2011 Medicare Part D Plan Formulary Information |
CIGNA Medicare Rx Plan One (PDP) (S5617-153-0)
Benefit Details
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The CIGNA Medicare Rx Plan One (PDP) (S5617-153-0) Formulary Drugs Starting with the Letter T in CMS PDP Region 31 which includes: ID UT
|
Drugs Starting with Letter T
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
TACLONEX OINTMENT ![Compare how all Medicare Part D PDP plans in UT cover TACLONEX OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$83.00 | $207.50 | None |
TACROLIMUS 0.5 MG ORAL CAPSULE ![Compare how all Medicare Part D PDP plans in UT cover TACROLIMUS 0.5 MG ORAL CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | P |
TACROLIMUS 1 MG ORAL CAPSULE ![Compare how all Medicare Part D PDP plans in UT cover TACROLIMUS 1 MG ORAL CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | P |
TACROLIMUS 5 MG ORAL CAPSULE ![Compare how all Medicare Part D PDP plans in UT cover TACROLIMUS 5 MG ORAL CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | P |
TALWIN 30MG/ML VIAL ![Compare how all Medicare Part D PDP plans in UT cover TALWIN 30MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$83.00 | $207.50 | P |
TAMIFLU 30MG CAPSULE ![Compare how all Medicare Part D PDP plans in UT cover TAMIFLU 30MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | Q:120 /365Days |
TAMIFLU 45MG CAPSULE ![Compare how all Medicare Part D PDP plans in UT cover TAMIFLU 45MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | Q:60 /365Days |
TAMIFLU 75MG CAPSULE UD ![Compare how all Medicare Part D PDP plans in UT cover TAMIFLU 75MG CAPSULE UD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | Q:56 /365Days |
TAMIFLU ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in UT cover TAMIFLU ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | None |
TAMOXIFEN CITRATE 20MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in UT cover TAMOXIFEN CITRATE 20MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TAMOXIFEN CITRATE TABLETS 10MG 180 BOT ![Compare how all Medicare Part D PDP plans in UT cover TAMOXIFEN CITRATE TABLETS 10MG 180 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TAMSULOSIN HCL 0.4 MG CAPSULE ![Compare how all Medicare Part D PDP plans in UT cover TAMSULOSIN HCL 0.4 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | Q:60 /30Days |
TARCEVA 100MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover TARCEVA 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P |
TARCEVA 150MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover TARCEVA 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P |
TARCEVA 25MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover TARCEVA 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P |
TARGRETIN 1% GEL 60GM TUBE ![Compare how all Medicare Part D PDP plans in UT cover TARGRETIN 1% GEL 60GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P |
TARGRETIN 75MG (100 CT) ![Compare how all Medicare Part D PDP plans in UT cover TARGRETIN 75MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P |
TASIGNA 200MG CAPSULE 28 BLPK ![Compare how all Medicare Part D PDP plans in UT cover TASIGNA 200MG CAPSULE 28 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | None |
TASMAR 100MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover TASMAR 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | P |
TAXOTERE 80MG/2ML VIAL ![Compare how all Medicare Part D PDP plans in UT cover TAXOTERE 80MG/2ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P |
TAZICEF 1GM VIAL ![Compare how all Medicare Part D PDP plans in UT cover TAZICEF 1GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TAZICEF 2GM ADD-VANTAGE ![Compare how all Medicare Part D PDP plans in UT cover TAZICEF 2GM ADD-VANTAGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | None |
TAZICEF 6GM/100ML VIAL ![Compare how all Medicare Part D PDP plans in UT cover TAZICEF 6GM/100ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | None |
TAZTIA DILTIAZEM HYDROCHLORIDE EXTENDED RELEASE CAPSULES ![Compare how all Medicare Part D PDP plans in UT cover TAZTIA DILTIAZEM HYDROCHLORIDE EXTENDED RELEASE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TAZTIA DILTIAZEM HYDROCHLORIDE EXTENDED RELEASE CAPSULES ![Compare how all Medicare Part D PDP plans in UT cover TAZTIA DILTIAZEM HYDROCHLORIDE EXTENDED RELEASE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TAZTIA DILTIAZEM HYDROCHLORIDE EXTENDED RELEASE CAPSULES ![Compare how all Medicare Part D PDP plans in UT cover TAZTIA DILTIAZEM HYDROCHLORIDE EXTENDED RELEASE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TAZTIA XT 240MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in UT cover TAZTIA XT 240MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TAZTIA XT 360MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in UT cover TAZTIA XT 360MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TEGRETOL XR TABLETS 100MG 100 BOT ![Compare how all Medicare Part D PDP plans in UT cover TEGRETOL XR TABLETS 100MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$83.00 | $207.50 | None |
