2025 Medicare Part D Plan Formulary Information |
AARP Medicare Rx Preferred from UHC (PDP) (S5820-035-0)
Benefits & Contact Info
 Insulin on a Medicare Part D plan's formulary will have a monthly copay of $35 or less. Call drug plan for more details. |
The AARP Medicare Rx Preferred from UHC (PDP) (S5820-035-0) Formulary Drugs Starting with the Letter M in CMS PDP Region 36 which includes: GU
|
Drugs Starting with Letter M
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
M-M-R II VACCINE W/DILUENT 1 DOSE/0.5ML  |
3 |
Tier 3 |
25% | 25% | Q:1 /1Days |
MAGNESIUM SULFATE 50% SYRINGE  |
4 |
Tier 4 |
25% | 25% | None |
MAGNESIUM SULFATE 50% VIAL  |
4 |
Tier 4 |
25% | 25% | None |
MALATHION 0.5% LOTION  |
4 |
Tier 4 |
25% | 25% | None |
MARAVIROC 150 MG TABLET [Selzentry] ![Compare how all Medicare Part D PDP plans in GU cover MARAVIROC 150 MG TABLET [Selzentry].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | Q:60 /30Days |
MARAVIROC 300 MG TABLET [Selzentry] ![Compare how all Medicare Part D PDP plans in GU cover MARAVIROC 300 MG TABLET [Selzentry].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | Q:120 /30Days |
MARLISSA-28 TABLET  |
3 |
Tier 3 |
25% | 25% | None |
MARPLAN 10MG TABLET (100 CT)  |
4 |
Tier 4 |
25% | 25% | None |
MATULANE 50 MG CAPSULE  |
5 |
Tier 5 |
25% | 25% | None |
MATZIM LA 180 MG TABLET  |
2 |
Tier 2 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MATZIM LA 240 MG TABLET  |
2 |
Tier 2 |
25% | 25% | None |
MATZIM LA 300 MG TABLET  |
2 |
Tier 2 |
25% | 25% | None |
MATZIM LA 360 MG TABLET  |
2 |
Tier 2 |
25% | 25% | None |
MATZIM LA 420 MG TABLET  |
2 |
Tier 2 |
25% | 25% | None |
MAVYRET 100-40 MG TABLET  |
5 |
Tier 5 |
25% | 25% | P Q:84 /28Days |
MAVYRET 50-20 MG PELLET PACKET  |
5 |
Tier 5 |
25% | 25% | P Q:140 /28Days |
MECLIZINE 12.5 MG TABLET [Antivert] ![Compare how all Medicare Part D PDP plans in GU cover MECLIZINE 12.5 MG TABLET [Antivert].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
MECLIZINE 25 MG TABLET [Meni-D] ![Compare how all Medicare Part D PDP plans in GU cover MECLIZINE 25 MG TABLET [Meni-D].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
MEDROXYPROGESTERONE 10 MG TABLET [Provera] ![Compare how all Medicare Part D PDP plans in GU cover MEDROXYPROGESTERONE 10 MG TABLET [Provera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All formulary drugs |
25% | 25% | None |
MEDROXYPROGESTERONE 150 MG/ML SYRINGE [Depo-Provera] ![Compare how all Medicare Part D PDP plans in GU cover MEDROXYPROGESTERONE 150 MG/ML SYRINGE [Depo-Provera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
MEDROXYPROGESTERONE 150 MG/ML VIAL [Depo-Provera] ![Compare how all Medicare Part D PDP plans in GU cover MEDROXYPROGESTERONE 150 MG/ML VIAL [Depo-Provera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MEDROXYPROGESTERONE 2.5 MG TABLET [Provera] ![Compare how all Medicare Part D PDP plans in GU cover MEDROXYPROGESTERONE 2.5 MG TABLET [Provera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All formulary drugs |
25% | 25% | None |
MEDROXYPROGESTERONE 5 MG TABLET [Provera] ![Compare how all Medicare Part D PDP plans in GU cover MEDROXYPROGESTERONE 5 MG TABLET [Provera].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All formulary drugs |
25% | 25% | None |
MEFLOQUINE HCL 250 MG TABLET  |
2 |
Tier 2 |
25% | 25% | None |
MEGESTROL 20 MG TABLET [Megace] ![Compare how all Medicare Part D PDP plans in GU cover MEGESTROL 20 MG TABLET [Megace].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
MEGESTROL 40 MG TABLET [Megace] ![Compare how all Medicare Part D PDP plans in GU cover MEGESTROL 40 MG TABLET [Megace].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
MEGESTROL 625 MG/5 ML ORAL SUSPENSION [Megace ES] ![Compare how all Medicare Part D PDP plans in GU cover MEGESTROL 625 MG/5 ML ORAL SUSPENSION [Megace ES].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
