2011 Medicare Part D Plan Formulary Information |
Clarian Medicare Select Plus (HMO) (H7220-003-0)
Benefit Details
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The Clarian Medicare Select Plus (HMO) (H7220-003-0) Formulary Drugs Starting with the Letter T in Marion County, IN: CMS MA Region 13 which includes: IN
|
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 |
TACROLIMUS 0.5 MG ORAL CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover TACROLIMUS 0.5 MG ORAL CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | P |
TACROLIMUS 1 MG ORAL CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover TACROLIMUS 1 MG ORAL CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | P |
TACROLIMUS 5 MG ORAL CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover TACROLIMUS 5 MG ORAL CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | P |
TALACEN CAPLET ![Compare how all Medicare Part D PDP plans in IN cover TALACEN CAPLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TALWIN NX TABLET ![Compare how all Medicare Part D PDP plans in IN cover TALWIN NX TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TAMBOCOR 100MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TAMBOCOR 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TAMBOCOR 150MG TABLET 100 EA ![Compare how all Medicare Part D PDP plans in IN cover TAMBOCOR 150MG TABLET 100 EA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TAMBOCOR 50MG TABLET 100 EA ![Compare how all Medicare Part D PDP plans in IN cover TAMBOCOR 50MG TABLET 100 EA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TAMIFLU 30MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover TAMIFLU 30MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | Q:84 /180Days |
TAMIFLU 45MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover TAMIFLU 45MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | Q:42 /180Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TAMIFLU 75MG CAPSULE UD ![Compare how all Medicare Part D PDP plans in IN cover TAMIFLU 75MG CAPSULE UD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | Q:28 /180Days |
TAMIFLU ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in IN cover TAMIFLU ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | Q:275 /180Days |
TAMOXIFEN CITRATE 20MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in IN cover TAMOXIFEN CITRATE 20MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TAMOXIFEN CITRATE TABLETS 10MG 180 BOT ![Compare how all Medicare Part D PDP plans in IN cover TAMOXIFEN CITRATE TABLETS 10MG 180 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TAMSULOSIN HCL 0.4 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover TAMSULOSIN HCL 0.4 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TAPAZOLE 10MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TAPAZOLE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TAPAZOLE 5MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TAPAZOLE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TARCEVA 100MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TARCEVA 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | N/A | P |
TARCEVA 150MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TARCEVA 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | N/A | P |
TARCEVA 25MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TARCEVA 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | N/A | P |
TARGRETIN 1% GEL 60GM TUBE ![Compare how all Medicare Part D PDP plans in IN cover TARGRETIN 1% GEL 60GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TARGRETIN 75MG (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover TARGRETIN 75MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | N/A | None |
TARKA 1/240MG TABLET SA ![Compare how all Medicare Part D PDP plans in IN cover TARKA 1/240MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |
TARKA 2/180MG TABLET SA ![Compare how all Medicare Part D PDP plans in IN cover TARKA 2/180MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TARKA 2/240MG TABLET SA ![Compare how all Medicare Part D PDP plans in IN cover TARKA 2/240MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TARKA 4/240MG TABLET SA ![Compare how all Medicare Part D PDP plans in IN cover TARKA 4/240MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TASIGNA 200MG CAPSULE 28 BLPK ![Compare how all Medicare Part D PDP plans in IN cover TASIGNA 200MG CAPSULE 28 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | N/A | P |
TASMAR 100MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TASMAR 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
TAXOTERE 80MG/2ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover TAXOTERE 80MG/2ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | N/A | P |
TAZORAC 0.05% CREAM ![Compare how all Medicare Part D PDP plans in IN cover TAZORAC 0.05% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
TAZORAC 0.05% GEL ![Compare how all Medicare Part D PDP plans in IN cover TAZORAC 0.05% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
TAZORAC 0.1% CREAM ![Compare how all Medicare Part D PDP plans in IN cover TAZORAC 0.1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TAZORAC 0.1% GEL ![Compare how all Medicare Part D PDP plans in IN cover TAZORAC 0.1% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
