2011 Medicare Part D Plan Formulary Information |
Aetna Medicare Rx Premier (PDP) (S5810-176-0)
Sanctioned Plan
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The Aetna Medicare Rx Premier (PDP) (S5810-176-0) Formulary Drugs Starting with the Letter T in CMS PDP Region 6 which includes: PA WV
|
Drugs Starting with Letter T
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
TACLONEX SCALP SUSPENSION ![Compare how all Medicare Part D PDP plans in WV cover TACLONEX SCALP SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$60.00 | $165.00 | S |
TACROLIMUS 0.5 MG ORAL CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover TACROLIMUS 0.5 MG ORAL CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | P |
TACROLIMUS 1 MG ORAL CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover TACROLIMUS 1 MG ORAL CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | P |
TACROLIMUS 5 MG ORAL CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover TACROLIMUS 5 MG ORAL CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | P |
TALWIN 30MG/ML VIAL ![Compare how all Medicare Part D PDP plans in WV cover TALWIN 30MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$60.00 | $165.00 | P |
TAMIFLU 30MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover TAMIFLU 30MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$60.00 | $165.00 | Q:168 /365Days |
TAMIFLU 45MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover TAMIFLU 45MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$60.00 | $165.00 | Q:84 /365Days |
TAMIFLU 75MG CAPSULE UD ![Compare how all Medicare Part D PDP plans in WV cover TAMIFLU 75MG CAPSULE UD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$60.00 | $165.00 | Q:84 /365Days |
TAMIFLU ORAL SUSPENSION ![Compare how all Medicare Part D PDP plans in WV cover TAMIFLU ORAL SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$60.00 | $165.00 | Q:525 /365Days |
TAMOXIFEN CITRATE 20MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in WV cover TAMOXIFEN CITRATE 20MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | 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 WV cover TAMOXIFEN CITRATE TABLETS 10MG 180 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TAMSULOSIN HCL 0.4 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover TAMSULOSIN HCL 0.4 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | Q:2 /1Days |
TAPAZOLE 10MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover TAPAZOLE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TAPAZOLE 5MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover TAPAZOLE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TAPENTADOL 100 MG ORAL TABLET [NUCYNTA] ![Compare how all Medicare Part D PDP plans in WV cover TAPENTADOL 100 MG ORAL TABLET [NUCYNTA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $60.00 | S Q:6 /1Days |
TAPENTADOL 50 MG ORAL TABLET [NUCYNTA] ![Compare how all Medicare Part D PDP plans in WV cover TAPENTADOL 50 MG ORAL TABLET [NUCYNTA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $60.00 | S Q:6 /1Days |
TAPENTADOL 75 MG ORAL TABLET [NUCYNTA] ![Compare how all Medicare Part D PDP plans in WV cover TAPENTADOL 75 MG ORAL TABLET [NUCYNTA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $60.00 | S Q:6 /1Days |
TARCEVA 100MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover TARCEVA 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | P Q:1 /1Days |
TARCEVA 150MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover TARCEVA 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | P Q:1 /1Days |
TARCEVA 25MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover TARCEVA 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | P Q:1 /1Days |
TARGRETIN 1% GEL 60GM TUBE ![Compare how all Medicare Part D PDP plans in WV cover TARGRETIN 1% GEL 60GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | 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 WV cover TARGRETIN 75MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | P |
TASIGNA 200MG CAPSULE 28 BLPK ![Compare how all Medicare Part D PDP plans in WV cover TASIGNA 200MG CAPSULE 28 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | P Q:4 /1Days |
TAZICEF 1GM VIAL ![Compare how all Medicare Part D PDP plans in WV cover TAZICEF 1GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | None |
TAZICEF 2GM ADD-VANTAGE ![Compare how all Medicare Part D PDP plans in WV cover TAZICEF 2GM ADD-VANTAGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | None |
TAZICEF 6GM/100ML VIAL ![Compare how all Medicare Part D PDP plans in WV cover TAZICEF 6GM/100ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | None |
TAZORAC 0.05% CREAM ![Compare how all Medicare Part D PDP plans in WV cover TAZORAC 0.05% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $60.00 | None |
TAZORAC 0.05% GEL ![Compare how all Medicare Part D PDP plans in WV cover TAZORAC 0.05% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $60.00 | None |
