2025 Medicare Part D Plan Formulary Information |
AARP Medicare Rx Preferred from UHC (PDP) (S5921-387-0)
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) (S5921-387-0) Formulary Drugs Starting with the Letter P in CMS PDP Region 5 which includes: DC DE MD
|
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 |
PALIPERIDONE ER 1.5 MG TABLET 24 [Invega] ![Compare how all Medicare Part D PDP plans in DE cover PALIPERIDONE ER 1.5 MG TABLET 24 [Invega].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | Q:30 /30Days |
PALIPERIDONE ER 3 MG TABLET 24H [Invega] ![Compare how all Medicare Part D PDP plans in DE cover PALIPERIDONE ER 3 MG TABLET 24H [Invega].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | Q:30 /30Days |
PALIPERIDONE ER 6 MG TABLET 24H [Invega] ![Compare how all Medicare Part D PDP plans in DE cover PALIPERIDONE ER 6 MG TABLET 24H [Invega].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | Q:60 /30Days |
PALIPERIDONE ER 9 MG TABLET 24 [Invega] ![Compare how all Medicare Part D PDP plans in DE cover PALIPERIDONE ER 9 MG TABLET 24 [Invega].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | Q:30 /30Days |
PANRETIN 0.1% GEL  |
5 |
Specialty Tier |
33% | N/A | P |
PANTOPRAZOLE SOD DR 20 MG TABLET  |
1 |
Preferred Generic |
$5.00 | $0.00 | Q:90 /30Days |
PANTOPRAZOLE SOD DR 40 MG TABLET DR [Protonix] ![Compare how all Medicare Part D PDP plans in DE cover PANTOPRAZOLE SOD DR 40 MG TABLET DR [Protonix].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $0.00 | Q:60 /30Days |
PANZYGA 10% (1 G/10 ML) VIAL  |
5 |
Specialty Tier |
33% | N/A | P |
PANZYGA 10% (10 G/100 ML) VIAL  |
5 |
Specialty Tier |
33% | N/A | P |
PANZYGA 10% (2.5 G/25 ML) VIAL  |
5 |
Specialty Tier |
33% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PANZYGA 10% (20 G/200 ML) VIAL  |
5 |
Specialty Tier |
33% | N/A | P |
PANZYGA 10% (30 G/300 ML) VIAL  |
5 |
Specialty Tier |
33% | N/A | P |
PANZYGA 10% (5 G/50 ML) VIAL  |
5 |
Specialty Tier |
33% | N/A | P |
PARICALCITOL 1 MCG CAPSULE [Zemplar] ![Compare how all Medicare Part D PDP plans in DE cover PARICALCITOL 1 MCG CAPSULE [Zemplar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | P |
PARICALCITOL 2 MCG CAPSULE [Zemplar] ![Compare how all Medicare Part D PDP plans in DE cover PARICALCITOL 2 MCG CAPSULE [Zemplar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | P |
PARICALCITOL 4 MCG CAPSULE [Zemplar] ![Compare how all Medicare Part D PDP plans in DE cover PARICALCITOL 4 MCG CAPSULE [Zemplar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | P |
PAROXETINE ER 12.5 MG TABLET 24H [Paxil CR] ![Compare how all Medicare Part D PDP plans in DE cover PAROXETINE ER 12.5 MG TABLET 24H [Paxil CR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | None |
PAROXETINE ER 25 MG TABLET 24H [Paxil CR] ![Compare how all Medicare Part D PDP plans in DE cover PAROXETINE ER 25 MG TABLET 24H [Paxil CR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | None |
PAROXETINE ER 37.5 MG TABLET 24H [Paxil CR] ![Compare how all Medicare Part D PDP plans in DE cover PAROXETINE ER 37.5 MG TABLET 24H [Paxil CR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | None |
PAROXETINE HCL 10 MG TABLET  |
2 |
Generic |
$10.00 | $0.00 | None |
PAROXETINE HCL 10 MG/5 ML ORAL SUSPENSION [Paxil] ![Compare how all Medicare Part D PDP plans in DE 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 |
40% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PAROXETINE HCL 20 MG TABLET  |
2 |
Generic |
$10.00 | $0.00 | None |
PAROXETINE HCL 30 MG TABLET  |
2 |
Generic |
$10.00 | $0.00 | None |
PAROXETINE HCL 40 MG TABLET  |
2 |
Generic |
$10.00 | $0.00 | None |
Paxlovid 150 mg / 100 mg 20 Tablet Blister Pack  |
5 |
Specialty Tier |
33% | N/A | Q:20 /5Days |
Paxlovid 300 mg / 100 mg 30 Tablet Blister Pack  |
5 |
Specialty Tier |
33% | N/A | Q:30 /5Days |
PAZOPANIB HCL 200 MG TABLET [Votrient] ![Compare how all Medicare Part D PDP plans in DE cover PAZOPANIB HCL 200 MG TABLET [Votrient].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:120 /30Days |
PEDVAXHIB VACCINE VIAL  |
3 |
Preferred Brand |
$47.00 | $126.00 | Q:0.50 /1Days |
PEG 3350-ELECTROLYTE SOLUTION RECON [TriLyte] ![Compare how all Medicare Part D PDP plans in DE cover PEG 3350-ELECTROLYTE SOLUTION RECON [TriLyte].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
PEG-3350 AND ELECTROLYTES SOLUTION SOLUTION RECON  |
2 |
Generic |
$10.00 | $0.00 | None |
PEGASYS 180 MCG/0.5 ML SYRINGE  |