TAZTIA DILTIAZEM HYDROCHLORIDE EXTENDED RELEASE CAPSULES ![Compare how all Medicare Part D PDP plans in IN cover TAZTIA DILTIAZEM HYDROCHLORIDE EXTENDED RELEASE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TAZTIA DILTIAZEM HYDROCHLORIDE EXTENDED RELEASE CAPSULES ![Compare how all Medicare Part D PDP plans in IN cover TAZTIA DILTIAZEM HYDROCHLORIDE EXTENDED RELEASE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TAZTIA DILTIAZEM HYDROCHLORIDE EXTENDED RELEASE CAPSULES ![Compare how all Medicare Part D PDP plans in IN cover TAZTIA DILTIAZEM HYDROCHLORIDE EXTENDED RELEASE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TAZTIA XT 240MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in IN cover TAZTIA XT 240MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TAZTIA XT 360MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in IN cover TAZTIA XT 360MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TEGRETOL CHEWABLE TABLETS 100MG 100 BOT ![Compare how all Medicare Part D PDP plans in IN cover TEGRETOL CHEWABLE TABLETS 100MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |
TEGRETOL SUSPENSION 100MG/5ML 450 ML BOT ![Compare how all Medicare Part D PDP plans in IN cover TEGRETOL SUSPENSION 100MG/5ML 450 ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |
TEGRETOL TABLETS 200MG 100 BOT ![Compare how all Medicare Part D PDP plans in IN cover TEGRETOL TABLETS 200MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |
TEGRETOL XR TABLETS 100MG 100 BOT ![Compare how all Medicare Part D PDP plans in IN cover TEGRETOL XR TABLETS 100MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |
TEGRETOL XR TABLETS 200MG 100 BOT ![Compare how all Medicare Part D PDP plans in IN cover TEGRETOL XR TABLETS 200MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TEGRETOL XR TABLETS 400MG 100 BOT ![Compare how all Medicare Part D PDP plans in IN cover TEGRETOL XR TABLETS 400MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |
TEKTURNA 150MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TEKTURNA 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
TEKTURNA 300MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TEKTURNA 300MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
TEKTURNA HCT 150-12.5MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TEKTURNA HCT 150-12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
TEKTURNA HCT 150MG-25MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TEKTURNA HCT 150MG-25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
TEKTURNA HCT 300-12.5MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TEKTURNA HCT 300-12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
TEKTURNA HCT 300MG-25MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TEKTURNA HCT 300MG-25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
TEMOVATE 0.05% CREAM 60GM TUBE ![Compare how all Medicare Part D PDP plans in IN cover TEMOVATE 0.05% CREAM 60GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TEMOVATE 0.05% GEL 60GM BOX ![Compare how all Medicare Part D PDP plans in IN cover TEMOVATE 0.05% GEL 60GM BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TEMOVATE 0.05% OINTMENT ![Compare how all Medicare Part D PDP plans in IN cover TEMOVATE 0.05% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TEMOVATE 0.05% SOLUTION NON-ORAL TOPICAL ![Compare how all Medicare Part D PDP plans in IN cover TEMOVATE 0.05% SOLUTION NON-ORAL TOPICAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TENEX 1MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TENEX 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TENEX 2MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TENEX 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TENORETIC 100 TABLET ![Compare how all Medicare Part D PDP plans in IN cover TENORETIC 100 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TENORETIC 50 TABLET ![Compare how all Medicare Part D PDP plans in IN cover TENORETIC 50 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TENORMIN 100MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TENORMIN 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TENORMIN 25MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TENORMIN 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TENORMIN 50MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TENORMIN 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TERAZOSIN HCL 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover TERAZOSIN HCL 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TERAZOSIN HCL 1MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover TERAZOSIN HCL 1MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TERAZOSIN HCL 2MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover TERAZOSIN HCL 2MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TERAZOSIN HCL 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover TERAZOSIN HCL 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TERBINAFINE HCL 250MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TERBINAFINE HCL 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TERBUTALINE SULF 1MG/ML VL ![Compare how all Medicare Part D PDP plans in IN cover TERBUTALINE SULF 1MG/ML VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TERBUTALINE SULF 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TERBUTALINE SULF 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TERBUTALINE SULFATE 5MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TERBUTALINE SULFATE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TERCONAZOLE 0.4% CREAM WITH APPLICATOR ![Compare how all Medicare Part D PDP plans in IN cover TERCONAZOLE 0.4% CREAM WITH APPLICATOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TERCONAZOLE 80MG SUPPOSITORY VAGINAL ![Compare how all Medicare Part D PDP plans in IN cover TERCONAZOLE 80MG SUPPOSITORY VAGINAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TERCONAZOLE VAGINAL CREAM ![Compare how all Medicare Part D PDP plans in IN cover TERCONAZOLE VAGINAL CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TESTIM 1%(50MG) GEL ![Compare how all Medicare Part D PDP plans in IN cover TESTIM 1%(50MG) GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