MEGESTROL ACET 40 MG/ML ORAL SUSPENSION [Megace] ![Compare how all Medicare Part D PDP plans in GU cover MEGESTROL ACET 40 MG/ML ORAL SUSPENSION [Megace].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
MEKINIST 0.05 MG/ML SOLUTION RECON  |
5 |
Tier 5 |
25% | 25% | P |
MEKINIST 0.5 MG TABLET  |
5 |
Tier 5 |
25% | 25% | P |
MEKINIST 2 MG TABLET  |
5 |
Tier 5 |
25% | 25% | P |
MEKTOVI 15 MG TABLET  |
5 |
Tier 5 |
25% | 25% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MELOXICAM 15 MG TABLET  |
1 |
All formulary drugs |
25% | 25% | None |
MELOXICAM 7.5 MG TABLET [Mobic] ![Compare how all Medicare Part D PDP plans in GU cover MELOXICAM 7.5 MG TABLET [Mobic].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All formulary drugs |
25% | 25% | None |
MEMANTINE 5-10 MG TITRATION PK [Namenda Titration] ![Compare how all Medicare Part D PDP plans in GU cover MEMANTINE 5-10 MG TITRATION PK [Namenda Titration].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | P Q:98 /365Days |
MEMANTINE HCL 10 MG TABLET [Namenda] ![Compare how all Medicare Part D PDP plans in GU cover MEMANTINE HCL 10 MG TABLET [Namenda].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | P Q:60 /30Days |
MEMANTINE HCL 2 MG/ML SOLUTION [Namenda] ![Compare how all Medicare Part D PDP plans in GU cover MEMANTINE HCL 2 MG/ML SOLUTION [Namenda].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P Q:300 /30Days |
MEMANTINE HCL 5 MG TABLET [Namenda] ![Compare how all Medicare Part D PDP plans in GU cover MEMANTINE HCL 5 MG TABLET [Namenda].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | P Q:90 /30Days |
MEMANTINE HCL ER 14 MG CAPSULE SPR 24 [Namenda XR] ![Compare how all Medicare Part D PDP plans in GU cover MEMANTINE HCL ER 14 MG CAPSULE SPR 24 [Namenda XR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | P Q:30 /30Days |
MEMANTINE HCL ER 21 MG CAPSULE SPR 24 [Namenda XR] ![Compare how all Medicare Part D PDP plans in GU cover MEMANTINE HCL ER 21 MG CAPSULE SPR 24 [Namenda XR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | P Q:30 /30Days |
MEMANTINE HCL ER 28 MG CAPSULE SPR 24 [Namenda XR] ![Compare how all Medicare Part D PDP plans in GU cover MEMANTINE HCL ER 28 MG CAPSULE SPR 24 [Namenda XR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | P Q:30 /30Days |
MEMANTINE HCL ER 7 MG CAPSULE SPR 24 [Namenda XR] ![Compare how all Medicare Part D PDP plans in GU cover MEMANTINE HCL ER 7 MG CAPSULE SPR 24 [Namenda XR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | P Q:30 /30Days |
Menactra 4; 4; 4; 4ug/0.5mL; ug/0.5mL; ug/0.5mL; ug/0.5mL 5 VIAL, SINGLE-DOSE in 1 PACKAGE / 0.5 mL  |
3 |
Tier 3 |
25% | 25% | P Q:0.50 /1Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MENEST 0.3MG TABLET  |
3 |
Tier 3 |
25% | 25% | None |
MENEST 0.625MG TABLET  |
3 |
Tier 3 |
25% | 25% | None |
MENEST 1.25MG TABLET  |
3 |
Tier 3 |
25% | 25% | None |
MENEST 2.5 MG TABLET  |
3 |
Tier 3 |
25% | 25% | None |
MENQUADFI VIAL  |
3 |
Tier 3 |
25% | 25% | P Q:0.50 /1Days |
MENVEO A-C-Y-W-135-DIP VIAL  |
3 |
Tier 3 |
25% | 25% | P Q:1 /1Days |
MERCAPTOPURINE 50 MG TABLET  |
3 |
Tier 3 |
25% | 25% | None |
MEROPENEM IV 1 GM VIAL [Merrem] ![Compare how all Medicare Part D PDP plans in GU cover MEROPENEM IV 1 GM VIAL [Merrem].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
MEROPENEM IV 500 MG VIAL [Merrem] ![Compare how all Medicare Part D PDP plans in GU cover MEROPENEM IV 500 MG VIAL [Merrem].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
MESALAMINE 1,000 MG SUPP.RECT [Canasa] ![Compare how all Medicare Part D PDP plans in GU cover MESALAMINE 1,000 MG SUPP.RECT [Canasa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | Q:30 /30Days |
MESALAMINE 4 GM/60 ML ENEMA  |
4 |
Tier 4 |
25% | 25% | Q:1800 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MESALAMINE DR 1.2 GM TABLET  |
3 |
Tier 3 |
25% | 25% | Q:120 /30Days |
