2010 Medicare Part D Plan Formulary Information |
Aetna Medicare Rx Essentials (PDP) (S5810-035-0)
Sanctioned Plan
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The Aetna Medicare Rx Essentials (PDP) (S5810-035-0) Formulary Drugs Starting with the Letter T in CMS PDP Region 01 which includes: ME NH
|
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 SCALP SUSP 0.064%/0.005% ![Compare how all Medicare Part D PDP plans in NH 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 |
$69.00 | $192.00 | S |
TALWIN 30MG/ML VIAL ![Compare how all Medicare Part D PDP plans in NH cover TALWIN 30MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | P |
TAMIFLU 30MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover TAMIFLU 30MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | Q:20 /365Days |
TAMIFLU 45MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover TAMIFLU 45MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | Q:20 /365Days |
TAMIFLU 75MG CAPSULE UD ![Compare how all Medicare Part D PDP plans in NH cover TAMIFLU 75MG CAPSULE UD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | Q:84 /365Days |
TAMIFLU ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in NH cover TAMIFLU ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | Q:525 /365Days |
TAMOXIFEN CITRATE 20MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in NH cover TAMOXIFEN CITRATE 20MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TAMOXIFEN CITRATE TABLETS 10MG 180 BOT ![Compare how all Medicare Part D PDP plans in NH cover TAMOXIFEN CITRATE TABLETS 10MG 180 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TARCEVA 100MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover TARCEVA 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 Specialty |
25% | 25% | P |
TARCEVA 150MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover TARCEVA 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 Specialty |
25% | 25% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TARCEVA 25MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover TARCEVA 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 Specialty |
25% | 25% | P |
TARGRETIN 1% GEL 60GM TUBE ![Compare how all Medicare Part D PDP plans in NH cover TARGRETIN 1% GEL 60GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 Specialty |
25% | 25% | None |
TARGRETIN 75MG (100 CT) ![Compare how all Medicare Part D PDP plans in NH cover TARGRETIN 75MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 Specialty |
25% | 25% | None |
TARKA 1/240MG TABLET SA ![Compare how all Medicare Part D PDP plans in NH cover TARKA 1/240MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
TARKA 2/180MG TABLET SA ![Compare how all Medicare Part D PDP plans in NH cover TARKA 2/180MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
TARKA 2/240MG TABLET SA ![Compare how all Medicare Part D PDP plans in NH cover TARKA 2/240MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
TARKA 4/240MG TABLET SA ![Compare how all Medicare Part D PDP plans in NH cover TARKA 4/240MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
TASIGNA 200MG CAPSULE 28 BLPK ![Compare how all Medicare Part D PDP plans in NH cover TASIGNA 200MG CAPSULE 28 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 Specialty |
25% | 25% | P Q:4 /1Days |
TASMAR 100MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover TASMAR 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
TASMAR 200MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover TASMAR 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
TAXOTERE 80MG/2ML VIAL ![Compare how all Medicare Part D PDP plans in NH cover TAXOTERE 80MG/2ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 Specialty |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TAZICEF 1GM VIAL ![Compare how all Medicare Part D PDP plans in NH cover TAZICEF 1GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$27.00 | $66.00 | None |
TAZICEF 2GM ADD-VANTAGE ![Compare how all Medicare Part D PDP plans in NH cover TAZICEF 2GM ADD-VANTAGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$27.00 | $66.00 | None |
TAZICEF 6GM/100ML VIAL ![Compare how all Medicare Part D PDP plans in NH cover TAZICEF 6GM/100ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$27.00 | $66.00 | None |
TAZORAC 0.05% CREAM ![Compare how all Medicare Part D PDP plans in NH cover TAZORAC 0.05% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$28.00 | $69.00 | S |
TAZORAC 0.05% GEL ![Compare how all Medicare Part D PDP plans in NH cover TAZORAC 0.05% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$28.00 | $69.00 | S |
TAZORAC 0.1% CREAM ![Compare how all Medicare Part D PDP plans in NH cover TAZORAC 0.1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$28.00 | $69.00 | None |
TAZORAC 0.1% GEL ![Compare how all Medicare Part D PDP plans in NH cover TAZORAC 0.1% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$28.00 | $69.00 | None |
TAZTIA XT 120MG CAPSULE SA (500 CT) ![Compare how all Medicare Part D PDP plans in NH cover TAZTIA XT 120MG CAPSULE SA (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | Q:1 /1Days |