TAZORAC 0.1% CREAM ![Compare how all Medicare Part D PDP plans in WV cover TAZORAC 0.1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $60.00 | None |
TAZORAC 0.1% GEL ![Compare how all Medicare Part D PDP plans in WV cover TAZORAC 0.1% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $60.00 | None |
TAZTIA DILTIAZEM HYDROCHLORIDE EXTENDED RELEASE CAPSULES ![Compare how all Medicare Part D PDP plans in WV cover TAZTIA DILTIAZEM HYDROCHLORIDE EXTENDED RELEASE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | Q:1 /1Days |
TAZTIA DILTIAZEM HYDROCHLORIDE EXTENDED RELEASE CAPSULES ![Compare how all Medicare Part D PDP plans in WV cover TAZTIA DILTIAZEM HYDROCHLORIDE EXTENDED RELEASE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | Q:3 /1Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TAZTIA DILTIAZEM HYDROCHLORIDE EXTENDED RELEASE CAPSULES ![Compare how all Medicare Part D PDP plans in WV cover TAZTIA DILTIAZEM HYDROCHLORIDE EXTENDED RELEASE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TAZTIA XT 240MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in WV cover TAZTIA XT 240MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | Q:1 /1Days |
TAZTIA XT 360MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in WV cover TAZTIA XT 360MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TEGRETOL XR TABLETS 100MG 100 BOT ![Compare how all Medicare Part D PDP plans in WV cover TEGRETOL XR TABLETS 100MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$60.00 | $165.00 | None |
TEGRETOL XR TABLETS 200MG 100 BOT ![Compare how all Medicare Part D PDP plans in WV cover TEGRETOL XR TABLETS 200MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$60.00 | $165.00 | None |
TEGRETOL XR TABLETS 400MG 100 BOT ![Compare how all Medicare Part D PDP plans in WV cover TEGRETOL XR TABLETS 400MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$60.00 | $165.00 | None |
TEKTURNA 150MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover TEKTURNA 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $60.00 | Q:1 /1Days |
TEKTURNA 300MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover TEKTURNA 300MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $60.00 | None |
TEKTURNA HCT 150-12.5MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover TEKTURNA HCT 150-12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $60.00 | Q:1 /1Days |
TEKTURNA HCT 150MG-25MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover TEKTURNA HCT 150MG-25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $60.00 | Q:1 /1Days |
TEKTURNA HCT 300-12.5MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover TEKTURNA HCT 300-12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $60.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TEKTURNA HCT 300MG-25MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover TEKTURNA HCT 300MG-25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $60.00 | None |
TELAVANCIN 15 MG/ML INJECTABLE SOLUTION [VIBATIV] ![Compare how all Medicare Part D PDP plans in WV cover TELAVANCIN 15 MG/ML INJECTABLE SOLUTION [VIBATIV].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | None |
TEMOVATE 0.05% CREAM 60GM TUBE ![Compare how all Medicare Part D PDP plans in WV cover TEMOVATE 0.05% CREAM 60GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TEMOVATE 0.05% GEL 60GM BOX ![Compare how all Medicare Part D PDP plans in WV cover TEMOVATE 0.05% GEL 60GM BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TEMOVATE 0.05% OINTMENT ![Compare how all Medicare Part D PDP plans in WV cover TEMOVATE 0.05% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TEMOVATE 0.05% SOLUTION NON-ORAL TOPICAL ![Compare how all Medicare Part D PDP plans in WV cover TEMOVATE 0.05% SOLUTION NON-ORAL TOPICAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TENORETIC 100 TABLET ![Compare how all Medicare Part D PDP plans in WV cover TENORETIC 100 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TENORMIN 25MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover TENORMIN 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TERAZOSIN HCL 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover TERAZOSIN HCL 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TERAZOSIN HCL 1MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover TERAZOSIN HCL 1MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TERAZOSIN HCL 2MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover TERAZOSIN HCL 2MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TERAZOSIN HCL 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover TERAZOSIN HCL 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TERBINAFINE HCL 250MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover TERBINAFINE HCL 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | P Q:1 /1Days |
TERBUTALINE SULF 1MG/ML VL ![Compare how all Medicare Part D PDP plans in WV cover TERBUTALINE SULF 1MG/ML VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | P |
