2013 Medicare Part D Plan Formulary Information |
HumanaChoice H5216-006 (PPO) (H5216-006-0)
Benefit Details
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The HumanaChoice H5216-006 (PPO) (H5216-006-0) Formulary Drugs Starting with the Letter T in IOWA County, WI: CMS MA Region 14 which includes: WI
|
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 |
TABLOID 40 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TABLOID 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TACLONEX OINTMENT ![Compare how all Medicare Part D PDP plans in WI cover TACLONEX OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | None |
TACLONEX SCALP SUSPENSION ![Compare how all Medicare Part D PDP plans in WI cover TACLONEX SCALP SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | Q:120 /30Days |
Tacrolimus 0.5mg/1 100 CAPSULE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Tacrolimus 0.5mg/1 100 CAPSULE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | P |
Tacrolimus 1mg/1 100 CAPSULE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Tacrolimus 1mg/1 100 CAPSULE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | P |
Tacrolimus 5mg/1 100 CAPSULE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Tacrolimus 5mg/1 100 CAPSULE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | P |
Tamiflu 30mg/1 1 BLISTER PACK in 1 CARTON / 10 CAPSULE in 1 BLISTER PACK ![Compare how all Medicare Part D PDP plans in WI cover Tamiflu 30mg/1 1 BLISTER PACK in 1 CARTON / 10 CAPSULE in 1 BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | Q:112 /365Days |
Tamiflu 45mg/1 1 BLISTER PACK in 1 CARTON / 10 CAPSULE in 1 BLISTER PACK ![Compare how all Medicare Part D PDP plans in WI cover Tamiflu 45mg/1 1 BLISTER PACK in 1 CARTON / 10 CAPSULE in 1 BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | Q:56 /365Days |
Tamiflu 6mg/mL 1 BOTTLE, GLASS in 1 CARTON / 6 mL in 1 BOTTLE, GLASS ![Compare how all Medicare Part D PDP plans in WI cover Tamiflu 6mg/mL 1 BOTTLE, GLASS in 1 CARTON / 6 mL in 1 BOTTLE, GLASS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | Q:720 /365Days |
TAMIFLU 75MG CAPSULE UD ![Compare how all Medicare Part D PDP plans in WI cover TAMIFLU 75MG CAPSULE UD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | Q:56 /365Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TAMOXIFEN CITRATE 20MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in WI cover TAMOXIFEN CITRATE 20MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
TAMOXIFEN CITRATE TABLETS 10MG 180 BOT ![Compare how all Medicare Part D PDP plans in WI cover TAMOXIFEN CITRATE TABLETS 10MG 180 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
TAMSULOSIN HCL 0.4 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover TAMSULOSIN HCL 0.4 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | Q:60 /30Days |
TAPAZOLE 10MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TAPAZOLE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TAPAZOLE 5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TAPAZOLE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TARCEVA 100MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TARCEVA 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
TARCEVA 150MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TARCEVA 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
TARCEVA 25MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TARCEVA 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P Q:90 /30Days |
TARGRETIN 1% GEL 60GM TUBE ![Compare how all Medicare Part D PDP plans in WI cover TARGRETIN 1% GEL 60GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P |
TARGRETIN 75MG (100 CT) ![Compare how all Medicare Part D PDP plans in WI cover TARGRETIN 75MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P Q:300 /30Days |
Tasigna 150mg/1 4 BLISTER PACK in 1 CARTON / 28 CAPSULE in 1 BLISTER PACK ![Compare how all Medicare Part D PDP plans in WI cover Tasigna 150mg/1 4 BLISTER PACK in 1 CARTON / 28 CAPSULE in 1 BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P Q:120 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TASIGNA 200MG CAPSULE 28 BLPK ![Compare how all Medicare Part D PDP plans in WI cover TASIGNA 200MG CAPSULE 28 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P Q:120 /30Days |
TASMAR 100MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TASMAR 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | P |
TAXOTERE 80mg/4mL 1 VIAL, GLASS in 1 CARTON / 4 mL in 1 VIAL, GLASS ![Compare how all Medicare Part D PDP plans in WI cover TAXOTERE 80mg/4mL 1 VIAL, GLASS in 1 CARTON / 4 mL in 1 VIAL, GLASS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P |
TAZORAC 0.05% CREAM ![Compare how all Medicare Part D PDP plans in WI cover TAZORAC 0.05% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TAZORAC 0.05% GEL ![Compare how all Medicare Part D PDP plans in WI cover TAZORAC 0.05% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TAZORAC 0.1% CREAM ![Compare how all Medicare Part D PDP plans in WI cover TAZORAC 0.1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TAZORAC 0.1% GEL ![Compare how all Medicare Part D PDP plans in WI cover TAZORAC 0.1% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TAZTIA DILTIAZEM HYDROCHLORIDE EXTENDED RELEASE CAPSULES ![Compare how all Medicare Part D PDP plans in WI cover TAZTIA DILTIAZEM HYDROCHLORIDE EXTENDED RELEASE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | Q:60 /30Days |
TAZTIA DILTIAZEM HYDROCHLORIDE EXTENDED RELEASE CAPSULES ![Compare how all Medicare Part D PDP plans in WI cover TAZTIA DILTIAZEM HYDROCHLORIDE EXTENDED RELEASE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | Q:60 /30Days |
TAZTIA DILTIAZEM HYDROCHLORIDE EXTENDED RELEASE CAPSULES ![Compare how all Medicare Part D PDP plans in WI cover TAZTIA DILTIAZEM HYDROCHLORIDE EXTENDED RELEASE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | Q:30 /30Days |
TAZTIA XT 240MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in WI cover TAZTIA XT 240MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TAZTIA XT 360MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in WI cover TAZTIA XT 360MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | Q:30 /30Days |