TAZTIA XT 180MG CAPSULE SA (500 CT) ![Compare how all Medicare Part D PDP plans in NH cover TAZTIA XT 180MG CAPSULE SA (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | Q:3 /1Days |
TAZTIA XT 240MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in NH cover TAZTIA XT 240MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TAZTIA XT 300MG CAPSULE SA (500 CT) ![Compare how all Medicare Part D PDP plans in NH cover TAZTIA XT 300MG CAPSULE SA (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TAZTIA XT 360MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in NH cover TAZTIA XT 360MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TEGRETOL XR TABLETS 100MG 100 BOT ![Compare how all Medicare Part D PDP plans in NH cover TEGRETOL XR TABLETS 100MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
TEGRETOL XR TABLETS 200MG 100 BOT ![Compare how all Medicare Part D PDP plans in NH cover TEGRETOL XR TABLETS 200MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
TEGRETOL XR TABLETS 400MG 100 BOT ![Compare how all Medicare Part D PDP plans in NH cover TEGRETOL XR TABLETS 400MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
TEKTURNA 150MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover TEKTURNA 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$28.00 | $69.00 | Q:1 /1Days |
TEKTURNA 300MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover TEKTURNA 300MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$28.00 | $69.00 | Q:1 /1Days |
TEKTURNA HCT 150-12.5MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover TEKTURNA HCT 150-12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$28.00 | $69.00 | Q:1 /1Days |
TEKTURNA HCT 150MG-25MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover TEKTURNA HCT 150MG-25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$28.00 | $69.00 | Q:1 /1Days |
TEKTURNA HCT 300-12.5MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover TEKTURNA HCT 300-12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$28.00 | $69.00 | Q:1 /1Days |
TEKTURNA HCT 300MG-25MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover TEKTURNA HCT 300MG-25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$28.00 | $69.00 | Q:1 /1Days |
TERAZOSIN HCL 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover TERAZOSIN HCL 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TERAZOSIN HCL 1MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover TERAZOSIN HCL 1MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TERAZOSIN HCL 2MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover TERAZOSIN HCL 2MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TERAZOSIN HCL 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover TERAZOSIN HCL 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TERBINAFINE HCL 250MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover TERBINAFINE HCL 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | P |
TERBUTALINE SULF 1MG/ML VL ![Compare how all Medicare Part D PDP plans in NH cover TERBUTALINE SULF 1MG/ML VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | P |
TERBUTALINE SULF 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover TERBUTALINE SULF 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TERBUTALINE SULFATE 5MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover TERBUTALINE SULFATE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TERCONAZOLE 0.4% CREAM WITH APPLICATOR ![Compare how all Medicare Part D PDP plans in NH cover TERCONAZOLE 0.4% CREAM WITH APPLICATOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TERCONAZOLE 0.8% CREAM WITH APPLICATOR ![Compare how all Medicare Part D PDP plans in NH cover TERCONAZOLE 0.8% CREAM WITH APPLICATOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TERCONAZOLE 80MG SUPPOSITORY VAGINAL ![Compare how all Medicare Part D PDP plans in NH cover TERCONAZOLE 80MG SUPPOSITORY VAGINAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TESTIM 1%(50MG) GEL ![Compare how all Medicare Part D PDP plans in NH cover TESTIM 1%(50MG) GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | S |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TESTOSTERONE CYPIONATE INJECTION ![Compare how all Medicare Part D PDP plans in NH cover TESTOSTERONE CYPIONATE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$27.00 | $66.00 | None |
TESTOSTERONE ENANTHATE INJECTION ![Compare how all Medicare Part D PDP plans in NH cover TESTOSTERONE ENANTHATE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$27.00 | $66.00 | None |
TESTRED 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover TESTRED 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | P |
TETANUS AND DIPHTHERIA TOXOIDS ADSORBED FOR ADULT USE 2 UNT/VIAL ![Compare how all Medicare Part D PDP plans in NH 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 |
$28.00 | $69.00 | None |
TETANUS TOXOID ADSORBED VIAL 5LF ![Compare how all Medicare Part D PDP plans in NH cover TETANUS TOXOID ADSORBED VIAL 5LF.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$28.00 | $69.00 | P |
