2014 Medicare Part D Plan Formulary Information |
Fallon Senior Plan Super Saver Rx (HMO) (H9001-032-1)
Benefit Details
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The Fallon Senior Plan Super Saver Rx (HMO) (H9001-032-1) Formulary Drugs Starting with the Letter T in SUFFOLK County, MA: CMS MA Region 2 which includes: MA Plan Monthly Premium: $0.00 Deductible: $310 |
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 MA cover TABLOID 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | None |
Tacrolimus 0.5mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in MA cover Tacrolimus 0.5mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | P |
Tacrolimus 1mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in MA cover Tacrolimus 1mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | P |
Tacrolimus 5mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in MA cover Tacrolimus 5mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
TAFINLAR 50 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MA cover TAFINLAR 50 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
TAFINLAR 75 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MA cover TAFINLAR 75 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
Tamiflu 30mg/1 1 BLISTER PACK per CARTON / 10 CAPSULE per BLISTER PACK ![Compare how all Medicare Part D PDP plans in MA cover Tamiflu 30mg/1 1 BLISTER PACK per CARTON / 10 CAPSULE per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | Q:60 /30Days |
Tamiflu 45mg/1 1 BLISTER PACK per CARTON / 10 CAPSULE per BLISTER PACK ![Compare how all Medicare Part D PDP plans in MA cover Tamiflu 45mg/1 1 BLISTER PACK per CARTON / 10 CAPSULE per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | Q:30 /30Days |
TAMIFLU 75MG CAPSULE UD ![Compare how all Medicare Part D PDP plans in MA cover TAMIFLU 75MG CAPSULE UD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | Q:30 /30Days |
TAMOXIFEN CITRATE 20MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in MA cover TAMOXIFEN CITRATE 20MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | 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 MA cover TAMOXIFEN CITRATE TABLETS 10MG 180 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TAMSULOSIN HCL 0.4 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MA cover TAMSULOSIN HCL 0.4 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TARCEVA 100MG TABLET ![Compare how all Medicare Part D PDP plans in MA cover TARCEVA 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
TARCEVA 150MG TABLET ![Compare how all Medicare Part D PDP plans in MA cover TARCEVA 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
TARCEVA 25MG TABLET ![Compare how all Medicare Part D PDP plans in MA cover TARCEVA 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
TARGRETIN 1% GEL 60GM TUBE ![Compare how all Medicare Part D PDP plans in MA cover TARGRETIN 1% GEL 60GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$32.00 | $96.00 | None |
TARGRETIN 75 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MA cover TARGRETIN 75 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
TARKA 1/240MG TABLET SA ![Compare how all Medicare Part D PDP plans in MA cover TARKA 1/240MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | None |
Tarka 2; 240mg/1; mg/1 100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in MA cover Tarka 2; 240mg/1; mg/1 100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | None |
TARKA 2/180MG TABLET SA ![Compare how all Medicare Part D PDP plans in MA cover TARKA 2/180MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | None |
Tarka 4; 240mg/1; mg/1 100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in MA cover Tarka 4; 240mg/1; mg/1 100 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Tasigna 150mg/1 4 BLISTER PACK per CARTON / 28 CAPSULE per BLISTER PACK ![Compare how all Medicare Part D PDP plans in MA cover Tasigna 150mg/1 4 BLISTER PACK per CARTON / 28 CAPSULE per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
TASIGNA 200MG CAPSULE 28 BLPK ![Compare how all Medicare Part D PDP plans in MA cover TASIGNA 200MG CAPSULE 28 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
TASMAR 100MG TABLET ![Compare how all Medicare Part D PDP plans in MA cover TASMAR 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
TAZORAC 0.05% CREAM ![Compare how all Medicare Part D PDP plans in MA cover TAZORAC 0.05% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | None |