TERBUTALINE SULF 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover TERBUTALINE SULF 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TERBUTALINE SULFATE 5MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover TERBUTALINE SULFATE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TERCONAZOLE 0.4% CREAM WITH APPLICATOR ![Compare how all Medicare Part D PDP plans in WV cover TERCONAZOLE 0.4% CREAM WITH APPLICATOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TERCONAZOLE 80MG SUPPOSITORY VAGINAL ![Compare how all Medicare Part D PDP plans in WV cover TERCONAZOLE 80MG SUPPOSITORY VAGINAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TERCONAZOLE VAGINAL CREAM ![Compare how all Medicare Part D PDP plans in WV cover TERCONAZOLE VAGINAL CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TESTOSTERONE CYPIONATE INJECTION ![Compare how all Medicare Part D PDP plans in WV cover TESTOSTERONE CYPIONATE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | None |
TESTOSTERONE ENANTHATE INJECTION ![Compare how all Medicare Part D PDP plans in WV cover TESTOSTERONE ENANTHATE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | None |
TESTRED 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover TESTRED 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TETANUS AND DIPHTHERIA TOXOIDS ADSORBED FOR ADULT USE 2 UNT/VIAL ![Compare how all Medicare Part D PDP plans in WV cover TETANUS AND DIPHTHERIA TOXOIDS ADSORBED FOR ADULT USE 2 UNT/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $60.00 | None |
TETANUS TOXOID ADSORBED VIAL 5LF ![Compare how all Medicare Part D PDP plans in WV cover TETANUS TOXOID ADSORBED VIAL 5LF.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $60.00 | P |
TETRACYCLINE 250 MG ORAL CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover TETRACYCLINE 250 MG ORAL CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | P |
TETRACYCLINE 500MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover TETRACYCLINE 500MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | P |
THALITONE 15MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover THALITONE 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$60.00 | $165.00 | None |
THALOMID 100MG CAPSULE 140 BOX ![Compare how all Medicare Part D PDP plans in WV cover THALOMID 100MG CAPSULE 140 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | P Q:28 /28Days |
THALOMID 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover THALOMID 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | P Q:28 /28Days |
THALOMID 200MG CAPSULE 28 BLPK ![Compare how all Medicare Part D PDP plans in WV cover THALOMID 200MG CAPSULE 28 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | P Q:28 /28Days |
THALOMID 50MG CAPSULE 280 BOX ![Compare how all Medicare Part D PDP plans in WV cover THALOMID 50MG CAPSULE 280 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | P Q:28 /28Days |
THEO-24 100MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in WV cover THEO-24 100MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
THEO-24 200MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in WV cover THEO-24 200MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
THEO-24 300MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in WV cover THEO-24 300MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
THEO-24 400MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in WV cover THEO-24 400MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
THEOCHRON 100MG TABLET SA ![Compare how all Medicare Part D PDP plans in WV cover THEOCHRON 100MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
THEOCHRON 100MG TABLET SA ![Compare how all Medicare Part D PDP plans in WV cover THEOCHRON 100MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
THEOCHRON 200MG TABLET SA 100 EA ![Compare how all Medicare Part D PDP plans in WV cover THEOCHRON 200MG TABLET SA 100 EA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
THEOCHRON TABLETS EXTENDED RELEASE 300MG 100 BOT ![Compare how all Medicare Part D PDP plans in WV cover THEOCHRON TABLETS EXTENDED RELEASE 300MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
THEOPHYLLINE 400MG TABLET SA ![Compare how all Medicare Part D PDP plans in WV cover THEOPHYLLINE 400MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
THEOPHYLLINE 600MG TABLET SA ![Compare how all Medicare Part D PDP plans in WV cover THEOPHYLLINE 600MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
THEOPHYLLINE ANHYDROUS ER TABLET 200MG (1000 CT) ![Compare how all Medicare Part D PDP plans in WV cover THEOPHYLLINE ANHYDROUS ER TABLET 200MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
THEOPHYLLINE TABLET ER 300MG (100 CT) ![Compare how all Medicare Part D PDP plans in WV cover THEOPHYLLINE TABLET ER 300MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
THEOPHYLLINE TABLET ER 450MG (100 CT) ![Compare how all Medicare Part D PDP plans in WV cover THEOPHYLLINE TABLET ER 450MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
THERMAZENE 50GM CREAM ![Compare how all Medicare Part D PDP plans in WV cover THERMAZENE 50GM CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