MESALAMINE ER 500 MG CAPSULE ER [Pentasa] ![Compare how all Medicare Part D PDP plans in GU cover MESALAMINE ER 500 MG CAPSULE ER [Pentasa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | Q:240 /30Days |
MESNEX 400MG TABLET  |
4 |
Tier 4 |
25% | 25% | None |
METFORMIN HCL 1,000 MG TABLET [Glucophage] ![Compare how all Medicare Part D PDP plans in GU cover METFORMIN HCL 1,000 MG TABLET [Glucophage].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All formulary drugs |
25% | 25% | Q:75 /30Days |
METFORMIN HCL 500 MG TABLET [Glucophage] ![Compare how all Medicare Part D PDP plans in GU cover METFORMIN HCL 500 MG TABLET [Glucophage].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All formulary drugs |
25% | 25% | Q:150 /30Days |
METFORMIN HCL 850 MG TABLET [Glucophage] ![Compare how all Medicare Part D PDP plans in GU cover METFORMIN HCL 850 MG TABLET [Glucophage].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All formulary drugs |
25% | 25% | Q:90 /30Days |
METFORMIN HCL ER 500 MG TABLET 24H [Glumetza] ![Compare how all Medicare Part D PDP plans in GU cover METFORMIN HCL ER 500 MG TABLET 24H [Glumetza].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All formulary drugs |
25% | 25% | Q:120 /30Days |
METFORMIN HCL ER 750 MG TABLET 24H [Glucophage XR] ![Compare how all Medicare Part D PDP plans in GU cover METFORMIN HCL ER 750 MG TABLET 24H [Glucophage XR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All formulary drugs |
25% | 25% | Q:60 /30Days |
METHADONE 10 MG/5 ML SOLUTION  |
3 |
Tier 3 |
25% | 25% | Q:1800 /30Days |
METHADONE 5 MG/5 ML SOLUTION  |
3 |
Tier 3 |
25% | 25% | Q:3600 /30Days |
METHADONE HCL 10 MG TABLET [Methadose] ![Compare how all Medicare Part D PDP plans in GU cover METHADONE HCL 10 MG TABLET [Methadose].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | Q:360 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
METHADONE HCL 5 MG TABLET [Methadose] ![Compare how all Medicare Part D PDP plans in GU cover METHADONE HCL 5 MG TABLET [Methadose].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | Q:240 /30Days |
METHAZOLAMIDE 25 MG TABLET [Neptazane] ![Compare how all Medicare Part D PDP plans in GU cover METHAZOLAMIDE 25 MG TABLET [Neptazane].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
METHAZOLAMIDE 50 MG TABLET [Neptazane] ![Compare how all Medicare Part D PDP plans in GU cover METHAZOLAMIDE 50 MG TABLET [Neptazane].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
METHENAMINE HIPP 1 GM TABLET [Urex] ![Compare how all Medicare Part D PDP plans in GU cover METHENAMINE HIPP 1 GM TABLET [Urex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
METHIMAZOLE 10 MG TABLET [Tapazole] ![Compare how all Medicare Part D PDP plans in GU cover METHIMAZOLE 10 MG TABLET [Tapazole].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All formulary drugs |
25% | 25% | None |
METHIMAZOLE 5 MG TABLET [Tapazole] ![Compare how all Medicare Part D PDP plans in GU cover METHIMAZOLE 5 MG TABLET [Tapazole].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All formulary drugs |
25% | 25% | None |
METHOTREXATE 2.5 MG TABLET [Rheumatrex] ![Compare how all Medicare Part D PDP plans in GU cover METHOTREXATE 2.5 MG TABLET [Rheumatrex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
METHOTREXATE 50 MG/2 ML VIAL  |
2 |
Tier 2 |
25% | 25% | None |
METHOTREXATE 50 MG/2 ML VIAL  |
2 |
Tier 2 |
25% | 25% | None |
Methoxsalen 10 mg Capsule [8-MOP] ![Compare how all Medicare Part D PDP plans in GU cover Methoxsalen 10 mg Capsule [8-MOP].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | None |
METHSUXIMIDE 300 MG CAPSULE [Celontin] ![Compare how all Medicare Part D PDP plans in GU cover METHSUXIMIDE 300 MG CAPSULE [Celontin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