TETRACYCLINE 500MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover TETRACYCLINE 500MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | P |
TETRACYCLINE HCL CAPSULES 250MG 100 (10 X 10) NS ![Compare how all Medicare Part D PDP plans in NH cover TETRACYCLINE HCL CAPSULES 250MG 100 (10 X 10) NS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | P |
TEVETEN HCT TABLETS 600;25MG;MG 100 BOT ![Compare how all Medicare Part D PDP plans in NH cover TEVETEN HCT TABLETS 600;25MG;MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | S |
TEVETEN TABLETS 400MG 100 BOT ![Compare how all Medicare Part D PDP plans in NH cover TEVETEN TABLETS 400MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | S Q:2 /1Days |
TEVETEN TABLETS 600;12.5MG;MG 100 BOT ![Compare how all Medicare Part D PDP plans in NH cover TEVETEN TABLETS 600;12.5MG;MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | S |
TEVETEN TABLETS 600MG 100 BOT ![Compare how all Medicare Part D PDP plans in NH cover TEVETEN TABLETS 600MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | S |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TEXACORT ![Compare how all Medicare Part D PDP plans in NH cover TEXACORT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TEXACORT 2.5% SOLUTION NON-ORAL ![Compare how all Medicare Part D PDP plans in NH cover TEXACORT 2.5% SOLUTION NON-ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
THALITONE 15MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover THALITONE 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
THALOMID 100MG CAPSULE 140 BOX ![Compare how all Medicare Part D PDP plans in NH cover THALOMID 100MG CAPSULE 140 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 Specialty |
25% | 25% | None |
THALOMID 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover THALOMID 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 Specialty |
25% | 25% | None |
THALOMID 200MG CAPSULE 28 BLPK ![Compare how all Medicare Part D PDP plans in NH cover THALOMID 200MG CAPSULE 28 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 Specialty |
25% | 25% | None |
THALOMID 50MG CAPSULE 280 BOX ![Compare how all Medicare Part D PDP plans in NH cover THALOMID 50MG CAPSULE 280 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 Specialty |
25% | 25% | None |
THEO-24 100MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in NH cover THEO-24 100MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
THEO-24 200MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in NH cover THEO-24 200MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
THEO-24 300MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in NH cover THEO-24 300MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
THEO-24 400MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in NH cover THEO-24 400MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
THEOCHRON 100MG TABLET SA ![Compare how all Medicare Part D PDP plans in NH cover THEOCHRON 100MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
THEOCHRON 100MG TABLET SA ![Compare how all Medicare Part D PDP plans in NH cover THEOCHRON 100MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
THEOCHRON 200MG TABLET SA 100 EA ![Compare how all Medicare Part D PDP plans in NH cover THEOCHRON 200MG TABLET SA 100 EA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
THEOCHRON TABLETS EXTENDED RELEASE 300MG 100 BOT ![Compare how all Medicare Part D PDP plans in NH cover THEOCHRON TABLETS EXTENDED RELEASE 300MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
THEOPHYLLINE 200MG TABLET SA ![Compare how all Medicare Part D PDP plans in NH cover THEOPHYLLINE 200MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
THEOPHYLLINE 300MG TABLET SA ![Compare how all Medicare Part D PDP plans in NH cover THEOPHYLLINE 300MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
THEOPHYLLINE 400MG TABLET SA ![Compare how all Medicare Part D PDP plans in NH cover THEOPHYLLINE 400MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
THEOPHYLLINE 600MG TABLET SA ![Compare how all Medicare Part D PDP plans in NH cover THEOPHYLLINE 600MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
THEOPHYLLINE ANHYDROUS ER TABLET 200MG (1000 CT) ![Compare how all Medicare Part D PDP plans in NH cover THEOPHYLLINE ANHYDROUS ER TABLET 200MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
THEOPHYLLINE TABLET ER 300MG (100 CT) ![Compare how all Medicare Part D PDP plans in NH cover THEOPHYLLINE TABLET ER 300MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
THEOPHYLLINE TABLET ER 450MG (100 CT) ![Compare how all Medicare Part D PDP plans in NH cover THEOPHYLLINE TABLET ER 450MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
THERMAZENE 50GM CREAM ![Compare how all Medicare Part D PDP plans in NH cover THERMAZENE 50GM CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
THIOGUANINE TABLET LOID 40MG ![Compare how all Medicare Part D PDP plans in NH cover THIOGUANINE TABLET LOID 40MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
THIOLA 100MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover THIOLA 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$28.00 | $69.00 | None |