Teflaro 400mg/20mL 10 VIAL, SINGLE-DOSE in 1 CARTON / 20 mL in 1 VIAL, SINGLE-DOSE ![Compare how all Medicare Part D PDP plans in WI cover Teflaro 400mg/20mL 10 VIAL, SINGLE-DOSE in 1 CARTON / 20 mL in 1 VIAL, SINGLE-DOSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
Teflaro 600mg/20mL 10 VIAL, SINGLE-DOSE in 1 CARTON / 20 mL in 1 VIAL, SINGLE-DOSE ![Compare how all Medicare Part D PDP plans in WI cover Teflaro 600mg/20mL 10 VIAL, SINGLE-DOSE in 1 CARTON / 20 mL in 1 VIAL, SINGLE-DOSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TEGRETOL XR TABLETS 100MG 100 BOT ![Compare how all Medicare Part D PDP plans in WI cover TEGRETOL XR TABLETS 100MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TEGRETOL XR TABLETS 200MG 100 BOT ![Compare how all Medicare Part D PDP plans in WI cover TEGRETOL XR TABLETS 200MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TEGRETOL XR TABLETS 400MG 100 BOT ![Compare how all Medicare Part D PDP plans in WI cover TEGRETOL XR TABLETS 400MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
Tekamlo 150; 10mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Tekamlo 150; 10mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | Q:30 /30Days |
Tekamlo 150; 5mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Tekamlo 150; 5mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | Q:30 /30Days |
Tekamlo 300; 10mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Tekamlo 300; 10mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | Q:30 /30Days |
Tekamlo 300; 5mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Tekamlo 300; 5mg/1; mg/1 30 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | Q:30 /30Days |
TEKTURNA 150MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TEKTURNA 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TEKTURNA 300MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TEKTURNA 300MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | Q:30 /30Days |
TEKTURNA HCT 150-12.5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TEKTURNA HCT 150-12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | Q:30 /30Days |
TEKTURNA HCT 150MG-25MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TEKTURNA HCT 150MG-25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | Q:30 /30Days |
TEKTURNA HCT 300-12.5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TEKTURNA HCT 300-12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | Q:30 /30Days |
TEKTURNA HCT 300MG-25MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TEKTURNA HCT 300MG-25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | Q:30 /30Days |
Temazepam 15mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 CAPSULE in 1 BLISTER PACK ![Compare how all Medicare Part D PDP plans in WI cover Temazepam 15mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 CAPSULE in 1 BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | Q:30 /30Days |
Temazepam 22.5mg/1 30 CAPSULE in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in WI cover Temazepam 22.5mg/1 30 CAPSULE in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TEMAZEPAM 30 MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover TEMAZEPAM 30 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | Q:30 /30Days |
Temazepam 7.5mg/1 100 CAPSULE in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in WI cover Temazepam 7.5mg/1 100 CAPSULE in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TENORETIC 100 TABLET ![Compare how all Medicare Part D PDP plans in WI cover TENORETIC 100 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TENORETIC 50; 25mg/1; mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover TENORETIC 50; 25mg/1; mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TENORMIN 100mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover TENORMIN 100mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TENORMIN 25MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TENORMIN 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TENORMIN 50MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TENORMIN 50MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TERAZOL 3 80MG SUPPOSITORY ![Compare how all Medicare Part D PDP plans in WI cover TERAZOL 3 80MG SUPPOSITORY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TERAZOL 3 CRE 0.8% ![Compare how all Medicare Part D PDP plans in WI cover TERAZOL 3 CRE 0.8%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TERAZOL 7 0.4% CREAM ![Compare how all Medicare Part D PDP plans in WI cover TERAZOL 7 0.4% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
Terazosin Hydrochloride 10mg/1 100 CAPSULE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Terazosin Hydrochloride 10mg/1 100 CAPSULE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
Terazosin hydrochloride 1mg/1 500 CAPSULE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Terazosin hydrochloride 1mg/1 500 CAPSULE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
Terazosin Hydrochloride 2mg/1 100 CAPSULE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Terazosin Hydrochloride 2mg/1 100 CAPSULE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
Terazosin Hydrochloride 5mg/1 100 CAPSULE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Terazosin Hydrochloride 5mg/1 100 CAPSULE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
TERBINAFINE HCL 250MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TERBINAFINE HCL 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | Q:90 /365Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TERBUTALINE SULF 1MG/ML VL ![Compare how all Medicare Part D PDP plans in WI cover TERBUTALINE SULF 1MG/ML VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | None |
TERBUTALINE SULF 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TERBUTALINE SULF 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | None |
TERBUTALINE SULFATE 5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TERBUTALINE SULFATE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | None |
TERCONAZOLE 0.4% CREAM WITH APPLICATOR ![Compare how all Medicare Part D PDP plans in WI cover TERCONAZOLE 0.4% CREAM WITH APPLICATOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