5 |
Specialty Tier |
33% | N/A | P |
PEGASYS 180 MCG/ML VIAL  |
5 |
Specialty Tier |
33% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PEMAZYRE 13.5 MG TABLET  |
5 |
Specialty Tier |
33% | N/A | P Q:14 /21Days |
PEMAZYRE 4.5 MG TABLET  |
5 |
Specialty Tier |
33% | N/A | P Q:14 /21Days |
PEMAZYRE 9 MG TABLET  |
5 |
Specialty Tier |
33% | N/A | P Q:14 /21Days |
PENBRAYA Prefilled Syringe  |
3 |
Preferred Brand |
$47.00 | $126.00 | P Q:1 /1Days |
PENICILLAMINE 250 MG TABLET [Depen] ![Compare how all Medicare Part D PDP plans in DE 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 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 DE 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 |
40% | N/A | None |
PENICILLIN GK 20 MILLION UNIT  |
4 |
Non-Preferred Drug |
40% | N/A | None |
PENICILLIN V POTASSIUM 250MG/5ML LIQUID  |
2 |
Generic |
$10.00 | $0.00 | None |
PENICILLIN VK 125 MG/5 ML SOLUTION  |
2 |
Generic |
$10.00 | $0.00 | None |
PENICILLIN VK 250 MG TABLET  |
1 |
Preferred Generic |
$5.00 | $0.00 | None |
PENICILLIN VK 500 MG TABLET [Veetids] ![Compare how all Medicare Part D PDP plans in DE cover PENICILLIN VK 500 MG TABLET [Veetids].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PENTACEL VIAL KIT  |
3 |
Preferred Brand |
$47.00 | $126.00 | Q:1 /1Days |
PENTAMIDINE 300 MG INHAL POWDER VIAL-NEB [NebuPent] ![Compare how all Medicare Part D PDP plans in DE cover PENTAMIDINE 300 MG INHAL POWDER VIAL-NEB [NebuPent].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | P Q:1 /28Days |
PENTAMIDINE 300 MG VIAL [Pentam] ![Compare how all Medicare Part D PDP plans in DE cover PENTAMIDINE 300 MG VIAL [Pentam].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | None |
PENTASA 250MG CAPSULE SA  |
4 |
Non-Preferred Drug |
40% | N/A | Q:480 /30Days |
PENTASA 500MG CAPSULE  |
4 |
Non-Preferred Drug |
40% | N/A | Q:240 /30Days |
PENTOXIFYLLINE 400MG TABLET SA  |
2 |
Generic |
$10.00 | $0.00 | None |
PERINDOPRIL ERBUMINE 2 MG TABLET  |
2 |
Generic |
$10.00 | $0.00 | None |
PERINDOPRIL ERBUMINE 4 MG TABLET  |
2 |
Generic |
$10.00 | $0.00 | None |
PERINDOPRIL ERBUMINE 8 MG TABLET  |
2 |
Generic |
$10.00 | $0.00 | None |
PERIOGARD 0.12% ORAL RINSE MOUTHWASH [Perisol] ![Compare how all Medicare Part D PDP plans in DE cover PERIOGARD 0.12% ORAL RINSE MOUTHWASH [Perisol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $0.00 | None |
PERMETHRIN 5% CREAM (G) [Elimite] ![Compare how all Medicare Part D PDP plans in DE cover PERMETHRIN 5% CREAM (G) [Elimite].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PERPHENAZINE 16 MG TABLET [Trilafon] ![Compare how all Medicare Part D PDP plans in DE cover PERPHENAZINE 16 MG TABLET [Trilafon].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | None |
PERPHENAZINE 2 MG TABLET [Trilafon] ![Compare how all Medicare Part D PDP plans in DE cover PERPHENAZINE 2 MG TABLET [Trilafon].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | None |
PERPHENAZINE 4 MG TABLET [Trilafon] ![Compare how all Medicare Part D PDP plans in DE cover PERPHENAZINE 4 MG TABLET [Trilafon].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | None |
PERPHENAZINE 8 MG TABLET [Trilafon] ![Compare how all Medicare Part D PDP plans in DE cover PERPHENAZINE 8 MG TABLET [Trilafon].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | None |
PERSERIS ER 120 MG SYRINGE KIT SUSER SYKT  |
5 |
Specialty Tier |
33% | N/A | None |
PERSERIS ER 90 MG SYRINGE KIT SUSER SYKT  |
5 |
Specialty Tier |
33% | N/A | None |
PHENELZINE SULFATE 15 MG TABLET [Nardil] ![Compare how all Medicare Part D PDP plans in DE cover PHENELZINE SULFATE 15 MG TABLET [Nardil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | None |
Phenobarbital 100mg/1  |
2 |
Generic |
$10.00 | $0.00 | None |
PHENOBARBITAL 15 MG TABLET  |
2 |
Generic |
$10.00 | $0.00 | None |
PHENOBARBITAL 16.2 MG TABLET  |
2 |
Generic |
$10.00 | $0.00 | None |
PHENOBARBITAL 20 MG/5 ML SOLUTION ELIXIR  |
2 |
Generic |
$10.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PHENOBARBITAL 30 MG TABLET  |
2 |
Generic |
$10.00 | $0.00 | None |
PHENOBARBITAL 32.4 MG TABLET  |
2 |
Generic |
$10.00 | $0.00 | None |
Phenobarbital 60mg/1  |
2 |
Generic |
$10.00 | $0.00 | None |
PHENOBARBITAL 64.8 MG TABLET  |
2 |
Generic |
$10.00 | $0.00 | None |
PHENOBARBITAL 97.2 MG TABLET  |
2 |
Generic |
$10.00 | $0.00 | None |
PHENYTEK 200 MG CAPSULE  |
2 |
Generic |
$10.00 | $0.00 | None |
PHENYTEK 300 MG CAPSULE  |
2 |
Generic |