TAZORAC 0.05% GEL ![Compare how all Medicare Part D PDP plans in MA cover TAZORAC 0.05% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | None |
TAZORAC 0.1% CREAM ![Compare how all Medicare Part D PDP plans in MA cover TAZORAC 0.1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | None |
TAZORAC 0.1% GEL ![Compare how all Medicare Part D PDP plans in MA cover TAZORAC 0.1% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | None |
TAZTIA DILTIAZEM HYDROCHLORIDE 120MG EXTENDED RELEASE CAPSULES ![Compare how all Medicare Part D PDP plans in MA cover TAZTIA DILTIAZEM HYDROCHLORIDE 120MG EXTENDED RELEASE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TAZTIA DILTIAZEM HYDROCHLORIDE 180MG EXTENDED RELEASE CAPSULES ![Compare how all Medicare Part D PDP plans in MA cover TAZTIA DILTIAZEM HYDROCHLORIDE 180MG EXTENDED RELEASE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TAZTIA DILTIAZEM HYDROCHLORIDE 300MG EXTENDED RELEASE CAPSULES ![Compare how all Medicare Part D PDP plans in MA cover TAZTIA DILTIAZEM HYDROCHLORIDE 300MG EXTENDED RELEASE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TAZTIA XT 240MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in MA cover TAZTIA XT 240MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
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 MA cover TAZTIA XT 360MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TEGRETOL XR TABLETS 100MG 100 BOT ![Compare how all Medicare Part D PDP plans in MA cover TEGRETOL XR TABLETS 100MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | None |
TEKTURNA 150MG TABLET ![Compare how all Medicare Part D PDP plans in MA cover TEKTURNA 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | None |
TEKTURNA 300MG TABLET ![Compare how all Medicare Part D PDP plans in MA cover TEKTURNA 300MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | None |
Temazepam 15mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 CAPSULE per BLISTER PACK ![Compare how all Medicare Part D PDP plans in MA cover Temazepam 15mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 CAPSULE per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
TEMAZEPAM 30 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MA cover TEMAZEPAM 30 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
TERAZOSIN 1 MG CAPSULE ![Compare how all Medicare Part D PDP plans in MA cover TERAZOSIN 1 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
Terazosin Hydrochloride 10mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in MA cover Terazosin Hydrochloride 10mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
Terazosin Hydrochloride 2mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in MA cover Terazosin Hydrochloride 2mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
Terazosin Hydrochloride 5mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in MA cover Terazosin Hydrochloride 5mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
TERBINAFINE HCL 250 MG TABLET ![Compare how all Medicare Part D PDP plans in MA cover TERBINAFINE HCL 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TERBUTALINE SULF 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in MA cover TERBUTALINE SULF 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TERBUTALINE SULFATE 5MG TABLET ![Compare how all Medicare Part D PDP plans in MA cover TERBUTALINE SULFATE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TERCONAZOLE 0.4% CREAM WITH APPLICATOR ![Compare how all Medicare Part D PDP plans in MA cover TERCONAZOLE 0.4% CREAM WITH APPLICATOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TERCONAZOLE 0.8% CREAM ![Compare how all Medicare Part D PDP plans in MA cover TERCONAZOLE 0.8% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TERCONAZOLE 80MG SUPPOSITORY VAGINAL ![Compare how all Medicare Part D PDP plans in MA cover TERCONAZOLE 80MG SUPPOSITORY VAGINAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TESTIM 1%(50MG) GEL ![Compare how all Medicare Part D PDP plans in MA cover TESTIM 1%(50MG) GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | P |
TESTOSTERONE CYPIONATE 100MG/ML INJECTION ![Compare how all Medicare Part D PDP plans in MA cover TESTOSTERONE CYPIONATE 100MG/ML INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | P |
Testosterone Cypionate 200mg/mL 1 VIAL, MULTI-DOSE per CARTON / 10 mL in 1 VIAL, MULTI-DOSE ![Compare how all Medicare Part D PDP plans in MA cover Testosterone Cypionate 200mg/mL 1 VIAL, MULTI-DOSE per CARTON / 10 mL in 1 VIAL, MULTI-DOSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | P |