THIORIDAZINE 100MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover THIORIDAZINE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | P |
THIORIDAZINE HCL 10MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in NH cover THIORIDAZINE HCL 10MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | P |
THIORIDAZINE HCL 25MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in NH cover THIORIDAZINE HCL 25MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | P |
THIORIDAZINE HCL 50MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in NH cover THIORIDAZINE HCL 50MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | P |
THIOTEPA POWDER FOR INJECTION 15MG/VIL 1 VIAL SINGLE DOSE CRTN ![Compare how all Medicare Part D PDP plans in NH cover THIOTEPA POWDER FOR INJECTION 15MG/VIL 1 VIAL SINGLE DOSE CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$27.00 | $66.00 | None |
THIOTHIXENE 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover THIOTHIXENE 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
THIOTHIXENE 1MG CAPSULE (100 CT) ![Compare how all Medicare Part D PDP plans in NH cover THIOTHIXENE 1MG CAPSULE (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
THIOTHIXENE 2MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover THIOTHIXENE 2MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
THIOTHIXENE 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover THIOTHIXENE 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
THYMOGLOBULIN 25MG VIAL ![Compare how all Medicare Part D PDP plans in NH cover THYMOGLOBULIN 25MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | P |
THYROLAR-1 60MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover THYROLAR-1 60MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
THYROLAR-1/2 30MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover THYROLAR-1/2 30MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
THYROLAR-1/4 15MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover THYROLAR-1/4 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
THYROLAR-2 120MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover THYROLAR-2 120MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
THYROLAR-3 180MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover THYROLAR-3 180MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
TICLOPIDINE HCL 250MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover TICLOPIDINE HCL 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TIKOSYN .125MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover TIKOSYN .125MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$28.00 | $69.00 | None |
TIKOSYN .250MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover TIKOSYN .250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$28.00 | $69.00 | None |
TIKOSYN .5MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover TIKOSYN .5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$28.00 | $69.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TIMOLIDE 10/25 TABLET ![Compare how all Medicare Part D PDP plans in NH cover TIMOLIDE 10/25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
TIMOLOL MAL SOL 0.25% OP 15ML BOT ![Compare how all Medicare Part D PDP plans in NH 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 |
$4.00 | $12.00 | None |
TIMOLOL MAL SOL 0.5% OP 10ML BOT ![Compare how all Medicare Part D PDP plans in NH 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 |
$4.00 | $12.00 | None |
TIMOLOL MALEATE 10MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover TIMOLOL MALEATE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TIMOLOL MALEATE 20MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover TIMOLOL MALEATE 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TIMOLOL MALEATE 5MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover TIMOLOL MALEATE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TINDAMAX 250MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover TINDAMAX 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
TINDAMAX 500MG TABLET (60 CT) ![Compare how all Medicare Part D PDP plans in NH cover TINDAMAX 500MG TABLET (60 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
TIS-U-SOL IRRIGATION SOLUTION ![Compare how all Medicare Part D PDP plans in NH cover TIS-U-SOL IRRIGATION SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
TIZANIDINE HCL 2MG TABLET (150 CT) ![Compare how all Medicare Part D PDP plans in NH cover TIZANIDINE HCL 2MG TABLET (150 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TIZANIDINE HCL 4MG TABLET 150 BOT ![Compare how all Medicare Part D PDP plans in NH cover TIZANIDINE HCL 4MG TABLET 150 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TOBRADEX EYE OINTMENT ![Compare how all Medicare Part D PDP plans in NH cover TOBRADEX EYE OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
TOBRAMYCIN 10MG/ML VIAL ![Compare how all Medicare Part D PDP plans in NH cover TOBRAMYCIN 10MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$27.00 | $66.00 | None |
TOBRAMYCIN 40MG/ML VIAL ![Compare how all Medicare Part D PDP plans in NH cover TOBRAMYCIN 40MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$27.00 | $66.00 | None |