METHYLPHENIDATE 10 MG TABLET [Ritalin] ![Compare how all Medicare Part D PDP plans in GU cover METHYLPHENIDATE 10 MG TABLET [Ritalin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | Q:90 /30Days |
METHYLPHENIDATE 10 MG/5 ML SOLUTION [Methylin] ![Compare how all Medicare Part D PDP plans in GU cover METHYLPHENIDATE 10 MG/5 ML SOLUTION [Methylin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | Q:900 /30Days |
METHYLPHENIDATE 20 MG TABLET [Ritalin] ![Compare how all Medicare Part D PDP plans in GU cover METHYLPHENIDATE 20 MG TABLET [Ritalin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | Q:90 /30Days |
METHYLPHENIDATE 5 MG TABLET [Ritalin] ![Compare how all Medicare Part D PDP plans in GU cover METHYLPHENIDATE 5 MG TABLET [Ritalin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | Q:90 /30Days |
METHYLPHENIDATE 5 MG/5 ML SOLUTION [Methylin] ![Compare how all Medicare Part D PDP plans in GU cover METHYLPHENIDATE 5 MG/5 ML SOLUTION [Methylin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | Q:1800 /30Days |
METHYLPHENIDATE ER 10 MG TABLET [Methylin] ![Compare how all Medicare Part D PDP plans in GU cover METHYLPHENIDATE ER 10 MG TABLET [Methylin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | Q:120 /30Days |
METHYLPHENIDATE ER 20 MG TABLET [Ritalin SR] ![Compare how all Medicare Part D PDP plans in GU cover METHYLPHENIDATE ER 20 MG TABLET [Ritalin SR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | Q:90 /30Days |
METHYLPREDNISOLONE 16 MG TABLET [Medrol Dosepak] ![Compare how all Medicare Part D PDP plans in GU cover METHYLPREDNISOLONE 16 MG TABLET [Medrol Dosepak].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
METHYLPREDNISOLONE 32 MG TABLET [Medrol] ![Compare how all Medicare Part D PDP plans in GU cover METHYLPREDNISOLONE 32 MG TABLET [Medrol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
METHYLPREDNISOLONE 4 MG DOSEPK  |
2 |
Tier 2 |
25% | 25% | None |
METHYLPREDNISOLONE 4 MG TABLET  |
2 |
Tier 2 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
METHYLPREDNISOLONE 8 MG TABLET [Medrol] ![Compare how all Medicare Part D PDP plans in GU cover METHYLPREDNISOLONE 8 MG TABLET [Medrol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
Metoclopramide 10mg/1 500 TABLET BOTTLE  |
2 |
Tier 2 |
25% | 25% | None |
METOCLOPRAMIDE 5 MG TABLET  |
2 |
Tier 2 |
25% | 25% | None |
METOCLOPRAMIDE 5 MG/5 ML SOLUTION  |
2 |
Tier 2 |
25% | 25% | None |
METOLAZONE 10 MG TABLET [Zaroxolyn] ![Compare how all Medicare Part D PDP plans in GU cover METOLAZONE 10 MG TABLET [Zaroxolyn].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
METOLAZONE 2.5 MG TABLET [Zaroxolyn] ![Compare how all Medicare Part D PDP plans in GU cover METOLAZONE 2.5 MG TABLET [Zaroxolyn].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
METOLAZONE 5 MG TABLET [Zaroxolyn] ![Compare how all Medicare Part D PDP plans in GU cover METOLAZONE 5 MG TABLET [Zaroxolyn].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
METOPROLOL SUCC ER 100 MG TABLET 24H [Toprol XL] ![Compare how all Medicare Part D PDP plans in GU cover METOPROLOL SUCC ER 100 MG TABLET 24H [Toprol XL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All formulary drugs |
25% | 25% | None |
METOPROLOL SUCC ER 200 MG TABLET ER 24H [Toprol XL] ![Compare how all Medicare Part D PDP plans in GU cover METOPROLOL SUCC ER 200 MG TABLET ER 24H [Toprol XL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All formulary drugs |
25% | 25% | None |
METOPROLOL SUCC ER 25 MG TABLET 24H [Toprol XL] ![Compare how all Medicare Part D PDP plans in GU cover METOPROLOL SUCC ER 25 MG TABLET 24H [Toprol XL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All formulary drugs |
25% | 25% | None |
METOPROLOL SUCC ER 50 MG TABLET ER 24H [Toprol XL] ![Compare how all Medicare Part D PDP plans in GU cover METOPROLOL SUCC ER 50 MG TABLET ER 24H [Toprol XL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All formulary drugs |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