TESTOSTERONE ENANTHATE 200MG/ML INJECTION ![Compare how all Medicare Part D PDP plans in MA cover TESTOSTERONE ENANTHATE 200MG/ML INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | P |
TESTRED 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in MA cover TESTRED 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | None |
TETANUS DIPHTHERIA TOXOIDS ![Compare how all Medicare Part D PDP plans in MA cover TETANUS DIPHTHERIA TOXOIDS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | 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 MA cover tetanus toxoid adsorbed vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | None |
TEV-TROPIN 2 CARTON in 1 BOX / 1 POWDER, FOR SOLUTION per CARTON ![Compare how all Medicare Part D PDP plans in MA cover TEV-TROPIN 2 CARTON in 1 BOX / 1 POWDER, FOR SOLUTION per CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
THALOMID 100MG CAPSULE 140 BOX ![Compare how all Medicare Part D PDP plans in MA cover THALOMID 100MG CAPSULE 140 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
Thalomid 150mg/1 ![Compare how all Medicare Part D PDP plans in MA cover Thalomid 150mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
Thalomid 200mg/1 ![Compare how all Medicare Part D PDP plans in MA cover Thalomid 200mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
THALOMID 50MG CAPSULE 280 BOX ![Compare how all Medicare Part D PDP plans in MA cover THALOMID 50MG CAPSULE 280 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
Theophylline 100mg/1 500 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in MA cover Theophylline 100mg/1 500 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
Theophylline 200mg/1 500 TABLET, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in MA cover Theophylline 200mg/1 500 TABLET, EXTENDED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
THEOPHYLLINE 400MG TABLET SA ![Compare how all Medicare Part D PDP plans in MA cover THEOPHYLLINE 400MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
THEOPHYLLINE 600MG TABLET SA ![Compare how all Medicare Part D PDP plans in MA cover THEOPHYLLINE 600MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
THEOPHYLLINE TABLET ER 300MG (100 CT) ![Compare how all Medicare Part D PDP plans in MA cover THEOPHYLLINE TABLET ER 300MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
THEOPHYLLINE TABLET ER 450MG (100 CT) ![Compare how all Medicare Part D PDP plans in MA cover THEOPHYLLINE TABLET ER 450MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
Thermazene 10mg/g ![Compare how all Medicare Part D PDP plans in MA cover Thermazene 10mg/g.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
THIORIDAZINE 100MG TABLET ![Compare how all Medicare Part D PDP plans in MA cover THIORIDAZINE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
THIORIDAZINE HCL 10MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in MA cover THIORIDAZINE HCL 10MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
THIORIDAZINE HCL 25MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in MA cover THIORIDAZINE HCL 25MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
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 MA 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 |
$1.00 | $3.00 | None |
THIOTHIXENE 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in MA cover THIOTHIXENE 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
THIOTHIXENE 1MG CAPSULE (100 CT) ![Compare how all Medicare Part D PDP plans in MA cover THIOTHIXENE 1MG CAPSULE (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
THIOTHIXENE 2MG CAPSULE ![Compare how all Medicare Part D PDP plans in MA cover THIOTHIXENE 2MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
THIOTHIXENE 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in MA cover THIOTHIXENE 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
THYMOGLOBULIN 25MG VIAL ![Compare how all Medicare Part D PDP plans in MA cover THYMOGLOBULIN 25MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$32.00 | $96.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
THYROLAR-1 TABLETS ![Compare how all Medicare Part D PDP plans in MA cover THYROLAR-1 TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$32.00 | $96.00 | None |
THYROLAR-1/2 TABLETS ![Compare how all Medicare Part D PDP plans in MA cover THYROLAR-1/2 TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$32.00 | $96.00 | None |