TOBRAMYCIN 60MG/0.9% NACL ![Compare how all Medicare Part D PDP plans in NH cover TOBRAMYCIN 60MG/0.9% NACL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$27.00 | $66.00 | None |
TOBRAMYCIN 80MG/0.9% NACL ![Compare how all Medicare Part D PDP plans in NH cover TOBRAMYCIN 80MG/0.9% NACL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$27.00 | $66.00 | None |
TOBRAMYCIN INHALATION SOLUTION ![Compare how all Medicare Part D PDP plans in NH cover TOBRAMYCIN INHALATION SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 Specialty |
25% | 25% | P Q:8400 /28Days |
TOBRAMYCIN OPHTHALMIC SOLUTION 0.3% 5ML BOT ![Compare how all Medicare Part D PDP plans in NH cover TOBRAMYCIN OPHTHALMIC SOLUTION 0.3% 5ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TOBRAMYCIN-DEXAMETH OPTH SUSP ![Compare how all Medicare Part D PDP plans in NH cover TOBRAMYCIN-DEXAMETH OPTH SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$27.00 | $66.00 | None |
TOBRASOL 0.3% EYE DROPS ![Compare how all Medicare Part D PDP plans in NH cover TOBRASOL 0.3% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TOBREX 0.3% EYE OINTMENT ![Compare how all Medicare Part D PDP plans in NH cover TOBREX 0.3% EYE OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
TOLAZAMIDE TABLETS 250MG 100 BOT ![Compare how all Medicare Part D PDP plans in NH cover TOLAZAMIDE TABLETS 250MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TOLAZAMIDE TABLETS 500MG 100 BOT ![Compare how all Medicare Part D PDP plans in NH cover TOLAZAMIDE TABLETS 500MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TOLBUTAMIDE 500MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover TOLBUTAMIDE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TOLMETIN SODIUM 200MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover TOLMETIN SODIUM 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$27.00 | $66.00 | None |
TOLMETIN SODIUM 400MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover TOLMETIN SODIUM 400MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TOLMETIN SODIUM 600MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover TOLMETIN SODIUM 600MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$27.00 | $66.00 | None |
TOPAMAX 15MG SPRINKLE CAP ![Compare how all Medicare Part D PDP plans in NH cover TOPAMAX 15MG SPRINKLE CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
TOPAMAX 25MG SPRINKLE CAP ![Compare how all Medicare Part D PDP plans in NH cover TOPAMAX 25MG SPRINKLE CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
TOPAMAX TABLETS 100MG 60 BOT ![Compare how all Medicare Part D PDP plans in NH cover TOPAMAX TABLETS 100MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
TOPAMAX TABLETS 200MG 60 BOT ![Compare how all Medicare Part D PDP plans in NH cover TOPAMAX TABLETS 200MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
TOPAMAX TABLETS 25MG 60 BOT ![Compare how all Medicare Part D PDP plans in NH cover TOPAMAX TABLETS 25MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
TOPAMAX TABLETS 50MG 60 BOT ![Compare how all Medicare Part D PDP plans in NH cover TOPAMAX TABLETS 50MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TOPIRAMATE CAPSULES 25MG 60 CAPS BOT ![Compare how all Medicare Part D PDP plans in NH cover TOPIRAMATE CAPSULES 25MG 60 CAPS BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$27.00 | $66.00 | None |
TOPIRAMATE SPRINKLE CAPSULES 15MG 60 BOT ![Compare how all Medicare Part D PDP plans in NH cover TOPIRAMATE SPRINKLE CAPSULES 15MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$27.00 | $66.00 | None |
TOPIRAMATE TABLETS 100MG 1000 BOT ![Compare how all Medicare Part D PDP plans in NH cover TOPIRAMATE TABLETS 100MG 1000 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$27.00 | $66.00 | None |
TOPIRAMATE TABLETS 200MG 1000 BOT ![Compare how all Medicare Part D PDP plans in NH cover TOPIRAMATE TABLETS 200MG 1000 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$27.00 | $66.00 | None |
TOPIRAMATE TABLETS 25MG 1000 BOT ![Compare how all Medicare Part D PDP plans in NH cover TOPIRAMATE TABLETS 25MG 1000 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$27.00 | $66.00 | None |
TOPIRAMATE TABLETS 50MG 1000 BOT ![Compare how all Medicare Part D PDP plans in NH cover TOPIRAMATE TABLETS 50MG 1000 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$27.00 | $66.00 | None |
TOPOSAR INJECTION 20MG/ML 50ML VIAL MD CRTN ![Compare how all Medicare Part D PDP plans in NH cover TOPOSAR INJECTION 20MG/ML 50ML VIAL MD CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | P |
TORISEL SOL 25MG/ML ![Compare how all Medicare Part D PDP plans in NH cover TORISEL SOL 25MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 Specialty |
25% | 25% | None |