TERCONAZOLE 0.8% CREAM ![Compare how all Medicare Part D PDP plans in WI cover TERCONAZOLE 0.8% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
TERCONAZOLE 80MG SUPPOSITORY VAGINAL ![Compare how all Medicare Part D PDP plans in WI cover TERCONAZOLE 80MG SUPPOSITORY VAGINAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
Testosterone Cypionate 200mg/mL 1 VIAL, MULTI-DOSE in 1 CARTON / 10 mL in 1 VIAL, MULTI-DOSE ![Compare how all Medicare Part D PDP plans in WI cover Testosterone Cypionate 200mg/mL 1 VIAL, MULTI-DOSE in 1 CARTON / 10 mL in 1 VIAL, MULTI-DOSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | None |
TESTOSTERONE CYPIONATE INJECTION ![Compare how all Medicare Part D PDP plans in WI cover TESTOSTERONE CYPIONATE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | None |
TESTOSTERONE ENANTHATE INJECTION ![Compare how all Medicare Part D PDP plans in WI cover TESTOSTERONE ENANTHATE INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | None |
TESTRED 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover TESTRED 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
Tetanus and Diphtheria Toxoids Adsorbed 2.0; 2.0[Lf]/0.5mL; [Lf]/0.5mL 10 VIAL, SINGLE-DOSE in 1 CA ![Compare how all Medicare Part D PDP plans in WI cover Tetanus and Diphtheria Toxoids Adsorbed 2.0; 2.0[Lf]/0.5mL; [Lf]/0.5mL 10 VIAL, SINGLE-DOSE in 1 CA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
tetanus toxoid adsorbed vial ![Compare how all Medicare Part D PDP plans in WI cover tetanus toxoid adsorbed vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | P |
Tetracycline Hydrochloride 250mg/1 1000 CAPSULE in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in WI cover Tetracycline Hydrochloride 250mg/1 1000 CAPSULE in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
Tetracycline Hydrochloride 500mg/1 1000 CAPSULE in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in WI cover Tetracycline Hydrochloride 500mg/1 1000 CAPSULE in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
THALITONE 15MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover THALITONE 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
THALOMID 100MG CAPSULE 140 BOX ![Compare how all Medicare Part D PDP plans in WI cover THALOMID 100MG CAPSULE 140 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
Thalomid 150mg/1 ![Compare how all Medicare Part D PDP plans in WI cover Thalomid 150mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P Q:60 /30Days |
Thalomid 200mg/1 ![Compare how all Medicare Part D PDP plans in WI cover Thalomid 200mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
THALOMID 50MG CAPSULE 280 BOX ![Compare how all Medicare Part D PDP plans in WI cover THALOMID 50MG CAPSULE 280 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
Theophylline 100mg/1 500 CAPSULE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Theophylline 100mg/1 500 CAPSULE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
Theophylline 200mg/1 500 TABLET, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Theophylline 200mg/1 500 TABLET, EXTENDED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
THEOPHYLLINE 400MG TABLET SA ![Compare how all Medicare Part D PDP plans in WI cover THEOPHYLLINE 400MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
THEOPHYLLINE 600MG TABLET SA ![Compare how all Medicare Part D PDP plans in WI cover THEOPHYLLINE 600MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
THEOPHYLLINE TABLET ER 300MG (100 CT) ![Compare how all Medicare Part D PDP plans in WI cover THEOPHYLLINE TABLET ER 300MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
THEOPHYLLINE TABLET ER 450MG (100 CT) ![Compare how all Medicare Part D PDP plans in WI cover THEOPHYLLINE TABLET ER 450MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
Thermazene 10mg/g ![Compare how all Medicare Part D PDP plans in WI cover Thermazene 10mg/g.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
THIORIDAZINE 100MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover THIORIDAZINE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | P |
THIORIDAZINE HCL 10MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in WI cover THIORIDAZINE HCL 10MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | P |
THIORIDAZINE HCL 25MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in WI cover THIORIDAZINE HCL 25MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | P |
Thioridazine Hydrochloride 50mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 TABLET, FILM COATED in 1 ![Compare how all Medicare Part D PDP plans in WI cover Thioridazine Hydrochloride 50mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 TABLET, FILM COATED in 1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | P |
THIOTEPA POWDER FOR INJECTION 15MG/VIL 1 VIAL SINGLE DOSE CRTN ![Compare how all Medicare Part D PDP plans in WI 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 |
$6.00 | $0.00 | P |
THIOTHIXENE 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover THIOTHIXENE 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
THIOTHIXENE 1MG CAPSULE (100 CT) ![Compare how all Medicare Part D PDP plans in WI cover THIOTHIXENE 1MG CAPSULE (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | 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 WI cover THIOTHIXENE 2MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
THIOTHIXENE 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover THIOTHIXENE 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
THYMOGLOBULIN 25MG VIAL ![Compare how all Medicare Part D PDP plans in WI cover THYMOGLOBULIN 25MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | P |
tiagabine hcl 2 mg tablet ![Compare how all Medicare Part D PDP plans in WI cover tiagabine hcl 2 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
tiagabine hcl 4 mg tablet ![Compare how all Medicare Part D PDP plans in WI cover tiagabine hcl 4 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TIAZAC 120MG E.R. CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover TIAZAC 120MG E.R. CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | Q:60 /30Days |
