2009 Medicare Part D Plan Formulary Information |
Aetna Medicare Rx Premier (S5810-191-0)
Benefit Details
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The Aetna Medicare Rx Premier (S5810-191-0) Formulary Drugs Starting with the Letter T in CMS PDP Region 21 which includes: LA
|
Drugs Starting with Letter T
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
TACLONEX OINTMENT ![Compare how all Medicare Part D PDP plans in LA cover TACLONEX OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | S |
TACLONEX SCALP SUSP 0.064%/0.005% ![Compare how all Medicare Part D PDP plans in LA cover TACLONEX SCALP SUSP 0.064%/0.005%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | S |
TALACEN CAPLET ![Compare how all Medicare Part D PDP plans in LA cover TALACEN CAPLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | P S |
TALADINE 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover TALADINE 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TALWIN 30MG/ML VIAL ![Compare how all Medicare Part D PDP plans in LA cover TALWIN 30MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | P |
TALWIN NX TABLET ![Compare how all Medicare Part D PDP plans in LA cover TALWIN NX TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | P |
TAMBOCOR 100MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TAMBOCOR 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TAMBOCOR 150MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TAMBOCOR 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TAMBOCOR 50MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TAMBOCOR 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TAMIFLU 30MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover TAMIFLU 30MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | Q:20 /365Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TAMIFLU 45MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover TAMIFLU 45MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | Q:20 /365Days |
TAMIFLU 75MG CAPSULE UD ![Compare how all Medicare Part D PDP plans in LA cover TAMIFLU 75MG CAPSULE UD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | Q:84 /365Days |
TAMIFLU ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in LA cover TAMIFLU ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | Q:525 /365Days |
TAMOXIFEN CITRATE 10MG TABLET (180 CT) ![Compare how all Medicare Part D PDP plans in LA cover TAMOXIFEN CITRATE 10MG TABLET (180 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TAMOXIFEN CITRATE 20MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in LA cover TAMOXIFEN CITRATE 20MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TAPAZOLE 10MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TAPAZOLE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TAPAZOLE 5MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TAPAZOLE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TARCEVA 100MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TARCEVA 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | None |
TARCEVA 150MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TARCEVA 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | None |
TARCEVA 25MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TARCEVA 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | None |
TARGRETIN 1% GEL 60GM TUBE ![Compare how all Medicare Part D PDP plans in LA cover TARGRETIN 1% GEL 60GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TARGRETIN 75MG (100 CT) ![Compare how all Medicare Part D PDP plans in LA cover TARGRETIN 75MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | None |
TARKA 1/240MG TABLET SA ![Compare how all Medicare Part D PDP plans in LA cover TARKA 1/240MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TARKA 2/180MG TABLET SA ![Compare how all Medicare Part D PDP plans in LA cover TARKA 2/180MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TARKA 2/240MG TABLET SA ![Compare how all Medicare Part D PDP plans in LA cover TARKA 2/240MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TARKA 4/240MG TABLET SA ![Compare how all Medicare Part D PDP plans in LA cover TARKA 4/240MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TASIGNA 200MG CAPSULE 28 BLPK ![Compare how all Medicare Part D PDP plans in LA cover TASIGNA 200MG CAPSULE 28 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | P S Q:4 /1Days |
TASMAR 100MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TASMAR 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TASMAR 200MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TASMAR 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TAXOL 30MG/5ML VIAL ![Compare how all Medicare Part D PDP plans in LA cover TAXOL 30MG/5ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | None |
TAXOTERE 20MG/0.5ML VIAL ![Compare how all Medicare Part D PDP plans in LA cover TAXOTERE 20MG/0.5ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | None |
TAXOTERE 80MG/2ML VIAL ![Compare how all Medicare Part D PDP plans in LA cover TAXOTERE 80MG/2ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TAZICEF 1GM ADD-VANTAGE ![Compare how all Medicare Part D PDP plans in LA cover TAZICEF 1GM ADD-VANTAGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TAZICEF 1GM VIAL ![Compare how all Medicare Part D PDP plans in LA cover TAZICEF 1GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TAZICEF 2GM ADD-VANTAGE ![Compare how all Medicare Part D PDP plans in LA cover TAZICEF 2GM ADD-VANTAGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TAZICEF 2GM VIAL ![Compare how all Medicare Part D PDP plans in LA cover TAZICEF 2GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
Tazicef 500MG ![Compare how all Medicare Part D PDP plans in LA cover Tazicef 500MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TAZICEF 6GM/100ML VIAL ![Compare how all Medicare Part D PDP plans in LA cover TAZICEF 6GM/100ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TAZORAC 0.05% CREAM ![Compare how all Medicare Part D PDP plans in LA cover TAZORAC 0.05% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$30.00 | $60.00 | S |
TAZORAC 0.05% GEL ![Compare how all Medicare Part D PDP plans in LA cover TAZORAC 0.05% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$30.00 | $60.00 | S |
TAZORAC 0.1% CREAM ![Compare how all Medicare Part D PDP plans in LA cover TAZORAC 0.1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$30.00 | $60.00 | S |
TAZORAC 0.1% GEL ![Compare how all Medicare Part D PDP plans in LA cover TAZORAC 0.1% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$30.00 | $60.00 | S |
TAZTIA XT 120MG CAPSULE SA (500 CT) ![Compare how all Medicare Part D PDP plans in LA cover TAZTIA XT 120MG CAPSULE SA (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | Q:1 /1Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TAZTIA XT 180MG CAPSULE SA (500 CT) ![Compare how all Medicare Part D PDP plans in LA cover TAZTIA XT 180MG CAPSULE SA (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | Q:3 /1Days |