TEKTURNA 150MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover TEKTURNA 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$83.00 | $207.50 | S Q:30 /30Days |
TEKTURNA 300MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover TEKTURNA 300MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$83.00 | $207.50 | S Q:30 /30Days |
TEKTURNA HCT 150-12.5MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover TEKTURNA HCT 150-12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$83.00 | $207.50 | S Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TEKTURNA HCT 150MG-25MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover TEKTURNA HCT 150MG-25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$83.00 | $207.50 | S Q:30 /30Days |
TEKTURNA HCT 300-12.5MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover TEKTURNA HCT 300-12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$83.00 | $207.50 | S Q:30 /30Days |
TEKTURNA HCT 300MG-25MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover TEKTURNA HCT 300MG-25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$83.00 | $207.50 | S Q:30 /30Days |
TERAZOSIN HCL 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in UT cover TERAZOSIN HCL 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TERAZOSIN HCL 1MG CAPSULE ![Compare how all Medicare Part D PDP plans in UT cover TERAZOSIN HCL 1MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TERAZOSIN HCL 2MG CAPSULE ![Compare how all Medicare Part D PDP plans in UT cover TERAZOSIN HCL 2MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TERAZOSIN HCL 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in UT cover TERAZOSIN HCL 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TERBINAFINE HCL 250MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover TERBINAFINE HCL 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | Q:90 /270Days |
TERBUTALINE SULF 1MG/ML VL ![Compare how all Medicare Part D PDP plans in UT cover TERBUTALINE SULF 1MG/ML VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TERBUTALINE SULF 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover TERBUTALINE SULF 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TERBUTALINE SULFATE 5MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover TERBUTALINE SULFATE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TERCONAZOLE 0.4% CREAM WITH APPLICATOR ![Compare how all Medicare Part D PDP plans in UT cover TERCONAZOLE 0.4% CREAM WITH APPLICATOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TERCONAZOLE 80MG SUPPOSITORY VAGINAL ![Compare how all Medicare Part D PDP plans in UT cover TERCONAZOLE 80MG SUPPOSITORY VAGINAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TERCONAZOLE VAGINAL CREAM ![Compare how all Medicare Part D PDP plans in UT cover TERCONAZOLE VAGINAL CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TESTIM 1%(50MG) GEL ![Compare how all Medicare Part D PDP plans in UT cover TESTIM 1%(50MG) GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | None |
TESTOSTERONE CYPIONATE INJECTION ![Compare how all Medicare Part D PDP plans in UT cover TESTOSTERONE CYPIONATE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | P |
TESTOSTERONE ENANTHATE INJECTION ![Compare how all Medicare Part D PDP plans in UT cover TESTOSTERONE ENANTHATE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | P |
TETANUS AND DIPHTHERIA TOXOIDS ADSORBED FOR ADULT USE 2 UNT/VIAL ![Compare how all Medicare Part D PDP plans in UT cover TETANUS AND DIPHTHERIA TOXOIDS ADSORBED FOR ADULT USE 2 UNT/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | None |
TETANUS TOXOID ADSORBED VIAL 5LF ![Compare how all Medicare Part D PDP plans in UT cover TETANUS TOXOID ADSORBED VIAL 5LF.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | None |
TETRACYCLINE 250 MG ORAL CAPSULE ![Compare how all Medicare Part D PDP plans in UT cover TETRACYCLINE 250 MG ORAL CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TETRACYCLINE 500MG CAPSULE ![Compare how all Medicare Part D PDP plans in UT cover TETRACYCLINE 500MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TEV-TROPIN 5MG VIAL ![Compare how all Medicare Part D PDP plans in UT cover TEV-TROPIN 5MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