$10.00 | $0.00 | None |
PHENYTOIN 125 MG/5 ML ORAL SUSPENSION [Dilantin] ![Compare how all Medicare Part D PDP plans in DE cover PHENYTOIN 125 MG/5 ML ORAL SUSPENSION [Dilantin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
PHENYTOIN 50 MG CHEWABLE TABLET [Dilantin] ![Compare how all Medicare Part D PDP plans in DE cover PHENYTOIN 50 MG CHEWABLE TABLET [Dilantin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | None |
PHENYTOIN SOD EXT 100 MG CAPSULE  |
2 |
Generic |
$10.00 | $0.00 | None |
PHENYTOIN SOD EXT 200 MG CAPSULE  |
2 |
Generic |
$10.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PHENYTOIN SOD EXT 300 MG CAPSULE [Phenytek] ![Compare how all Medicare Part D PDP plans in DE cover PHENYTOIN SOD EXT 300 MG CAPSULE [Phenytek].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
PIFELTRO 100 MG TABLET  |
5 |
Specialty Tier |
33% | N/A | Q:30 /30Days |
PILOCARPINE 1% EYE DROPS [Pilocar] ![Compare how all Medicare Part D PDP plans in DE cover PILOCARPINE 1% EYE DROPS [Pilocar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | None |
PILOCARPINE 2% EYE DROPS [Pilocar] ![Compare how all Medicare Part D PDP plans in DE cover PILOCARPINE 2% EYE DROPS [Pilocar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | None |
PILOCARPINE 4% EYE DROPS [Pilocar] ![Compare how all Medicare Part D PDP plans in DE cover PILOCARPINE 4% EYE DROPS [Pilocar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | None |
PILOCARPINE HCL 5 MG TABLET [Salagen] ![Compare how all Medicare Part D PDP plans in DE cover PILOCARPINE HCL 5 MG TABLET [Salagen].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | None |
PILOCARPINE HCL 7.5 MG TABLET [Salagen] ![Compare how all Medicare Part D PDP plans in DE cover PILOCARPINE HCL 7.5 MG TABLET [Salagen].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | None |
PIMECROLIMUS 1% CREAM (g) [Elidel] ![Compare how all Medicare Part D PDP plans in DE cover PIMECROLIMUS 1% CREAM (g) [Elidel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | S Q:100 /30Days |
PIMOZIDE 1 MG TABLET [Orap] ![Compare how all Medicare Part D PDP plans in DE cover PIMOZIDE 1 MG TABLET [Orap].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | None |
PIMOZIDE 2 MG TABLET [Orap] ![Compare how all Medicare Part D PDP plans in DE cover PIMOZIDE 2 MG TABLET [Orap].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | None |
PIMTREA 28 DAY TABLET  |
4 |
Non-Preferred Drug |
40% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PINDOLOL 10 MG TABLET [Visken] ![Compare how all Medicare Part D PDP plans in DE cover PINDOLOL 10 MG TABLET [Visken].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | None |
PINDOLOL 5 MG TABLET [Visken] ![Compare how all Medicare Part D PDP plans in DE cover PINDOLOL 5 MG TABLET [Visken].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | None |
PIOGLITAZONE HCL 15 MG TABLET [Actos] ![Compare how all Medicare Part D PDP plans in DE cover PIOGLITAZONE HCL 15 MG TABLET [Actos].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $0.00 | Q:30 /30Days |
PIOGLITAZONE HCL 30 MG TABLET [Actos] ![Compare how all Medicare Part D PDP plans in DE cover PIOGLITAZONE HCL 30 MG TABLET [Actos].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $0.00 | Q:30 /30Days |
PIOGLITAZONE HCL 45 MG TABLET [Actos] ![Compare how all Medicare Part D PDP plans in DE cover PIOGLITAZONE HCL 45 MG TABLET [Actos].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $0.00 | Q:30 /30Days |
PIOGLITAZONE-GLIMEPIRIDE 30-2 TABLET [Duetact] ![Compare how all Medicare Part D PDP plans in DE cover PIOGLITAZONE-GLIMEPIRIDE 30-2 TABLET [Duetact].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | Q:30 /30Days |
PIOGLITAZONE-GLIMEPIRIDE 30-4 Tablet [Duetact] ![Compare how all Medicare Part D PDP plans in DE cover PIOGLITAZONE-GLIMEPIRIDE 30-4 Tablet [Duetact].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | Q:30 /30Days |
PIOGLITAZONE-METFORMIN 15-500 TABLET [Actoplus Met] ![Compare how all Medicare Part D PDP plans in DE cover PIOGLITAZONE-METFORMIN 15-500 TABLET [Actoplus Met].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | Q:90 /30Days |
PIOGLITAZONE-METFORMIN 15-850 TABLET [Actoplus Met] ![Compare how all Medicare Part D PDP plans in DE cover PIOGLITAZONE-METFORMIN 15-850 TABLET [Actoplus Met].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | Q:90 /30Days |