THYROLAR-1/4 TABLETS ![Compare how all Medicare Part D PDP plans in MA cover THYROLAR-1/4 TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$32.00 | $96.00 | None |
THYROLAR-2 TABLETS ![Compare how all Medicare Part D PDP plans in MA cover THYROLAR-2 TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$32.00 | $96.00 | None |
THYROLAR-3 TABLETS ![Compare how all Medicare Part D PDP plans in MA cover THYROLAR-3 TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$32.00 | $96.00 | None |
tiagabine hcl 2 mg tablet [Gabitril] ![Compare how all Medicare Part D PDP plans in MA cover tiagabine hcl 2 mg tablet [Gabitril].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
tiagabine hcl 4 mg tablet [Gabitril] ![Compare how all Medicare Part D PDP plans in MA cover tiagabine hcl 4 mg tablet [Gabitril].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
Ticlopidine 250 mg tablet ![Compare how all Medicare Part D PDP plans in MA cover Ticlopidine 250 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TIKOSYN .125MG CAPSULE ![Compare how all Medicare Part D PDP plans in MA cover TIKOSYN .125MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | None |
TIKOSYN .250MG CAPSULE ![Compare how all Medicare Part D PDP plans in MA cover TIKOSYN .250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | None |
TIKOSYN .5MG CAPSULE ![Compare how all Medicare Part D PDP plans in MA cover TIKOSYN .5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | 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 MA cover TIMOLOL MAL SOL 0.25% OP 15ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
TIMOLOL MAL SOL 0.5% OP 10ML BOT ![Compare how all Medicare Part D PDP plans in MA cover TIMOLOL MAL SOL 0.5% OP 10ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
TIMOLOL MALEATE 10MG TABLET ![Compare how all Medicare Part D PDP plans in MA cover TIMOLOL MALEATE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TIMOLOL MALEATE 20MG TABLET ![Compare how all Medicare Part D PDP plans in MA cover TIMOLOL MALEATE 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
Timolol Maleate 3.4mg/mL 1 BOTTLE, DISPENSING per CARTON / 5 mL in 1 BOTTLE, DISPENSING ![Compare how all Medicare Part D PDP plans in MA cover Timolol Maleate 3.4mg/mL 1 BOTTLE, DISPENSING per CARTON / 5 mL in 1 BOTTLE, DISPENSING.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TIMOLOL MALEATE 5MG TABLET ![Compare how all Medicare Part D PDP plans in MA cover TIMOLOL MALEATE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
Timolol Maleate 6.8mg/mL 1 BOTTLE, DISPENSING per CARTON / 5 mL in 1 BOTTLE, DISPENSING ![Compare how all Medicare Part D PDP plans in MA cover Timolol Maleate 6.8mg/mL 1 BOTTLE, DISPENSING per CARTON / 5 mL in 1 BOTTLE, DISPENSING.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TIVICAY 50 MG TABLET ![Compare how all Medicare Part D PDP plans in MA cover TIVICAY 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
Tizanidine 4mg/1 1000 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in MA cover Tizanidine 4mg/1 1000 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TIZANIDINE HCL 2 MG TABLET ![Compare how all Medicare Part D PDP plans in MA cover TIZANIDINE HCL 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TOBI 300mg/5mL 56 AMPULE per CARTON / 5 mL in 1 AMPULE ![Compare how all Medicare Part D PDP plans in MA cover TOBI 300mg/5mL 56 AMPULE per CARTON / 5 mL in 1 AMPULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
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 MA cover TOBI PODHALER 28 MG INHALE CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
TOBRADEX EYE OINTMENT ![Compare how all Medicare Part D PDP plans in MA cover TOBRADEX EYE OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$32.00 | $96.00 | None |
TOBRAMYCIN 300 MG/5 ML AMPULE [Bethkis, Tobi, Tobi Podhaler, Tobramycin Sulfate] ![Compare how all Medicare Part D PDP plans in MA cover TOBRAMYCIN 300 MG/5 ML AMPULE [Bethkis, Tobi, Tobi Podhaler, Tobramycin Sulfate].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
TOBRAMYCIN OPHTHALMIC SOLUTION 0.3% 5ML BOT ![Compare how all Medicare Part D PDP plans in MA cover TOBRAMYCIN OPHTHALMIC SOLUTION 0.3% 5ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
TOBRAMYCIN-DEXAMETH OPTH SUSP ![Compare how all Medicare Part D PDP plans in MA cover TOBRAMYCIN-DEXAMETH OPTH SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TOBREX 0.3% EYE OINTMENT ![Compare how all Medicare Part D PDP plans in MA cover TOBREX 0.3% EYE OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$32.00 | $96.00 | None |