TIAZAC 180MG E.R. CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover TIAZAC 180MG E.R. CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | Q:60 /30Days |
TIAZAC 240MG E.R. CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover TIAZAC 240MG E.R. CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | Q:60 /30Days |
TIAZAC 300MG E.R. CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover TIAZAC 300MG E.R. CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | Q:30 /30Days |
TIAZAC 360MG E.R. CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover TIAZAC 360MG E.R. CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | Q:30 /30Days |
TIAZAC 420MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in WI cover TIAZAC 420MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TICLOPIDINE 250 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TICLOPIDINE 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | P |
TIGAN 300MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover TIGAN 300MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | P |
TIKOSYN .125MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover TIKOSYN .125MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | Q:240 /30Days |
TIKOSYN .250MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover TIKOSYN .250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | Q:120 /30Days |
TIKOSYN .5MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover TIKOSYN .5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | Q:60 /30Days |
TIMENTIN ADD-VANTAGE 1; 30mg/mL; mg/mL 10 VIAL in 1 TRAY / 50 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in WI cover TIMENTIN ADD-VANTAGE 1; 30mg/mL; mg/mL 10 VIAL in 1 TRAY / 50 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TIMOLOL MAL SOL 0.25% OP 15ML BOT ![Compare how all Medicare Part D PDP plans in WI cover TIMOLOL MAL SOL 0.25% OP 15ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
TIMOLOL MAL SOL 0.5% OP 10ML BOT ![Compare how all Medicare Part D PDP plans in WI cover TIMOLOL MAL SOL 0.5% OP 10ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
TIMOLOL MALEATE 10MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TIMOLOL MALEATE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
TIMOLOL MALEATE 20MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TIMOLOL MALEATE 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
Timolol Maleate 3.4mg/mL 1 BOTTLE, DISPENSING in 1 CARTON / 5 mL in 1 BOTTLE, DISPENSING ![Compare how all Medicare Part D PDP plans in WI cover Timolol Maleate 3.4mg/mL 1 BOTTLE, DISPENSING in 1 CARTON / 5 mL in 1 BOTTLE, DISPENSING.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TIMOLOL MALEATE 5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TIMOLOL MALEATE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
Timolol Maleate 6.8mg/mL 1 BOTTLE, DISPENSING in 1 CARTON / 5 mL in 1 BOTTLE, DISPENSING ![Compare how all Medicare Part D PDP plans in WI cover Timolol Maleate 6.8mg/mL 1 BOTTLE, DISPENSING in 1 CARTON / 5 mL in 1 BOTTLE, DISPENSING.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | None |
Timoptic 3.4mg/mL 4 POUCH in 1 CARTON / 15 CONTAINER in 1 POUCH / 0.2 mL in 1 CONTAINER ![Compare how all Medicare Part D PDP plans in WI cover Timoptic 3.4mg/mL 4 POUCH in 1 CARTON / 15 CONTAINER in 1 POUCH / 0.2 mL in 1 CONTAINER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
Timoptic 6.8mg/mL 4 POUCH in 1 CARTON / 15 CONTAINER in 1 POUCH / 0.2 mL in 1 CONTAINER ![Compare how all Medicare Part D PDP plans in WI cover Timoptic 6.8mg/mL 4 POUCH in 1 CARTON / 15 CONTAINER in 1 POUCH / 0.2 mL in 1 CONTAINER.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
Timoptic-XE 3.4mg/mL 1 BOTTLE, DISPENSING in 1 CARTON / 5 mL in 1 BOTTLE, DISPENSING ![Compare how all Medicare Part D PDP plans in WI cover Timoptic-XE 3.4mg/mL 1 BOTTLE, DISPENSING in 1 CARTON / 5 mL in 1 BOTTLE, DISPENSING.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
Timoptic-XE 6.8mg/mL 1 BOTTLE, DISPENSING in 1 CARTON / 5 mL in 1 BOTTLE, DISPENSING ![Compare how all Medicare Part D PDP plans in WI cover Timoptic-XE 6.8mg/mL 1 BOTTLE, DISPENSING in 1 CARTON / 5 mL in 1 BOTTLE, DISPENSING.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | P |
tinidazole 250 mg tablet ![Compare how all Medicare Part D PDP plans in WI cover tinidazole 250 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | None |
tinidazole 500 mg tablet ![Compare how all Medicare Part D PDP plans in WI cover tinidazole 500 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | None |
Tizanidine 4mg/1 1000 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Tizanidine 4mg/1 1000 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
TIZANIDINE HCL 2 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TIZANIDINE HCL 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
TOBI 300mg/5mL 56 AMPULE in 1 CARTON / 5 mL in 1 AMPULE ![Compare how all Medicare Part D PDP plans in WI cover TOBI 300mg/5mL 56 AMPULE in 1 CARTON / 5 mL in 1 AMPULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P Q:280 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TOBI PODHALER 28 MG INHALE CAP ![Compare how all Medicare Part D PDP plans in WI cover TOBI PODHALER 28 MG INHALE CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P Q:224 /28Days |
TOBRADEX EYE OINTMENT ![Compare how all Medicare Part D PDP plans in WI cover TOBRADEX EYE OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TOBRADEX ST 0.5; 3mg/mL; mg/mL 5 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover TOBRADEX ST 0.5; 3mg/mL; mg/mL 5 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TOBRADEX SUSPENSION OPHTHALMIC 0.1%/0.3% 5ML BOT ![Compare how all Medicare Part D PDP plans in WI cover TOBRADEX SUSPENSION OPHTHALMIC 0.1%/0.3% 5ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TOBRAMYCIN 10MG/ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover TOBRAMYCIN 10MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
TOBRAMYCIN 40MG/ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover TOBRAMYCIN 40MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