THALOMID 100MG CAPSULE 140 BOX ![Compare how all Medicare Part D PDP plans in UT cover THALOMID 100MG CAPSULE 140 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | None |
THALOMID 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in UT cover THALOMID 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | None |
THALOMID 200MG CAPSULE 28 BLPK ![Compare how all Medicare Part D PDP plans in UT cover THALOMID 200MG CAPSULE 28 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | None |
THALOMID 50MG CAPSULE 280 BOX ![Compare how all Medicare Part D PDP plans in UT cover THALOMID 50MG CAPSULE 280 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | None |
THEOCHRON 100MG TABLET SA ![Compare how all Medicare Part D PDP plans in UT cover THEOCHRON 100MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
THEOCHRON 100MG TABLET SA ![Compare how all Medicare Part D PDP plans in UT cover THEOCHRON 100MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
THEOCHRON 200MG TABLET SA 100 EA ![Compare how all Medicare Part D PDP plans in UT cover THEOCHRON 200MG TABLET SA 100 EA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
THEOCHRON TABLETS EXTENDED RELEASE 300MG 100 BOT ![Compare how all Medicare Part D PDP plans in UT cover THEOCHRON TABLETS EXTENDED RELEASE 300MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
THEOPHYLLINE 400MG TABLET SA ![Compare how all Medicare Part D PDP plans in UT cover THEOPHYLLINE 400MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
THEOPHYLLINE 600MG TABLET SA ![Compare how all Medicare Part D PDP plans in UT cover THEOPHYLLINE 600MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
THEOPHYLLINE ANHYDROUS ER TABLET 200MG (1000 CT) ![Compare how all Medicare Part D PDP plans in UT cover THEOPHYLLINE ANHYDROUS ER TABLET 200MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | 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 UT cover THEOPHYLLINE TABLET ER 300MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
THEOPHYLLINE TABLET ER 450MG (100 CT) ![Compare how all Medicare Part D PDP plans in UT cover THEOPHYLLINE TABLET ER 450MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
THERMAZENE 50GM CREAM ![Compare how all Medicare Part D PDP plans in UT cover THERMAZENE 50GM CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
THIOGUANINE TABLET LOID 40MG ![Compare how all Medicare Part D PDP plans in UT cover THIOGUANINE TABLET LOID 40MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
THIORIDAZINE 100MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover THIORIDAZINE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
THIORIDAZINE HCL 10MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in UT cover THIORIDAZINE HCL 10MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
THIORIDAZINE HCL 25MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in UT cover THIORIDAZINE HCL 25MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
THIORIDAZINE HCL 50MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in UT cover THIORIDAZINE HCL 50MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
THIOTEPA POWDER FOR INJECTION 15MG/VIL 1 VIAL SINGLE DOSE CRTN ![Compare how all Medicare Part D PDP plans in UT cover THIOTEPA POWDER FOR INJECTION 15MG/VIL 1 VIAL SINGLE DOSE CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | P |
THIOTHIXENE 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in UT cover THIOTHIXENE 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
THIOTHIXENE 1MG CAPSULE (100 CT) ![Compare how all Medicare Part D PDP plans in UT cover THIOTHIXENE 1MG CAPSULE (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
THIOTHIXENE 2MG CAPSULE ![Compare how all Medicare Part D PDP plans in UT cover THIOTHIXENE 2MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
THIOTHIXENE 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in UT cover THIOTHIXENE 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
THYMOGLOBULIN 25MG VIAL ![Compare how all Medicare Part D PDP plans in UT cover THYMOGLOBULIN 25MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P |
THYROLAR-1 60MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover THYROLAR-1 60MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$83.00 | $207.50 | None |
THYROLAR-1/4 15MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover THYROLAR-1/4 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$83.00 | $207.50 | None |
THYROLAR-2 120MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover THYROLAR-2 120MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$83.00 | $207.50 | None |