TOLAZAMIDE TABLETS 250MG 100 BOT ![Compare how all Medicare Part D PDP plans in MA cover TOLAZAMIDE TABLETS 250MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TOLAZAMIDE TABLETS 500MG 100 BOT ![Compare how all Medicare Part D PDP plans in MA cover TOLAZAMIDE TABLETS 500MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TOLBUTAMIDE 500MG TABLET ![Compare how all Medicare Part D PDP plans in MA cover TOLBUTAMIDE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | None |
TOLMETIN SODIUM 200MG TABLET ![Compare how all Medicare Part D PDP plans in MA cover TOLMETIN SODIUM 200MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TOLMETIN SODIUM 400 MG CAP ![Compare how all Medicare Part D PDP plans in MA cover TOLMETIN SODIUM 400 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TOLMETIN SODIUM 600MG TABLET ![Compare how all Medicare Part D PDP plans in MA cover TOLMETIN SODIUM 600MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
Tolterodine Tartrate 1 MG TABLET [Detrol LA] ![Compare how all Medicare Part D PDP plans in MA cover Tolterodine Tartrate 1 MG TABLET [Detrol LA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
Tolterodine Tartrate 2 MG TABLET [Detrol LA] ![Compare how all Medicare Part D PDP plans in MA cover Tolterodine Tartrate 2 MG TABLET [Detrol LA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
Tolterodine Tartrate ER 2 MG CAPSULE [Detrol LA] ![Compare how all Medicare Part D PDP plans in MA cover Tolterodine Tartrate ER 2 MG CAPSULE [Detrol LA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
Tolterodine Tartrate ER 4 MG CAPSULE [Detrol LA] ![Compare how all Medicare Part D PDP plans in MA cover Tolterodine Tartrate ER 4 MG CAPSULE [Detrol LA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
Topiramate 25mg/1 ![Compare how all Medicare Part D PDP plans in MA cover Topiramate 25mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TOPIRAMATE SPRINKLE CAPSULES 15MG 60 BOT ![Compare how all Medicare Part D PDP plans in MA cover TOPIRAMATE SPRINKLE CAPSULES 15MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TOPIRAMATE TABLETS 100MG 1000 BOT ![Compare how all Medicare Part D PDP plans in MA cover TOPIRAMATE TABLETS 100MG 1000 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TOPIRAMATE TABLETS 200MG 1000 BOT ![Compare how all Medicare Part D PDP plans in MA cover TOPIRAMATE TABLETS 200MG 1000 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TOPIRAMATE TABLETS 25MG 1000 BOT ![Compare how all Medicare Part D PDP plans in MA cover TOPIRAMATE TABLETS 25MG 1000 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TOPIRAMATE TABLETS 50MG 1000 BOT ![Compare how all Medicare Part D PDP plans in MA cover TOPIRAMATE TABLETS 50MG 1000 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Topotecan hcl 4 mg vial ![Compare how all Medicare Part D PDP plans in MA cover Topotecan hcl 4 mg vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | P |
Torsemide 100mg/1 12 BOTTLE CASE / 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in MA cover Torsemide 100mg/1 12 BOTTLE CASE / 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TORSEMIDE 10MG TABLETS ![Compare how all Medicare Part D PDP plans in MA cover TORSEMIDE 10MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TORSEMIDE 20mg 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in MA cover TORSEMIDE 20mg 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TORSEMIDE 5MG TABLETS ![Compare how all Medicare Part D PDP plans in MA cover TORSEMIDE 5MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TPN ELECTROLYTES16.5/25.4 VIAL ![Compare how all Medicare Part D PDP plans in MA cover TPN ELECTROLYTES16.5/25.4 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | P |
TRACLEER 125MG TABLET ![Compare how all Medicare Part D PDP plans in MA cover TRACLEER 125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
TRACLEER 62.5MG TABLET ![Compare how all Medicare Part D PDP plans in MA cover TRACLEER 62.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
TRADJENTA 5mg/1 90 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in MA cover TRADJENTA 5mg/1 90 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$32.00 | $96.00 | S Q:30 /30Days |
TRAMADOL HCL 50 MG TABLET ![Compare how all Medicare Part D PDP plans in MA cover TRAMADOL HCL 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