TOBRAMYCIN 60MG/0.9% NACL ![Compare how all Medicare Part D PDP plans in WI cover TOBRAMYCIN 60MG/0.9% NACL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
TOBRAMYCIN 80MG/0.9% NACL ![Compare how all Medicare Part D PDP plans in WI cover TOBRAMYCIN 80MG/0.9% NACL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
TOBRAMYCIN OPHTHALMIC SOLUTION 0.3% 5ML BOT ![Compare how all Medicare Part D PDP plans in WI cover TOBRAMYCIN OPHTHALMIC SOLUTION 0.3% 5ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
TOBRAMYCIN-DEXAMETH OPTH SUSP ![Compare how all Medicare Part D PDP plans in WI cover TOBRAMYCIN-DEXAMETH OPTH SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | None |
TOBREX 0.3% EYE DROPS ![Compare how all Medicare Part D PDP plans in WI cover TOBREX 0.3% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TOBREX 0.3% EYE OINTMENT ![Compare how all Medicare Part D PDP plans in WI cover TOBREX 0.3% EYE OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TOFRANIL 50MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in WI cover TOFRANIL 50MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | P |
TOFRANIL TABLETS 10MG 30 BOT ![Compare how all Medicare Part D PDP plans in WI cover TOFRANIL TABLETS 10MG 30 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | P |
TOFRANIL TABLETS 25MG 30 BOT ![Compare how all Medicare Part D PDP plans in WI cover TOFRANIL TABLETS 25MG 30 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | P |
TOFRANIL-PM 100MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover TOFRANIL-PM 100MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | P |
TOFRANIL-PM 125MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover TOFRANIL-PM 125MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | P |
TOFRANIL-PM 150MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover TOFRANIL-PM 150MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | P |
TOFRANIL-PM 75MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover TOFRANIL-PM 75MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | P |
TOLAZAMIDE TABLETS 250MG 100 BOT ![Compare how all Medicare Part D PDP plans in WI cover TOLAZAMIDE TABLETS 250MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TOLAZAMIDE TABLETS 500MG 100 BOT ![Compare how all Medicare Part D PDP plans in WI cover TOLAZAMIDE TABLETS 500MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TOLBUTAMIDE 500MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TOLBUTAMIDE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | 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 WI cover TOLMETIN SODIUM 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | None |
TOLMETIN SODIUM 400 MG CAP ![Compare how all Medicare Part D PDP plans in WI cover TOLMETIN SODIUM 400 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | None |
TOLMETIN SODIUM 600MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TOLMETIN SODIUM 600MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | None |
tolterodine tartrate 1 mg tab ![Compare how all Medicare Part D PDP plans in WI cover tolterodine tartrate 1 mg tab.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | Q:60 /30Days |
tolterodine tartrate 2 mg tablet ![Compare how all Medicare Part D PDP plans in WI cover tolterodine tartrate 2 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | Q:60 /30Days |
TOLVAPTAN 15 MG ORAL TABLET [SAMSCA] ![Compare how all Medicare Part D PDP plans in WI cover TOLVAPTAN 15 MG ORAL TABLET [SAMSCA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | Q:60 /30Days |
TOLVAPTAN 30 MG ORAL TABLET [SAMSCA] ![Compare how all Medicare Part D PDP plans in WI cover TOLVAPTAN 30 MG ORAL TABLET [SAMSCA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | Q:60 /30Days |
TOPAMAX 15 MG SPRINKLE CAP ![Compare how all Medicare Part D PDP plans in WI cover TOPAMAX 15 MG SPRINKLE CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TOPAMAX 25 MG SPRINKLE CAP ![Compare how all Medicare Part D PDP plans in WI cover TOPAMAX 25 MG SPRINKLE CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TOPAMAX TABLETS 100MG 60 BOT ![Compare how all Medicare Part D PDP plans in WI cover TOPAMAX TABLETS 100MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | Q:120 /30Days |
TOPAMAX TABLETS 200MG 60 BOT ![Compare how all Medicare Part D PDP plans in WI cover TOPAMAX TABLETS 200MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | Q:120 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TOPAMAX TABLETS 25MG 60 BOT ![Compare how all Medicare Part D PDP plans in WI cover TOPAMAX TABLETS 25MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | Q:90 /30Days |
TOPAMAX TABLETS 50MG 60 BOT ![Compare how all Medicare Part D PDP plans in WI cover TOPAMAX TABLETS 50MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | Q:120 /30Days |
Topiramate 25mg/1 ![Compare how all Medicare Part D PDP plans in WI cover Topiramate 25mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
TOPIRAMATE SPRINKLE CAPSULES 15MG 60 BOT ![Compare how all Medicare Part D PDP plans in WI cover TOPIRAMATE SPRINKLE CAPSULES 15MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
TOPIRAMATE TABLETS 100MG 1000 BOT ![Compare how all Medicare Part D PDP plans in WI cover TOPIRAMATE TABLETS 100MG 1000 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | Q:120 /30Days |
TOPIRAMATE TABLETS 200MG 1000 BOT ![Compare how all Medicare Part D PDP plans in WI cover TOPIRAMATE TABLETS 200MG 1000 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | Q:120 /30Days |
TOPIRAMATE TABLETS 25MG 1000 BOT ![Compare how all Medicare Part D PDP plans in WI cover TOPIRAMATE TABLETS 25MG 1000 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | Q:90 /30Days |
TOPIRAMATE TABLETS 50MG 1000 BOT ![Compare how all Medicare Part D PDP plans in WI cover TOPIRAMATE TABLETS 50MG 1000 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | Q:120 /30Days |
TOPOSAR INJECTION 20MG/ML 50ML VIAL MD CRTN ![Compare how all Medicare Part D PDP plans in WI cover TOPOSAR INJECTION 20MG/ML 50ML VIAL MD CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | P |
TOPOTECAN HYDROCHLORIDE FOR INJECTION ![Compare how all Medicare Part D PDP plans in WI cover TOPOTECAN HYDROCHLORIDE FOR INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P |