TORSEMIDE 100MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover TORSEMIDE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TORSEMIDE 10MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover TORSEMIDE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TORSEMIDE 20MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover TORSEMIDE 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TORSEMIDE 5MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover TORSEMIDE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TOVIAZ TABLETS 4MG EXTENDED RELEASE ![Compare how all Medicare Part D PDP plans in NH cover TOVIAZ TABLETS 4MG EXTENDED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | S |
TOVIAZ TABLETS 8MG EXTENDED RELEASE ![Compare how all Medicare Part D PDP plans in NH cover TOVIAZ TABLETS 8MG EXTENDED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | S |
TPN ELECTROLYTES VIAL ![Compare how all Medicare Part D PDP plans in NH cover TPN ELECTROLYTES VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
TRACLEER 125MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover TRACLEER 125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 Specialty |
25% | 25% | None |
TRACLEER 62.5MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover TRACLEER 62.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 Specialty |
25% | 25% | None |
TRAMADOL HCL 50MG TABLET (500 CT) ![Compare how all Medicare Part D PDP plans in NH cover TRAMADOL HCL 50MG TABLET (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | Q:8 /1Days |
TRAMADOL HCL-ACETAMINOPHEN 37.5-325MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in NH cover TRAMADOL HCL-ACETAMINOPHEN 37.5-325MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | Q:8 /1Days |
TRANDOLAPRIL 1MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover TRANDOLAPRIL 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | Q:2 /1Days |
TRANDOLAPRIL 2MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover TRANDOLAPRIL 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | Q:2 /1Days |
TRANDOLAPRIL 4MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover TRANDOLAPRIL 4MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRANYLCYPROMINE SULFATE 10MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover TRANYLCYPROMINE SULFATE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$27.00 | $66.00 | None |
TRAVATAN Z 0.04MG DROPS 2.5ML BOT ![Compare how all Medicare Part D PDP plans in NH 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 |
$28.00 | $69.00 | None |
TRAZODONE 300MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover TRAZODONE 300MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TRAZODONE HCL TABLET USP 100MG (500 CT) ![Compare how all Medicare Part D PDP plans in NH cover TRAZODONE HCL TABLET USP 100MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TRAZODONE HCL TABLET USP 150MG (100 CT) ![Compare how all Medicare Part D PDP plans in NH cover TRAZODONE HCL TABLET USP 150MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TRAZODONE HCL TABLET USP 50MG (500 CT) ![Compare how all Medicare Part D PDP plans in NH cover TRAZODONE HCL TABLET USP 50MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TREANDA FOR INJECTION 100MG/VIAL ![Compare how all Medicare Part D PDP plans in NH cover TREANDA FOR INJECTION 100MG/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 Specialty |
25% | 25% | None |
TRECATOR 250MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover TRECATOR 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
TRETINOIN 0.01% GEL 45GM TUBE ![Compare how all Medicare Part D PDP plans in NH cover TRETINOIN 0.01% GEL 45GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$27.00 | $66.00 | None |
TRETINOIN 0.025% CREAM ![Compare how all Medicare Part D PDP plans in NH cover TRETINOIN 0.025% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TRETINOIN 0.025% GEL 45GM TUBE ![Compare how all Medicare Part D PDP plans in NH cover TRETINOIN 0.025% GEL 45GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$27.00 | $66.00 | 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 NH cover TRETINOIN 0.025% GEL 45GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$27.00 | $66.00 | None |
TRETINOIN 0.05% CREAM 45GM TUBE ![Compare how all Medicare Part D PDP plans in NH cover TRETINOIN 0.05% CREAM 45GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TRETINOIN 0.1% CREAM 45GM TUBE ![Compare how all Medicare Part D PDP plans in NH cover TRETINOIN 0.1% CREAM 45GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TRETINOIN 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover TRETINOIN 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 Specialty |
25% | 25% | None |
TREZIX 16-356-30 CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover TREZIX 16-356-30 CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$27.00 | $66.00 | Q:11 /1Days |