METOPROLOL TARTRATE 100 MG TABLET [Lopressor] ![Compare how all Medicare Part D PDP plans in GU cover METOPROLOL TARTRATE 100 MG TABLET [Lopressor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All formulary drugs |
25% | 25% | None |
METOPROLOL TARTRATE 25 MG TABLET  |
1 |
All formulary drugs |
25% | 25% | None |
METOPROLOL TARTRATE 37.5 MG TABLET  |
1 |
All formulary drugs |
25% | 25% | None |
METOPROLOL TARTRATE 50 MG TABLET [Lopressor] ![Compare how all Medicare Part D PDP plans in GU cover METOPROLOL TARTRATE 50 MG TABLET [Lopressor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All formulary drugs |
25% | 25% | None |
METOPROLOL TARTRATE 75 MG TABLET  |
1 |
All formulary drugs |
25% | 25% | None |
METOPROLOL-HCTZ 100-25 MG TABLET [Lopressor HCT] ![Compare how all Medicare Part D PDP plans in GU cover METOPROLOL-HCTZ 100-25 MG TABLET [Lopressor HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
METOPROLOL-HCTZ 50-25 MG TABLET [Lopressor HCT] ![Compare how all Medicare Part D PDP plans in GU cover METOPROLOL-HCTZ 50-25 MG TABLET [Lopressor HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
METOPROLOL-HYDROCHLOROTHIAZIDE 100-50MG TABLET  |
3 |
Tier 3 |
25% | 25% | None |
METRONIDAZOLE 0.75% CREAM (G) [Vitazol] ![Compare how all Medicare Part D PDP plans in GU cover METRONIDAZOLE 0.75% CREAM (G) [Vitazol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
METRONIDAZOLE 0.75% LOTION [MetroLotion] ![Compare how all Medicare Part D PDP plans in GU cover METRONIDAZOLE 0.75% LOTION [MetroLotion].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
METRONIDAZOLE 250 MG TABLET [Flagyl] ![Compare how all Medicare Part D PDP plans in GU cover METRONIDAZOLE 250 MG TABLET [Flagyl].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
METRONIDAZOLE 500 MG TABLET [Flagyl] ![Compare how all Medicare Part D PDP plans in GU cover METRONIDAZOLE 500 MG TABLET [Flagyl].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
METRONIDAZOLE 500 MG/100 ML PIGGYBACK [Flagyl RTU] ![Compare how all Medicare Part D PDP plans in GU cover METRONIDAZOLE 500 MG/100 ML PIGGYBACK [Flagyl RTU].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
METRONIDAZOLE TOPICAL 0.75% GL Gel [Nydamax] ![Compare how all Medicare Part D PDP plans in GU cover METRONIDAZOLE TOPICAL 0.75% GL Gel [Nydamax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
METRONIDAZOLE TOPICAL 1% GEL [MetroGel] ![Compare how all Medicare Part D PDP plans in GU cover METRONIDAZOLE TOPICAL 1% GEL [MetroGel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
METRONIDAZOLE VAGINAL 0.75% GEL W/APPL [Vandazole] ![Compare how all Medicare Part D PDP plans in GU cover METRONIDAZOLE VAGINAL 0.75% GEL W/APPL [Vandazole].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
METYROSINE 250 MG CAPSULE [Demser] ![Compare how all Medicare Part D PDP plans in GU cover METYROSINE 250 MG CAPSULE [Demser].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | None |
MEXILETINE 150MG CAPSULE  |
3 |
Tier 3 |
25% | 25% | None |
MEXILETINE 200MG CAPSULE  |
3 |
Tier 3 |
25% | 25% | None |
MEXILETINE 250MG CAPSULE  |
3 |
Tier 3 |
25% | 25% | None |
MIBELAS 24 FE CHEWABLE TABLET [Minastrin] ![Compare how all Medicare Part D PDP plans in GU cover MIBELAS 24 FE CHEWABLE TABLET [Minastrin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
MICAFUNGIN 100 MG VIAL [Mycamine] ![Compare how all Medicare Part D PDP plans in GU cover MICAFUNGIN 100 MG VIAL [Mycamine].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MICAFUNGIN 50 MG VIAL [Mycamine] ![Compare how all Medicare Part D PDP plans in GU cover MICAFUNGIN 50 MG VIAL [Mycamine].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
MICONAZOLE 3 200MG SUPPOS.  |
3 |
Tier 3 |
25% | 25% | None |
MICROGESTIN 21 1-20 TABLET [Microgestin 1/20] ![Compare how all Medicare Part D PDP plans in GU cover MICROGESTIN 21 1-20 TABLET [Microgestin 1/20].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