TOPROL XL 100MG TABLET SA ![Compare how all Medicare Part D PDP plans in WI cover TOPROL XL 100MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TOPROL XL 200MG TABLET SA ![Compare how all Medicare Part D PDP plans in WI cover TOPROL XL 200MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | Q:60 /30Days |
TOPROL XL 25MG TABLET SA ![Compare how all Medicare Part D PDP plans in WI cover TOPROL XL 25MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | Q:60 /30Days |
TOPROL XL 50MG TABLET SA ![Compare how all Medicare Part D PDP plans in WI cover TOPROL XL 50MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | Q:60 /30Days |
Torisel 1 KIT in 1 CARTON ![Compare how all Medicare Part D PDP plans in WI cover Torisel 1 KIT in 1 CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P Q:100 /28Days |
Torsemide 100mg/1 12 BOTTLE CASE / 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Torsemide 100mg/1 12 BOTTLE CASE / 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
TORSEMIDE 20mg 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover TORSEMIDE 20mg 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
TORSEMIDE INJECTION 20MG/2ML ![Compare how all Medicare Part D PDP plans in WI cover TORSEMIDE INJECTION 20MG/2ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
TORSEMIDE TABLETS ![Compare how all Medicare Part D PDP plans in WI cover TORSEMIDE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
TORSEMIDE TABLETS ![Compare how all Medicare Part D PDP plans in WI cover TORSEMIDE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
TOVIAZ TABLETS 4MG EXTENDED RELEASE ![Compare how all Medicare Part D PDP plans in WI cover TOVIAZ TABLETS 4MG EXTENDED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | Q:30 /30Days |
TOVIAZ TABLETS 8MG EXTENDED RELEASE ![Compare how all Medicare Part D PDP plans in WI cover TOVIAZ TABLETS 8MG EXTENDED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TPN ELECTROLYTES VIAL ![Compare how all Medicare Part D PDP plans in WI cover TPN ELECTROLYTES VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TRACLEER 125MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TRACLEER 125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P Q:60 /30Days |
TRACLEER 62.5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TRACLEER 62.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P Q:60 /30Days |
TRADJENTA 5mg/1 90 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover TRADJENTA 5mg/1 90 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | S Q:30 /30Days |
TRAMADOL HCL 50 MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TRAMADOL HCL 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | Q:240 /30Days |
TRAMADOL HCL-ACETAMINOPHEN 37.5-325MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in WI cover TRAMADOL HCL-ACETAMINOPHEN 37.5-325MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | Q:240 /30Days |
TRANDATE TABLETS 100MG 100 BOTPL ![Compare how all Medicare Part D PDP plans in WI cover TRANDATE TABLETS 100MG 100 BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TRANDATE TABLETS 200MG 100 BOT ![Compare how all Medicare Part D PDP plans in WI cover TRANDATE TABLETS 200MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TRANDOLAPRIL 1MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TRANDOLAPRIL 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
TRANDOLAPRIL 2MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TRANDOLAPRIL 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
TRANDOLAPRIL 4MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TRANDOLAPRIL 4MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRANEXAMIC ACID 1,000 MG/10 ML ![Compare how all Medicare Part D PDP plans in WI cover TRANEXAMIC ACID 1,000 MG/10 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | None |
TRANYLCYPROMINE SULFATE 10MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TRANYLCYPROMINE SULFATE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TRAVASOL 10% SOLUTION VIAFLEX ![Compare how all Medicare Part D PDP plans in WI cover TRAVASOL 10% SOLUTION VIAFLEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | P |
TRAVATAN Z 0.04MG DROPS 2.5ML BOT ![Compare how all Medicare Part D PDP plans in WI cover TRAVATAN Z 0.04MG DROPS 2.5ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | Q:3 /25Days |
TRAZODONE 300MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TRAZODONE 300MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
TRAZODONE HCL TABLET USP 100MG (500 CT) ![Compare how all Medicare Part D PDP plans in WI cover TRAZODONE HCL TABLET USP 100MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
TRAZODONE HCL TABLET USP 150MG (100 CT) ![Compare how all Medicare Part D PDP plans in WI cover TRAZODONE HCL TABLET USP 150MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
TRAZODONE HCL TABLET USP 50MG (500 CT) ![Compare how all Medicare Part D PDP plans in WI cover TRAZODONE HCL TABLET USP 50MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
TREANDA FOR INJECTION 100MG/VIAL ![Compare how all Medicare Part D PDP plans in WI cover TREANDA FOR INJECTION 100MG/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P Q:600 /21Days |
TRECATOR 250MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TRECATOR 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
Trelstar 22.5mg/2mL 2 mL in 1 VIAL, SINGLE-DOSE ![Compare how all Medicare Part D PDP plans in WI cover Trelstar 22.5mg/2mL 2 mL in 1 VIAL, SINGLE-DOSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRELSTAR DEPOT MIXJET FOR INJECTION 3.75 MG ![Compare how all Medicare Part D PDP plans in WI cover TRELSTAR DEPOT MIXJET FOR INJECTION 3.75 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | P |
TRELSTAR MIXJET FOR INJECTION 11.25 MG ![Compare how all Medicare Part D PDP plans in WI cover TRELSTAR MIXJET FOR INJECTION 11.25 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | P |
TRENTAL 400MG TABLET SA ![Compare how all Medicare Part D PDP plans in WI cover TRENTAL 400MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
