2011 Medicare Part D Plan Formulary Information |
Geisinger Gold Preferred 2 $0 Deductible Rx (PPO) (H3924-048-0)
Benefit Details
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The Geisinger Gold Preferred 2 $0 Deductible Rx (PPO) (H3924-048-0) Formulary Drugs Starting with the Letter T in Northampton County, PA: CMS MA Region 6 which includes: PA
|
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 |
TAMOXIFEN CITRATE 20MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in PA cover TAMOXIFEN CITRATE 20MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TAMOXIFEN CITRATE TABLETS 10MG 180 BOT ![Compare how all Medicare Part D PDP plans in PA cover TAMOXIFEN CITRATE TABLETS 10MG 180 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TAMSULOSIN HCL 0.4 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover TAMSULOSIN HCL 0.4 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TARCEVA 100MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TARCEVA 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
33% | 33% | P |
TARCEVA 150MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TARCEVA 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
33% | 33% | P |
TARCEVA 25MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TARCEVA 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
33% | 33% | P |
TARGRETIN 1% GEL 60GM TUBE ![Compare how all Medicare Part D PDP plans in PA cover TARGRETIN 1% GEL 60GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$69.00 | $172.50 | None |
TARGRETIN 75MG (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover TARGRETIN 75MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$69.00 | $172.50 | None |
TARKA 1/240MG TABLET SA ![Compare how all Medicare Part D PDP plans in PA cover TARKA 1/240MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$69.00 | $172.50 | None |
TARKA 2/180MG TABLET SA ![Compare how all Medicare Part D PDP plans in PA cover TARKA 2/180MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$69.00 | $172.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TARKA 2/240MG TABLET SA ![Compare how all Medicare Part D PDP plans in PA cover TARKA 2/240MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$69.00 | $172.50 | None |
TARKA 4/240MG TABLET SA ![Compare how all Medicare Part D PDP plans in PA cover TARKA 4/240MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$69.00 | $172.50 | None |
TASIGNA 200MG CAPSULE 28 BLPK ![Compare how all Medicare Part D PDP plans in PA cover TASIGNA 200MG CAPSULE 28 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
33% | 33% | P |
TAZORAC 0.05% CREAM ![Compare how all Medicare Part D PDP plans in PA cover TAZORAC 0.05% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$69.00 | $172.50 | None |
TAZORAC 0.05% GEL ![Compare how all Medicare Part D PDP plans in PA cover TAZORAC 0.05% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$69.00 | $172.50 | None |
TAZORAC 0.1% CREAM ![Compare how all Medicare Part D PDP plans in PA cover TAZORAC 0.1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$69.00 | $172.50 | None |
TAZORAC 0.1% GEL ![Compare how all Medicare Part D PDP plans in PA cover TAZORAC 0.1% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$69.00 | $172.50 | None |
TEGRETOL XR TABLETS 100MG 100 BOT ![Compare how all Medicare Part D PDP plans in PA cover TEGRETOL XR TABLETS 100MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
TEGRETOL XR TABLETS 200MG 100 BOT ![Compare how all Medicare Part D PDP plans in PA cover TEGRETOL XR TABLETS 200MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
TEGRETOL XR TABLETS 400MG 100 BOT ![Compare how all Medicare Part D PDP plans in PA cover TEGRETOL XR TABLETS 400MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
TEKTURNA 150MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TEKTURNA 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$69.00 | $172.50 | None |
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 PA cover TEKTURNA 300MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$69.00 | $172.50 | None |
TERAZOSIN HCL 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover TERAZOSIN HCL 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TERAZOSIN HCL 1MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover TERAZOSIN HCL 1MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TERAZOSIN HCL 2MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover TERAZOSIN HCL 2MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TERAZOSIN HCL 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover TERAZOSIN HCL 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TERBINAFINE HCL 250MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TERBINAFINE HCL 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TERCONAZOLE 0.4% CREAM WITH APPLICATOR ![Compare how all Medicare Part D PDP plans in PA cover TERCONAZOLE 0.4% CREAM WITH APPLICATOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TESTOSTERONE CYPIONATE INJECTION ![Compare how all Medicare Part D PDP plans in PA cover TESTOSTERONE CYPIONATE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TESTOSTERONE ENANTHATE INJECTION ![Compare how all Medicare Part D PDP plans in PA cover TESTOSTERONE ENANTHATE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TETANUS AND DIPHTHERIA TOXOIDS ADSORBED FOR ADULT USE 2 UNT/VIAL ![Compare how all Medicare Part D PDP plans in PA cover TETANUS AND DIPHTHERIA TOXOIDS ADSORBED FOR ADULT USE 2 UNT/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