TETANUS AND DIPHTHERIA TOXOIDS ADSORBED FOR ADULT USE 2 UNT/VIAL ![Compare how all Medicare Part D PDP plans in IN cover TETANUS AND DIPHTHERIA TOXOIDS ADSORBED FOR ADULT USE 2 UNT/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TETANUS TOXOID ADSORBED VIAL 5LF ![Compare how all Medicare Part D PDP plans in IN cover TETANUS TOXOID ADSORBED VIAL 5LF.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TETRACYCLINE 250 MG ORAL CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover TETRACYCLINE 250 MG ORAL CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TETRACYCLINE 500MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover TETRACYCLINE 500MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
THALOMID 100MG CAPSULE 140 BOX ![Compare how all Medicare Part D PDP plans in IN cover THALOMID 100MG CAPSULE 140 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | N/A | None |
THALOMID 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover THALOMID 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | N/A | None |
THALOMID 200MG CAPSULE 28 BLPK ![Compare how all Medicare Part D PDP plans in IN cover THALOMID 200MG CAPSULE 28 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | N/A | None |
THALOMID 50MG CAPSULE 280 BOX ![Compare how all Medicare Part D PDP plans in IN cover THALOMID 50MG CAPSULE 280 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | N/A | None |
THEO-24 100MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in IN cover THEO-24 100MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |
THEO-24 200MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in IN cover THEO-24 200MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |
THEO-24 300MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in IN cover THEO-24 300MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |
THEO-24 400MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in IN cover THEO-24 400MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |
THEOCHRON 100MG TABLET SA ![Compare how all Medicare Part D PDP plans in IN cover THEOCHRON 100MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
THEOCHRON 100MG TABLET SA ![Compare how all Medicare Part D PDP plans in IN cover THEOCHRON 100MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
THEOCHRON 200MG TABLET SA 100 EA ![Compare how all Medicare Part D PDP plans in IN cover THEOCHRON 200MG TABLET SA 100 EA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
THEOCHRON TABLETS EXTENDED RELEASE 300MG 100 BOT ![Compare how all Medicare Part D PDP plans in IN cover THEOCHRON TABLETS EXTENDED RELEASE 300MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
THEOPHYLLINE 400MG TABLET SA ![Compare how all Medicare Part D PDP plans in IN cover THEOPHYLLINE 400MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
THEOPHYLLINE 600MG TABLET SA ![Compare how all Medicare Part D PDP plans in IN cover THEOPHYLLINE 600MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
THEOPHYLLINE ANHYDROUS ER TABLET 200MG (1000 CT) ![Compare how all Medicare Part D PDP plans in IN cover THEOPHYLLINE ANHYDROUS ER TABLET 200MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
THEOPHYLLINE TABLET ER 300MG (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover THEOPHYLLINE TABLET ER 300MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
THEOPHYLLINE TABLET ER 450MG (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover THEOPHYLLINE TABLET ER 450MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
THERMAZENE 50GM CREAM ![Compare how all Medicare Part D PDP plans in IN cover THERMAZENE 50GM CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
THIOGUANINE TABLET LOID 40MG ![Compare how all Medicare Part D PDP plans in IN cover THIOGUANINE TABLET LOID 40MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
THIORIDAZINE 100MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover THIORIDAZINE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
THIORIDAZINE HCL 10MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in IN cover THIORIDAZINE HCL 10MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
THIORIDAZINE HCL 25MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in IN cover THIORIDAZINE HCL 25MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
THIORIDAZINE HCL 50MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in IN cover THIORIDAZINE HCL 50MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
THIOTEPA POWDER FOR INJECTION 15MG/VIL 1 VIAL SINGLE DOSE CRTN ![Compare how all Medicare Part D PDP plans in IN cover THIOTEPA POWDER FOR INJECTION 15MG/VIL 1 VIAL SINGLE DOSE CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
THIOTHIXENE 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover THIOTHIXENE 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