TRAMADOL HCL-ACETAMINOPHEN 37.5-325MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in MA cover TRAMADOL HCL-ACETAMINOPHEN 37.5-325MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRANDOLAPRIL 1MG TABLET ![Compare how all Medicare Part D PDP plans in MA cover TRANDOLAPRIL 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TRANDOLAPRIL 2MG TABLET ![Compare how all Medicare Part D PDP plans in MA cover TRANDOLAPRIL 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TRANDOLAPRIL 4MG TABLET ![Compare how all Medicare Part D PDP plans in MA cover TRANDOLAPRIL 4MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TRANEXAMIC ACID 1,000 MG/10 ML ![Compare how all Medicare Part D PDP plans in MA cover TRANEXAMIC ACID 1,000 MG/10 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | P |
TRANYLCYPROMINE SULFATE 10MG TABLET ![Compare how all Medicare Part D PDP plans in MA cover TRANYLCYPROMINE SULFATE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TRAVATAN Z 0.04MG DROPS 2.5ML BOT ![Compare how all Medicare Part D PDP plans in MA cover TRAVATAN Z 0.04MG DROPS 2.5ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | S |
travoprost 0.004% eye drop [Travatan] ![Compare how all Medicare Part D PDP plans in MA cover travoprost 0.004% eye drop [Travatan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$32.00 | $96.00 | None |
TRAZODONE 300MG TABLET ![Compare how all Medicare Part D PDP plans in MA cover TRAZODONE 300MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TRAZODONE HCL TABLET USP 100MG (500 CT) ![Compare how all Medicare Part D PDP plans in MA cover TRAZODONE HCL TABLET USP 100MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
TRAZODONE HCL TABLET USP 150MG (100 CT) ![Compare how all Medicare Part D PDP plans in MA cover TRAZODONE HCL TABLET USP 150MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TRAZODONE HCL TABLET USP 50MG (500 CT) ![Compare how all Medicare Part D PDP plans in MA cover TRAZODONE HCL TABLET USP 50MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRECATOR 250MG TABLET ![Compare how all Medicare Part D PDP plans in MA cover TRECATOR 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | None |
TRETINOIN 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in MA cover TRETINOIN 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
Tretinoin 1mg/g 1 TUBE per CARTON / 45 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in MA cover Tretinoin 1mg/g 1 TUBE per CARTON / 45 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TREXALL 10MG TABLET ![Compare how all Medicare Part D PDP plans in MA cover TREXALL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | P |
TREXALL 15MG TABLET ![Compare how all Medicare Part D PDP plans in MA cover TREXALL 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | P |
TREXALL 5MG TABLET ![Compare how all Medicare Part D PDP plans in MA cover TREXALL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | P |
TREXALL 7.5MG TABLET ![Compare how all Medicare Part D PDP plans in MA cover TREXALL 7.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | P |
TRI PREVIFEM TABLETS ![Compare how all Medicare Part D PDP plans in MA cover TRI PREVIFEM TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TRI-LEGEST FE 5-7-9-7 TABLET ![Compare how all Medicare Part D PDP plans in MA cover TRI-LEGEST FE 5-7-9-7 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TRI-SPRINTEC 7DAYSX3 28 TABLET ![Compare how all Medicare Part D PDP plans in MA cover TRI-SPRINTEC 7DAYSX3 28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TRIAMCINOLONE 0.1% OINTMENT ![Compare how all Medicare Part D PDP plans in MA cover TRIAMCINOLONE 0.1% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRIAMCINOLONE ACETONIDE 0.025% CREAM 80GM TUBE ![Compare how all Medicare Part D PDP plans in MA cover TRIAMCINOLONE ACETONIDE 0.025% CREAM 80GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
TRIAMCINOLONE ACETONIDE 0.025% LOTION 2 FL OZ BOT ![Compare how all Medicare Part D PDP plans in MA cover TRIAMCINOLONE ACETONIDE 0.025% LOTION 2 FL OZ BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TRIAMCINOLONE ACETONIDE 0.05% OINTMENT 15GM TUBE ![Compare how all Medicare Part D PDP plans in MA cover TRIAMCINOLONE ACETONIDE 0.05% OINTMENT 15GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TRIAMCINOLONE ACETONIDE 0.1% CREAM 80GM TUBE ![Compare how all Medicare Part D PDP plans in MA cover TRIAMCINOLONE ACETONIDE 0.1% CREAM 80GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