TRI-LEGEST FE 5-7-9-7 TABLET ![Compare how all Medicare Part D PDP plans in NH cover TRI-LEGEST FE 5-7-9-7 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TRI-SPRINTEC 7DAYSX3 28 TABLET ![Compare how all Medicare Part D PDP plans in NH cover TRI-SPRINTEC 7DAYSX3 28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TRIAMCINOLONE 0.1% OINTMENT ![Compare how all Medicare Part D PDP plans in NH cover TRIAMCINOLONE 0.1% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TRIAMCINOLONE 0.1% PASTE ![Compare how all Medicare Part D PDP plans in NH cover TRIAMCINOLONE 0.1% PASTE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TRIAMCINOLONE ACETONIDE 0.025% OINTMENT 80GM TUBE ![Compare how all Medicare Part D PDP plans in NH cover TRIAMCINOLONE ACETONIDE 0.025% OINTMENT 80GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TRIAMCINOLONE ACETONIDE 0.1% LOTION 60ML BOTPL ![Compare how all Medicare Part D PDP plans in NH cover TRIAMCINOLONE ACETONIDE 0.1% LOTION 60ML BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRIAMCINOLONE ACETONIDE 0.025% CREAM 80GM TUBE ![Compare how all Medicare Part D PDP plans in NH cover TRIAMCINOLONE ACETONIDE 0.025% CREAM 80GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TRIAMCINOLONE ACETONIDE 0.025% LOTION 2 FL OZ BOT ![Compare how all Medicare Part D PDP plans in NH cover TRIAMCINOLONE ACETONIDE 0.025% LOTION 2 FL OZ BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TRIAMCINOLONE ACETONIDE 0.05% CREAM 15GM TUBE ![Compare how all Medicare Part D PDP plans in NH cover TRIAMCINOLONE ACETONIDE 0.05% CREAM 15GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TRIAMCINOLONE ACETONIDE 0.05% OINTMENT ![Compare how all Medicare Part D PDP plans in NH cover TRIAMCINOLONE ACETONIDE 0.05% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TRIAMCINOLONE ACETONIDE 0.05% OINTMENT 15GM TUBE ![Compare how all Medicare Part D PDP plans in NH cover TRIAMCINOLONE ACETONIDE 0.05% OINTMENT 15GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TRIAMCINOLONE ACETONIDE 0.1% CREAM 80GM TUBE ![Compare how all Medicare Part D PDP plans in NH cover TRIAMCINOLONE ACETONIDE 0.1% CREAM 80GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TRIAMTERENE/HCTZ 25/37.5MG CAPSULES (100 CT) ![Compare how all Medicare Part D PDP plans in NH 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 |
$4.00 | $12.00 | None |
TRIAMTERENE/HCTZ 37.5/25 TABLET ![Compare how all Medicare Part D PDP plans in NH cover TRIAMTERENE/HCTZ 37.5/25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TRIAMTERENE/HCTZ 50/25 CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover TRIAMTERENE/HCTZ 50/25 CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TRIAMTERENE/HCTZ 75/50 TABLET ![Compare how all Medicare Part D PDP plans in NH cover TRIAMTERENE/HCTZ 75/50 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TRICOR 145MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover TRICOR 145MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRICOR 48MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover TRICOR 48MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
TRIDERM 0.1% CREAM ![Compare how all Medicare Part D PDP plans in NH cover TRIDERM 0.1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TRIDERM 0.1% OINTMENT ![Compare how all Medicare Part D PDP plans in NH cover TRIDERM 0.1% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TRIFLUOPERAZINE 1MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover TRIFLUOPERAZINE 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TRIFLUOPERAZINE HCL 2MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover TRIFLUOPERAZINE HCL 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TRIFLUOPERAZINE HCL 5MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover TRIFLUOPERAZINE HCL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TRIFLUOPERAZINE HCL USP 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in NH cover TRIFLUOPERAZINE HCL USP 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TRIFLURIDINE 1% OPTH SOLUTION 7.5ML BOT ![Compare how all Medicare Part D PDP plans in NH 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 |
$27.00 | $66.00 | None |
TRIGLIDE 160MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in NH cover TRIGLIDE 160MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | S |
TRIGLIDE 50MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in NH cover TRIGLIDE 50MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | S |
TRIHEXYPHENIDYL HCL 5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in NH cover TRIHEXYPHENIDYL HCL 5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRIHEXYPHENIDYL HCL ELIXIR 5%/2 16 FLO BOT ![Compare how all Medicare Part D PDP plans in NH cover TRIHEXYPHENIDYL HCL ELIXIR 5%/2 16 FLO BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TRIHEXYPHENIDYL HCL TABLET 2MG (1000 CT) ![Compare how all Medicare Part D PDP plans in NH cover TRIHEXYPHENIDYL HCL TABLET 2MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TRIHIBIT PRESERVATIVE FREE ![Compare how all Medicare Part D PDP plans in NH cover TRIHIBIT PRESERVATIVE FREE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
TRILEPTAL 300MG/5ML SUSP ![Compare how all Medicare Part D PDP plans in NH cover TRILEPTAL 300MG/5ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | S |
TRILIPIX CAPSULE DR 45MG ![Compare how all Medicare Part D PDP plans in NH cover TRILIPIX CAPSULE DR 45MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$28.00 | $69.00 | None |
TRILIPIX DELAYED RELEASE CAPSULES 135MG ![Compare how all Medicare Part D PDP plans in NH cover TRILIPIX DELAYED RELEASE CAPSULES 135MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$28.00 | $69.00 | None |