MICROGESTIN 21 1.5-30 TABLET [Microgestin 1.5/30] ![Compare how all Medicare Part D PDP plans in GU cover MICROGESTIN 21 1.5-30 TABLET [Microgestin 1.5/30].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
MICROGESTIN 24 FE 1 MG-20 MCG TABLET [Tarina Fe 1/20] ![Compare how all Medicare Part D PDP plans in GU cover MICROGESTIN 24 FE 1 MG-20 MCG TABLET [Tarina Fe 1/20].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
MICROGESTIN FE 1-20 TABLET [Tarina Fe 1/20] ![Compare how all Medicare Part D PDP plans in GU cover MICROGESTIN FE 1-20 TABLET [Tarina Fe 1/20].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
MICROGESTIN FE 1.5-30 TABLET [Microgestin Fe 1.5/30] ![Compare how all Medicare Part D PDP plans in GU cover MICROGESTIN FE 1.5-30 TABLET [Microgestin Fe 1.5/30].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
MIDODRINE HCL 10 MG TABLET  |
3 |
Tier 3 |
25% | 25% | None |
MIDODRINE HCL 2.5 MG TABLET [ProAmatine] ![Compare how all Medicare Part D PDP plans in GU cover MIDODRINE HCL 2.5 MG TABLET [ProAmatine].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
MIDODRINE HCL 5 MG TABLET [ProAmatine] ![Compare how all Medicare Part D PDP plans in GU cover MIDODRINE HCL 5 MG TABLET [ProAmatine].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
MIFEPRISTONE 300 MG TABLET [Korlym] ![Compare how all Medicare Part D PDP plans in GU cover MIFEPRISTONE 300 MG TABLET [Korlym].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | P Q:120 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MIGLUSTAT 100 MG CAPSULE [Zavesca] ![Compare how all Medicare Part D PDP plans in GU cover MIGLUSTAT 100 MG CAPSULE [Zavesca].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | P |
MILI 0.25-0.035 MG TABLET [VyLibra] ![Compare how all Medicare Part D PDP plans in GU cover MILI 0.25-0.035 MG TABLET [VyLibra].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
MIMVEY 1-0.5 MG TABLET  |
3 |
Tier 3 |
25% | 25% | None |
MINOCYCLINE 100 MG CAPSULE  |
2 |
Tier 2 |
25% | 25% | None |
MINOCYCLINE 50 MG CAPSULE [Minocin PAC] ![Compare how all Medicare Part D PDP plans in GU cover MINOCYCLINE 50 MG CAPSULE [Minocin PAC].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
MINOCYCLINE 75 MG CAPSULE [Minocin] ![Compare how all Medicare Part D PDP plans in GU cover MINOCYCLINE 75 MG CAPSULE [Minocin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
MINOCYCLINE HCL 100 MG TABLET [Myrac] ![Compare how all Medicare Part D PDP plans in GU cover MINOCYCLINE HCL 100 MG TABLET [Myrac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
MINOCYCLINE HCL 50 MG TABLET [Myrac] ![Compare how all Medicare Part D PDP plans in GU cover MINOCYCLINE HCL 50 MG TABLET [Myrac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
MINOCYCLINE HCL 75 MG TABLET [Myrac] ![Compare how all Medicare Part D PDP plans in GU cover MINOCYCLINE HCL 75 MG TABLET [Myrac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
MINOXIDIL 10 MG TABLET [Loniten] ![Compare how all Medicare Part D PDP plans in GU cover MINOXIDIL 10 MG TABLET [Loniten].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
MINOXIDIL 2.5 MG TABLET [Loniten] ![Compare how all Medicare Part D PDP plans in GU cover MINOXIDIL 2.5 MG TABLET [Loniten].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MIRTAZAPINE 15 MG ODT  |
2 |
Tier 2 |
25% | 25% | None |
MIRTAZAPINE 15 MG TABLET [Remeron] ![Compare how all Medicare Part D PDP plans in GU cover MIRTAZAPINE 15 MG TABLET [Remeron].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All formulary drugs |
25% | 25% | None |
MIRTAZAPINE 30 MG ODT TABLET RAPDIS [Remeron SolTab] ![Compare how all Medicare Part D PDP plans in GU cover MIRTAZAPINE 30 MG ODT TABLET RAPDIS [Remeron SolTab].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