TAZTIA XT 240MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in LA cover TAZTIA XT 240MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TAZTIA XT 300MG CAPSULE SA (500 CT) ![Compare how all Medicare Part D PDP plans in LA cover TAZTIA XT 300MG CAPSULE SA (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TAZTIA XT 360MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in LA cover TAZTIA XT 360MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TEGRETOL 100MG TABLET CHEW ![Compare how all Medicare Part D PDP plans in LA cover TEGRETOL 100MG TABLET CHEW.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TEGRETOL 100MG/5ML SUSP ![Compare how all Medicare Part D PDP plans in LA cover TEGRETOL 100MG/5ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TEGRETOL 200MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TEGRETOL 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TEGRETOL XR 100MG SA TABLET ![Compare how all Medicare Part D PDP plans in LA cover TEGRETOL XR 100MG SA TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TEGRETOL XR 200MG SA TABLET ![Compare how all Medicare Part D PDP plans in LA cover TEGRETOL XR 200MG SA TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TEGRETOL XR 400MG SA TABLET ![Compare how all Medicare Part D PDP plans in LA cover TEGRETOL XR 400MG SA TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TEKTURNA 150MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TEKTURNA 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$30.00 | $60.00 | Q:1 /1Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TEKTURNA 300MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TEKTURNA 300MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$30.00 | $60.00 | Q:1 /1Days |
TEKTURNA HCT 150-12.5MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TEKTURNA HCT 150-12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$30.00 | $60.00 | Q:1 /1Days |
TEKTURNA HCT 150MG-25MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TEKTURNA HCT 150MG-25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$30.00 | $60.00 | Q:1 /1Days |
TEKTURNA HCT 300-12.5MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TEKTURNA HCT 300-12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$30.00 | $60.00 | Q:1 /1Days |
TEKTURNA HCT 300MG-25MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TEKTURNA HCT 300MG-25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$30.00 | $60.00 | Q:1 /1Days |
TEMOVATE 0.05% CREAM 60GM TUBE ![Compare how all Medicare Part D PDP plans in LA cover TEMOVATE 0.05% CREAM 60GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TEMOVATE 0.05% GEL 60GM BOX ![Compare how all Medicare Part D PDP plans in LA cover TEMOVATE 0.05% GEL 60GM BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TEMOVATE 0.05% OINTMENT ![Compare how all Medicare Part D PDP plans in LA cover TEMOVATE 0.05% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TEMOVATE 0.05% SOLUTION NON-ORAL TOPICAL ![Compare how all Medicare Part D PDP plans in LA cover TEMOVATE 0.05% SOLUTION NON-ORAL TOPICAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TEMOVATE EMOLLIENT 0.05% CREAM ![Compare how all Medicare Part D PDP plans in LA cover TEMOVATE EMOLLIENT 0.05% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TENEX 1MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TENEX 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TENEX 2MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TENEX 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TENORETIC 100 TABLET ![Compare how all Medicare Part D PDP plans in LA cover TENORETIC 100 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TENORETIC 50 TABLET ![Compare how all Medicare Part D PDP plans in LA cover TENORETIC 50 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TENORMIN 100MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TENORMIN 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | S |
TENORMIN 25MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TENORMIN 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | S |
TENORMIN 50MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TENORMIN 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | S |
TERAZOL 3 80MG SUPPOSITORY ![Compare how all Medicare Part D PDP plans in LA cover TERAZOL 3 80MG SUPPOSITORY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TERAZOL 3 CRE 0.8% ![Compare how all Medicare Part D PDP plans in LA cover TERAZOL 3 CRE 0.8%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TERAZOL 7 0.4% CREAM ![Compare how all Medicare Part D PDP plans in LA cover TERAZOL 7 0.4% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TERAZOSIN HCL 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover TERAZOSIN HCL 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TERAZOSIN HCL 1MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover TERAZOSIN HCL 1MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TERAZOSIN HCL 2MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover TERAZOSIN HCL 2MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TERAZOSIN HCL 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover TERAZOSIN HCL 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TERBINAFINE HCL 250MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TERBINAFINE HCL 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | P |
TERBUTALINE SULF 1MG/ML VL ![Compare how all Medicare Part D PDP plans in LA cover TERBUTALINE SULF 1MG/ML VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | P |
TERBUTALINE SULF 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TERBUTALINE SULF 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TERBUTALINE SULFATE 5MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TERBUTALINE SULFATE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TERCONAZOLE 0.4% CREAM WITH APPLICATOR ![Compare how all Medicare Part D PDP plans in LA cover TERCONAZOLE 0.4% CREAM WITH APPLICATOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TERCONAZOLE 0.8% CREAM WITH APPLICATOR ![Compare how all Medicare Part D PDP plans in LA cover TERCONAZOLE 0.8% CREAM WITH APPLICATOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TERCONAZOLE 80MG SUPPOSITORY VAGINAL ![Compare how all Medicare Part D PDP plans in LA cover TERCONAZOLE 80MG SUPPOSITORY VAGINAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TESTIM 1%(50MG) GEL ![Compare how all Medicare Part D PDP plans in LA cover TESTIM 1%(50MG) GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | S |
TESTOSTERONE CYPIONATE INJECTION ![Compare how all Medicare Part D PDP plans in LA cover TESTOSTERONE CYPIONATE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TESTOSTERONE CYPIONATE INJECTION 200MG 1 X 10ML VIALMD ![Compare how all Medicare Part D PDP plans in LA cover TESTOSTERONE CYPIONATE INJECTION 200MG 1 X 10ML VIALMD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TESTOSTERONE ENANTHATE INJECTION ![Compare how all Medicare Part D PDP plans in LA cover TESTOSTERONE ENANTHATE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TESTRED 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover TESTRED 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | P |