THIOTHIXENE 1MG CAPSULE (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover THIOTHIXENE 1MG CAPSULE (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
THIOTHIXENE 2MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover THIOTHIXENE 2MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
THIOTHIXENE 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover THIOTHIXENE 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
THYMOGLOBULIN 25MG VIAL ![Compare how all Medicare Part D PDP plans in IN cover THYMOGLOBULIN 25MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | N/A | P |
THYROLAR-1 60MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover THYROLAR-1 60MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |
THYROLAR-1/4 15MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover THYROLAR-1/4 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |
THYROLAR-2 120MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover THYROLAR-2 120MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
THYROLAR-3 180MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover THYROLAR-3 180MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |
TIAZAC 120MG E.R. CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover TIAZAC 120MG E.R. CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TIAZAC 180MG E.R. CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover TIAZAC 180MG E.R. CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TIAZAC 240MG E.R. CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover TIAZAC 240MG E.R. CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TIAZAC 300MG E.R. CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover TIAZAC 300MG E.R. CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TIAZAC 360MG E.R. CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover TIAZAC 360MG E.R. CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TIAZAC 420MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in IN cover TIAZAC 420MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TICLOPIDINE 250 MG ORAL TABLET ![Compare how all Medicare Part D PDP plans in IN cover TICLOPIDINE 250 MG ORAL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TIGAN 300MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover TIGAN 300MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TIGAN INJECTION 100MG/ML 20 ML VIALMD ![Compare how all Medicare Part D PDP plans in IN cover TIGAN INJECTION 100MG/ML 20 ML VIALMD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TIKOSYN .125MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover TIKOSYN .125MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TIKOSYN .250MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover TIKOSYN .250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |
TIKOSYN .5MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover TIKOSYN .5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |
TIMOLOL 0.0025 MG/MG OPHTHALMIC GEL ![Compare how all Medicare Part D PDP plans in IN cover TIMOLOL 0.0025 MG/MG OPHTHALMIC GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TIMOLOL 0.005 MG/MG OPHTHALMIC GEL ![Compare how all Medicare Part D PDP plans in IN cover TIMOLOL 0.005 MG/MG OPHTHALMIC GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TIMOLOL 2.5 MG/ML OPHTHALMIC SOLUTION [TIMOPTIC] ![Compare how all Medicare Part D PDP plans in IN cover TIMOLOL 2.5 MG/ML OPHTHALMIC SOLUTION [TIMOPTIC].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |
TIMOLOL 5 MG/ML OPHTHALMIC SOLUTION [TIMOPTIC] ![Compare how all Medicare Part D PDP plans in IN cover TIMOLOL 5 MG/ML OPHTHALMIC SOLUTION [TIMOPTIC].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |
TIMOLOL MAL SOL 0.25% OP 15ML BOT ![Compare how all Medicare Part D PDP plans in IN cover TIMOLOL MAL SOL 0.25% OP 15ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TIMOLOL MAL SOL 0.5% OP 10ML BOT ![Compare how all Medicare Part D PDP plans in IN cover TIMOLOL MAL SOL 0.5% OP 10ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TIMOLOL MALEATE 10MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TIMOLOL MALEATE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TIMOLOL MALEATE 20MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TIMOLOL MALEATE 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TIMOLOL MALEATE 5MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TIMOLOL MALEATE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TIMOPTIC-XE 0.25% EYE SOLUTION ![Compare how all Medicare Part D PDP plans in IN cover TIMOPTIC-XE 0.25% EYE SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TIMOPTIC-XE 0.5% EYE SOLUTION ![Compare how all Medicare Part D PDP plans in IN cover TIMOPTIC-XE 0.5% EYE SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TIZANIDINE HCL 2MG TABLET (150 CT) ![Compare how all Medicare Part D PDP plans in IN cover TIZANIDINE HCL 2MG TABLET (150 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TIZANIDINE HCL 4MG TABLET 150 BOT ![Compare how all Medicare Part D PDP plans in IN cover TIZANIDINE HCL 4MG TABLET 150 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TOBRADEX EYE OINTMENT ![Compare how all Medicare Part D PDP plans in IN cover TOBRADEX EYE OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