PIPERACIL-TAZOBACT 2.25 GM VIAL [Zosyn Powder] ![Compare how all Medicare Part D PDP plans in DE cover PIPERACIL-TAZOBACT 2.25 GM VIAL [Zosyn Powder].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | None |
PIPERACIL-TAZOBACT 3.375 GM VIAL [Zosyn] ![Compare how all Medicare Part D PDP plans in DE cover PIPERACIL-TAZOBACT 3.375 GM VIAL [Zosyn].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PIPERACIL-TAZOBACT 4.5 GM VIAL [Zosyn] ![Compare how all Medicare Part D PDP plans in DE cover PIPERACIL-TAZOBACT 4.5 GM VIAL [Zosyn].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | None |
PIPERACIL-TAZOBACT 40.5 GRAM VIAL [Zosyn Powder] ![Compare how all Medicare Part D PDP plans in DE cover PIPERACIL-TAZOBACT 40.5 GRAM VIAL [Zosyn Powder].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | None |
PIQRAY 200 MG DAILY DOSE TABLET  |
5 |
Specialty Tier |
33% | N/A | P Q:28 /28Days |
PIQRAY 250 MG DAILY DOSE TABLET  |
5 |
Specialty Tier |
33% | N/A | P Q:56 /28Days |
PIQRAY 300 MG DAILY DOSE TABLET  |
5 |
Specialty Tier |
33% | N/A | P Q:56 /28Days |
PIRFENIDONE 267 MG CAPSULE [ESBRIET] ![Compare how all Medicare Part D PDP plans in DE cover PIRFENIDONE 267 MG CAPSULE [ESBRIET].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:270 /30Days |
PIRFENIDONE 267 MG TABLET [ESBRIET] ![Compare how all Medicare Part D PDP plans in DE 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:180 /30Days |
PIRFENIDONE 534 MG TABLET  |
5 |
Specialty Tier |
33% | N/A | P Q:90 /30Days |
PIRFENIDONE 801 MG TABLET [ESBRIET] ![Compare how all Medicare Part D PDP plans in DE 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 |
PLENAMINE 15% SOLUTION IV SOLUTION  |
4 |
Non-Preferred Drug |
40% | N/A | P |
PODOFILOX 0.5% TOPICAL SOLUTION [Condylox] ![Compare how all Medicare Part D PDP plans in DE cover PODOFILOX 0.5% TOPICAL SOLUTION [Condylox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
POLYCIN EYE OINTMENT [Polytracin] ![Compare how all Medicare Part D PDP plans in DE cover POLYCIN EYE OINTMENT [Polytracin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
POLYMYXIN B SULFATE VIAL  |
4 |
Non-Preferred Drug |
40% | N/A | None |
POLYMYXIN B-TMP EYE DROPS  |
2 |
Generic |
$10.00 | $0.00 | None |
POMALYST 1 MG CAPSULE  |
5 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
POMALYST 2 MG CAPSULE  |
5 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
POMALYST 3 MG CAPSULE  |
5 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
POMALYST 4 MG CAPSULE  |
5 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
PORTIA 0.15-0.03 TABLET  |
3 |
Preferred Brand |
$47.00 | $126.00 | None |
POSACONAZOLE DR 100 MG TABLET [Noxafil] ![Compare how all Medicare Part D PDP plans in DE 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:180 /30Days |
POTASSIUM CITRATE ER 10 MEQ TB  |
3 |
Preferred Brand |
$47.00 | $126.00 | None |
POTASSIUM CITRATE ER 15 MEQ TABLET [Urocit-K] ![Compare how all Medicare Part D PDP plans in DE cover POTASSIUM CITRATE ER 15 MEQ TABLET [Urocit-K].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
POTASSIUM CITRATE ER 5 MEQ TABLET  |
3 |
Preferred Brand |
$47.00 | $126.00 | None |
POTASSIUM CL 10 MEQ/100 ML SOL PIGGYBACK  |
4 |
Non-Preferred Drug |
40% | N/A | P |
POTASSIUM CL 10% (20 MEQ/15ML) LIQUID [Kay Ciel] ![Compare how all Medicare Part D PDP plans in DE cover POTASSIUM CL 10% (20 MEQ/15ML) LIQUID [Kay Ciel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | None |
POTASSIUM CL 20 MEQ PACKET [Klor-Con] ![Compare how all Medicare Part D PDP plans in DE cover POTASSIUM CL 20 MEQ PACKET [Klor-Con].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | None |
POTASSIUM CL 20 MEQ-0.45% NACL IV SOLUTION  |
4 |
Non-Preferred Drug |
40% | N/A | P |
POTASSIUM CL 20 MEQ/1,000ML-NS IV SOLUTION  |
4 |
Non-Preferred Drug |
40% | N/A | P |
POTASSIUM CL 20 MEQ/100 ML SOL PIGGYBACK  |
4 |
Non-Preferred Drug |
40% | N/A | P |
POTASSIUM CL 20% (40 MEQ/15ML) LIQUID [Kaon-CL] ![Compare how all Medicare Part D PDP plans in DE cover POTASSIUM CL 20% (40 MEQ/15ML) LIQUID [Kaon-CL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | None |
POTASSIUM CL 40 MEQ/1,000ML-NS IV SOLUTION  |
4 |
Non-Preferred Drug |
40% | N/A | P |
POTASSIUM CL 40 MEQ/100 ML SOL PIGGYBACK  |
4 |
Non-Preferred Drug |
40% | N/A | P |
POTASSIUM CL 40 MEQ/20 ML CONC VIAL [PROAMP] ![Compare how all Medicare Part D PDP plans in DE cover POTASSIUM CL 40 MEQ/20 ML CONC VIAL [PROAMP].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | P |