THYROLAR-3 180MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover THYROLAR-3 180MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$83.00 | $207.50 | None |
TICLOPIDINE 250 MG ORAL TABLET ![Compare how all Medicare Part D PDP plans in UT cover TICLOPIDINE 250 MG ORAL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TIKOSYN .125MG CAPSULE ![Compare how all Medicare Part D PDP plans in UT cover TIKOSYN .125MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$83.00 | $207.50 | None |
TIKOSYN .250MG CAPSULE ![Compare how all Medicare Part D PDP plans in UT cover TIKOSYN .250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$83.00 | $207.50 | None |
TIKOSYN .5MG CAPSULE ![Compare how all Medicare Part D PDP plans in UT cover TIKOSYN .5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$83.00 | $207.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TIMENTIN 3.1GM VIAL ![Compare how all Medicare Part D PDP plans in UT cover TIMENTIN 3.1GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$83.00 | $207.50 | None |
TIMOLOL 0.0025 MG/MG OPHTHALMIC GEL ![Compare how all Medicare Part D PDP plans in UT cover TIMOLOL 0.0025 MG/MG OPHTHALMIC GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TIMOLOL 0.005 MG/MG OPHTHALMIC GEL ![Compare how all Medicare Part D PDP plans in UT cover TIMOLOL 0.005 MG/MG OPHTHALMIC GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TIMOLOL MAL SOL 0.25% OP 15ML BOT ![Compare how all Medicare Part D PDP plans in UT cover TIMOLOL MAL SOL 0.25% OP 15ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TIMOLOL MAL SOL 0.5% OP 10ML BOT ![Compare how all Medicare Part D PDP plans in UT cover TIMOLOL MAL SOL 0.5% OP 10ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TIMOLOL MALEATE 10MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover TIMOLOL MALEATE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TIMOLOL MALEATE 20MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover TIMOLOL MALEATE 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TIMOLOL MALEATE 5MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover TIMOLOL MALEATE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TIS-U-SOL IRRIGATION SOLUTION ![Compare how all Medicare Part D PDP plans in UT cover TIS-U-SOL IRRIGATION SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | P |
TIZANIDINE HCL 2MG TABLET (150 CT) ![Compare how all Medicare Part D PDP plans in UT cover TIZANIDINE HCL 2MG TABLET (150 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TIZANIDINE HCL 4MG TABLET 150 BOT ![Compare how all Medicare Part D PDP plans in UT cover TIZANIDINE HCL 4MG TABLET 150 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TOBRAMYCIN 10MG/ML VIAL ![Compare how all Medicare Part D PDP plans in UT cover TOBRAMYCIN 10MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TOBRAMYCIN 40MG/ML VIAL ![Compare how all Medicare Part D PDP plans in UT cover TOBRAMYCIN 40MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TOBRAMYCIN 60MG/0.9% NACL ![Compare how all Medicare Part D PDP plans in UT cover TOBRAMYCIN 60MG/0.9% NACL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TOBRAMYCIN 80MG/0.9% NACL ![Compare how all Medicare Part D PDP plans in UT cover TOBRAMYCIN 80MG/0.9% NACL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TOBRAMYCIN INHALATION SOLUTION ![Compare how all Medicare Part D PDP plans in UT cover TOBRAMYCIN INHALATION SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P |
TOBRAMYCIN OPHTHALMIC SOLUTION 0.3% 5ML BOT ![Compare how all Medicare Part D PDP plans in UT cover TOBRAMYCIN OPHTHALMIC SOLUTION 0.3% 5ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TOBRAMYCIN-DEXAMETH OPTH SUSP ![Compare how all Medicare Part D PDP plans in UT cover TOBRAMYCIN-DEXAMETH OPTH SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TOBRASOL 0.3% EYE DROPS ![Compare how all Medicare Part D PDP plans in UT cover TOBRASOL 0.3% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TOLAZAMIDE TABLETS 250MG 100 BOT ![Compare how all Medicare Part D PDP plans in UT cover TOLAZAMIDE TABLETS 250MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TOLAZAMIDE TABLETS 500MG 100 BOT ![Compare how all Medicare Part D PDP plans in UT cover TOLAZAMIDE TABLETS 500MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TOLBUTAMIDE 500MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover TOLBUTAMIDE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TOLMETIN SODIUM 200MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover TOLMETIN SODIUM 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TOLMETIN SODIUM 400MG CAPSULE ![Compare how all Medicare Part D PDP plans in UT cover TOLMETIN SODIUM 400MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TOLMETIN SODIUM 600MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover TOLMETIN SODIUM 600MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TOLVAPTAN 15 MG ORAL TABLET [SAMSCA] ![Compare how all Medicare Part D PDP plans in UT cover TOLVAPTAN 15 MG ORAL TABLET [SAMSCA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P Q:30 /30Days |