THIOGUANINE TABLET LOID 40MG ![Compare how all Medicare Part D PDP plans in WV cover THIOGUANINE TABLET LOID 40MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$60.00 | $165.00 | None |
THIORIDAZINE 100MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover THIORIDAZINE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
THIORIDAZINE HCL 10MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in WV cover THIORIDAZINE HCL 10MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
THIORIDAZINE HCL 25MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in WV cover THIORIDAZINE HCL 25MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
THIORIDAZINE HCL 50MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in WV cover THIORIDAZINE HCL 50MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
THIOTHIXENE 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover THIOTHIXENE 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
THIOTHIXENE 1MG CAPSULE (100 CT) ![Compare how all Medicare Part D PDP plans in WV cover THIOTHIXENE 1MG CAPSULE (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
THIOTHIXENE 2MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover THIOTHIXENE 2MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
THIOTHIXENE 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover THIOTHIXENE 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
THYMOGLOBULIN 25MG VIAL ![Compare how all Medicare Part D PDP plans in WV cover THYMOGLOBULIN 25MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$60.00 | $165.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
THYROLAR-1 60MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover THYROLAR-1 60MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$60.00 | $165.00 | None |
THYROLAR-1/4 15MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover THYROLAR-1/4 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$60.00 | $165.00 | None |
THYROLAR-2 120MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover THYROLAR-2 120MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$60.00 | $165.00 | None |
THYROLAR-3 180MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover THYROLAR-3 180MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$60.00 | $165.00 | None |
TICLOPIDINE 250 MG ORAL TABLET ![Compare how all Medicare Part D PDP plans in WV cover TICLOPIDINE 250 MG ORAL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | Q:2 /1Days |
TIKOSYN .125MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover TIKOSYN .125MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$60.00 | $165.00 | None |
TIKOSYN .250MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover TIKOSYN .250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$60.00 | $165.00 | None |
TIKOSYN .5MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover TIKOSYN .5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$60.00 | $165.00 | None |
TIMENTIN 3.1GM VIAL ![Compare how all Medicare Part D PDP plans in WV cover TIMENTIN 3.1GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | None |
TIMOLOL 0.0025 MG/MG OPHTHALMIC GEL ![Compare how all Medicare Part D PDP plans in WV cover TIMOLOL 0.0025 MG/MG OPHTHALMIC GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TIMOLOL 0.005 MG/MG OPHTHALMIC GEL ![Compare how all Medicare Part D PDP plans in WV cover TIMOLOL 0.005 MG/MG OPHTHALMIC GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TIMOLOL MAL SOL 0.25% OP 15ML BOT ![Compare how all Medicare Part D PDP plans in WV cover TIMOLOL MAL SOL 0.25% OP 15ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TIMOLOL MAL SOL 0.5% OP 10ML BOT ![Compare how all Medicare Part D PDP plans in WV cover TIMOLOL MAL SOL 0.5% OP 10ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TIMOLOL MALEATE 10MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover TIMOLOL MALEATE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TIMOLOL MALEATE 20MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover TIMOLOL MALEATE 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TIMOLOL MALEATE 5MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover TIMOLOL MALEATE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TIS-U-SOL IRRIGATION SOLUTION ![Compare how all Medicare Part D PDP plans in WV cover TIS-U-SOL IRRIGATION SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$60.00 | $165.00 | None |
TIZANIDINE HCL 2MG TABLET (150 CT) ![Compare how all Medicare Part D PDP plans in WV cover TIZANIDINE HCL 2MG TABLET (150 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TIZANIDINE HCL 4MG TABLET 150 BOT ![Compare how all Medicare Part D PDP plans in WV cover TIZANIDINE HCL 4MG TABLET 150 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TOBRAMYCIN 10MG/ML VIAL ![Compare how all Medicare Part D PDP plans in WV cover TOBRAMYCIN 10MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | None |
TOBRAMYCIN 40MG/ML VIAL ![Compare how all Medicare Part D PDP plans in WV cover TOBRAMYCIN 40MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | None |