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 DE cover POTASSIUM CL 60 MEQ/30 ML CONC VIAL [PROAMP].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | P |
POTASSIUM CL ER 10 MEQ CAPSULE ER [Micro-K Extencaps] ![Compare how all Medicare Part D PDP plans in DE cover POTASSIUM CL ER 10 MEQ CAPSULE ER [Micro-K Extencaps].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
POTASSIUM CL ER 10 MEQ TABLET [Klotrix] ![Compare how all Medicare Part D PDP plans in DE cover POTASSIUM CL ER 10 MEQ TABLET [Klotrix].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
POTASSIUM CL ER 10 MEQ TABLET PRT [Klotrix] ![Compare how all Medicare Part D PDP plans in DE cover POTASSIUM CL ER 10 MEQ TABLET PRT [Klotrix].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
POTASSIUM CL ER 15 MEQ TABLET ER PRT [Klor-Con M15] ![Compare how all Medicare Part D PDP plans in DE cover POTASSIUM CL ER 15 MEQ TABLET ER PRT [Klor-Con M15].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
POTASSIUM CL ER 20 MEQ TABLET [K-Tab] ![Compare how all Medicare Part D PDP plans in DE cover POTASSIUM CL ER 20 MEQ TABLET [K-Tab].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
POTASSIUM CL ER 20 MEQ TABLET PRT [Klor-Con M20] ![Compare how all Medicare Part D PDP plans in DE cover POTASSIUM CL ER 20 MEQ TABLET PRT [Klor-Con M20].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
POTASSIUM CL ER 8 MEQ CAPSULE ER [Micro-K Extencaps] ![Compare how all Medicare Part D PDP plans in DE cover POTASSIUM CL ER 8 MEQ CAPSULE ER [Micro-K Extencaps].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
POTASSIUM CL ER 8 MEQ TABLET [Slow-K] ![Compare how all Medicare Part D PDP plans in DE cover POTASSIUM CL ER 8 MEQ TABLET [Slow-K].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
PRAMIPEXOLE 0.125 MG TABLET [Mirapex] ![Compare how all Medicare Part D PDP plans in DE cover PRAMIPEXOLE 0.125 MG TABLET [Mirapex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
PRAMIPEXOLE 0.25 MG TABLET [Mirapex] ![Compare how all Medicare Part D PDP plans in DE cover PRAMIPEXOLE 0.25 MG TABLET [Mirapex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PRAMIPEXOLE 0.5 MG TABLET  |
2 |
Generic |
$10.00 | $0.00 | None |
PRAMIPEXOLE 0.75 MG TABLET  |
2 |
Generic |
$10.00 | $0.00 | None |
PRAMIPEXOLE 1 MG TABLET [Mirapex] ![Compare how all Medicare Part D PDP plans in DE cover PRAMIPEXOLE 1 MG TABLET [Mirapex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
PRAMIPEXOLE 1.5 MG TABLET [Mirapex] ![Compare how all Medicare Part D PDP plans in DE cover PRAMIPEXOLE 1.5 MG TABLET [Mirapex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
PRASUGREL 10 MG TABLET [Effient] ![Compare how all Medicare Part D PDP plans in DE cover PRASUGREL 10 MG TABLET [Effient].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | Q:30 /30Days |
PRASUGREL 5 MG TABLET [Effient] ![Compare how all Medicare Part D PDP plans in DE cover PRASUGREL 5 MG TABLET [Effient].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | Q:30 /30Days |
PRAVASTATIN SODIUM 10 MG TABLET [Pravachol] ![Compare how all Medicare Part D PDP plans in DE cover PRAVASTATIN SODIUM 10 MG TABLET [Pravachol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $0.00 | None |
PRAVASTATIN SODIUM 20 MG TABLET  |
1 |
Preferred Generic |
$5.00 | $0.00 | None |
PRAVASTATIN SODIUM 40 MG TABLET [Pravachol] ![Compare how all Medicare Part D PDP plans in DE cover PRAVASTATIN SODIUM 40 MG TABLET [Pravachol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $0.00 | None |
PRAVASTATIN SODIUM 80 MG TABLET [Pravachol] ![Compare how all Medicare Part D PDP plans in DE cover PRAVASTATIN SODIUM 80 MG TABLET [Pravachol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $0.00 | None |
PRAZIQUANTEL 600 MG TABLET [Biltricide] ![Compare how all Medicare Part D PDP plans in DE cover PRAZIQUANTEL 600 MG TABLET [Biltricide].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PRAZOSIN 1 MG CAPSULE [Minipress] ![Compare how all Medicare Part D PDP plans in DE cover PRAZOSIN 1 MG CAPSULE [Minipress].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
PRAZOSIN 2 MG CAPSULE [Minipress] ![Compare how all Medicare Part D PDP plans in DE cover PRAZOSIN 2 MG CAPSULE [Minipress].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
PRAZOSIN 5 MG CAPSULE [Minipress] ![Compare how all Medicare Part D PDP plans in DE cover PRAZOSIN 5 MG CAPSULE [Minipress].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
PRED MILD 0.12% EYE DROPS  |
4 |
Non-Preferred Drug |