TETANUS TOXOID ADSORBED VIAL 5LF ![Compare how all Medicare Part D PDP plans in PA cover TETANUS TOXOID ADSORBED VIAL 5LF.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TETRACYCLINE 250 MG ORAL CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover TETRACYCLINE 250 MG ORAL CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TEVETEN HCT TABLETS 600;25MG;MG 100 BOT ![Compare how all Medicare Part D PDP plans in PA cover TEVETEN HCT TABLETS 600;25MG;MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$69.00 | $172.50 | None |
TEVETEN TABLETS 400MG 100 BOT ![Compare how all Medicare Part D PDP plans in PA cover TEVETEN TABLETS 400MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$69.00 | $172.50 | None |
TEVETEN TABLETS 600;12.5MG;MG 100 BOT ![Compare how all Medicare Part D PDP plans in PA cover TEVETEN TABLETS 600;12.5MG;MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$69.00 | $172.50 | None |
TEVETEN TABLETS 600MG 100 BOT ![Compare how all Medicare Part D PDP plans in PA cover TEVETEN TABLETS 600MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$69.00 | $172.50 | None |
THALOMID 100MG CAPSULE 140 BOX ![Compare how all Medicare Part D PDP plans in PA cover THALOMID 100MG CAPSULE 140 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
33% | 33% | None |
THALOMID 200MG CAPSULE 28 BLPK ![Compare how all Medicare Part D PDP plans in PA cover THALOMID 200MG CAPSULE 28 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
33% | 33% | None |
THALOMID 50MG CAPSULE 280 BOX ![Compare how all Medicare Part D PDP plans in PA cover THALOMID 50MG CAPSULE 280 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
33% | 33% | None |
THEOCHRON 100MG TABLET SA ![Compare how all Medicare Part D PDP plans in PA cover THEOCHRON 100MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
THEOPHYLLINE 400MG TABLET SA ![Compare how all Medicare Part D PDP plans in PA cover THEOPHYLLINE 400MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
THEOPHYLLINE ANHYDROUS ER TABLET 200MG (1000 CT) ![Compare how all Medicare Part D PDP plans in PA cover THEOPHYLLINE ANHYDROUS ER TABLET 200MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
THEOPHYLLINE TABLET ER 300MG (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover THEOPHYLLINE TABLET ER 300MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
THEOPHYLLINE TABLET ER 450MG (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover THEOPHYLLINE TABLET ER 450MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
THIOGUANINE TABLET LOID 40MG ![Compare how all Medicare Part D PDP plans in PA cover THIOGUANINE TABLET LOID 40MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
THIORIDAZINE 100MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover THIORIDAZINE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
THIORIDAZINE HCL 10MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in PA cover THIORIDAZINE HCL 10MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
THIORIDAZINE HCL 25MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in PA cover THIORIDAZINE HCL 25MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
THIORIDAZINE HCL 50MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in PA cover THIORIDAZINE HCL 50MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
THIOTHIXENE 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover THIOTHIXENE 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
THIOTHIXENE 1MG CAPSULE (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover THIOTHIXENE 1MG CAPSULE (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
THIOTHIXENE 2MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover THIOTHIXENE 2MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
THIOTHIXENE 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover THIOTHIXENE 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
THYMOGLOBULIN 25MG VIAL ![Compare how all Medicare Part D PDP plans in PA cover THYMOGLOBULIN 25MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
TICLOPIDINE 250 MG ORAL TABLET ![Compare how all Medicare Part D PDP plans in PA cover TICLOPIDINE 250 MG ORAL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TIKOSYN .125MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover TIKOSYN .125MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
TIKOSYN .250MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover TIKOSYN .250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
TIKOSYN .5MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover TIKOSYN .5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
TIMENTIN 3.1GM VIAL ![Compare how all Medicare Part D PDP plans in PA cover TIMENTIN 3.1GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