TOLVAPTAN 30 MG ORAL TABLET [SAMSCA] ![Compare how all Medicare Part D PDP plans in UT cover TOLVAPTAN 30 MG ORAL TABLET [SAMSCA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P Q:60 /30Days |
TOPIRAMATE 25 MG SPRINKLE CAP ![Compare how all Medicare Part D PDP plans in UT cover TOPIRAMATE 25 MG SPRINKLE CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | P |
TOPIRAMATE SPRINKLE CAPSULES 15MG 60 BOT ![Compare how all Medicare Part D PDP plans in UT cover TOPIRAMATE SPRINKLE CAPSULES 15MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | P |
TOPIRAMATE TABLETS 100MG 1000 BOT ![Compare how all Medicare Part D PDP plans in UT cover TOPIRAMATE TABLETS 100MG 1000 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | P Q:60 /30Days |
TOPIRAMATE TABLETS 200MG 1000 BOT ![Compare how all Medicare Part D PDP plans in UT cover TOPIRAMATE TABLETS 200MG 1000 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | P Q:60 /30Days |
TOPIRAMATE TABLETS 25MG 1000 BOT ![Compare how all Medicare Part D PDP plans in UT cover TOPIRAMATE TABLETS 25MG 1000 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | P Q:120 /30Days |
TOPIRAMATE TABLETS 50MG 1000 BOT ![Compare how all Medicare Part D PDP plans in UT cover TOPIRAMATE TABLETS 50MG 1000 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | P Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TOPOSAR INJECTION 20MG/ML 50ML VIAL MD CRTN ![Compare how all Medicare Part D PDP plans in UT cover TOPOSAR INJECTION 20MG/ML 50ML VIAL MD CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | P |
TOPOTECAN HYDROCHLORIDE FOR INJECTION ![Compare how all Medicare Part D PDP plans in UT cover TOPOTECAN HYDROCHLORIDE FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P |
TOPROL XL 100MG TABLET SA ![Compare how all Medicare Part D PDP plans in UT cover TOPROL XL 100MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$83.00 | $207.50 | Q:30 /30Days |
TOPROL XL 200MG TABLET SA ![Compare how all Medicare Part D PDP plans in UT cover TOPROL XL 200MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$83.00 | $207.50 | Q:60 /30Days |
TOPROL XL 25MG TABLET SA ![Compare how all Medicare Part D PDP plans in UT cover TOPROL XL 25MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$83.00 | $207.50 | Q:30 /30Days |
TOPROL XL 50MG TABLET SA ![Compare how all Medicare Part D PDP plans in UT cover TOPROL XL 50MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$83.00 | $207.50 | Q:30 /30Days |
TORISEL SOL 25MG/ML ![Compare how all Medicare Part D PDP plans in UT cover TORISEL SOL 25MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P |
TORSEMIDE 100 MG ORAL TABLET ![Compare how all Medicare Part D PDP plans in UT cover TORSEMIDE 100 MG ORAL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TORSEMIDE 20 MG ORAL TABLET ![Compare how all Medicare Part D PDP plans in UT cover TORSEMIDE 20 MG ORAL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TORSEMIDE INJECTION 20MG/2ML ![Compare how all Medicare Part D PDP plans in UT cover TORSEMIDE INJECTION 20MG/2ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | None |
TORSEMIDE TABLETS 10 MG ![Compare how all Medicare Part D PDP plans in UT cover TORSEMIDE TABLETS 10 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TORSEMIDE TABLETS 5 MG ![Compare how all Medicare Part D PDP plans in UT cover TORSEMIDE TABLETS 5 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TOVIAZ TABLETS 4MG EXTENDED RELEASE ![Compare how all Medicare Part D PDP plans in UT cover TOVIAZ TABLETS 4MG EXTENDED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | Q:30 /30Days |
TOVIAZ TABLETS 8MG EXTENDED RELEASE ![Compare how all Medicare Part D PDP plans in UT cover TOVIAZ TABLETS 8MG EXTENDED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | Q:30 /30Days |
TPN ELECTROLYTES VIAL ![Compare how all Medicare Part D PDP plans in UT cover TPN ELECTROLYTES VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | P |
TRACLEER 125MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover TRACLEER 125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | None |
TRACLEER 62.5MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover TRACLEER 62.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | None |