40% | N/A | None |
PREDNISOLONE 15 MG/5 ML SOLUTION [Prelone] ![Compare how all Medicare Part D PDP plans in DE cover PREDNISOLONE 15 MG/5 ML SOLUTION [Prelone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
PREDNISOLONE 5 MG/5 ML SOLUTION [Pediapred] ![Compare how all Medicare Part D PDP plans in DE cover PREDNISOLONE 5 MG/5 ML SOLUTION [Pediapred].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
PREDNISOLONE AC 1% EYE DROPPER [Pred-Forte] ![Compare how all Medicare Part D PDP plans in DE cover PREDNISOLONE AC 1% EYE DROPPER [Pred-Forte].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | None |
PREDNISOLONE SOD 1% EYE DROP  |
2 |
Generic |
$10.00 | $0.00 | None |
PREDNISOLONE SOD PH 25 MG/5 ML SOLUTION  |
2 |
Generic |
$10.00 | $0.00 | None |
PREDNISONE 1 MG TABLET  |
1 |
Preferred Generic |
$5.00 | $0.00 | None |
PREDNISONE 10 MG TABLET [Sterapred DS] ![Compare how all Medicare Part D PDP plans in DE cover PREDNISONE 10 MG TABLET [Sterapred DS].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PREDNISONE 10 MG TABLET DOSE PACK  |
2 |
Generic |
$10.00 | $0.00 | None |
PREDNISONE 10 MG TABLET DOSE PACK  |
2 |
Generic |
$10.00 | $0.00 | None |
PREDNISONE 2.5 MG TABLET  |
1 |
Preferred Generic |
$5.00 | $0.00 | None |
PREDNISONE 20 MG TABLET [Predone] ![Compare how all Medicare Part D PDP plans in DE cover PREDNISONE 20 MG TABLET [Predone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $0.00 | None |
PREDNISONE 5 MG TABLET  |
2 |
Generic |
$10.00 | $0.00 | None |
PREDNISONE 5 MG TABLET  |
2 |
Generic |
$10.00 | $0.00 | None |
PREDNISONE 5 MG TABLET [Sterapred] ![Compare how all Medicare Part D PDP plans in DE cover PREDNISONE 5 MG TABLET [Sterapred].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$5.00 | $0.00 | None |
PREDNISONE 5 MG/5 ML SOLUTION  |
2 |
Generic |
$10.00 | $0.00 | None |
PREDNISONE 50MG TABLET  |
1 |
Preferred Generic |
$5.00 | $0.00 | None |
PREDNISONE 5MG/ML SOLUTION  |
2 |
Generic |
$10.00 | $0.00 | None |
PREGABALIN 100 MG CAPSULE [Lyrica] ![Compare how all Medicare Part D PDP plans in DE cover PREGABALIN 100 MG CAPSULE [Lyrica].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | 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 DE cover PREGABALIN 150 MG CAPSULE [Lyrica].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | Q:90 /30Days |
PREGABALIN 20 MG/ML SOLUTION [Lyrica] ![Compare how all Medicare Part D PDP plans in DE cover PREGABALIN 20 MG/ML SOLUTION [Lyrica].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | Q:900 /30Days |
PREGABALIN 200 MG CAPSULE [Lyrica] ![Compare how all Medicare Part D PDP plans in DE cover PREGABALIN 200 MG CAPSULE [Lyrica].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | Q:90 /30Days |
PREGABALIN 225 MG CAPSULE [Lyrica] ![Compare how all Medicare Part D PDP plans in DE cover PREGABALIN 225 MG CAPSULE [Lyrica].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | Q:60 /30Days |
PREGABALIN 25 MG CAPSULE [Lyrica] ![Compare how all Medicare Part D PDP plans in DE cover PREGABALIN 25 MG CAPSULE [Lyrica].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | Q:120 /30Days |
PREGABALIN 300 MG CAPSULE [Lyrica] ![Compare how all Medicare Part D PDP plans in DE cover PREGABALIN 300 MG CAPSULE [Lyrica].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | Q:60 /30Days |
PREGABALIN 50 MG CAPSULE [Lyrica] ![Compare how all Medicare Part D PDP plans in DE cover PREGABALIN 50 MG CAPSULE [Lyrica].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | Q:120 /30Days |
PREGABALIN 75 MG CAPSULE [Lyrica] ![Compare how all Medicare Part D PDP plans in DE cover PREGABALIN 75 MG CAPSULE [Lyrica].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $126.00 | Q:120 /30Days |
PREHEVBRIO 10 MCG/ML VIAL  |
3 |
Preferred Brand |
$47.00 | $126.00 | P Q:1 /1Days |
PREMARIN 0.3 MG TABLET  |
4 |
Non-Preferred Drug |
40% | N/A | Q:30 /30Days |
PREMARIN 0.45MG TABLET  |
4 |
Non-Preferred Drug |
40% | N/A | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PREMARIN 0.625 MG TABLET  |
4 |
Non-Preferred Drug |
40% | N/A | Q:30 /30Days |
Premarin 0.625mg/g  |
3 |
Preferred Brand |
$47.00 | $126.00 | None |
PREMARIN 0.9MG TABLET  |
4 |
Non-Preferred Drug |
40% | N/A | Q:30 /30Days |
PREMARIN 1.25 MG TABLET  |
4 |
Non-Preferred Drug |
40% | N/A | Q:30 /30Days |
PREMASOL 10% IV SOLUTION  |
4 |
Non-Preferred Drug |
40% | N/A | P |
PREMPHASE 0.625-5 MG TABLET  |
4 |
Non-Preferred Drug |
40% | N/A | Q:28 /28Days |
