] ![Compare how all Medicare Part D PDP plans in IA cover PREDNISONE 20 MG TABLET [Predone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $16.00 | P |
PREDNISONE 5 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PREDNISONE 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PREDNISONE 5 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PREDNISONE 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PREDNISONE 5 MG TABLET [Sterapred] ![Compare how all Medicare Part D PDP plans in IA cover PREDNISONE 5 MG TABLET [Sterapred].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $16.00 | P |
PREDNISONE 5 MG/5 ML SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover PREDNISONE 5 MG/5 ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
PREDNISONE 50MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PREDNISONE 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $16.00 | P |
PREDNISONE 5MG/ML SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover PREDNISONE 5MG/ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
PREGABALIN 100 MG CAPSULE [Lyrica] ![Compare how all Medicare Part D PDP plans in IA cover PREGABALIN 100 MG CAPSULE [Lyrica].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | P Q:120 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PREGABALIN 150 MG CAPSULE [Lyrica] ![Compare how all Medicare Part D PDP plans in IA cover PREGABALIN 150 MG CAPSULE [Lyrica].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | P Q:120 /30Days |
PREGABALIN 20 MG/ML SOLUTION [Lyrica] ![Compare how all Medicare Part D PDP plans in IA cover PREGABALIN 20 MG/ML SOLUTION [Lyrica].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P Q:900 /30Days |
PREGABALIN 200 MG CAPSULE [Lyrica] ![Compare how all Medicare Part D PDP plans in IA cover PREGABALIN 200 MG CAPSULE [Lyrica].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | P Q:90 /30Days |
PREGABALIN 225 MG CAPSULE [Lyrica] ![Compare how all Medicare Part D PDP plans in IA cover PREGABALIN 225 MG CAPSULE [Lyrica].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | P Q:60 /30Days |
PREGABALIN 25 MG CAPSULE [Lyrica] ![Compare how all Medicare Part D PDP plans in IA cover PREGABALIN 25 MG CAPSULE [Lyrica].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | P Q:120 /30Days |
PREGABALIN 300 MG CAPSULE [Lyrica] ![Compare how all Medicare Part D PDP plans in IA cover PREGABALIN 300 MG CAPSULE [Lyrica].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | P Q:60 /30Days |
PREGABALIN 50 MG CAPSULE [Lyrica] ![Compare how all Medicare Part D PDP plans in IA cover PREGABALIN 50 MG CAPSULE [Lyrica].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | P Q:120 /30Days |
PREGABALIN 75 MG CAPSULE [Lyrica] ![Compare how all Medicare Part D PDP plans in IA cover PREGABALIN 75 MG CAPSULE [Lyrica].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | P Q:120 /30Days |
PREGABALIN ER 165 MG TABLET ER 24H [Lyrica CR] ![Compare how all Medicare Part D PDP plans in IA cover PREGABALIN ER 165 MG TABLET ER 24H [Lyrica CR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P Q:60 /30Days |
PREGABALIN ER 330 MG TABLET ER 24H [Lyrica CR] ![Compare how all Medicare Part D PDP plans in IA cover PREGABALIN ER 330 MG TABLET ER 24H [Lyrica CR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P Q:60 /30Days |
PREGABALIN ER 82.5 MG TABLET ER 24H [Lyrica CR] ![Compare how all Medicare Part D PDP plans in IA cover PREGABALIN ER 82.5 MG TABLET ER 24H [Lyrica CR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PREHEVBRIO 10 MCG/ML VIAL ![Compare how all Medicare Part D PDP plans in IA cover PREHEVBRIO 10 MCG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | P |
PREMASOL 10% IV SOLUTION ![Compare how all Medicare Part D PDP plans in IA cover PREMASOL 10% IV SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
PREVALITE PACKET ![Compare how all Medicare Part D PDP plans in IA cover PREVALITE PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PREVYMIS 240 MG ![Compare how all Medicare Part D PDP plans in IA cover PREVYMIS 240 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:28 /28Days |
PREVYMIS 480 MG ![Compare how all Medicare Part D PDP plans in IA cover PREVYMIS 480 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:28 /28Days |
PREZCOBIX 800 MG-150 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PREZCOBIX 800 MG-150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
PREZISTA 100 MG/ML SUSPENSION ![Compare how all Medicare Part D PDP plans in IA cover PREZISTA 100 MG/ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:400 /30Days |
PREZISTA 150MG TABLETS ![Compare how all Medicare Part D PDP plans in IA cover PREZISTA 150MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:240 /30Days |
PREZISTA 800 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PREZISTA 800 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:30 /30Days |
PREZISTA TABLET 600MG ![Compare how all Medicare Part D PDP plans in IA cover PREZISTA TABLET 600MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:60 /30Days |
PREZISTA TABLET 75MG ![Compare how all Medicare Part D PDP plans in IA cover PREZISTA TABLET 75MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:480 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PRIFTIN 150 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PRIFTIN 150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
PRILOSEC DR 10 MG SUSPENSION ![Compare how all Medicare Part D PDP plans in IA cover PRILOSEC DR 10 MG SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