TETANUS AND DIPHTHERIA TOXOIDS ADSORBED FOR ADULT USE 2 UNT/VIAL ![Compare how all Medicare Part D PDP plans in LA cover TETANUS AND DIPHTHERIA TOXOIDS ADSORBED FOR ADULT USE 2 UNT/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$30.00 | $60.00 | None |
TETANUS TOXOID ADSORBED VIAL 5LF ![Compare how all Medicare Part D PDP plans in LA cover TETANUS TOXOID ADSORBED VIAL 5LF.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$30.00 | $60.00 | P |
TETRACYCLINE 500MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover TETRACYCLINE 500MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | P |
TETRACYCLINE HCL 250MG CAPSULE (1000 CT) ![Compare how all Medicare Part D PDP plans in LA cover TETRACYCLINE HCL 250MG CAPSULE (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | P |
TEV-TROPIN 5MG VIAL ![Compare how all Medicare Part D PDP plans in LA cover TEV-TROPIN 5MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | P |
TEVETEN 400MG TILTAB ![Compare how all Medicare Part D PDP plans in LA cover TEVETEN 400MG TILTAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | S Q:2 /1Days |
TEVETEN 600MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TEVETEN 600MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | S |
TEVETEN HCT 600-12.5MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TEVETEN HCT 600-12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | S |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TEVETEN HCT 600-25MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TEVETEN HCT 600-25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | S |
TEXACORT ![Compare how all Medicare Part D PDP plans in LA cover TEXACORT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TEXACORT 2.5% SOLUTION NON-ORAL ![Compare how all Medicare Part D PDP plans in LA cover TEXACORT 2.5% SOLUTION NON-ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
THALITONE 15MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover THALITONE 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
THALOMID 100MG CAPSULE 140 BOX ![Compare how all Medicare Part D PDP plans in LA cover THALOMID 100MG CAPSULE 140 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | None |
THALOMID 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover THALOMID 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | None |
THALOMID 200MG CAPSULE 28 BLPK ![Compare how all Medicare Part D PDP plans in LA cover THALOMID 200MG CAPSULE 28 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | None |
THALOMID 50MG CAPSULE 280 BOX ![Compare how all Medicare Part D PDP plans in LA cover THALOMID 50MG CAPSULE 280 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | None |
THEO-24 100MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in LA cover THEO-24 100MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
THEO-24 200MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in LA cover THEO-24 200MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
THEO-24 300MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in LA cover THEO-24 300MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
THEO-24 400MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in LA cover THEO-24 400MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
THEOCHRON 100MG TABLET SA ![Compare how all Medicare Part D PDP plans in LA cover THEOCHRON 100MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
THEOCHRON 100MG TABLET SA ![Compare how all Medicare Part D PDP plans in LA cover THEOCHRON 100MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
THEOCHRON 200MG TABLET SA ![Compare how all Medicare Part D PDP plans in LA cover THEOCHRON 200MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
THEOCHRON 300MG TABLET SA ![Compare how all Medicare Part D PDP plans in LA cover THEOCHRON 300MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
THEOCHRON 450MG TABLET SA ![Compare how all Medicare Part D PDP plans in LA cover THEOCHRON 450MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
THEOPHYLLINE 100MG TABLET SA ![Compare how all Medicare Part D PDP plans in LA cover THEOPHYLLINE 100MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
THEOPHYLLINE 100MG TABLET SA ![Compare how all Medicare Part D PDP plans in LA cover THEOPHYLLINE 100MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
THEOPHYLLINE 200MG TABLET SA ![Compare how all Medicare Part D PDP plans in LA cover THEOPHYLLINE 200MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
THEOPHYLLINE 200MG TABLET SA U.D. ![Compare how all Medicare Part D PDP plans in LA cover THEOPHYLLINE 200MG TABLET SA U.D..](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
THEOPHYLLINE 300MG TABLET SA ![Compare how all Medicare Part D PDP plans in LA cover THEOPHYLLINE 300MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
THEOPHYLLINE 300MG TABLET SA U.D. ![Compare how all Medicare Part D PDP plans in LA cover THEOPHYLLINE 300MG TABLET SA U.D..](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
THEOPHYLLINE 400MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover THEOPHYLLINE 400MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
THEOPHYLLINE 400MG TABLET SA ![Compare how all Medicare Part D PDP plans in LA cover THEOPHYLLINE 400MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
THEOPHYLLINE 600MG TABLET SA ![Compare how all Medicare Part D PDP plans in LA cover THEOPHYLLINE 600MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
THEOPHYLLINE ANHYDROUS ER TABLET 200MG (1000 CT) ![Compare how all Medicare Part D PDP plans in LA cover THEOPHYLLINE ANHYDROUS ER TABLET 200MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
THEOPHYLLINE TABLET ER 300MG (100 CT) ![Compare how all Medicare Part D PDP plans in LA cover THEOPHYLLINE TABLET ER 300MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
THEOPHYLLINE TABLET ER 450MG (100 CT) ![Compare how all Medicare Part D PDP plans in LA cover THEOPHYLLINE TABLET ER 450MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
THERMAZENE 50GM CREAM ![Compare how all Medicare Part D PDP plans in LA cover THERMAZENE 50GM CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
THIOGUANINE TABLET LOID 40MG ![Compare how all Medicare Part D PDP plans in LA cover THIOGUANINE TABLET LOID 40MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
THIOLA 100MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover THIOLA 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$30.00 | $60.00 | None |
THIORIDAZINE 100MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover THIORIDAZINE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
THIORIDAZINE HCL 10MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in LA cover THIORIDAZINE HCL 10MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | P |
THIORIDAZINE HCL 25MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in LA cover THIORIDAZINE HCL 25MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | P |
THIORIDAZINE HCL 50MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in LA cover THIORIDAZINE HCL 50MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | P |
THIOTEPA 15MG VIAL ![Compare how all Medicare Part D PDP plans in LA cover THIOTEPA 15MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | P |