PREMPRO 0.3 MG-1.5 MG TABLET #28 EA  |
4 |
Non-Preferred Drug |
40% | N/A | Q:28 /28Days |
PREMPRO 0.45-1.5 MG TABLET 28 EA  |
4 |
Non-Preferred Drug |
40% | N/A | Q:28 /28Days |
PREMPRO 0.625-5 MG TABLET  |
4 |
Non-Preferred Drug |
40% | N/A | Q:28 /28Days |
Prempro 0.625; 2.5mg/1; mg/1 1 BLISTER PACK per CARTON / 28 TABLET, SUGAR COATED per BLISTER PACK  |
4 |
Non-Preferred Drug |
40% | N/A | Q:28 /28Days |
PREVALITE PACKET  |
3 |
Preferred Brand |
$47.00 | $126.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PREVYMIS 240 MG  |
5 |
Specialty Tier |
33% | N/A | P Q:28 /28Days |
PREVYMIS 480 MG  |
5 |
Specialty Tier |
33% | N/A | P Q:28 /28Days |
PREZCOBIX 800 MG-150 MG TABLET  |
5 |
Specialty Tier |
33% | N/A | Q:30 /30Days |
PREZISTA 100 MG/ML SUSPENSION  |
5 |
Specialty Tier |
33% | N/A | Q:400 /30Days |
PREZISTA 150MG TABLETS  |
5 |
Specialty Tier |
33% | N/A | Q:180 /30Days |
PREZISTA TABLET 75MG  |
4 |
Non-Preferred Drug |
40% | N/A | Q:300 /30Days |
PRIFTIN 150 MG TABLET  |
4 |
Non-Preferred Drug |
40% | N/A | None |
PRIMAQUINE 26.3 MG TABLET [Primaquine] ![Compare how all Medicare Part D PDP plans in DE cover PRIMAQUINE 26.3 MG TABLET [Primaquine].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | None |
PRIMIDONE 125 MG TABLET  |
2 |
Generic |
$10.00 | $0.00 | None |
PRIMIDONE 250 MG TABLET [Mysoline] ![Compare how all Medicare Part D PDP plans in DE cover PRIMIDONE 250 MG TABLET [Mysoline].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
PRIMIDONE 50 MG TABLET [Mysoline] ![Compare how all Medicare Part D PDP plans in DE cover PRIMIDONE 50 MG TABLET [Mysoline].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PRIORIX VIAL  |
3 |
Preferred Brand |
$47.00 | $126.00 | Q:1 /1Days |
PRIVIGEN 10% VIAL  |
5 |
Specialty Tier |
33% | N/A | P |
PROBENECID 500 MG TABLET  |
3 |
Preferred Brand |
$47.00 | $126.00 | None |
PROBENECID-COLCHICINE TABLET  |
3 |
Preferred Brand |
$47.00 | $126.00 | None |
PROCHLORPERAZINE 10 MG TABLET  |
2 |
Generic |
$10.00 | $0.00 | None |
PROCHLORPERAZINE 5 MG TABLET  |
2 |
Generic |
$10.00 | $0.00 | None |
PROCHLORPERAZINE SUPPOSITORIES 25MG 12 BOX  |
4 |
Non-Preferred Drug |
40% | N/A | None |
PROCRIT 10000U/ML VIAL  |
4 |
Non-Preferred Drug |
40% | N/A | P |
PROCRIT 2000U/ML VIAL 6 X 1ML VIAL  |
4 |
Non-Preferred Drug |
40% | N/A | P |
PROCRIT 3,000 UNITS/ML VIAL  |
4 |
Non-Preferred Drug |
40% | N/A | P |
PROCRIT 4,000 UNITS/ML VIAL  |
4 |
Non-Preferred Drug |
40% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROCRIT 40000U/ML VIAL PR  |
5 |
Specialty Tier |
33% | N/A | P |
PROCRIT SOLUTION FOR INJECTION 20000UNT/ML 24 X 1 ML TRAY  |
5 |
Specialty Tier |
33% | N/A | P |
PROCTO-MED HC 2.5% CREAM /PE APP [Proctozone-HC] ![Compare how all Medicare Part D PDP plans in DE cover PROCTO-MED HC 2.5% CREAM /PE APP [Proctozone-HC].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
PROGESTERONE 100 MG CAPSULE [Prometrium] ![Compare how all Medicare Part D PDP plans in DE cover PROGESTERONE 100 MG CAPSULE [Prometrium].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
PROGESTERONE 200 MG CAPSULE [Prometrium] ![Compare how all Medicare Part D PDP plans in DE cover PROGESTERONE 200 MG CAPSULE [Prometrium].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
PROGRAF 0.2 MG GRANULE PACKET  |
4 |
Non-Preferred Drug |
40% | N/A | P |
PROGRAF 1 MG GRANULE PACKET  |
4 |
Non-Preferred Drug |
40% | N/A | P |
PROLASTIN C 1,000 MG/20 ML VIAL  |
5 |
Specialty Tier |
33% | N/A | P |
PROLIA 60MG/ML INJECTION  |
4 |
Non-Preferred Drug |
40% | N/A | Q:1 /180Days |
PROMACTA 12.5 MG SUSPEN PACKET POWDER PACK  |
5 |
Specialty Tier |
33% | N/A | P Q:180 /30Days |
PROMACTA 12.5 MG TABLET  |
5 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROMACTA 25 MG SUSPENSION POWDER PACK  |
5 |
Specialty Tier |
33% | N/A | P Q:180 /30Days |
PROMACTA 25 MG TABLET  |
5 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
PROMACTA 50 MG TABLET  |
5 |
Specialty Tier |
33% | N/A | P Q:60 /30Days |
PROMACTA 75 MG TABLET  |
5 |
Specialty Tier |
33% | N/A | P Q:60 /30Days |
PROMETHAZINE 12.5 MG TABLET  |
3 |
Preferred Brand |
$47.00 | $126.00 | None |
PROMETHAZINE 25 MG TABLET  |
3 |
Preferred Brand |
$47.00 | $126.00 | None |
PROMETHAZINE 50 MG TABLET  |
3 |
Preferred Brand |
$47.00 | $126.00 | None |
PROMETHAZINE 6.25 MG/5 ML SYRUP [Prometh Plain] ![Compare how all Medicare Part D PDP plans in DE 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 | $126.00 | None |