TRILYTE WITH FLAVOR PACKETS 5.72GM/11.2GM ![Compare how all Medicare Part D PDP plans in NH cover TRILYTE WITH FLAVOR PACKETS 5.72GM/11.2GM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TRIMETHOBENZAMIDE 100MG/ML ![Compare how all Medicare Part D PDP plans in NH cover TRIMETHOBENZAMIDE 100MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$27.00 | $66.00 | P |
TRIMETHOBENZAMIDE HCL 300MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover TRIMETHOBENZAMIDE HCL 300MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | P |
TRIMETHOPRIM 100MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover TRIMETHOPRIM 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TRIMIPRAMINE MALEATE 25MG CAPSULE ![Compare how all Medicare Part D PDP plans in NH cover TRIMIPRAMINE MALEATE 25MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$27.00 | $66.00 | 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 NH cover TRIMIPRAMINE MALEATE 50MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 - Non-Preferred Generic |
$27.00 | $66.00 | None |
TRIMOX CAP 500MG ![Compare how all Medicare Part D PDP plans in NH cover TRIMOX CAP 500MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TRINESSA 28 TABLETS 0.180;0.35MG;MG ![Compare how all Medicare Part D PDP plans in NH cover TRINESSA 28 TABLETS 0.180;0.35MG;MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TRIPEDIA PRESERVATIVE FREE 6.7;23.4; UNT/.5 ML; ![Compare how all Medicare Part D PDP plans in NH cover TRIPEDIA PRESERVATIVE FREE 6.7;23.4; UNT/.5 ML;.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
TRIPLE THERAPY PREVPAC KIT 30;500;500MG;MG;MG; 14 PKGCOM ![Compare how all Medicare Part D PDP plans in NH cover TRIPLE THERAPY PREVPAC KIT 30;500;500MG;MG;MG; 14 PKGCOM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | Q:28 /365Days |
TRISENOX 10MG/10ML AMPULE ![Compare how all Medicare Part D PDP plans in NH cover TRISENOX 10MG/10ML AMPULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
TRIVORA-28 TABLET ![Compare how all Medicare Part D PDP plans in NH cover TRIVORA-28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TRIZIVIR TABLET ![Compare how all Medicare Part D PDP plans in NH cover TRIZIVIR TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 Specialty |
25% | 25% | None |
TROPICACYL SOL 0.5% OP ![Compare how all Medicare Part D PDP plans in NH cover TROPICACYL SOL 0.5% OP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TROPICACYL SOL 1% OP ![Compare how all Medicare Part D PDP plans in NH cover TROPICACYL SOL 1% OP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TROPICAMIDE 0.5% EYE DROPS ![Compare how all Medicare Part D PDP plans in NH cover TROPICAMIDE 0.5% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TROPICAMIDE 1% EYE DROPS ![Compare how all Medicare Part D PDP plans in NH cover TROPICAMIDE 1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 Preferred Generic |
$4.00 | $12.00 | None |
TRUVADA TABLET ![Compare how all Medicare Part D PDP plans in NH cover TRUVADA TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 Specialty |
25% | 25% | None |
TWINJECT AUTO INJECTOR INJECTION 1% AUTO INJECTOR TWO PACK SYR ![Compare how all Medicare Part D PDP plans in NH cover TWINJECT AUTO INJECTOR INJECTION 1% AUTO INJECTOR TWO PACK SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
TWINJECT AUTO INJECTOR INJECTION 1% AUTO TWO PACK SYR ![Compare how all Medicare Part D PDP plans in NH cover TWINJECT AUTO INJECTOR INJECTION 1% AUTO TWO PACK SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
TWINRIX TF PF VACCINE 720UNT/20ML 10 X 1ML VIALSD ![Compare how all Medicare Part D PDP plans in NH cover TWINRIX TF PF VACCINE 720UNT/20ML 10 X 1ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
TYGACIL 50MG VIAL 10 VILSU BOX ![Compare how all Medicare Part D PDP plans in NH cover TYGACIL 50MG VIAL 10 VILSU BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
TYKERB 250MG TABLET ![Compare how all Medicare Part D PDP plans in NH cover TYKERB 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 Specialty |
25% | 25% | P Q:5 /1Days |
TYPHIM VI 25MCG/0.5ML VIAL ![Compare how all Medicare Part D PDP plans in NH cover TYPHIM VI 25MCG/0.5ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | None |
TYSABRI 300MG/15ML VIAL ![Compare how all Medicare Part D PDP plans in NH cover TYSABRI 300MG/15ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 Specialty |
25% | 25% | P |
TYZEKA 600MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in NH cover TYZEKA 600MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 - Non-Preferred Brand |
$69.00 | $192.00 | Q:1 /1Days |
TYZINE 0.1% NOSE DROPS ![Compare how all Medicare Part D PDP plans in NH cover TYZINE 0.1% NOSE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$28.00 | $69.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TYZINE PEDIATRIC 0.05% DROP ![Compare how all Medicare Part D PDP plans in NH cover TYZINE PEDIATRIC 0.05% DROP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 - Preferred Brand |
$28.00 | $69.00 | None |