TIMOLOL MAL SOL 0.25% OP 15ML BOT ![Compare how all Medicare Part D PDP plans in PA cover TIMOLOL MAL SOL 0.25% OP 15ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TIMOLOL MAL SOL 0.5% OP 10ML BOT ![Compare how all Medicare Part D PDP plans in PA cover TIMOLOL MAL SOL 0.5% OP 10ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TIMOLOL MALEATE 10MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TIMOLOL MALEATE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TIMOLOL MALEATE 20MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TIMOLOL MALEATE 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TIMOLOL MALEATE 5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TIMOLOL MALEATE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TIZANIDINE HCL 2MG TABLET (150 CT) ![Compare how all Medicare Part D PDP plans in PA cover TIZANIDINE HCL 2MG TABLET (150 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TIZANIDINE HCL 4MG TABLET 150 BOT ![Compare how all Medicare Part D PDP plans in PA cover TIZANIDINE HCL 4MG TABLET 150 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TOBRADEX EYE OINTMENT ![Compare how all Medicare Part D PDP plans in PA cover TOBRADEX EYE OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
TOBRAMYCIN 10MG/ML VIAL ![Compare how all Medicare Part D PDP plans in PA cover TOBRAMYCIN 10MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TOBRAMYCIN 40MG/ML VIAL ![Compare how all Medicare Part D PDP plans in PA cover TOBRAMYCIN 40MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TOBRAMYCIN OPHTHALMIC SOLUTION 0.3% 5ML BOT ![Compare how all Medicare Part D PDP plans in PA cover TOBRAMYCIN OPHTHALMIC SOLUTION 0.3% 5ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TOBRAMYCIN-DEXAMETH OPTH SUSP ![Compare how all Medicare Part D PDP plans in PA cover TOBRAMYCIN-DEXAMETH OPTH SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TOLAZAMIDE TABLETS 250MG 100 BOT ![Compare how all Medicare Part D PDP plans in PA cover TOLAZAMIDE TABLETS 250MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TOLAZAMIDE TABLETS 500MG 100 BOT ![Compare how all Medicare Part D PDP plans in PA cover TOLAZAMIDE TABLETS 500MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TOLBUTAMIDE 500MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TOLBUTAMIDE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TOPAMAX 15 MG SPRINKLE CAP ![Compare how all Medicare Part D PDP plans in PA cover TOPAMAX 15 MG SPRINKLE CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TOPAMAX 25 MG SPRINKLE CAP ![Compare how all Medicare Part D PDP plans in PA cover TOPAMAX 25 MG SPRINKLE CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
TOPAMAX TABLETS 100MG 60 BOT ![Compare how all Medicare Part D PDP plans in PA cover TOPAMAX TABLETS 100MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$69.00 | $172.50 | None |
TOPAMAX TABLETS 200MG 60 BOT ![Compare how all Medicare Part D PDP plans in PA cover TOPAMAX TABLETS 200MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$69.00 | $172.50 | None |
TOPAMAX TABLETS 25MG 60 BOT ![Compare how all Medicare Part D PDP plans in PA cover TOPAMAX TABLETS 25MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$69.00 | $172.50 | None |
TOPAMAX TABLETS 50MG 60 BOT ![Compare how all Medicare Part D PDP plans in PA cover TOPAMAX TABLETS 50MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$69.00 | $172.50 | None |
TOPROL XL 100MG TABLET SA ![Compare how all Medicare Part D PDP plans in PA cover TOPROL XL 100MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$69.00 | $172.50 | None |
TOPROL XL 200MG TABLET SA ![Compare how all Medicare Part D PDP plans in PA cover TOPROL XL 200MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$69.00 | $172.50 | None |
TOPROL XL 25MG TABLET SA ![Compare how all Medicare Part D PDP plans in PA cover TOPROL XL 25MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$69.00 | $172.50 | None |
TOPROL XL 50MG TABLET SA ![Compare how all Medicare Part D PDP plans in PA cover TOPROL XL 50MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$69.00 | $172.50 | None |
TORSEMIDE 100 MG ORAL TABLET ![Compare how all Medicare Part D PDP plans in PA cover TORSEMIDE 100 MG ORAL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TORSEMIDE 20 MG ORAL TABLET ![Compare how all Medicare Part D PDP plans in PA cover TORSEMIDE 20 MG ORAL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TORSEMIDE TABLETS 10 MG ![Compare how all Medicare Part D PDP plans in PA cover TORSEMIDE TABLETS 10 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TORSEMIDE TABLETS 5 MG ![Compare how all Medicare Part D PDP plans in PA cover TORSEMIDE TABLETS 5 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TPN ELECTROLYTES VIAL ![Compare how all Medicare Part D PDP plans in PA cover TPN ELECTROLYTES VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TRACLEER 125MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRACLEER 125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
33% | 33% | P |
TRACLEER 62.5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRACLEER 62.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