TRAMADOL HCL 50 MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover TRAMADOL HCL 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TRANDOLAPRIL 1MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover TRANDOLAPRIL 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TRANDOLAPRIL 2MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover TRANDOLAPRIL 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TRANDOLAPRIL 4MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover TRANDOLAPRIL 4MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TRANYLCYPROMINE SULFATE 10MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover TRANYLCYPROMINE SULFATE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRAVASOL 10% SOLUTION VIAFLEX ![Compare how all Medicare Part D PDP plans in UT cover TRAVASOL 10% SOLUTION VIAFLEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$83.00 | $207.50 | P |
TRAVATAN Z 0.04MG DROPS 2.5ML BOT ![Compare how all Medicare Part D PDP plans in UT cover TRAVATAN Z 0.04MG DROPS 2.5ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | Q:3 /30Days |
TRAZODONE 300MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover TRAZODONE 300MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TRAZODONE HCL TABLET USP 100MG (500 CT) ![Compare how all Medicare Part D PDP plans in UT cover TRAZODONE HCL TABLET USP 100MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TRAZODONE HCL TABLET USP 150MG (100 CT) ![Compare how all Medicare Part D PDP plans in UT cover TRAZODONE HCL TABLET USP 150MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TRAZODONE HCL TABLET USP 50MG (500 CT) ![Compare how all Medicare Part D PDP plans in UT cover TRAZODONE HCL TABLET USP 50MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TREANDA FOR INJECTION 100MG/VIAL ![Compare how all Medicare Part D PDP plans in UT cover TREANDA FOR INJECTION 100MG/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P |
TRECATOR 250MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover TRECATOR 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | None |
TRELSTAR DEPOT MIXJET FOR INJECTION 3.75 MG ![Compare how all Medicare Part D PDP plans in UT cover TRELSTAR DEPOT MIXJET FOR INJECTION 3.75 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$83.00 | $207.50 | P |
TRELSTAR MIXJET FOR INJECTION 11.25 MG ![Compare how all Medicare Part D PDP plans in UT cover TRELSTAR MIXJET FOR INJECTION 11.25 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$83.00 | $207.50 | P |
TRETINOIN 0.01% GEL 45GM TUBE ![Compare how all Medicare Part D PDP plans in UT cover TRETINOIN 0.01% GEL 45GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRETINOIN 0.025% GEL 45GM TUBE ![Compare how all Medicare Part D PDP plans in UT cover TRETINOIN 0.025% GEL 45GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | P |
TRETINOIN 0.05% CREAM 45GM TUBE ![Compare how all Medicare Part D PDP plans in UT cover TRETINOIN 0.05% CREAM 45GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | P |
TRETINOIN 0.1% CREAM 45GM TUBE ![Compare how all Medicare Part D PDP plans in UT cover TRETINOIN 0.1% CREAM 45GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | P |
TRETINOIN 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in UT cover TRETINOIN 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | None |
TRETINOIN CREAM ![Compare how all Medicare Part D PDP plans in UT cover TRETINOIN CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | P |
TREXALL 10MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover TREXALL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$83.00 | $207.50 | P |
TREXALL 15MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover TREXALL 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$83.00 | $207.50 | P |
TREXALL 5MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover TREXALL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$83.00 | $207.50 | P |
TREXALL 7.5MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover TREXALL 7.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$83.00 | $207.50 | P |
TREXIMET 500MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover TREXIMET 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | Q:9 /30Days |
TRI PREVIFEM TABLETS ![Compare how all Medicare Part D PDP plans in UT cover TRI PREVIFEM TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRI-LEGEST FE 5-7-9-7 TABLET ![Compare how all Medicare Part D PDP plans in UT cover TRI-LEGEST FE 5-7-9-7 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | None |
TRI-SPRINTEC 7DAYSX3 28 TABLET ![Compare how all Medicare Part D PDP plans in UT cover TRI-SPRINTEC 7DAYSX3 28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | None |