TOBRAMYCIN 60MG/0.9% NACL ![Compare how all Medicare Part D PDP plans in WV cover TOBRAMYCIN 60MG/0.9% NACL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TOBRAMYCIN 80MG/0.9% NACL ![Compare how all Medicare Part D PDP plans in WV cover TOBRAMYCIN 80MG/0.9% NACL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | None |
TOBRAMYCIN INHALATION SOLUTION ![Compare how all Medicare Part D PDP plans in WV cover TOBRAMYCIN INHALATION SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | P Q:8400 /28Days |
TOBRAMYCIN OPHTHALMIC SOLUTION 0.3% 5ML BOT ![Compare how all Medicare Part D PDP plans in WV cover TOBRAMYCIN OPHTHALMIC SOLUTION 0.3% 5ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TOBRAMYCIN-DEXAMETH OPTH SUSP ![Compare how all Medicare Part D PDP plans in WV cover TOBRAMYCIN-DEXAMETH OPTH SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | None |
TOBRASOL 0.3% EYE DROPS ![Compare how all Medicare Part D PDP plans in WV cover TOBRASOL 0.3% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TOBREX 0.3% EYE DROPS ![Compare how all Medicare Part D PDP plans in WV cover TOBREX 0.3% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TOFRANIL 50MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in WV cover TOFRANIL 50MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TOFRANIL TABLETS 10MG 30 BOT ![Compare how all Medicare Part D PDP plans in WV cover TOFRANIL TABLETS 10MG 30 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TOFRANIL TABLETS 25MG 30 BOT ![Compare how all Medicare Part D PDP plans in WV cover TOFRANIL TABLETS 25MG 30 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TOLAZAMIDE TABLETS 250MG 100 BOT ![Compare how all Medicare Part D PDP plans in WV cover TOLAZAMIDE TABLETS 250MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | Q:2 /1Days |
TOLAZAMIDE TABLETS 500MG 100 BOT ![Compare how all Medicare Part D PDP plans in WV cover TOLAZAMIDE TABLETS 500MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | Q:2 /1Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TOLBUTAMIDE 500MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover TOLBUTAMIDE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | Q:6 /1Days |
TOLMETIN SODIUM 200MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover TOLMETIN SODIUM 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | None |
TOLMETIN SODIUM 400MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover TOLMETIN SODIUM 400MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TOLMETIN SODIUM 600MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover TOLMETIN SODIUM 600MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | None |
TOPICORT 0.05% GEL ![Compare how all Medicare Part D PDP plans in WV cover TOPICORT 0.05% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | None |
TOPICORT 0.25% CREAM ![Compare how all Medicare Part D PDP plans in WV cover TOPICORT 0.25% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | None |
TOPICORT 0.25% OINTMENT ![Compare how all Medicare Part D PDP plans in WV cover TOPICORT 0.25% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | None |
TOPICORT LP 0.05% CREAM ![Compare how all Medicare Part D PDP plans in WV cover TOPICORT LP 0.05% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | None |
TOPIRAMATE 25 MG SPRINKLE CAP ![Compare how all Medicare Part D PDP plans in WV cover TOPIRAMATE 25 MG SPRINKLE CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | None |
TOPIRAMATE SPRINKLE CAPSULES 15MG 60 BOT ![Compare how all Medicare Part D PDP plans in WV cover TOPIRAMATE SPRINKLE CAPSULES 15MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | None |
TOPIRAMATE TABLETS 100MG 1000 BOT ![Compare how all Medicare Part D PDP plans in WV cover TOPIRAMATE TABLETS 100MG 1000 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TOPIRAMATE TABLETS 200MG 1000 BOT ![Compare how all Medicare Part D PDP plans in WV cover TOPIRAMATE TABLETS 200MG 1000 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | None |
TOPIRAMATE TABLETS 25MG 1000 BOT ![Compare how all Medicare Part D PDP plans in WV cover TOPIRAMATE TABLETS 25MG 1000 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | None |
TOPIRAMATE TABLETS 50MG 1000 BOT ![Compare how all Medicare Part D PDP plans in WV cover TOPIRAMATE TABLETS 50MG 1000 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | None |
TOPOTECAN HYDROCHLORIDE FOR INJECTION ![Compare how all Medicare Part D PDP plans in WV cover TOPOTECAN HYDROCHLORIDE FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | P |
TORSEMIDE 100 MG ORAL TABLET ![Compare how all Medicare Part D PDP plans in WV cover TORSEMIDE 100 MG ORAL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TORSEMIDE 20 MG ORAL TABLET ![Compare how all Medicare Part D PDP plans in WV cover TORSEMIDE 20 MG ORAL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TORSEMIDE INJECTION 20MG/2ML ![Compare how all Medicare Part D PDP plans in WV cover TORSEMIDE INJECTION 20MG/2ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | None |