Tretinoin 0.1mg/g 1 TUBE in 1 CARTON / 45 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in WI cover Tretinoin 0.1mg/g 1 TUBE in 1 CARTON / 45 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | P |
Tretinoin 0.25mg/g 1 TUBE in 1 CARTON / 45 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in WI cover Tretinoin 0.25mg/g 1 TUBE in 1 CARTON / 45 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | P |
Tretinoin 0.25mg/g 1 TUBE in 1 CARTON / 45 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in WI cover Tretinoin 0.25mg/g 1 TUBE in 1 CARTON / 45 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | P |
Tretinoin 0.5mg/g 1 TUBE in 1 CARTON / 20 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in WI cover Tretinoin 0.5mg/g 1 TUBE in 1 CARTON / 20 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | P |
TRETINOIN 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover TRETINOIN 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | None |
Tretinoin 1mg/g 1 TUBE in 1 CARTON / 45 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in WI cover Tretinoin 1mg/g 1 TUBE in 1 CARTON / 45 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | P |
TREXALL 10MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TREXALL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | P |
TREXALL 15MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TREXALL 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TREXALL 5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TREXALL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | P |
TREXALL 7.5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TREXALL 7.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | P |
TREXIMET 500; 85mg/1; mg/1 ![Compare how all Medicare Part D PDP plans in WI cover TREXIMET 500; 85mg/1; mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | Q:12 /30Days |
TRI PREVIFEM TABLETS ![Compare how all Medicare Part D PDP plans in WI cover TRI PREVIFEM TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TRI-LEGEST FE 5-7-9-7 TABLET ![Compare how all Medicare Part D PDP plans in WI cover TRI-LEGEST FE 5-7-9-7 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TRI-NORINYL 28 TABLET ![Compare how all Medicare Part D PDP plans in WI cover TRI-NORINYL 28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TRI-SPRINTEC 7DAYSX3 28 TABLET ![Compare how all Medicare Part D PDP plans in WI cover TRI-SPRINTEC 7DAYSX3 28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TRIAMCINOLONE 0.1% OINTMENT ![Compare how all Medicare Part D PDP plans in WI cover TRIAMCINOLONE 0.1% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
TRIAMCINOLONE ACETONIDE 0.025% CREAM 80GM TUBE ![Compare how all Medicare Part D PDP plans in WI cover TRIAMCINOLONE ACETONIDE 0.025% CREAM 80GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
TRIAMCINOLONE ACETONIDE 0.025% LOTION 2 FL OZ BOT ![Compare how all Medicare Part D PDP plans in WI cover TRIAMCINOLONE ACETONIDE 0.025% LOTION 2 FL OZ BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
TRIAMCINOLONE ACETONIDE 0.025% OINTMENT 80GM TUBE ![Compare how all Medicare Part D PDP plans in WI cover TRIAMCINOLONE ACETONIDE 0.025% OINTMENT 80GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRIAMCINOLONE ACETONIDE 0.05% OINTMENT 15GM TUBE ![Compare how all Medicare Part D PDP plans in WI cover TRIAMCINOLONE ACETONIDE 0.05% OINTMENT 15GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
TRIAMCINOLONE ACETONIDE 0.1% CREAM 80GM TUBE ![Compare how all Medicare Part D PDP plans in WI cover TRIAMCINOLONE ACETONIDE 0.1% CREAM 80GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
TRIAMCINOLONE ACETONIDE 0.1% LOTION 60ML BOTPL ![Compare how all Medicare Part D PDP plans in WI cover TRIAMCINOLONE ACETONIDE 0.1% LOTION 60ML BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
Triamcinolone Acetonide 1mg/g 1 TUBE in 1 CARTON / 5 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in WI cover Triamcinolone Acetonide 1mg/g 1 TUBE in 1 CARTON / 5 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | None |
Triamcinolone Acetonide 5mg/g 1 TUBE in 1 CARTON / 15 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in WI cover Triamcinolone Acetonide 5mg/g 1 TUBE in 1 CARTON / 15 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
Triamterene and Hydrochlorothiazide 25; 37.5mg 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Triamterene and Hydrochlorothiazide 25; 37.5mg 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
TRIAMTERENE/HCTZ 37.5/25 TABLET ![Compare how all Medicare Part D PDP plans in WI cover TRIAMTERENE/HCTZ 37.5/25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
TRIAMTERENE/HCTZ 75/50 TABLET ![Compare how all Medicare Part D PDP plans in WI cover TRIAMTERENE/HCTZ 75/50 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
Tribenzor 5; 12.5; 40mg/1; mg/1; mg/1 ![Compare how all Medicare Part D PDP plans in WI cover Tribenzor 5; 12.5; 40mg/1; mg/1; mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | Q:30 /30Days |
Tribenzor 5; 25; 40mg/1; mg/1; mg/1 ![Compare how all Medicare Part D PDP plans in WI cover Tribenzor 5; 25; 40mg/1; mg/1; mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | Q:30 /30Days |
TRIBENZOR TABLETS ![Compare how all Medicare Part D PDP plans in WI cover TRIBENZOR TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRIBENZOR TABLETS ![Compare how all Medicare Part D PDP plans in WI cover TRIBENZOR TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | Q:30 /30Days |
TRIBENZOR TABLETS ![Compare how all Medicare Part D PDP plans in WI cover TRIBENZOR TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | Q:30 /30Days |
TRICOR 145MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TRICOR 145MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | Q:30 /30Days |
Tricor 48mg/1 90 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Tricor 48mg/1 90 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | Q:60 /30Days |
TRIDERM 0.1% CREAM ![Compare how all Medicare Part D PDP plans in WI cover TRIDERM 0.1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
TRIFLUOPERAZINE 1MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TRIFLUOPERAZINE 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