33% | 33% | P |
TRAMADOL HCL 50 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRAMADOL HCL 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TRAMADOL HCL-ACETAMINOPHEN 37.5-325MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in PA cover TRAMADOL HCL-ACETAMINOPHEN 37.5-325MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TRANDOLAPRIL 1MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRANDOLAPRIL 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TRANDOLAPRIL 2MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRANDOLAPRIL 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TRANDOLAPRIL 4MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRANDOLAPRIL 4MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TRANYLCYPROMINE SULFATE 10MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRANYLCYPROMINE SULFATE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRAVATAN Z 0.04MG DROPS 2.5ML BOT ![Compare how all Medicare Part D PDP plans in PA cover TRAVATAN Z 0.04MG DROPS 2.5ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
TRAZODONE 300MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRAZODONE 300MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TRAZODONE HCL TABLET USP 100MG (500 CT) ![Compare how all Medicare Part D PDP plans in PA cover TRAZODONE HCL TABLET USP 100MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TRAZODONE HCL TABLET USP 150MG (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover TRAZODONE HCL TABLET USP 150MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TRAZODONE HCL TABLET USP 50MG (500 CT) ![Compare how all Medicare Part D PDP plans in PA cover TRAZODONE HCL TABLET USP 50MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TRECATOR 250MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRECATOR 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$69.00 | $172.50 | None |
TRETINOIN 0.01% GEL 45GM TUBE ![Compare how all Medicare Part D PDP plans in PA cover TRETINOIN 0.01% GEL 45GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TRETINOIN 0.025% GEL 45GM TUBE ![Compare how all Medicare Part D PDP plans in PA cover TRETINOIN 0.025% GEL 45GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TRETINOIN 0.05% CREAM 45GM TUBE ![Compare how all Medicare Part D PDP plans in PA cover TRETINOIN 0.05% CREAM 45GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TRETINOIN 0.1% CREAM 45GM TUBE ![Compare how all Medicare Part D PDP plans in PA cover TRETINOIN 0.1% CREAM 45GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TRETINOIN 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover TRETINOIN 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
33% | 33% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRETINOIN CREAM ![Compare how all Medicare Part D PDP plans in PA cover TRETINOIN CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TRI-NORINYL 28 TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRI-NORINYL 28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TRI-SPRINTEC 7DAYSX3 28 TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRI-SPRINTEC 7DAYSX3 28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TRIAMCINOLONE 0.1% OINTMENT ![Compare how all Medicare Part D PDP plans in PA cover TRIAMCINOLONE 0.1% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TRIAMCINOLONE 0.1% PASTE ![Compare how all Medicare Part D PDP plans in PA cover TRIAMCINOLONE 0.1% PASTE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TRIAMCINOLONE ACETONIDE 0.025% OINTMENT 80GM TUBE ![Compare how all Medicare Part D PDP plans in PA cover TRIAMCINOLONE ACETONIDE 0.025% OINTMENT 80GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TRIAMCINOLONE ACETONIDE 0.1% LOTION 60ML BOTPL ![Compare how all Medicare Part D PDP plans in PA cover TRIAMCINOLONE ACETONIDE 0.1% LOTION 60ML BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TRIAMCINOLONE ACETONIDE 0.025% CREAM 80GM TUBE ![Compare how all Medicare Part D PDP plans in PA cover TRIAMCINOLONE ACETONIDE 0.025% CREAM 80GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TRIAMCINOLONE ACETONIDE 0.025% LOTION 2 FL OZ BOT ![Compare how all Medicare Part D PDP plans in PA cover TRIAMCINOLONE ACETONIDE 0.025% LOTION 2 FL OZ BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TRIAMCINOLONE ACETONIDE 0.05% CREAM 15GM TUBE ![Compare how all Medicare Part D PDP plans in PA cover TRIAMCINOLONE ACETONIDE 0.05% CREAM 15GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TRIAMCINOLONE ACETONIDE 0.05% OINTMENT 15GM TUBE ![Compare how all Medicare Part D PDP plans in PA cover TRIAMCINOLONE ACETONIDE 0.05% OINTMENT 15GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRIAMCINOLONE ACETONIDE 0.1% CREAM 80GM TUBE ![Compare how all Medicare Part D PDP plans in PA cover TRIAMCINOLONE ACETONIDE 0.1% CREAM 80GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TRIAMTERENE/HCTZ 37.5/25 TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRIAMTERENE/HCTZ 37.5/25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TRIAMTERENE/HCTZ 75/50 TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRIAMTERENE/HCTZ 75/50 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TRICOR 145MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRICOR 145MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