TORSEMIDE TABLETS 10 MG ![Compare how all Medicare Part D PDP plans in WV cover TORSEMIDE TABLETS 10 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TORSEMIDE TABLETS 5 MG ![Compare how all Medicare Part D PDP plans in WV cover TORSEMIDE TABLETS 5 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TPN ELECTROLYTES VIAL ![Compare how all Medicare Part D PDP plans in WV cover TPN ELECTROLYTES VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$60.00 | $165.00 | None |
TRACLEER 125MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover TRACLEER 125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | P Q:2 /1Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRACLEER 62.5MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover TRACLEER 62.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | P Q:2 /1Days |
TRAMADOL HCL 50 MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover TRAMADOL HCL 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | Q:8 /1Days |
TRAMADOL HCL-ACETAMINOPHEN 37.5-325MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in WV cover TRAMADOL HCL-ACETAMINOPHEN 37.5-325MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | Q:8 /1Days |
TRAMADOL HYDROCHLORIDE 100 MG ER TABLET 24 HR ![Compare how all Medicare Part D PDP plans in WV cover TRAMADOL HYDROCHLORIDE 100 MG ER TABLET 24 HR .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | Q:1 /1Days |
TRAMADOL HYDROCHLORIDE 200 MG ER TABLET 24 HR ![Compare how all Medicare Part D PDP plans in WV cover TRAMADOL HYDROCHLORIDE 200 MG ER TABLET 24 HR .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | Q:1 /1Days |
TRANDOLAPRIL 1MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover TRANDOLAPRIL 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | Q:2 /1Days |
TRANDOLAPRIL 2MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover TRANDOLAPRIL 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | Q:2 /1Days |
TRANDOLAPRIL 4MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover TRANDOLAPRIL 4MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TRANDOLAPRIL AND VERAPAMIL HYDROCHLORIDE TABLETS EXTENDED RELEASE ![Compare how all Medicare Part D PDP plans in WV cover TRANDOLAPRIL AND VERAPAMIL HYDROCHLORIDE TABLETS EXTENDED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | None |
TRANDOLAPRIL-VERAPAMIL ER 2-180 MG ![Compare how all Medicare Part D PDP plans in WV cover TRANDOLAPRIL-VERAPAMIL ER 2-180 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | None |
TRANDOLAPRIL-VERAPAMIL ER 2-240 MG ![Compare how all Medicare Part D PDP plans in WV cover TRANDOLAPRIL-VERAPAMIL ER 2-240 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRANDOLAPRIL-VERAPAMIL ER 4-240 MG ![Compare how all Medicare Part D PDP plans in WV cover TRANDOLAPRIL-VERAPAMIL ER 4-240 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | None |
TRANYLCYPROMINE SULFATE 10MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover TRANYLCYPROMINE SULFATE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | None |
TRAVATAN Z 0.04MG DROPS 2.5ML BOT ![Compare how all Medicare Part D PDP plans in WV cover TRAVATAN Z 0.04MG DROPS 2.5ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $60.00 | None |
TRAZODONE 300MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover TRAZODONE 300MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TRAZODONE HCL TABLET USP 100MG (500 CT) ![Compare how all Medicare Part D PDP plans in WV cover TRAZODONE HCL TABLET USP 100MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TRAZODONE HCL TABLET USP 150MG (100 CT) ![Compare how all Medicare Part D PDP plans in WV cover TRAZODONE HCL TABLET USP 150MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TRAZODONE HCL TABLET USP 50MG (500 CT) ![Compare how all Medicare Part D PDP plans in WV cover TRAZODONE HCL TABLET USP 50MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TRECATOR 250MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover TRECATOR 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$60.00 | $165.00 | None |
TRETINOIN 0.01% GEL 45GM TUBE ![Compare how all Medicare Part D PDP plans in WV cover TRETINOIN 0.01% GEL 45GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | P |
TRETINOIN 0.025% GEL 45GM TUBE ![Compare how all Medicare Part D PDP plans in WV cover TRETINOIN 0.025% GEL 45GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | P |
TRETINOIN 0.025% GEL 45GM TUBE ![Compare how all Medicare Part D PDP plans in WV cover TRETINOIN 0.025% GEL 45GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | P |
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 WV cover TRETINOIN 0.05% CREAM 45GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | P |
TRETINOIN 0.1% CREAM 45GM TUBE ![Compare how all Medicare Part D PDP plans in WV cover TRETINOIN 0.1% CREAM 45GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | P |
TRETINOIN 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover TRETINOIN 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | P |