MIRTAZAPINE 30 MG TABLET [Remeron] ![Compare how all Medicare Part D PDP plans in GU cover MIRTAZAPINE 30 MG TABLET [Remeron].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All formulary drugs |
25% | 25% | None |
MIRTAZAPINE 45 MG ODT  |
2 |
Tier 2 |
25% | 25% | None |
MIRTAZAPINE 45 MG TABLET  |
1 |
All formulary drugs |
25% | 25% | None |
MIRTAZAPINE 7.5 MG TABLET  |
1 |
All formulary drugs |
25% | 25% | None |
MISOPROSTOL 100 MCG TABLET [Cytotec] ![Compare how all Medicare Part D PDP plans in GU cover MISOPROSTOL 100 MCG TABLET [Cytotec].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
MISOPROSTOL 200 MCG TABLET [Cytotec] ![Compare how all Medicare Part D PDP plans in GU cover MISOPROSTOL 200 MCG TABLET [Cytotec].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
MODAFINIL 100 MG TABLET [Provigil] ![Compare how all Medicare Part D PDP plans in GU cover MODAFINIL 100 MG TABLET [Provigil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | P Q:30 /30Days |
MODAFINIL 200 MG TABLET [Provigil] ![Compare how all Medicare Part D PDP plans in GU cover MODAFINIL 200 MG TABLET [Provigil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | P Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MOEXIPRIL HCL 15 MG TABLET [Univasc] ![Compare how all Medicare Part D PDP plans in GU cover MOEXIPRIL HCL 15 MG TABLET [Univasc].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
MOEXIPRIL HCL 7.5 MG TABLET  |
2 |
Tier 2 |
25% | 25% | None |
MOLINDONE HCL 10 MG TABLET  |
4 |
Tier 4 |
25% | 25% | None |
MOLINDONE HCL 25 MG TABLET  |
4 |
Tier 4 |
25% | 25% | None |
MOLINDONE HCL 5 MG TABLET  |
4 |
Tier 4 |
25% | 25% | None |
MOMETASONE FUROATE 0.1% CREAM (G) [Elocon] ![Compare how all Medicare Part D PDP plans in GU cover MOMETASONE FUROATE 0.1% CREAM (G) [Elocon].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
MOMETASONE FUROATE 0.1% OINTMENT [Elocon] ![Compare how all Medicare Part D PDP plans in GU cover MOMETASONE FUROATE 0.1% OINTMENT [Elocon].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
MOMETASONE FUROATE 0.1% SOLUTION  |
2 |
Tier 2 |
25% | 25% | None |
MOMETASONE FUROATE 50 MCG SPRAY  |
4 |
Tier 4 |
25% | 25% | None |
MONTELUKAST SOD 10 MG TABLET [Singulair] ![Compare how all Medicare Part D PDP plans in GU cover MONTELUKAST SOD 10 MG TABLET [Singulair].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All formulary drugs |
25% | 25% | Q:30 /30Days |
MONTELUKAST SOD 4 MG CHEWABLE TABLET [Singulair] ![Compare how all Medicare Part D PDP plans in GU cover MONTELUKAST SOD 4 MG CHEWABLE TABLET [Singulair].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All formulary drugs |
25% | 25% | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MONTELUKAST SOD 4 MG GRANULES [Singulair] ![Compare how all Medicare Part D PDP plans in GU cover MONTELUKAST SOD 4 MG GRANULES [Singulair].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | Q:30 /30Days |
MONTELUKAST SOD 5 MG CHEWABLE TABLET [Singulair] ![Compare how all Medicare Part D PDP plans in GU cover MONTELUKAST SOD 5 MG CHEWABLE TABLET [Singulair].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All formulary drugs |
25% | 25% | Q:30 /30Days |
MORPHINE SULF 10 MG/5 ML SOLUTION [MSIR] ![Compare how all Medicare Part D PDP plans in GU cover MORPHINE SULF 10 MG/5 ML SOLUTION [MSIR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | Q:3000 /30Days |
MORPHINE SULF 100 MG/5 ML CONC SOLUTION [Roxanol-T] ![Compare how all Medicare Part D PDP plans in GU cover MORPHINE SULF 100 MG/5 ML CONC SOLUTION [Roxanol-T].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | Q:300 /30Days |
MORPHINE SULF 20 MG/5 ML SOLUTION [MSIR] ![Compare how all Medicare Part D PDP plans in GU cover MORPHINE SULF 20 MG/5 ML SOLUTION [MSIR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | Q:1500 /30Days |
MORPHINE SULF ER 100 MG TABLET  |
3 |
Tier 3 |
25% | 25% | Q:90 /30Days |