TRIFLUOPERAZINE HCL 2MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TRIFLUOPERAZINE HCL 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
TRIFLUOPERAZINE HCL 5MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TRIFLUOPERAZINE HCL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
TRIFLUOPERAZINE HCL USP 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in WI cover TRIFLUOPERAZINE HCL USP 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
TRIFLURIDINE 1% OPTH SOLUTION 7.5ML BOT ![Compare how all Medicare Part D PDP plans in WI cover TRIFLURIDINE 1% OPTH SOLUTION 7.5ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TRIHEXYPHENIDYL HYDROCHLORIDE 2mg/1 ![Compare how all Medicare Part D PDP plans in WI cover TRIHEXYPHENIDYL HYDROCHLORIDE 2mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Trihexyphenidyl Hydrochloride 2mg/5mL 473 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Trihexyphenidyl Hydrochloride 2mg/5mL 473 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | P |
Trihexyphenidyl Hydrochloride 5mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover Trihexyphenidyl Hydrochloride 5mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | P |
TRILEPTAL 300MG/5ML SUSP ![Compare how all Medicare Part D PDP plans in WI cover TRILEPTAL 300MG/5ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TRILIPIX CAPSULE DR 45MG ![Compare how all Medicare Part D PDP plans in WI cover TRILIPIX CAPSULE DR 45MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | Q:30 /30Days |
TRILIPIX DELAYED RELEASE CAPSULES 135MG ![Compare how all Medicare Part D PDP plans in WI cover TRILIPIX DELAYED RELEASE CAPSULES 135MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | Q:30 /30Days |
TRIMETHOBENZAMIDE HCL 300MG CAPSULE ![Compare how all Medicare Part D PDP plans in WI cover TRIMETHOBENZAMIDE HCL 300MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | P |
TRIMETHOPRIM TABLETS ![Compare how all Medicare Part D PDP plans in WI cover TRIMETHOPRIM TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$6.00 | $0.00 | None |
TRIMIPRAMINE MALEATE 100 MG CAP ![Compare how all Medicare Part D PDP plans in WI cover TRIMIPRAMINE MALEATE 100 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | P |
TRIMIPRAMINE MALEATE 25 MG CAP ![Compare how all Medicare Part D PDP plans in WI cover TRIMIPRAMINE MALEATE 25 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | P |
TRIMIPRAMINE MALEATE 50 MG CAP ![Compare how all Medicare Part D PDP plans in WI cover TRIMIPRAMINE MALEATE 50 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | P |
TRINESSA TABLET ![Compare how all Medicare Part D PDP plans in WI cover TRINESSA TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | 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 WI cover TRISENOX 10MG/10ML AMPULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | P |
Trivora 6 BLISTER PACK in 1 CARTON / 1 KIT in 1 BLISTER PACK ![Compare how all Medicare Part D PDP plans in WI cover Trivora 6 BLISTER PACK in 1 CARTON / 1 KIT in 1 BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TRIZIVIR 300; 150; 300mg/1; mg/1; mg/1 60 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in WI cover TRIZIVIR 300; 150; 300mg/1; mg/1; mg/1 60 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | Q:60 /30Days |
TROPHAMINE INJECTION SOLUTION ![Compare how all Medicare Part D PDP plans in WI cover TROPHAMINE INJECTION SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | P |
TROPHAMINE INJECTION SOLUTION 6% ![Compare how all Medicare Part D PDP plans in WI cover TROPHAMINE INJECTION SOLUTION 6%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | P |
TROSPIUM CHLORIDE ER 60 MG CAP ![Compare how all Medicare Part D PDP plans in WI cover TROSPIUM CHLORIDE ER 60 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | Q:30 /30Days |
TROSPIUM CHLORIDE TABLETS ![Compare how all Medicare Part D PDP plans in WI cover TROSPIUM CHLORIDE TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TRUVADA TABLET ![Compare how all Medicare Part D PDP plans in WI cover TRUVADA TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | Q:30 /30Days |
TUDORZA PRESSAIR 400 MCG INH ![Compare how all Medicare Part D PDP plans in WI cover TUDORZA PRESSAIR 400 MCG INH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | Q:1 /30Days |
TWINJECT AUTO INJECTOR INJECTION 1% AUTO INJECTOR TWO PACK SYR ![Compare how all Medicare Part D PDP plans in WI cover TWINJECT AUTO INJECTOR INJECTION 1% AUTO INJECTOR TWO PACK SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TWINJECT AUTO INJECTOR INJECTION 1% AUTO TWO PACK SYR ![Compare how all Medicare Part D PDP plans in WI cover TWINJECT AUTO INJECTOR INJECTION 1% AUTO TWO PACK SYR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TWINRIX TF PF VACCINE 720UNT/20ML 10 X 1ML VIALSD ![Compare how all Medicare Part D PDP plans in WI cover TWINRIX TF PF VACCINE 720UNT/20ML 10 X 1ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
Tygacil 50mg/5mL 10 VIAL, SINGLE-USE in 1 CARTON / 50 mL in 1 VIAL, SINGLE-USE ![Compare how all Medicare Part D PDP plans in WI cover Tygacil 50mg/5mL 10 VIAL, SINGLE-USE in 1 CARTON / 50 mL in 1 VIAL, SINGLE-USE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TYKERB 250MG TABLET ![Compare how all Medicare Part D PDP plans in WI cover TYKERB 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P Q:150 /30Days |
TYPHIM VI 25MCG/0.5ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover TYPHIM VI 25MCG/0.5ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |
TYSABRI 300MG/15ML VIAL ![Compare how all Medicare Part D PDP plans in WI cover TYSABRI 300MG/15ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P |
TYZEKA 600MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in WI cover TYZEKA 600MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | Q:30 /30Days |
TYZINE 0.1% NOSE DROPS ![Compare how all Medicare Part D PDP plans in WI cover TYZINE 0.1% NOSE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$34.00 | $92.00 | None |
TYZINE PEDIATRIC 0.05% DROP ![Compare how all Medicare Part D PDP plans in WI cover TYZINE PEDIATRIC 0.05% DROP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Brand |
$75.00 | $215.00 | None |