TOBRADEX SUSPENSION OPHTHALMIC 0.1%/0.3% 5ML BOT ![Compare how all Medicare Part D PDP plans in IN cover TOBRADEX SUSPENSION OPHTHALMIC 0.1%/0.3% 5ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TOBRAMYCIN 10MG/ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover TOBRAMYCIN 10MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TOBRAMYCIN 40MG/ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover TOBRAMYCIN 40MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TOBRAMYCIN OPHTHALMIC SOLUTION 0.3% 5ML BOT ![Compare how all Medicare Part D PDP plans in IN cover TOBRAMYCIN OPHTHALMIC SOLUTION 0.3% 5ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TOBRAMYCIN-DEXAMETH OPTH SUSP ![Compare how all Medicare Part D PDP plans in IN cover TOBRAMYCIN-DEXAMETH OPTH SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TOBRASOL 0.3% EYE DROPS ![Compare how all Medicare Part D PDP plans in IN cover TOBRASOL 0.3% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TOBREX 0.3% EYE DROPS ![Compare how all Medicare Part D PDP plans in IN cover TOBREX 0.3% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TOFRANIL 50MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in IN cover TOFRANIL 50MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TOFRANIL TABLETS 10MG 30 BOT ![Compare how all Medicare Part D PDP plans in IN cover TOFRANIL TABLETS 10MG 30 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TOFRANIL TABLETS 25MG 30 BOT ![Compare how all Medicare Part D PDP plans in IN cover TOFRANIL TABLETS 25MG 30 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TOLAZAMIDE TABLETS 250MG 100 BOT ![Compare how all Medicare Part D PDP plans in IN cover TOLAZAMIDE TABLETS 250MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TOLAZAMIDE TABLETS 500MG 100 BOT ![Compare how all Medicare Part D PDP plans in IN cover TOLAZAMIDE TABLETS 500MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TOLBUTAMIDE 500MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TOLBUTAMIDE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TOLMETIN SODIUM 200MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TOLMETIN SODIUM 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TOLMETIN SODIUM 400MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover TOLMETIN SODIUM 400MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TOLMETIN SODIUM 600MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TOLMETIN SODIUM 600MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TOLVAPTAN 15 MG ORAL TABLET [SAMSCA] ![Compare how all Medicare Part D PDP plans in IN cover TOLVAPTAN 15 MG ORAL TABLET [SAMSCA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TOLVAPTAN 30 MG ORAL TABLET [SAMSCA] ![Compare how all Medicare Part D PDP plans in IN cover TOLVAPTAN 30 MG ORAL TABLET [SAMSCA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | N/A | None |
TOPAMAX 15 MG SPRINKLE CAP ![Compare how all Medicare Part D PDP plans in IN cover TOPAMAX 15 MG SPRINKLE CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TOPAMAX 25 MG SPRINKLE CAP ![Compare how all Medicare Part D PDP plans in IN cover TOPAMAX 25 MG SPRINKLE CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TOPAMAX TABLETS 100MG 60 BOT ![Compare how all Medicare Part D PDP plans in IN cover TOPAMAX TABLETS 100MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TOPAMAX TABLETS 200MG 60 BOT ![Compare how all Medicare Part D PDP plans in IN cover TOPAMAX TABLETS 200MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TOPAMAX TABLETS 25MG 60 BOT ![Compare how all Medicare Part D PDP plans in IN cover TOPAMAX TABLETS 25MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TOPAMAX TABLETS 50MG 60 BOT ![Compare how all Medicare Part D PDP plans in IN cover TOPAMAX TABLETS 50MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TOPICORT 0.05% GEL ![Compare how all Medicare Part D PDP plans in IN cover TOPICORT 0.05% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TOPICORT 0.25% CREAM ![Compare how all Medicare Part D PDP plans in IN cover TOPICORT 0.25% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TOPICORT 0.25% OINTMENT ![Compare how all Medicare Part D PDP plans in IN cover TOPICORT 0.25% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TOPICORT LP 0.05% CREAM ![Compare how all Medicare Part D PDP plans in IN cover TOPICORT LP 0.05% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TOPIRAMATE 25 MG SPRINKLE CAP ![Compare how all Medicare Part D PDP plans in IN cover TOPIRAMATE 25 MG SPRINKLE CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TOPIRAMATE SPRINKLE CAPSULES 15MG 60 BOT ![Compare how all Medicare Part D PDP plans in IN cover TOPIRAMATE SPRINKLE CAPSULES 15MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TOPIRAMATE TABLETS 100MG 1000 BOT ![Compare how all Medicare Part D PDP plans in IN cover TOPIRAMATE TABLETS 100MG 1000 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TOPIRAMATE TABLETS 200MG 1000 BOT ![Compare how all Medicare Part D PDP plans in IN cover TOPIRAMATE TABLETS 200MG 1000 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TOPIRAMATE TABLETS 25MG 1000 BOT ![Compare how all Medicare Part D PDP plans in IN cover TOPIRAMATE TABLETS 25MG 1000 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TOPIRAMATE TABLETS 50MG 1000 BOT ![Compare how all Medicare Part D PDP plans in IN cover TOPIRAMATE TABLETS 50MG 1000 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TOPOSAR INJECTION 20MG/ML 50ML VIAL MD CRTN ![Compare how all Medicare Part D PDP plans in IN cover TOPOSAR INJECTION 20MG/ML 50ML VIAL MD CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TOPOTECAN HYDROCHLORIDE FOR INJECTION ![Compare how all Medicare Part D PDP plans in IN cover TOPOTECAN HYDROCHLORIDE FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | N/A | P |