THIOTHIXENE 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover THIOTHIXENE 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
THIOTHIXENE 1MG CAPSULE (100 CT) ![Compare how all Medicare Part D PDP plans in LA cover THIOTHIXENE 1MG CAPSULE (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
THIOTHIXENE 2MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover THIOTHIXENE 2MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
THIOTHIXENE 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover THIOTHIXENE 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
THYMOGLOBULIN 25MG VIAL ![Compare how all Medicare Part D PDP plans in LA cover THYMOGLOBULIN 25MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$30.00 | $60.00 | P |
THYROLAR-1 60MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover THYROLAR-1 60MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
THYROLAR-1/2 30MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover THYROLAR-1/2 30MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
THYROLAR-1/4 15MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover THYROLAR-1/4 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
THYROLAR-2 120MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover THYROLAR-2 120MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
THYROLAR-3 180MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover THYROLAR-3 180MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TIAZAC 120MG E.R. CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover TIAZAC 120MG E.R. CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | S Q:1 /1Days |
TIAZAC 180MG E.R. CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover TIAZAC 180MG E.R. CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | S Q:3 /1Days |
TIAZAC 240MG E.R. CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover TIAZAC 240MG E.R. CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | S |
TIAZAC 300MG E.R. CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover TIAZAC 300MG E.R. CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | S |
TIAZAC 360MG E.R. CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover TIAZAC 360MG E.R. CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | S |
TIAZAC 420MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in LA cover TIAZAC 420MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | S |
TICLID 250MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TICLID 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TICLOPIDINE HCL 250MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TICLOPIDINE HCL 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TIGAN 100MG/ML VIAL ![Compare how all Medicare Part D PDP plans in LA cover TIGAN 100MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | P |
TIGAN 300MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover TIGAN 300MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | P |
TIKOSYN .125MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover TIKOSYN .125MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$30.00 | $60.00 | None |
TIKOSYN .250MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover TIKOSYN .250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$30.00 | $60.00 | None |
TIKOSYN .5MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover TIKOSYN .5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$30.00 | $60.00 | None |
TIMENTIN 3.1GM VIAL ![Compare how all Medicare Part D PDP plans in LA cover TIMENTIN 3.1GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TIMENTIN 3.1GM/100ML ISO ![Compare how all Medicare Part D PDP plans in LA cover TIMENTIN 3.1GM/100ML ISO.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TIMENTIN 31GM BULK VIAL ![Compare how all Medicare Part D PDP plans in LA cover TIMENTIN 31GM BULK VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TIMOLIDE 10/25 TABLET ![Compare how all Medicare Part D PDP plans in LA cover TIMOLIDE 10/25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TIMOLOL 0.25% GEL/SOLUTION ![Compare how all Medicare Part D PDP plans in LA cover TIMOLOL 0.25% GEL/SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TIMOLOL 0.5% GEL/SOLUTION ![Compare how all Medicare Part D PDP plans in LA cover TIMOLOL 0.5% GEL/SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TIMOLOL MAL SOL 0.25% OP 15ML BOT ![Compare how all Medicare Part D PDP plans in LA cover TIMOLOL MAL SOL 0.25% OP 15ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
TIMOLOL MAL SOL 0.5% OP 10ML BOT ![Compare how all Medicare Part D PDP plans in LA cover TIMOLOL MAL SOL 0.5% OP 10ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
TIMOLOL MALEATE 10MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TIMOLOL MALEATE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | S |
TIMOLOL MALEATE 20MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TIMOLOL MALEATE 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | S |
TIMOLOL MALEATE 5MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TIMOLOL MALEATE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | S |
TIMOPTIC 0.25% OCUDOSE DROP ![Compare how all Medicare Part D PDP plans in LA cover TIMOPTIC 0.25% OCUDOSE DROP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TIMOPTIC 0.25% OCUM PLS DRP ![Compare how all Medicare Part D PDP plans in LA cover TIMOPTIC 0.25% OCUM PLS DRP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TIMOPTIC 0.5% OCUDOSE DROP ![Compare how all Medicare Part D PDP plans in LA cover TIMOPTIC 0.5% OCUDOSE DROP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TIMOPTIC 0.5% OCUM PLUS DRP ![Compare how all Medicare Part D PDP plans in LA cover TIMOPTIC 0.5% OCUM PLUS DRP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TIMOPTIC-XE 0.25% EYE SOLUTION ![Compare how all Medicare Part D PDP plans in LA cover TIMOPTIC-XE 0.25% EYE SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TIMOPTIC-XE 0.5% EYE SOLUTION ![Compare how all Medicare Part D PDP plans in LA cover TIMOPTIC-XE 0.5% EYE SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TINDAMAX 250MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TINDAMAX 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TINDAMAX 500MG TABLET (60 CT) ![Compare how all Medicare Part D PDP plans in LA cover TINDAMAX 500MG TABLET (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TIS-U-SOL IRRIGATION SOLUTION ![Compare how all Medicare Part D PDP plans in LA cover TIS-U-SOL IRRIGATION SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
TIS-U-SOL IRRIGATION SOLUTION ![Compare how all Medicare Part D PDP plans in LA cover TIS-U-SOL IRRIGATION SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