TRIAMCINOLONE 0.1% OINTMENT ![Compare how all Medicare Part D PDP plans in UT cover TRIAMCINOLONE 0.1% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TRIAMCINOLONE 0.1% PASTE ![Compare how all Medicare Part D PDP plans in UT cover TRIAMCINOLONE 0.1% PASTE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TRIAMCINOLONE ACETONIDE 0.025% OINTMENT 80GM TUBE ![Compare how all Medicare Part D PDP plans in UT cover TRIAMCINOLONE ACETONIDE 0.025% OINTMENT 80GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TRIAMCINOLONE ACETONIDE 0.1% LOTION 60ML BOTPL ![Compare how all Medicare Part D PDP plans in UT cover TRIAMCINOLONE ACETONIDE 0.1% LOTION 60ML BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TRIAMCINOLONE ACETONIDE 0.025% CREAM 80GM TUBE ![Compare how all Medicare Part D PDP plans in UT cover TRIAMCINOLONE ACETONIDE 0.025% CREAM 80GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TRIAMCINOLONE ACETONIDE 0.025% LOTION 2 FL OZ BOT ![Compare how all Medicare Part D PDP plans in UT cover TRIAMCINOLONE ACETONIDE 0.025% LOTION 2 FL OZ BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TRIAMCINOLONE ACETONIDE 0.05% CREAM 15GM TUBE ![Compare how all Medicare Part D PDP plans in UT cover TRIAMCINOLONE ACETONIDE 0.05% CREAM 15GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TRIAMCINOLONE ACETONIDE 0.05% OINTMENT ![Compare how all Medicare Part D PDP plans in UT cover TRIAMCINOLONE ACETONIDE 0.05% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TRIAMCINOLONE ACETONIDE 0.05% OINTMENT 15GM TUBE ![Compare how all Medicare Part D PDP plans in UT cover TRIAMCINOLONE ACETONIDE 0.05% OINTMENT 15GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | 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 UT cover TRIAMCINOLONE ACETONIDE 0.1% CREAM 80GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TRIAMTERENE/HCTZ 25/37.5MG CAPSULES (100 CT) ![Compare how all Medicare Part D PDP plans in UT cover TRIAMTERENE/HCTZ 25/37.5MG CAPSULES (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TRIAMTERENE/HCTZ 37.5/25 TABLET ![Compare how all Medicare Part D PDP plans in UT cover TRIAMTERENE/HCTZ 37.5/25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TRIAMTERENE/HCTZ 75/50 TABLET ![Compare how all Medicare Part D PDP plans in UT cover TRIAMTERENE/HCTZ 75/50 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TRICOR 145MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover TRICOR 145MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$83.00 | $207.50 | Q:30 /30Days |
TRICOR 48MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover TRICOR 48MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$83.00 | $207.50 | Q:60 /30Days |
TRIDERM 0.1% CREAM ![Compare how all Medicare Part D PDP plans in UT cover TRIDERM 0.1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TRIDERM 0.1% OINTMENT ![Compare how all Medicare Part D PDP plans in UT cover TRIDERM 0.1% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TRIFLUOPERAZINE 1MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover TRIFLUOPERAZINE 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TRIFLUOPERAZINE HCL 2MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover TRIFLUOPERAZINE HCL 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TRIFLUOPERAZINE HCL 5MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover TRIFLUOPERAZINE HCL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRIFLUOPERAZINE HCL USP 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in UT cover TRIFLUOPERAZINE HCL USP 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TRIFLURIDINE 1% OPTH SOLUTION 7.5ML BOT ![Compare how all Medicare Part D PDP plans in UT cover TRIFLURIDINE 1% OPTH SOLUTION 7.5ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | None |
TRIHEXYPHENIDYL HCL 5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in UT cover TRIHEXYPHENIDYL HCL 5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TRIHEXYPHENIDYL HCL ELIXIR 5%/2 16 FLO BOT ![Compare how all Medicare Part D PDP plans in UT cover TRIHEXYPHENIDYL HCL ELIXIR 5%/2 16 FLO BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TRIHEXYPHENIDYL HCL TABLET 2MG (1000 CT) ![Compare how all Medicare Part D PDP plans in UT cover TRIHEXYPHENIDYL HCL TABLET 2MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TRIHIBIT PRESERVATIVE FREE ![Compare how all Medicare Part D PDP plans in UT cover TRIHIBIT PRESERVATIVE FREE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | None |
TRILIPIX CAPSULE DR 45MG ![Compare how all Medicare Part D PDP plans in UT cover TRILIPIX CAPSULE DR 45MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | Q:60 /30Days |