TOPROL XL 100MG TABLET SA ![Compare how all Medicare Part D PDP plans in IN cover TOPROL XL 100MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TOPROL XL 200MG TABLET SA ![Compare how all Medicare Part D PDP plans in IN cover TOPROL XL 200MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TOPROL XL 25MG TABLET SA ![Compare how all Medicare Part D PDP plans in IN cover TOPROL XL 25MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TOPROL XL 50MG TABLET SA ![Compare how all Medicare Part D PDP plans in IN cover TOPROL XL 50MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TORISEL SOL 25MG/ML ![Compare how all Medicare Part D PDP plans in IN cover TORISEL SOL 25MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | N/A | P |
TORSEMIDE 100 MG ORAL TABLET ![Compare how all Medicare Part D PDP plans in IN cover TORSEMIDE 100 MG ORAL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TORSEMIDE 20 MG ORAL TABLET ![Compare how all Medicare Part D PDP plans in IN cover TORSEMIDE 20 MG ORAL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TORSEMIDE TABLETS 10 MG ![Compare how all Medicare Part D PDP plans in IN cover TORSEMIDE TABLETS 10 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TORSEMIDE TABLETS 5 MG ![Compare how all Medicare Part D PDP plans in IN cover TORSEMIDE TABLETS 5 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRACLEER 125MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TRACLEER 125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | N/A | P |
TRACLEER 62.5MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TRACLEER 62.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | N/A | P |
TRAMADOL HCL 50 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TRAMADOL HCL 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRAMADOL HCL-ACETAMINOPHEN 37.5-325MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in IN cover TRAMADOL HCL-ACETAMINOPHEN 37.5-325MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRANDATE TABLETS 100MG 100 BOTPL ![Compare how all Medicare Part D PDP plans in IN cover TRANDATE TABLETS 100MG 100 BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRANDATE TABLETS 200MG 100 BOT ![Compare how all Medicare Part D PDP plans in IN cover TRANDATE TABLETS 200MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TRANDATE TABLETS 300MG 100 BOTPL ![Compare how all Medicare Part D PDP plans in IN cover TRANDATE TABLETS 300MG 100 BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TRANDOLAPRIL 1MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TRANDOLAPRIL 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRANDOLAPRIL 2MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TRANDOLAPRIL 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRANDOLAPRIL 4MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TRANDOLAPRIL 4MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRANDOLAPRIL AND VERAPAMIL HYDROCHLORIDE TABLETS EXTENDED RELEASE ![Compare how all Medicare Part D PDP plans in IN cover TRANDOLAPRIL AND VERAPAMIL HYDROCHLORIDE TABLETS EXTENDED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRANDOLAPRIL-VERAPAMIL ER 2-180 MG ![Compare how all Medicare Part D PDP plans in IN cover TRANDOLAPRIL-VERAPAMIL ER 2-180 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRANDOLAPRIL-VERAPAMIL ER 2-240 MG ![Compare how all Medicare Part D PDP plans in IN cover TRANDOLAPRIL-VERAPAMIL ER 2-240 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRANDOLAPRIL-VERAPAMIL ER 4-240 MG ![Compare how all Medicare Part D PDP plans in IN cover TRANDOLAPRIL-VERAPAMIL ER 4-240 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRANSDERM-SCOP 1.5MG 24 PKG ![Compare how all Medicare Part D PDP plans in IN cover TRANSDERM-SCOP 1.5MG 24 PKG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |
TRANYLCYPROMINE SULFATE 10MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TRANYLCYPROMINE SULFATE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | 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 IN cover TRAVATAN Z 0.04MG DROPS 2.5ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
TRAZODONE 300MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TRAZODONE 300MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRAZODONE HCL TABLET USP 100MG (500 CT) ![Compare how all Medicare Part D PDP plans in IN cover TRAZODONE HCL TABLET USP 100MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRAZODONE HCL TABLET USP 150MG (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover TRAZODONE HCL TABLET USP 150MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRAZODONE HCL TABLET USP 50MG (500 CT) ![Compare how all Medicare Part D PDP plans in IN cover TRAZODONE HCL TABLET USP 50MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRECATOR 250MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TRECATOR 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |
TRELSTAR DEPOT MIXJET FOR INJECTION 3.75 MG ![Compare how all Medicare Part D PDP plans in IN cover TRELSTAR DEPOT MIXJET FOR INJECTION 3.75 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TRELSTAR MIXJET FOR INJECTION 11.25 MG ![Compare how all Medicare Part D PDP plans in IN cover TRELSTAR MIXJET FOR INJECTION 11.25 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TRENTAL 400MG TABLET SA ![Compare how all Medicare Part D PDP plans in IN cover TRENTAL 400MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TRETINOIN 0.01% GEL 45GM TUBE ![Compare how all Medicare Part D PDP plans in IN cover TRETINOIN 0.01% GEL 45GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRETINOIN 0.025% GEL 45GM TUBE ![Compare how all Medicare Part D PDP plans in IN cover TRETINOIN 0.025% GEL 45GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRETINOIN 0.05% CREAM 45GM TUBE ![Compare how all Medicare Part D PDP plans in IN cover TRETINOIN 0.05% CREAM 45GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRETINOIN 0.1% CREAM 45GM TUBE ![Compare how all Medicare Part D PDP plans in IN cover TRETINOIN 0.1% CREAM 45GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRETINOIN 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover TRETINOIN 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | N/A | None |
TRETINOIN CREAM ![Compare how all Medicare Part D PDP plans in IN cover TRETINOIN CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TREXALL 10MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TREXALL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TREXALL 15MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TREXALL 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TREXALL 5MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TREXALL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TREXALL 7.5MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TREXALL 7.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TREXIMET 500MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TREXIMET 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
TRI PREVIFEM TABLETS ![Compare how all Medicare Part D PDP plans in IN cover TRI PREVIFEM TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRI-LEGEST FE 5-7-9-7 TABLET ![Compare how all Medicare Part D PDP plans in IN cover TRI-LEGEST FE 5-7-9-7 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRI-NORINYL 28 TABLET ![Compare how all Medicare Part D PDP plans in IN cover TRI-NORINYL 28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TRI-SPRINTEC 7DAYSX3 28 TABLET ![Compare how all Medicare Part D PDP plans in IN cover TRI-SPRINTEC 7DAYSX3 28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRIAMCINOLONE 0.1% OINTMENT ![Compare how all Medicare Part D PDP plans in IN cover TRIAMCINOLONE 0.1% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRIAMCINOLONE 0.1% PASTE ![Compare how all Medicare Part D PDP plans in IN cover TRIAMCINOLONE 0.1% PASTE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRIAMCINOLONE ACETONIDE 0.025% OINTMENT 80GM TUBE ![Compare how all Medicare Part D PDP plans in IN cover TRIAMCINOLONE ACETONIDE 0.025% OINTMENT 80GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRIAMCINOLONE ACETONIDE 0.1% LOTION 60ML BOTPL ![Compare how all Medicare Part D PDP plans in IN cover TRIAMCINOLONE ACETONIDE 0.1% LOTION 60ML BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRIAMCINOLONE ACETONIDE 0.025% CREAM 80GM TUBE ![Compare how all Medicare Part D PDP plans in IN cover TRIAMCINOLONE ACETONIDE 0.025% CREAM 80GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRIAMCINOLONE ACETONIDE 0.025% LOTION 2 FL OZ BOT ![Compare how all Medicare Part D PDP plans in IN cover TRIAMCINOLONE ACETONIDE 0.025% LOTION 2 FL OZ BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRIAMCINOLONE ACETONIDE 0.05% CREAM 15GM TUBE ![Compare how all Medicare Part D PDP plans in IN cover TRIAMCINOLONE ACETONIDE 0.05% CREAM 15GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRIAMCINOLONE ACETONIDE 0.05% OINTMENT 15GM TUBE ![Compare how all Medicare Part D PDP plans in IN cover TRIAMCINOLONE ACETONIDE 0.05% OINTMENT 15GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRIAMCINOLONE ACETONIDE 0.1% CREAM 80GM TUBE ![Compare how all Medicare Part D PDP plans in IN cover TRIAMCINOLONE ACETONIDE 0.1% CREAM 80GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRIAMTERENE/HCTZ 25/37.5MG CAPSULES (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover TRIAMTERENE/HCTZ 25/37.5MG CAPSULES (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRIAMTERENE/HCTZ 37.5/25 TABLET ![Compare how all Medicare Part D PDP plans in IN cover TRIAMTERENE/HCTZ 37.5/25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRIAMTERENE/HCTZ 75/50 TABLET ![Compare how all Medicare Part D PDP plans in IN cover TRIAMTERENE/HCTZ 75/50 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRIBENZOR TABLETS ![Compare how all Medicare Part D PDP plans in IN cover TRIBENZOR TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
TRIBENZOR TABLETS ![Compare how all Medicare Part D PDP plans in IN cover TRIBENZOR TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
TRIBENZOR TABLETS ![Compare how all Medicare Part D PDP plans in IN cover TRIBENZOR TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