TIZANIDINE HCL 2MG TABLET (150 CT) ![Compare how all Medicare Part D PDP plans in LA cover TIZANIDINE HCL 2MG TABLET (150 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TIZANIDINE HCL 4MG TABLET 150 BOT ![Compare how all Medicare Part D PDP plans in LA cover TIZANIDINE HCL 4MG TABLET 150 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TOBRADEX EYE OINTMENT ![Compare how all Medicare Part D PDP plans in LA cover TOBRADEX EYE OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TOBRADEX SUSPENSION OPHTHALMIC 0.1%/0.3% 5ML BOT ![Compare how all Medicare Part D PDP plans in LA cover TOBRADEX SUSPENSION OPHTHALMIC 0.1%/0.3% 5ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TOBRAMYCIN 10MG/ML VIAL ![Compare how all Medicare Part D PDP plans in LA cover TOBRAMYCIN 10MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TOBRAMYCIN 10MG/ML VIAL ![Compare how all Medicare Part D PDP plans in LA cover TOBRAMYCIN 10MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TOBRAMYCIN 40MG/ML VIAL ![Compare how all Medicare Part D PDP plans in LA cover TOBRAMYCIN 40MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TOBRAMYCIN 60MG/0.9% NACL ![Compare how all Medicare Part D PDP plans in LA cover TOBRAMYCIN 60MG/0.9% NACL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TOBRAMYCIN 80MG/0.9% NACL ![Compare how all Medicare Part D PDP plans in LA cover TOBRAMYCIN 80MG/0.9% NACL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TOBRAMYCIN FOR INJECTION 1.2MG/VIAL ![Compare how all Medicare Part D PDP plans in LA cover TOBRAMYCIN FOR INJECTION 1.2MG/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TOBRAMYCIN INHALATION SOLUTION ![Compare how all Medicare Part D PDP plans in LA cover TOBRAMYCIN INHALATION SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | P |
TOBRAMYCIN INJECTION SOLUTION 40MG 10 X 30ML VIAL ![Compare how all Medicare Part D PDP plans in LA cover TOBRAMYCIN INJECTION SOLUTION 40MG 10 X 30ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TOBRAMYCIN OPHTHALMIC SOLUTION 0.3% 5ML BOT ![Compare how all Medicare Part D PDP plans in LA cover TOBRAMYCIN OPHTHALMIC SOLUTION 0.3% 5ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
TOBRAMYCIN SULFATE ![Compare how all Medicare Part D PDP plans in LA cover TOBRAMYCIN SULFATE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TOBRAMYCIN-DEXAMETH OPTH SUSP ![Compare how all Medicare Part D PDP plans in LA cover TOBRAMYCIN-DEXAMETH OPTH SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TOBRASOL 0.3% EYE DROPS ![Compare how all Medicare Part D PDP plans in LA cover TOBRASOL 0.3% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
TOBREX 0.3% EYE DROPS ![Compare how all Medicare Part D PDP plans in LA cover TOBREX 0.3% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TOBREX 0.3% EYE OINTMENT ![Compare how all Medicare Part D PDP plans in LA cover TOBREX 0.3% EYE OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TOFRANIL 10MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TOFRANIL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TOFRANIL 25MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TOFRANIL 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TOFRANIL 50MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in LA cover TOFRANIL 50MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TOFRANIL-PM 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover TOFRANIL-PM 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TOFRANIL-PM 125MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover TOFRANIL-PM 125MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TOFRANIL-PM 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover TOFRANIL-PM 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TOFRANIL-PM 75MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover TOFRANIL-PM 75MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TOLAZAMIDE 250MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TOLAZAMIDE 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
TOLAZAMIDE 500MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TOLAZAMIDE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
TOLBUTAMIDE 500MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TOLBUTAMIDE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TOLMETIN SODIUM 200MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TOLMETIN SODIUM 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TOLMETIN SODIUM 400MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover TOLMETIN SODIUM 400MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TOLMETIN SODIUM 600MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TOLMETIN SODIUM 600MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TOPAMAX 100MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TOPAMAX 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TOPAMAX 15MG SPRINKLE CAP ![Compare how all Medicare Part D PDP plans in LA cover TOPAMAX 15MG SPRINKLE CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TOPAMAX 200MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TOPAMAX 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TOPAMAX 25MG SPRINKLE CAP ![Compare how all Medicare Part D PDP plans in LA cover TOPAMAX 25MG SPRINKLE CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TOPAMAX 25MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TOPAMAX 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TOPAMAX 50MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TOPAMAX 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TOPICORT 0.05% GEL ![Compare how all Medicare Part D PDP plans in LA cover TOPICORT 0.05% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TOPICORT 0.25% CREAM ![Compare how all Medicare Part D PDP plans in LA cover TOPICORT 0.25% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TOPICORT 0.25% OINTMENT ![Compare how all Medicare Part D PDP plans in LA cover TOPICORT 0.25% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TOPICORT LP 0.05% CREAM ![Compare how all Medicare Part D PDP plans in LA cover TOPICORT LP 0.05% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TOPIRAMATE TABLETS 100MG 1000 BOT ![Compare how all Medicare Part D PDP plans in LA cover TOPIRAMATE TABLETS 100MG 1000 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TOPIRAMATE TABLETS 200MG 1000 BOT ![Compare how all Medicare Part D PDP plans in LA cover TOPIRAMATE TABLETS 200MG 1000 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TOPIRAMATE TABLETS 25MG 1000 BOT ![Compare how all Medicare Part D PDP plans in LA cover TOPIRAMATE TABLETS 25MG 1000 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TOPIRAMATE TABLETS 50MG 1000 BOT ![Compare how all Medicare Part D PDP plans in LA cover TOPIRAMATE TABLETS 50MG 1000 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TOPOSAR INJECTION 20MG/ML 50ML VIAL MD CRTN ![Compare how all Medicare Part D PDP plans in LA cover TOPOSAR INJECTION 20MG/ML 50ML VIAL MD CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | P |
TOPROL XL 100MG TABLET SA ![Compare how all Medicare Part D PDP plans in LA cover TOPROL XL 100MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | S |
TOPROL XL 200MG TABLET SA ![Compare how all Medicare Part D PDP plans in LA cover TOPROL XL 200MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | S |
TOPROL XL 25MG TABLET SA ![Compare how all Medicare Part D PDP plans in LA cover TOPROL XL 25MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | S |
TOPROL XL 50MG TABLET SA ![Compare how all Medicare Part D PDP plans in LA cover TOPROL XL 50MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | S |