TRILIPIX DELAYED RELEASE CAPSULES 135MG ![Compare how all Medicare Part D PDP plans in UT cover TRILIPIX DELAYED RELEASE CAPSULES 135MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | Q:30 /30Days |
TRIMETHOBENZAMIDE 100MG/ML ![Compare how all Medicare Part D PDP plans in UT cover TRIMETHOBENZAMIDE 100MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | P |
TRIMETHOBENZAMIDE HCL 300MG CAPSULE ![Compare how all Medicare Part D PDP plans in UT cover TRIMETHOBENZAMIDE HCL 300MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | P |
TRIMETHOPRIM TABLETS ![Compare how all Medicare Part D PDP plans in UT cover TRIMETHOPRIM TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRINESSA TABLET ![Compare how all Medicare Part D PDP plans in UT cover TRINESSA TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | None |
TRIPEDIA PRESERVATIVE FREE 6.7;23.4; UNT/.5 ML; ![Compare how all Medicare Part D PDP plans in UT cover TRIPEDIA PRESERVATIVE FREE 6.7;23.4; UNT/.5 ML;.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | None |
TRISENOX 10MG/10ML AMPULE ![Compare how all Medicare Part D PDP plans in UT cover TRISENOX 10MG/10ML AMPULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$83.00 | $207.50 | P |
TRIVORA-28 TABLET ![Compare how all Medicare Part D PDP plans in UT cover TRIVORA-28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | None |
TRIZIVIR TABLET ![Compare how all Medicare Part D PDP plans in UT cover TRIZIVIR TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | None |
TROPHAMINE INJECTION SOLUTION ![Compare how all Medicare Part D PDP plans in UT cover TROPHAMINE INJECTION SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | P |
TROPHAMINE INJECTION SOLUTION 6% ![Compare how all Medicare Part D PDP plans in UT cover TROPHAMINE INJECTION SOLUTION 6%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | P |
TROPICAMIDE 0.5% EYE DROPS ![Compare how all Medicare Part D PDP plans in UT cover TROPICAMIDE 0.5% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TROPICAMIDE OPHTHALMIC SOLUTION USP ![Compare how all Medicare Part D PDP plans in UT cover TROPICAMIDE OPHTHALMIC SOLUTION USP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic/Preferred Brand |
$3.00 | $7.50 | None |
TROSPIUM CHLORIDE TABLETS ![Compare how all Medicare Part D PDP plans in UT cover TROSPIUM CHLORIDE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | Q:60 /30Days |
TRUSOPT PLUS 2% EYE DROPS 10ML BOT ![Compare how all Medicare Part D PDP plans in UT cover TRUSOPT PLUS 2% EYE DROPS 10ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$83.00 | $207.50 | None |
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 UT cover TRUVADA TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | None |
TWINJECT AUTO INJECTOR INJECTION 1% AUTO INJECTOR TWO PACK SYR ![Compare how all Medicare Part D PDP plans in UT cover TWINJECT AUTO INJECTOR INJECTION 1% AUTO INJECTOR TWO PACK SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | Q:2 /1Days |
TWINJECT AUTO INJECTOR INJECTION 1% AUTO TWO PACK SYR ![Compare how all Medicare Part D PDP plans in UT cover TWINJECT AUTO INJECTOR INJECTION 1% AUTO TWO PACK SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | Q:2 /1Days |
TWINRIX TF PF VACCINE 720UNT/20ML 10 X 1ML VIALSD ![Compare how all Medicare Part D PDP plans in UT cover TWINRIX TF PF VACCINE 720UNT/20ML 10 X 1ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | None |
TYGACIL 50MG VIAL 10 VILSU BOX ![Compare how all Medicare Part D PDP plans in UT cover TYGACIL 50MG VIAL 10 VILSU BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | None |
TYKERB 250MG TABLET ![Compare how all Medicare Part D PDP plans in UT cover TYKERB 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P |
TYPHIM VI 25MCG/0.5ML VIAL ![Compare how all Medicare Part D PDP plans in UT cover TYPHIM VI 25MCG/0.5ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Generic/Non-Preferred Brand |
$83.00 | $207.50 | None |
TYSABRI 300MG/15ML VIAL ![Compare how all Medicare Part D PDP plans in UT cover TYSABRI 300MG/15ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | P |
TYZEKA 600MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in UT cover TYZEKA 600MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
25% | 25% | None |
TYZINE 0.1% NOSE DROPS ![Compare how all Medicare Part D PDP plans in UT cover TYZINE 0.1% NOSE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | None |
TYZINE PEDIATRIC 0.05% DROP ![Compare how all Medicare Part D PDP plans in UT cover TYZINE PEDIATRIC 0.05% DROP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic/Preferred Brand |
$29.00 | $72.50 | None |