TRETINOIN CREAM ![Compare how all Medicare Part D PDP plans in WV cover TRETINOIN CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | P |
TREXALL 10MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover TREXALL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | P |
TREXALL 15MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover TREXALL 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | P |
TREXALL 5MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover TREXALL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | P |
TREXALL 7.5MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover TREXALL 7.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | P |
TRI PREVIFEM TABLETS ![Compare how all Medicare Part D PDP plans in WV cover TRI PREVIFEM TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | Q:28 /28Days |
TRI-LEGEST FE 5-7-9-7 TABLET ![Compare how all Medicare Part D PDP plans in WV cover TRI-LEGEST FE 5-7-9-7 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TRI-SPRINTEC 7DAYSX3 28 TABLET ![Compare how all Medicare Part D PDP plans in WV cover TRI-SPRINTEC 7DAYSX3 28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | Q:28 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRIAMCINOLONE 0.1% OINTMENT ![Compare how all Medicare Part D PDP plans in WV cover TRIAMCINOLONE 0.1% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TRIAMCINOLONE 0.1% PASTE ![Compare how all Medicare Part D PDP plans in WV cover TRIAMCINOLONE 0.1% PASTE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TRIAMCINOLONE ACETONIDE 0.025% OINTMENT 80GM TUBE ![Compare how all Medicare Part D PDP plans in WV cover TRIAMCINOLONE ACETONIDE 0.025% OINTMENT 80GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TRIAMCINOLONE ACETONIDE 0.1% LOTION 60ML BOTPL ![Compare how all Medicare Part D PDP plans in WV cover TRIAMCINOLONE ACETONIDE 0.1% LOTION 60ML BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TRIAMCINOLONE ACETONIDE 0.025% CREAM 80GM TUBE ![Compare how all Medicare Part D PDP plans in WV cover TRIAMCINOLONE ACETONIDE 0.025% CREAM 80GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TRIAMCINOLONE ACETONIDE 0.025% LOTION 2 FL OZ BOT ![Compare how all Medicare Part D PDP plans in WV cover TRIAMCINOLONE ACETONIDE 0.025% LOTION 2 FL OZ BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TRIAMCINOLONE ACETONIDE 0.05% CREAM 15GM TUBE ![Compare how all Medicare Part D PDP plans in WV cover TRIAMCINOLONE ACETONIDE 0.05% CREAM 15GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TRIAMCINOLONE ACETONIDE 0.05% OINTMENT ![Compare how all Medicare Part D PDP plans in WV cover TRIAMCINOLONE ACETONIDE 0.05% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TRIAMCINOLONE ACETONIDE 0.05% OINTMENT 15GM TUBE ![Compare how all Medicare Part D PDP plans in WV cover TRIAMCINOLONE ACETONIDE 0.05% OINTMENT 15GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TRIAMCINOLONE ACETONIDE 0.1% CREAM 80GM TUBE ![Compare how all Medicare Part D PDP plans in WV cover TRIAMCINOLONE ACETONIDE 0.1% CREAM 80GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TRIAMTERENE/HCTZ 25/37.5MG CAPSULES (100 CT) ![Compare how all Medicare Part D PDP plans in WV cover TRIAMTERENE/HCTZ 25/37.5MG CAPSULES (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRIAMTERENE/HCTZ 37.5/25 TABLET ![Compare how all Medicare Part D PDP plans in WV cover TRIAMTERENE/HCTZ 37.5/25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TRIAMTERENE/HCTZ 75/50 TABLET ![Compare how all Medicare Part D PDP plans in WV cover TRIAMTERENE/HCTZ 75/50 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TRICOR 145MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover TRICOR 145MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $60.00 | None |
TRICOR 48MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover TRICOR 48MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $60.00 | None |
TRIDERM 0.1% CREAM ![Compare how all Medicare Part D PDP plans in WV cover TRIDERM 0.1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TRIDERM 0.1% OINTMENT ![Compare how all Medicare Part D PDP plans in WV cover TRIDERM 0.1% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TRIFLUOPERAZINE 1MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover TRIFLUOPERAZINE 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TRIFLUOPERAZINE HCL 2MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover TRIFLUOPERAZINE HCL 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TRIFLUOPERAZINE HCL 5MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover TRIFLUOPERAZINE HCL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TRIFLUOPERAZINE HCL USP 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in WV cover TRIFLUOPERAZINE HCL USP 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TRIFLURIDINE 1% OPTH SOLUTION 7.5ML BOT ![Compare how all Medicare Part D PDP plans in WV cover TRIFLURIDINE 1% OPTH SOLUTION 7.5ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRIHEXYPHENIDYL HCL 5MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in WV cover TRIHEXYPHENIDYL HCL 5MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TRIHEXYPHENIDYL HCL ELIXIR 5%/2 16 FLO BOT ![Compare how all Medicare Part D PDP plans in WV cover TRIHEXYPHENIDYL HCL ELIXIR 5%/2 16 FLO BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TRIHEXYPHENIDYL HCL TABLET 2MG (1000 CT) ![Compare how all Medicare Part D PDP plans in WV cover TRIHEXYPHENIDYL HCL TABLET 2MG (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TRIHIBIT PRESERVATIVE FREE ![Compare how all Medicare Part D PDP plans in WV cover TRIHIBIT PRESERVATIVE FREE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$60.00 | $165.00 | None |