TORISEL SOL 25MG/ML ![Compare how all Medicare Part D PDP plans in LA cover TORISEL SOL 25MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TORSEMIDE 100MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TORSEMIDE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TORSEMIDE 10MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TORSEMIDE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TORSEMIDE 20MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TORSEMIDE 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TORSEMIDE 5MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TORSEMIDE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TOVIAZ TABLETS 4MG EXTENDED RELEASE ![Compare how all Medicare Part D PDP plans in LA cover TOVIAZ TABLETS 4MG EXTENDED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | S |
TOVIAZ TABLETS 8MG EXTENDED RELEASE ![Compare how all Medicare Part D PDP plans in LA cover TOVIAZ TABLETS 8MG EXTENDED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | S |
TPN ELECTROLYTES VIAL ![Compare how all Medicare Part D PDP plans in LA cover TPN ELECTROLYTES VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
TRACLEER 125MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TRACLEER 125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | None |
TRACLEER 62.5MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TRACLEER 62.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | None |
TRAMADOL HCL 50MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in LA cover TRAMADOL HCL 50MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TRAMADOL HCL-ACETAMINOPHEN 37.5-325MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in LA cover TRAMADOL HCL-ACETAMINOPHEN 37.5-325MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRANDATE 100MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TRANDATE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TRANDATE 200MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in LA cover TRANDATE 200MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TRANDATE 300MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in LA cover TRANDATE 300MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TRANDATE 5MG/ML VIAL ![Compare how all Medicare Part D PDP plans in LA cover TRANDATE 5MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TRANDOLAPRIL 1MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TRANDOLAPRIL 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | Q:2 /1Days |
TRANDOLAPRIL 2MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TRANDOLAPRIL 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | Q:2 /1Days |
TRANDOLAPRIL 4MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TRANDOLAPRIL 4MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TRANSDERM-SCOP 1.5MG 24 PKG ![Compare how all Medicare Part D PDP plans in LA cover TRANSDERM-SCOP 1.5MG 24 PKG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | P |
TRANYLCYPROMINE SULFATE 10MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TRANYLCYPROMINE SULFATE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TRAVASOL 10% SOLUTION VIAFLEX ![Compare how all Medicare Part D PDP plans in LA cover TRAVASOL 10% SOLUTION VIAFLEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TRAVASOL 3.5%-ELECTROLYTES ![Compare how all Medicare Part D PDP plans in LA cover TRAVASOL 3.5%-ELECTROLYTES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRAVASOL 5.5% SOLUTION/VIAFLEX ![Compare how all Medicare Part D PDP plans in LA cover TRAVASOL 5.5% SOLUTION/VIAFLEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TRAVASOL 5.5%-ELECTROLYTES ![Compare how all Medicare Part D PDP plans in LA cover TRAVASOL 5.5%-ELECTROLYTES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TRAVASOL 5.5%/DEXTROSE 20% QUICK MIX CONT ![Compare how all Medicare Part D PDP plans in LA cover TRAVASOL 5.5%/DEXTROSE 20% QUICK MIX CONT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TRAVASOL 8.5%-ELECTROLYTES ![Compare how all Medicare Part D PDP plans in LA cover TRAVASOL 8.5%-ELECTROLYTES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TRAVASOL 8.5%/DEXTROSE 10% QUICK MIX CONT ![Compare how all Medicare Part D PDP plans in LA cover TRAVASOL 8.5%/DEXTROSE 10% QUICK MIX CONT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TRAVASOL 8.5%/DEXTROSE 20% QUICK MIX CONT ![Compare how all Medicare Part D PDP plans in LA cover TRAVASOL 8.5%/DEXTROSE 20% QUICK MIX CONT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TRAVASOL 8.5%/DEXTROSE 50% QUICK MIX CONT ![Compare how all Medicare Part D PDP plans in LA cover TRAVASOL 8.5%/DEXTROSE 50% QUICK MIX CONT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TRAVASOL AMINO ACID INJECTION 8.5% 500ML BAG ![Compare how all Medicare Part D PDP plans in LA cover TRAVASOL AMINO ACID INJECTION 8.5% 500ML BAG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TRAVASOL QUICK MIX 5.5% ![Compare how all Medicare Part D PDP plans in LA cover TRAVASOL QUICK MIX 5.5%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TRAVATAN 0.004% EYE DROP 2.5ML BOT ![Compare how all Medicare Part D PDP plans in LA cover TRAVATAN 0.004% EYE DROP 2.5ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$30.00 | $60.00 | None |
TRAVATAN Z 0.04MG DROPS 2.5ML BOT ![Compare how all Medicare Part D PDP plans in LA cover TRAVATAN Z 0.04MG DROPS 2.5ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$30.00 | $60.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRAZODONE 300MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TRAZODONE 300MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
TRAZODONE HCL TABLET USP 100MG (500 CT) ![Compare how all Medicare Part D PDP plans in LA cover TRAZODONE HCL TABLET USP 100MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
TRAZODONE HCL TABLET USP 150MG (100 CT) ![Compare how all Medicare Part D PDP plans in LA cover TRAZODONE HCL TABLET USP 150MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
TRAZODONE HCL TABLET USP 50MG (500 CT) ![Compare how all Medicare Part D PDP plans in LA cover TRAZODONE HCL TABLET USP 50MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
TREANDA FOR INJECTION 100MG/VIAL ![Compare how all Medicare Part D PDP plans in LA cover TREANDA FOR INJECTION 100MG/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | None |
TRECATOR 250MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TRECATOR 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TRELSTAR DEPOT 3.75MG VIAL ![Compare how all Medicare Part D PDP plans in LA cover TRELSTAR DEPOT 3.75MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | P |
TRELSTAR LA 11.25MG VIAL SINGLE DOSE VIAL ![Compare how all Medicare Part D PDP plans in LA cover TRELSTAR LA 11.25MG VIAL SINGLE DOSE VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | P |