PROMETHAZINE HYDROCHLORIDE SUPPOSITORIES 12.5MG 12 BOX  |
4 |
Non-Preferred Drug |
40% | N/A | Q:180 /30Days |
PROMETHAZINE HYDROCHLORIDE SUPPOSITORIES 25MG 12 BOX  |
4 |
Non-Preferred Drug |
40% | N/A | Q:120 /30Days |
PROMETHEGAN 25MG SUPP  |
4 |
Non-Preferred Drug |
40% | N/A | Q:120 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROPAFENONE HCL 150 MG TABLET [Rythmol] ![Compare how all Medicare Part D PDP plans in DE cover PROPAFENONE HCL 150 MG TABLET [Rythmol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
PROPAFENONE HCL 225 MG TABLET [Rythmol] ![Compare how all Medicare Part D PDP plans in DE cover PROPAFENONE HCL 225 MG TABLET [Rythmol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
PROPAFENONE HCL 300 MG TABLET [Rythmol] ![Compare how all Medicare Part D PDP plans in DE cover PROPAFENONE HCL 300 MG TABLET [Rythmol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
PROPAFENONE HCL ER 225 MG CAPSULE 12H [Rythmol SR] ![Compare how all Medicare Part D PDP plans in DE cover PROPAFENONE HCL ER 225 MG CAPSULE 12H [Rythmol SR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | None |
PROPAFENONE HCL ER 325 MG CAPSULE 12H [Rythmol SR] ![Compare how all Medicare Part D PDP plans in DE cover PROPAFENONE HCL ER 325 MG CAPSULE 12H [Rythmol SR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | None |
PROPAFENONE HCL ER 425 MG CAPSULE 12H [Rythmol SR] ![Compare how all Medicare Part D PDP plans in DE cover PROPAFENONE HCL ER 425 MG CAPSULE 12H [Rythmol SR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | None |
PROPRANOLOL 10 MG TABLET  |
2 |
Generic |
$10.00 | $0.00 | None |
PROPRANOLOL 20 MG TABLET [Inderal] ![Compare how all Medicare Part D PDP plans in DE cover PROPRANOLOL 20 MG TABLET [Inderal].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
PROPRANOLOL 20MG/5ML TUBEX  |
2 |
Generic |
$10.00 | $0.00 | None |
PROPRANOLOL 40 MG TABLET [Inderal] ![Compare how all Medicare Part D PDP plans in DE cover PROPRANOLOL 40 MG TABLET [Inderal].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
PROPRANOLOL 40MG/5ML TUBEX  |
2 |
Generic |
$10.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PROPRANOLOL 60 MG TABLET  |
2 |
Generic |
$10.00 | $0.00 | None |
PROPRANOLOL 80 MG TABLET [Inderal] ![Compare how all Medicare Part D PDP plans in DE cover PROPRANOLOL 80 MG TABLET [Inderal].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$10.00 | $0.00 | None |
PROPRANOLOL ER 120 MG CAPSULE  |
2 |
Generic |
$10.00 | $0.00 | None |
PROPRANOLOL ER 160 MG CAPSULE  |
2 |
Generic |
$10.00 | $0.00 | None |
PROPRANOLOL ER 60 MG CAPSULE  |
2 |
Generic |
$10.00 | $0.00 | None |
PROPRANOLOL ER 80 MG CAPSULE  |
2 |
Generic |
$10.00 | $0.00 | None |
PROPYLTHIOURACIL 50 MG TABLET  |
2 |
Generic |
$10.00 | $0.00 | None |
PROQUAD VIAL  |
3 |
Preferred Brand |
$47.00 | $126.00 | Q:1 /1Days |
PROSOL 20% INJECTION  |
4 |
Non-Preferred Drug |
40% | N/A | P |
PROTRIPTYLINE HCL 10 MG TABLET [Vivactil] ![Compare how all Medicare Part D PDP plans in DE cover PROTRIPTYLINE HCL 10 MG TABLET [Vivactil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | None |
PROTRIPTYLINE HCL 5 MG TABLET [Vivactil] ![Compare how all Medicare Part D PDP plans in DE cover PROTRIPTYLINE HCL 5 MG TABLET [Vivactil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PULMOZYME 1MG/ML AMPUL  |
5 |
Specialty Tier |
33% | N/A | P Q:150 /30Days |
PURIXAN 20 MG/ML ORAL SUSPENSION  |
5 |
Specialty Tier |
33% | N/A | P |
PYRAZINAMIDE 500 MG TABLET  |
4 |
Non-Preferred Drug |
40% | N/A | None |
PYRIDOSTIGMINE BR 60 MG TABLET  |
3 |
Preferred Brand |
$47.00 | $126.00 | None |
PYRIDOSTIGMINE BR ER 180 MG TABLET  |
4 |
Non-Preferred Drug |
40% | N/A | None |
PYRIMETHAMINE 25 MG TABLET [Daraprim] ![Compare how all Medicare Part D PDP plans in DE cover PYRIMETHAMINE 25 MG TABLET [Daraprim].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
40% | N/A | None |
PYRUKYND 20 MG TABLET  |
5 |
Specialty Tier |
33% | N/A | P Q:56 /28Days |
PYRUKYND 20-5 MG TAPER PACK TABLET DS PK  |
5 |
Specialty Tier |
33% | N/A | P Q:14 /14Days |
PYRUKYND 5 MG TABLET  |
5 |
Specialty Tier |
33% | N/A | P Q:56 /28Days |
PYRUKYND 5 MG TAPER PACK TABLET  |
5 |
Specialty Tier |
33% | N/A | P Q:7 /7Days |
PYRUKYND 50 MG TABLET  |
5 |
Specialty Tier |
33% | N/A | P Q:112 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
PYRUKYND 50-20 MG TAPER PACK TABLET DS PK  |
5 |
Specialty Tier |
33% | N/A | P Q:14 /14Days |