TRILIPIX CAPSULE DR 45MG ![Compare how all Medicare Part D PDP plans in WV cover TRILIPIX CAPSULE DR 45MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $60.00 | None |
TRILIPIX DELAYED RELEASE CAPSULES 135MG ![Compare how all Medicare Part D PDP plans in WV cover TRILIPIX DELAYED RELEASE CAPSULES 135MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
$25.00 | $60.00 | None |
TRIMETHOBENZAMIDE 100MG/ML ![Compare how all Medicare Part D PDP plans in WV cover TRIMETHOBENZAMIDE 100MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | P |
TRIMETHOBENZAMIDE HCL 300MG CAPSULE ![Compare how all Medicare Part D PDP plans in WV cover TRIMETHOBENZAMIDE HCL 300MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | P |
TRIMETHOPRIM TABLETS ![Compare how all Medicare Part D PDP plans in WV cover TRIMETHOPRIM TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TRINESSA TABLET ![Compare how all Medicare Part D PDP plans in WV cover TRINESSA TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | Q:28 /28Days |
TRIPEDIA PRESERVATIVE FREE 6.7;23.4; UNT/.5 ML; ![Compare how all Medicare Part D PDP plans in WV cover TRIPEDIA PRESERVATIVE FREE 6.7;23.4; UNT/.5 ML;.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$60.00 | $165.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRISENOX 10MG/10ML AMPULE ![Compare how all Medicare Part D PDP plans in WV cover TRISENOX 10MG/10ML AMPULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$60.00 | $165.00 | None |
TRIVORA-28 TABLET ![Compare how all Medicare Part D PDP plans in WV cover TRIVORA-28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TRIZIVIR TABLET ![Compare how all Medicare Part D PDP plans in WV cover TRIZIVIR TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | None |
TROPICAMIDE 0.5% EYE DROPS ![Compare how all Medicare Part D PDP plans in WV cover TROPICAMIDE 0.5% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TROPICAMIDE OPHTHALMIC SOLUTION USP ![Compare how all Medicare Part D PDP plans in WV cover TROPICAMIDE OPHTHALMIC SOLUTION USP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | None |
TROSPIUM CHLORIDE TABLETS ![Compare how all Medicare Part D PDP plans in WV cover TROSPIUM CHLORIDE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | Q:3 /1Days |
TRUVADA TABLET ![Compare how all Medicare Part D PDP plans in WV cover TRUVADA TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | None |
TWINRIX TF PF VACCINE 720UNT/20ML 10 X 1ML VIALSD ![Compare how all Medicare Part D PDP plans in WV cover TWINRIX TF PF VACCINE 720UNT/20ML 10 X 1ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$60.00 | $165.00 | None |
TYGACIL 50MG VIAL 10 VILSU BOX ![Compare how all Medicare Part D PDP plans in WV cover TYGACIL 50MG VIAL 10 VILSU BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$60.00 | $165.00 | None |
TYKERB 250MG TABLET ![Compare how all Medicare Part D PDP plans in WV cover TYKERB 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | P Q:5 /1Days |
TYLENOL W/CODEINE #3 TABLET ![Compare how all Medicare Part D PDP plans in WV cover TYLENOL W/CODEINE #3 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | Q:13 /1Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TYLENOL W/CODEINE #4 TABLET ![Compare how all Medicare Part D PDP plans in WV cover TYLENOL W/CODEINE #4 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | Q:13 /1Days |
TYLOX CAPSULES ![Compare how all Medicare Part D PDP plans in WV cover TYLOX CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$2.00 | $6.00 | Q:8 /1Days |
TYPHIM VI 25MCG/0.5ML VIAL ![Compare how all Medicare Part D PDP plans in WV cover TYPHIM VI 25MCG/0.5ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$60.00 | $165.00 | None |
TYSABRI 300MG/15ML VIAL ![Compare how all Medicare Part D PDP plans in WV cover TYSABRI 300MG/15ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | P Q:15 /28Days |
TYZEKA 600MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in WV cover TYZEKA 600MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
$60.00 | $165.00 | P Q:1 /1Days |
TYZINE 0.1% NOSE DROPS ![Compare how all Medicare Part D PDP plans in WV cover TYZINE 0.1% NOSE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | None |
TYZINE PEDIATRIC 0.05% DROP ![Compare how all Medicare Part D PDP plans in WV cover TYZINE PEDIATRIC 0.05% DROP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$20.00 | $45.00 | None |