TRENTAL 400MG TABLET SA ![Compare how all Medicare Part D PDP plans in LA cover TRENTAL 400MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TRETINOIN 0.01% GEL 45GM TUBE ![Compare how all Medicare Part D PDP plans in LA cover TRETINOIN 0.01% GEL 45GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TRETINOIN 0.025% CREAM ![Compare how all Medicare Part D PDP plans in LA cover TRETINOIN 0.025% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRETINOIN 0.025% GEL 45GM TUBE ![Compare how all Medicare Part D PDP plans in LA cover TRETINOIN 0.025% GEL 45GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TRETINOIN 0.025% GEL 45GM TUBE ![Compare how all Medicare Part D PDP plans in LA cover TRETINOIN 0.025% GEL 45GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TRETINOIN 0.05% CREAM 45GM TUBE ![Compare how all Medicare Part D PDP plans in LA cover TRETINOIN 0.05% CREAM 45GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TRETINOIN 0.1% CREAM 45GM TUBE ![Compare how all Medicare Part D PDP plans in LA cover TRETINOIN 0.1% CREAM 45GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TRETINOIN 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover TRETINOIN 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | None |
TREXALL 10MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TREXALL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | P |
TREXALL 15MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TREXALL 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | P |
TREXALL 5MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TREXALL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | P |
TREXALL 7.5MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TREXALL 7.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | P |
TREXIMET 500MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TREXIMET 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | Q:9 /30Days |
TREZIX 16-356-30 CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover TREZIX 16-356-30 CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 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 |
TRI-LEGEST FE 5-7-9-7 TABLET ![Compare how all Medicare Part D PDP plans in LA cover TRI-LEGEST FE 5-7-9-7 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TRI-NORINYL 28 TABLET ![Compare how all Medicare Part D PDP plans in LA cover TRI-NORINYL 28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TRI-PREVIFEM 7DAYSX3 28 168 CRTN ![Compare how all Medicare Part D PDP plans in LA cover TRI-PREVIFEM 7DAYSX3 28 168 CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TRI-SPRINTEC 7DAYSX3 28 TABLET ![Compare how all Medicare Part D PDP plans in LA cover TRI-SPRINTEC 7DAYSX3 28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TRIAMCINOLONE 0.1% OINTMENT ![Compare how all Medicare Part D PDP plans in LA cover TRIAMCINOLONE 0.1% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
TRIAMCINOLONE 0.1% PASTE ![Compare how all Medicare Part D PDP plans in LA cover TRIAMCINOLONE 0.1% PASTE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TRIAMCINOLONE ACETONIDE 0.025% OINTMENT 80GM TUBE ![Compare how all Medicare Part D PDP plans in LA cover TRIAMCINOLONE ACETONIDE 0.025% OINTMENT 80GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
TRIAMCINOLONE ACETONIDE 0.1% LOTION 60ML BOTPL ![Compare how all Medicare Part D PDP plans in LA cover TRIAMCINOLONE ACETONIDE 0.1% LOTION 60ML BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TRIAMCINOLONE ACETONIDE 0.025% CREAM 80GM TUBE ![Compare how all Medicare Part D PDP plans in LA cover TRIAMCINOLONE ACETONIDE 0.025% CREAM 80GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
TRIAMCINOLONE ACETONIDE 0.025% LOTION 2 FL OZ BOT ![Compare how all Medicare Part D PDP plans in LA cover TRIAMCINOLONE ACETONIDE 0.025% LOTION 2 FL OZ BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TRIAMCINOLONE ACETONIDE 0.05% CREAM 15GM TUBE ![Compare how all Medicare Part D PDP plans in LA cover TRIAMCINOLONE ACETONIDE 0.05% CREAM 15GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 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 |
TRIAMCINOLONE ACETONIDE 0.05% OINTMENT ![Compare how all Medicare Part D PDP plans in LA cover TRIAMCINOLONE ACETONIDE 0.05% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
TRIAMCINOLONE ACETONIDE 0.05% OINTMENT 15GM TUBE ![Compare how all Medicare Part D PDP plans in LA cover TRIAMCINOLONE ACETONIDE 0.05% OINTMENT 15GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
TRIAMCINOLONE ACETONIDE 0.1% CREAM 80GM TUBE ![Compare how all Medicare Part D PDP plans in LA cover TRIAMCINOLONE ACETONIDE 0.1% CREAM 80GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
TRIAMTERENE/HCTZ 25/37.5MG CAPSULES (100 CT) ![Compare how all Medicare Part D PDP plans in LA cover TRIAMTERENE/HCTZ 25/37.5MG CAPSULES (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
TRIAMTERENE/HCTZ 37.5/25 TABLET ![Compare how all Medicare Part D PDP plans in LA cover TRIAMTERENE/HCTZ 37.5/25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
TRIAMTERENE/HCTZ 50/25 CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover TRIAMTERENE/HCTZ 50/25 CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
TRIAMTERENE/HCTZ 75/50 TABLET ![Compare how all Medicare Part D PDP plans in LA cover TRIAMTERENE/HCTZ 75/50 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
TRICOR 145MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TRICOR 145MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$30.00 | $60.00 | None |
TRICOR 48MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TRICOR 48MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$30.00 | $60.00 | None |
TRIDERM 0.1% CREAM ![Compare how all Medicare Part D PDP plans in LA cover TRIDERM 0.1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
TRIDERM 0.1% OINTMENT ![Compare how all Medicare Part D PDP plans in LA cover TRIDERM 0.1% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 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 |
TRIFLUOPERAZINE 1MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TRIFLUOPERAZINE 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TRIFLUOPERAZINE HCL 2MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TRIFLUOPERAZINE HCL 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TRIFLUOPERAZINE HCL 5MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TRIFLUOPERAZINE HCL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TRIFLUOPERAZINE HCL USP 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in LA cover TRIFLUOPERAZINE HCL USP 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TRIFLURIDINE 1% OPTH SOLUTION 7.5ML BOT ![Compare how all Medicare Part D PDP plans in LA cover TRIFLURIDINE 1% OPTH SOLUTION 7.5ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TRIGLIDE 160MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in LA cover TRIGLIDE 160MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TRIGLIDE 50MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in LA cover TRIGLIDE 50MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TRIHEXYPHENIDYL HCL 5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in LA cover TRIHEXYPHENIDYL HCL 5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
TRIHEXYPHENIDYL HCL ELIXIR 5%/2 16 FLO BOT ![Compare how all Medicare Part D PDP plans in LA cover TRIHEXYPHENIDYL HCL ELIXIR 5%/2 16 FLO BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TRIHEXYPHENIDYL HCL TABLET 2MG (1000 CT) ![Compare how all Medicare Part D PDP plans in LA cover TRIHEXYPHENIDYL HCL TABLET 2MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