TRIDERM 0.1% CREAM ![Compare how all Medicare Part D PDP plans in IN cover TRIDERM 0.1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRIFLUOPERAZINE 1MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TRIFLUOPERAZINE 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRIFLUOPERAZINE HCL 2MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TRIFLUOPERAZINE HCL 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRIFLUOPERAZINE HCL 5MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TRIFLUOPERAZINE HCL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRIFLUOPERAZINE HCL USP 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover TRIFLUOPERAZINE HCL USP 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRIFLURIDINE 1% OPTH SOLUTION 7.5ML BOT ![Compare how all Medicare Part D PDP plans in IN cover TRIFLURIDINE 1% OPTH SOLUTION 7.5ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRIHEXYPHENIDYL HCL 5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in IN cover TRIHEXYPHENIDYL HCL 5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRIHEXYPHENIDYL HCL ELIXIR 5%/2 16 FLO BOT ![Compare how all Medicare Part D PDP plans in IN cover TRIHEXYPHENIDYL HCL ELIXIR 5%/2 16 FLO BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRIHEXYPHENIDYL HCL TABLET 2MG (1000 CT) ![Compare how all Medicare Part D PDP plans in IN cover TRIHEXYPHENIDYL HCL TABLET 2MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRIHIBIT PRESERVATIVE FREE ![Compare how all Medicare Part D PDP plans in IN cover TRIHIBIT PRESERVATIVE FREE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
TRILEPTAL 150MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TRILEPTAL 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TRILEPTAL 300MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TRILEPTAL 300MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TRILEPTAL 300MG/5ML SUSP ![Compare how all Medicare Part D PDP plans in IN cover TRILEPTAL 300MG/5ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |
TRILEPTAL 600MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TRILEPTAL 600MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TRILIPIX CAPSULE DR 45MG ![Compare how all Medicare Part D PDP plans in IN cover TRILIPIX CAPSULE DR 45MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
TRILIPIX DELAYED RELEASE CAPSULES 135MG ![Compare how all Medicare Part D PDP plans in IN cover TRILIPIX DELAYED RELEASE CAPSULES 135MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRIMETHOBENZAMIDE 100MG/ML ![Compare how all Medicare Part D PDP plans in IN cover TRIMETHOBENZAMIDE 100MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRIMETHOBENZAMIDE HCL 300MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover TRIMETHOBENZAMIDE HCL 300MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRIMETHOPRIM TABLETS ![Compare how all Medicare Part D PDP plans in IN cover TRIMETHOPRIM TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRINESSA TABLET ![Compare how all Medicare Part D PDP plans in IN cover TRINESSA TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRIPEDIA PRESERVATIVE FREE 6.7;23.4; UNT/.5 ML; ![Compare how all Medicare Part D PDP plans in IN 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 |
$35.00 | $87.50 | None |
TRISENOX 10MG/10ML AMPULE ![Compare how all Medicare Part D PDP plans in IN cover TRISENOX 10MG/10ML AMPULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TRIVORA-28 TABLET ![Compare how all Medicare Part D PDP plans in IN cover TRIVORA-28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRIZIVIR TABLET ![Compare how all Medicare Part D PDP plans in IN cover TRIZIVIR TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
TROPICAMIDE 0.5% EYE DROPS ![Compare how all Medicare Part D PDP plans in IN cover TROPICAMIDE 0.5% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TROPICAMIDE OPHTHALMIC SOLUTION USP ![Compare how all Medicare Part D PDP plans in IN cover TROPICAMIDE OPHTHALMIC SOLUTION USP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$5.50 | $13.75 | None |
TRUSOPT PLUS 2% EYE DROPS 10ML BOT ![Compare how all Medicare Part D PDP plans in IN cover TRUSOPT PLUS 2% EYE DROPS 10ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRUVADA TABLET ![Compare how all Medicare Part D PDP plans in IN cover TRUVADA TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
TWINRIX TF PF VACCINE 720UNT/20ML 10 X 1ML VIALSD ![Compare how all Medicare Part D PDP plans in IN 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 |
$35.00 | $87.50 | P |
TYKERB 250MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover TYKERB 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | N/A | P |
TYLENOL W/CODEINE #3 TABLET ![Compare how all Medicare Part D PDP plans in IN cover TYLENOL W/CODEINE #3 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TYLENOL W/CODEINE #4 TABLET ![Compare how all Medicare Part D PDP plans in IN cover TYLENOL W/CODEINE #4 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TYLOX CAPSULES ![Compare how all Medicare Part D PDP plans in IN cover TYLOX CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | P |
TYPHIM VI 25MCG/0.5ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover TYPHIM VI 25MCG/0.5ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$35.00 | $87.50 | None |
TYSABRI 300MG/15ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover TYSABRI 300MG/15ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | N/A | P |
TYZEKA 600MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in IN cover TYZEKA 600MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |
TYZINE 0.1% NOSE DROPS ![Compare how all Medicare Part D PDP plans in IN cover TYZINE 0.1% NOSE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$85.00 | $212.50 | None |