TRICOR 48MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRICOR 48MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
TRIFLUOPERAZINE 1MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRIFLUOPERAZINE 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TRIFLUOPERAZINE HCL 2MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRIFLUOPERAZINE HCL 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TRIFLUOPERAZINE HCL 5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRIFLUOPERAZINE HCL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TRIFLUOPERAZINE HCL USP 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover TRIFLUOPERAZINE HCL USP 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TRIHEXYPHENIDYL HCL 5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover TRIHEXYPHENIDYL HCL 5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TRIHEXYPHENIDYL HCL ELIXIR 5%/2 16 FLO BOT ![Compare how all Medicare Part D PDP plans in PA cover TRIHEXYPHENIDYL HCL ELIXIR 5%/2 16 FLO BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRIHEXYPHENIDYL HCL TABLET 2MG (1000 CT) ![Compare how all Medicare Part D PDP plans in PA cover TRIHEXYPHENIDYL HCL TABLET 2MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TRIHIBIT PRESERVATIVE FREE ![Compare how all Medicare Part D PDP plans in PA cover TRIHIBIT PRESERVATIVE FREE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
TRILEPTAL 300MG/5ML SUSP ![Compare how all Medicare Part D PDP plans in PA cover TRILEPTAL 300MG/5ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$69.00 | $172.50 | None |
TRILIPIX CAPSULE DR 45MG ![Compare how all Medicare Part D PDP plans in PA cover TRILIPIX CAPSULE DR 45MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
TRILIPIX DELAYED RELEASE CAPSULES 135MG ![Compare how all Medicare Part D PDP plans in PA cover TRILIPIX DELAYED RELEASE CAPSULES 135MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
TRIMETHOBENZAMIDE 100MG/ML ![Compare how all Medicare Part D PDP plans in PA cover TRIMETHOBENZAMIDE 100MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TRIMETHOBENZAMIDE HCL 300MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover TRIMETHOBENZAMIDE HCL 300MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TRIMETHOPRIM TABLETS ![Compare how all Medicare Part D PDP plans in PA cover TRIMETHOPRIM TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$6.00 | $15.00 | None |
TRIPEDIA PRESERVATIVE FREE 6.7;23.4; UNT/.5 ML; ![Compare how all Medicare Part D PDP plans in PA cover TRIPEDIA PRESERVATIVE FREE 6.7;23.4; UNT/.5 ML;.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
TRISENOX 10MG/10ML AMPULE ![Compare how all Medicare Part D PDP plans in PA cover TRISENOX 10MG/10ML AMPULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
TRIZIVIR TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRIZIVIR TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
33% | 33% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TROPHAMINE INJECTION SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover TROPHAMINE INJECTION SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
TRUVADA TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRUVADA TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
33% | 33% | None |
TWINJECT AUTO INJECTOR INJECTION 1% AUTO INJECTOR TWO PACK SYR ![Compare how all Medicare Part D PDP plans in PA cover TWINJECT AUTO INJECTOR INJECTION 1% AUTO INJECTOR TWO PACK SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$69.00 | $172.50 | Q:2 /15Days |
TWINJECT AUTO INJECTOR INJECTION 1% AUTO TWO PACK SYR ![Compare how all Medicare Part D PDP plans in PA cover TWINJECT AUTO INJECTOR INJECTION 1% AUTO TWO PACK SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$69.00 | $172.50 | Q:2 /15Days |
TWINRIX TF PF VACCINE 720UNT/20ML 10 X 1ML VIALSD ![Compare how all Medicare Part D PDP plans in PA cover TWINRIX TF PF VACCINE 720UNT/20ML 10 X 1ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
TYGACIL 50MG VIAL 10 VILSU BOX ![Compare how all Medicare Part D PDP plans in PA cover TYGACIL 50MG VIAL 10 VILSU BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
33% | 33% | None |
TYKERB 250MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TYKERB 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
33% | 33% | P |
TYPHIM VI 25MCG/0.5ML VIAL ![Compare how all Medicare Part D PDP plans in PA cover TYPHIM VI 25MCG/0.5ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |
TYSABRI 300MG/15ML VIAL ![Compare how all Medicare Part D PDP plans in PA cover TYSABRI 300MG/15ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$69.00 | $172.50 | P |
TYZEKA 600MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in PA cover TYZEKA 600MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$69.00 | $172.50 | None |
TYZINE 0.1% NOSE DROPS ![Compare how all Medicare Part D PDP plans in PA cover TYZINE 0.1% NOSE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$39.00 | $97.50 | None |