PRILOSEC DR 2.5 MG SUSPENSION ![Compare how all Medicare Part D PDP plans in IA cover PRILOSEC DR 2.5 MG SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
PRIMAQUINE 26.3 MG TABLET [Primaquine] ![Compare how all Medicare Part D PDP plans in IA cover PRIMAQUINE 26.3 MG TABLET [Primaquine].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PRIMIDONE 250 MG TABLET [Mysoline] ![Compare how all Medicare Part D PDP plans in IA cover PRIMIDONE 250 MG TABLET [Mysoline].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $16.00 | None |
PRIMIDONE 50 MG TABLET [Mysoline] ![Compare how all Medicare Part D PDP plans in IA cover PRIMIDONE 50 MG TABLET [Mysoline].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $16.00 | None |
PRIVIGEN 10% VIAL ![Compare how all Medicare Part D PDP plans in IA cover PRIVIGEN 10% VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
PROBENECID 500 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PROBENECID 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PROBENECID-COLCHICINE TABLET ![Compare how all Medicare Part D PDP plans in IA cover PROBENECID-COLCHICINE TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
ProcalAmine 0.21; 0.29; 0.026; 0.014; 3; 0.42; 0.085; 0.21; 0.27; 0.22; 0.054; 0.16; 0.17; 0.041; 0 ![Compare how all Medicare Part D PDP plans in IA cover ProcalAmine 0.21; 0.29; 0.026; 0.014; 3; 0.42; 0.085; 0.21; 0.27; 0.22; 0.054; 0.16; 0.17; 0.041; 0.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
PROCHLORPERAZINE 10 MG TAB ![Compare how all Medicare Part D PDP plans in IA cover PROCHLORPERAZINE 10 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $16.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROCHLORPERAZINE 5 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PROCHLORPERAZINE 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $16.00 | None |
PROCHLORPERAZINE SUPPOSITORIES 25MG 12 BOX ![Compare how all Medicare Part D PDP plans in IA cover PROCHLORPERAZINE SUPPOSITORIES 25MG 12 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
PROCRIT 10000U/ML VIAL ![Compare how all Medicare Part D PDP plans in IA cover PROCRIT 10000U/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | P |
PROCRIT 2000U/ML VIAL 6 X 1ML VIAL ![Compare how all Medicare Part D PDP plans in IA cover PROCRIT 2000U/ML VIAL 6 X 1ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | P |
PROCRIT 3,000 UNITS/ML VIAL ![Compare how all Medicare Part D PDP plans in IA cover PROCRIT 3,000 UNITS/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | P |
PROCRIT 4,000 UNITS/ML VIAL ![Compare how all Medicare Part D PDP plans in IA cover PROCRIT 4,000 UNITS/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | P |
PROCRIT 40000U/ML VIAL PR ![Compare how all Medicare Part D PDP plans in IA cover PROCRIT 40000U/ML VIAL PR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
PROCRIT SOLUTION FOR INJECTION 20000UNT/ML 24 X 1 ML TRAY ![Compare how all Medicare Part D PDP plans in IA cover PROCRIT SOLUTION FOR INJECTION 20000UNT/ML 24 X 1 ML TRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
PROCTO-MED HC 2.5% CREAM CRM/PE APP [Proctozone-HC] ![Compare how all Medicare Part D PDP plans in IA cover PROCTO-MED HC 2.5% CREAM CRM/PE APP [Proctozone-HC].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
procto-pak 1% cream ![Compare how all Medicare Part D PDP plans in IA cover procto-pak 1% cream.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PROCTOSOL-HC 2.5% CREAM ![Compare how all Medicare Part D PDP plans in IA cover PROCTOSOL-HC 2.5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROCTOZONE-HC 2.5% CREAM ![Compare how all Medicare Part D PDP plans in IA cover PROCTOZONE-HC 2.5% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PROGRAF 0.2 MG GRANULE PACKET ![Compare how all Medicare Part D PDP plans in IA cover PROGRAF 0.2 MG GRANULE PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
PROGRAF 1 MG GRANULE PACKET ![Compare how all Medicare Part D PDP plans in IA cover PROGRAF 1 MG GRANULE PACKET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
PROLASTIN C 1,000 MG VIAL ![Compare how all Medicare Part D PDP plans in IA cover PROLASTIN C 1,000 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
PROLENSA 0.07% EYE DROPS ![Compare how all Medicare Part D PDP plans in IA cover PROLENSA 0.07% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PROLIA 60MG/ML INJECTION ![Compare how all Medicare Part D PDP plans in IA cover PROLIA 60MG/ML INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:1 /180Days |
PROMACTA 12.5 MG SUSPEN PACKET POWDER PACK ![Compare how all Medicare Part D PDP plans in IA cover PROMACTA 12.5 MG SUSPEN PACKET POWDER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:360 /30Days |
PROMACTA 12.5 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PROMACTA 12.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
PROMACTA 25 MG SUSPENSION POWDER PACK ![Compare how all Medicare Part D PDP plans in IA cover PROMACTA 25 MG SUSPENSION POWDER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:180 /30Days |
PROMACTA 25 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PROMACTA 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
PROMACTA 50 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PROMACTA 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROMACTA 75 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PROMACTA 75 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:60 /30Days |