MORPHINE SULF ER 15 MG TABLET  |
3 |
Tier 3 |
25% | 25% | Q:90 /30Days |
MORPHINE SULF ER 200 MG TABLET  |
4 |
Tier 4 |
25% | 25% | Q:60 /30Days |
MORPHINE SULF ER 30 MG TABLET  |
3 |
Tier 3 |
25% | 25% | Q:120 /30Days |
MORPHINE SULF ER 60 MG TABLET  |
3 |
Tier 3 |
25% | 25% | Q:120 /30Days |
MORPHINE SULFATE IR 15 MG TABLET [MSIR] ![Compare how all Medicare Part D PDP plans in GU cover MORPHINE SULFATE IR 15 MG TABLET [MSIR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | Q:240 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MORPHINE SULFATE IR 30 MG TABLET [MSIR] ![Compare how all Medicare Part D PDP plans in GU cover MORPHINE SULFATE IR 30 MG TABLET [MSIR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | Q:180 /30Days |
MOTEGRITY 1 MG TABLET  |
4 |
Tier 4 |
25% | 25% | Q:30 /30Days |
MOTEGRITY 2 MG TABLET  |
4 |
Tier 4 |
25% | 25% | Q:30 /30Days |
MOUNJARO 10 MG/0.5 ML PEN INJECTOR  |
3 |
Tier 3 |
25% | 25% | P Q:2 /28Days |
MOUNJARO 12.5 MG/0.5 ML PEN INJECTOR  |
3 |
Tier 3 |
25% | 25% | P Q:2 /28Days |
MOUNJARO 15 MG/0.5 ML PEN INJECTOR  |
3 |
Tier 3 |
25% | 25% | P Q:2 /28Days |
MOUNJARO 2.5 MG/0.5 ML PEN INJECTOR  |
3 |
Tier 3 |
25% | 25% | P Q:2 /28Days |
MOUNJARO 5 MG/0.5 ML PEN INJECTOR  |
3 |
Tier 3 |
25% | 25% | P Q:2 /28Days |
MOUNJARO 7.5 MG/0.5 ML PEN INJECTOR  |
3 |
Tier 3 |
25% | 25% | P Q:2 /28Days |
MOVANTIK 12.5 MG TABLET  |
3 |
Tier 3 |
25% | 25% | Q:30 /30Days |
MOVANTIK 25 MG TABLET  |
3 |
Tier 3 |
25% | 25% | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MOXIFLOXACIN 0.5% EYE DROPS [Vigamox] ![Compare how all Medicare Part D PDP plans in GU cover MOXIFLOXACIN 0.5% EYE DROPS [Vigamox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
MOXIFLOXACIN 400 MG/250 ML BAG PIGGYBACK [Avelox I.V.] ![Compare how all Medicare Part D PDP plans in GU cover MOXIFLOXACIN 400 MG/250 ML BAG PIGGYBACK [Avelox I.V.].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
MOXIFLOXACIN HCL 400 MG TABLET [Avelox ABC Pack] ![Compare how all Medicare Part D PDP plans in GU cover MOXIFLOXACIN HCL 400 MG TABLET [Avelox ABC Pack].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
MRESVIA 50 MCG/0.5 ML SYRINGE  |
3 |
Tier 3 |
25% | 25% | P Q:0.50 /1Days |
Multaq 400mg/1 60 FILM COATED TABLETS in BOTTLE  |
3 |
Tier 3 |
25% | 25% | Q:60 /30Days |
MULTIPLE ELECTROLYTES T1 PH5.5 IV SOLUTION  |
4 |
Tier 4 |
25% | 25% | None |
MUPIROCIN 2% CREAM (g) [Bactroban] ![Compare how all Medicare Part D PDP plans in GU cover MUPIROCIN 2% CREAM (g) [Bactroban].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
MUPIROCIN 2% OINTMENT [Centany AT] ![Compare how all Medicare Part D PDP plans in GU cover MUPIROCIN 2% OINTMENT [Centany AT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | Q:110 /30Days |
MYCOPHENOLATE 200 MG/ML SUSP  |
4 |
Tier 4 |
25% | 25% | P |
MYCOPHENOLATE 250 MG CAPSULE [CellCept] ![Compare how all Medicare Part D PDP plans in GU cover MYCOPHENOLATE 250 MG CAPSULE [CellCept].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | P |
MYCOPHENOLATE 500 MG TABLET [CellCept] ![Compare how all Medicare Part D PDP plans in GU cover MYCOPHENOLATE 500 MG TABLET [CellCept].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
MYCOPHENOLIC ACID DR 180 MG TABLET DR [Myfortic] ![Compare how all Medicare Part D PDP plans in GU cover MYCOPHENOLIC ACID DR 180 MG TABLET DR [Myfortic].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P |
MYCOPHENOLIC ACID DR 360 MG TABLET DR [Myfortic] ![Compare how all Medicare Part D PDP plans in GU cover MYCOPHENOLIC ACID DR 360 MG TABLET DR [Myfortic].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P |
MYHIBBIN 200 MG/ML ORAL SUSPENSION  |
5 |
Tier 5 |
25% | 25% | P |
MYRBETRIQ ER 25 MG TABLET  |
3 |
Tier 3 |
25% | 25% | None |
MYRBETRIQ ER 50 MG TABLET  |
3 |
Tier 3 |
25% | 25% | None |
MYRBETRIQ ER 8 MG/ML SUSP ER REC  |
3 |
Tier 3 |
25% | 25% | None |