TRIHIBIT PRESERVATIVE FREE ![Compare how all Medicare Part D PDP plans in LA cover TRIHIBIT PRESERVATIVE FREE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$30.00 | $60.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRILEPTAL 150MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TRILEPTAL 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | S |
TRILEPTAL 300MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TRILEPTAL 300MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | S |
TRILEPTAL 300MG/5ML SUSP ![Compare how all Medicare Part D PDP plans in LA cover TRILEPTAL 300MG/5ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | S |
TRILEPTAL 600MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TRILEPTAL 600MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | S |
TRILIPIX CAPSULE DR 45MG ![Compare how all Medicare Part D PDP plans in LA cover TRILIPIX CAPSULE DR 45MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$30.00 | $60.00 | None |
TRILIPIX DELAYED RELEASE CAPSULES 135MG ![Compare how all Medicare Part D PDP plans in LA cover TRILIPIX DELAYED RELEASE CAPSULES 135MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$30.00 | $60.00 | None |
TRILYTE WITH FLAVOR PACKETS 5.72GM/11.2GM ![Compare how all Medicare Part D PDP plans in LA cover TRILYTE WITH FLAVOR PACKETS 5.72GM/11.2GM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TRIMETHOBENZAMIDE 100MG/ML ![Compare how all Medicare Part D PDP plans in LA cover TRIMETHOBENZAMIDE 100MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | P |
TRIMETHOBENZAMIDE HCL 300MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover TRIMETHOBENZAMIDE HCL 300MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | P |
TRIMETHOPRIM 100MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TRIMETHOPRIM 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TRIMIPRAMINE MALEATE 25MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover TRIMIPRAMINE MALEATE 25MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRIMIPRAMINE MALEATE 50MG CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover TRIMIPRAMINE MALEATE 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TRIMOX CAP 500MG ![Compare how all Medicare Part D PDP plans in LA cover TRIMOX CAP 500MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
TRINESSA 7DAYSX3 28 TABLET ![Compare how all Medicare Part D PDP plans in LA cover TRINESSA 7DAYSX3 28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TRIPEDIA PRESERVATIVE FREE 6.7;23.4; UNT/.5 ML; ![Compare how all Medicare Part D PDP plans in LA cover TRIPEDIA PRESERVATIVE FREE 6.7;23.4; UNT/.5 ML;.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$30.00 | $60.00 | None |
TRIPLE ANTIBIOTIC EYE OINT ![Compare how all Medicare Part D PDP plans in LA cover TRIPLE ANTIBIOTIC EYE OINT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
TRISENOX 10MG/10ML AMPULE ![Compare how all Medicare Part D PDP plans in LA cover TRISENOX 10MG/10ML AMPULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | None |
TRIVORA-28 TABLET ![Compare how all Medicare Part D PDP plans in LA cover TRIVORA-28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$10.00 | $20.00 | None |
TRIZIVIR TABLET ![Compare how all Medicare Part D PDP plans in LA cover TRIZIVIR TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TROPHAMINE INJECTION SOLUTION ![Compare how all Medicare Part D PDP plans in LA cover TROPHAMINE INJECTION SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TROPHAMINE INJECTION SOLUTION 6% ![Compare how all Medicare Part D PDP plans in LA cover TROPHAMINE INJECTION SOLUTION 6%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TROPICACYL SOL 0.5% OP ![Compare how all Medicare Part D PDP plans in LA cover TROPICACYL SOL 0.5% OP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 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 |
TROPICACYL SOL 1% OP ![Compare how all Medicare Part D PDP plans in LA cover TROPICACYL SOL 1% OP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
TROPICAMIDE 0.5% EYE DROPS ![Compare how all Medicare Part D PDP plans in LA cover TROPICAMIDE 0.5% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
TROPICAMIDE 1% EYE DROPS ![Compare how all Medicare Part D PDP plans in LA cover TROPICAMIDE 1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 - Preferred Generic |
$0.00 | $0.00 | None |
TRUSOPT PLUS 2% EYE DROPS 10ML BOT ![Compare how all Medicare Part D PDP plans in LA cover TRUSOPT PLUS 2% EYE DROPS 10ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TRUVADA TABLET ![Compare how all Medicare Part D PDP plans in LA cover TRUVADA TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | None |
TWINJECT 0.15MG AUTO-INJECTOR ![Compare how all Medicare Part D PDP plans in LA cover TWINJECT 0.15MG AUTO-INJECTOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TWINJECT 0.3MG AUTO-INJECTOR ![Compare how all Medicare Part D PDP plans in LA cover TWINJECT 0.3MG AUTO-INJECTOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TWINRIX TF PF VACCINE 720UNT/20ML 10 X 1ML VIALSD ![Compare how all Medicare Part D PDP plans in LA cover TWINRIX TF PF VACCINE 720UNT/20ML 10 X 1ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$30.00 | $60.00 | None |
TYGACIL 50MG VIAL 10 VILSU BOX ![Compare how all Medicare Part D PDP plans in LA cover TYGACIL 50MG VIAL 10 VILSU BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | None |
TYKERB 250MG TABLET ![Compare how all Medicare Part D PDP plans in LA cover TYKERB 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | P Q:5 /1Days |
TYLENOL W/CODEINE #3 TABLET ![Compare how all Medicare Part D PDP plans in LA cover TYLENOL W/CODEINE #3 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | S |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TYLENOL W/CODEINE #4 TABLET ![Compare how all Medicare Part D PDP plans in LA cover TYLENOL W/CODEINE #4 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | S |
TYLOX 5/500 CAPSULE ![Compare how all Medicare Part D PDP plans in LA cover TYLOX 5/500 CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$65.00 | $130.00 | S |
TYPHIM VI 25MCG/0.5ML VIAL ![Compare how all Medicare Part D PDP plans in LA cover TYPHIM VI 25MCG/0.5ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$30.00 | $60.00 | None |
TYSABRI 300MG/15ML VIAL ![Compare how all Medicare Part D PDP plans in LA cover TYSABRI 300MG/15ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 - Specialty |
33% | 33% | None |
TYZEKA 600MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in LA cover TYZEKA 600MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$30.00 | $60.00 | Q:1 /1Days |
TYZINE 0.1% NOSE DROPS ![Compare how all Medicare Part D PDP plans in LA cover TYZINE 0.1% NOSE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$30.00 | $60.00 | None |
TYZINE PEDIATRIC 0.05% DROP ![Compare how all Medicare Part D PDP plans in LA cover TYZINE PEDIATRIC 0.05% DROP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$30.00 | $60.00 | None |