PROMETHAZINE 12.5 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PROMETHAZINE 12.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | P |
PROMETHAZINE 25 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PROMETHAZINE 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | P |
PROMETHAZINE 50 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PROMETHAZINE 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | P |
PROMETHAZINE 6.25 MG/5 ML SYRUP [Prometh Plain] ![Compare how all Medicare Part D PDP plans in IA cover PROMETHAZINE 6.25 MG/5 ML SYRUP [Prometh Plain].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | P |
PROPAFENONE HCL 150 MG TABLET [Rythmol] ![Compare how all Medicare Part D PDP plans in IA cover PROPAFENONE HCL 150 MG TABLET [Rythmol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PROPAFENONE HCL 225MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PROPAFENONE HCL 225MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PROPAFENONE HCL 300 MG TABLET [Rythmol] ![Compare how all Medicare Part D PDP plans in IA cover PROPAFENONE HCL 300 MG TABLET [Rythmol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PROPAFENONE HCL ER 225 MG CAP ![Compare how all Medicare Part D PDP plans in IA cover PROPAFENONE HCL ER 225 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
PROPAFENONE HYDROCHLORIDE 325MG CAPSULES EXTENDED RELEASE ![Compare how all Medicare Part D PDP plans in IA cover PROPAFENONE HYDROCHLORIDE 325MG CAPSULES EXTENDED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
PROPAFENONE HYDROCHLORIDE 425MG CAPSULES EXTENDED RELEASE ![Compare how all Medicare Part D PDP plans in IA cover PROPAFENONE HYDROCHLORIDE 425MG CAPSULES EXTENDED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROPRANOLOL 10 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PROPRANOLOL 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $16.00 | None |
PROPRANOLOL 20 MG TABLET [Inderal] ![Compare how all Medicare Part D PDP plans in IA cover PROPRANOLOL 20 MG TABLET [Inderal].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $16.00 | None |
PROPRANOLOL 20MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in IA cover PROPRANOLOL 20MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PROPRANOLOL 40 MG TABLET [Inderal] ![Compare how all Medicare Part D PDP plans in IA cover PROPRANOLOL 40 MG TABLET [Inderal].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $16.00 | None |
PROPRANOLOL 40MG/5ML TUBEX ![Compare how all Medicare Part D PDP plans in IA cover PROPRANOLOL 40MG/5ML TUBEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PROPRANOLOL 60 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PROPRANOLOL 60 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $16.00 | None |
PROPRANOLOL 80 MG TABLET [Inderal] ![Compare how all Medicare Part D PDP plans in IA cover PROPRANOLOL 80 MG TABLET [Inderal].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $16.00 | None |
PROPRANOLOL ER 120 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover PROPRANOLOL ER 120 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PROPRANOLOL ER 160 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover PROPRANOLOL ER 160 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PROPRANOLOL ER 60 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover PROPRANOLOL ER 60 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PROPRANOLOL ER 80 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IA cover PROPRANOLOL ER 80 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROPYLTHIOURACIL 50 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PROPYLTHIOURACIL 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PROQUAD VIAL ![Compare how all Medicare Part D PDP plans in IA cover PROQUAD VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |
PROSOL 20% INJECTION ![Compare how all Medicare Part D PDP plans in IA cover PROSOL 20% INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | P |
PROTRIPTYLINE HCL 10 MG TABLET [Vivactil] ![Compare how all Medicare Part D PDP plans in IA cover PROTRIPTYLINE HCL 10 MG TABLET [Vivactil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
PROTRIPTYLINE HCL 5 MG TABLET [Vivactil] ![Compare how all Medicare Part D PDP plans in IA cover PROTRIPTYLINE HCL 5 MG TABLET [Vivactil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
PULMICORT FLEXHALER 180MCG AEROSOL POWDER BREATH ACTIVATED ![Compare how all Medicare Part D PDP plans in IA cover PULMICORT FLEXHALER 180MCG AEROSOL POWDER BREATH ACTIVATED.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:2 /30Days |
PULMICORT FLEXHALER 90MCG AEROSOL POWDER BREATH ACTIVATED ![Compare how all Medicare Part D PDP plans in IA cover PULMICORT FLEXHALER 90MCG AEROSOL POWDER BREATH ACTIVATED.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:3 /30Days |
PULMOZYME 1MG/ML AMPUL ![Compare how all Medicare Part D PDP plans in IA cover PULMOZYME 1MG/ML AMPUL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
PURIXAN 20 MG/ML ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in IA cover PURIXAN 20 MG/ML ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
PYRAZINAMIDE 500 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PYRAZINAMIDE 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None |
PYRIDOSTIGMINE BR 60 MG TABLET ![Compare how all Medicare Part D PDP plans in IA cover PYRIDOSTIGMINE BR 60 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $111.00 | None |