TRIAMCINOLONE ACETONIDE 0.1% LOTION 60ML BOTPL ![Compare how all Medicare Part D PDP plans in MA cover TRIAMCINOLONE ACETONIDE 0.1% LOTION 60ML BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
triamcinolone acetonide 0.25mg/g 80 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in MA cover triamcinolone acetonide 0.25mg/g 80 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
Triamcinolone Acetonide 1mg/g 1 TUBE per CARTON / 5 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in MA cover Triamcinolone Acetonide 1mg/g 1 TUBE per CARTON / 5 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
Triamcinolone Acetonide 55ug/1 1 BOTTLE, SPRAY per CARTON / 120 SPRAY, METERED in 1 BOTTLE, SPRAY ![Compare how all Medicare Part D PDP plans in MA cover Triamcinolone Acetonide 55ug/1 1 BOTTLE, SPRAY per CARTON / 120 SPRAY, METERED in 1 BOTTLE, SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
Triamcinolone Acetonide 5mg/g 1 TUBE per CARTON / 15 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in MA cover Triamcinolone Acetonide 5mg/g 1 TUBE per CARTON / 15 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
Triamterene and Hydrochlorothiazide 25; 37.5mg 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in MA cover Triamterene and Hydrochlorothiazide 25; 37.5mg 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TRIAMTERENE/HCTZ 37.5/25 TABLET ![Compare how all Medicare Part D PDP plans in MA cover TRIAMTERENE/HCTZ 37.5/25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRIAMTERENE/HCTZ 50-25 MG CAP ![Compare how all Medicare Part D PDP plans in MA cover TRIAMTERENE/HCTZ 50-25 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TRIAMTERENE/HCTZ 75/50 TABLET ![Compare how all Medicare Part D PDP plans in MA cover TRIAMTERENE/HCTZ 75/50 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
Triazolam 0.125mg/1 10 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in MA cover Triazolam 0.125mg/1 10 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TRIDERM 0.1% CREAM ![Compare how all Medicare Part D PDP plans in MA cover TRIDERM 0.1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
TRIFLUOPERAZINE 1MG TABLET ![Compare how all Medicare Part D PDP plans in MA cover TRIFLUOPERAZINE 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
TRIFLUOPERAZINE HCL 2MG TABLET ![Compare how all Medicare Part D PDP plans in MA cover TRIFLUOPERAZINE HCL 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
TRIFLUOPERAZINE HCL 5MG TABLET ![Compare how all Medicare Part D PDP plans in MA cover TRIFLUOPERAZINE HCL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TRIFLUOPERAZINE HCL USP 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in MA cover TRIFLUOPERAZINE HCL USP 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TRIFLURIDINE 1% OPTH SOLUTION 7.5ML BOT ![Compare how all Medicare Part D PDP plans in MA cover TRIFLURIDINE 1% OPTH SOLUTION 7.5ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TRIHEXYPHENIDYL 5 MG TABLET ![Compare how all Medicare Part D PDP plans in MA cover TRIHEXYPHENIDYL 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
TRIHEXYPHENIDYL HYDROCHLORIDE 2mg/1 ![Compare how all Medicare Part D PDP plans in MA cover TRIHEXYPHENIDYL HYDROCHLORIDE 2mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
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 MA cover Trihexyphenidyl Hydrochloride 2mg/5mL 473 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TRILYTE WITH FLAVOR PACKETS ![Compare how all Medicare Part D PDP plans in MA cover TRILYTE WITH FLAVOR PACKETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TRIMETHOBENZAMIDE HCL 300MG CAPSULE ![Compare how all Medicare Part D PDP plans in MA cover TRIMETHOBENZAMIDE HCL 300MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TRIMETHOPRIM 100MG TABLETS ![Compare how all Medicare Part D PDP plans in MA cover TRIMETHOPRIM 100MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TRIMIPRAMINE MALEATE 100 MG CAP ![Compare how all Medicare Part D PDP plans in MA cover TRIMIPRAMINE MALEATE 100 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TRIMIPRAMINE MALEATE 25 MG CAP ![Compare how all Medicare Part D PDP plans in MA cover TRIMIPRAMINE MALEATE 25 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TRIMIPRAMINE MALEATE 50 MG CAP ![Compare how all Medicare Part D PDP plans in MA cover TRIMIPRAMINE MALEATE 50 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TRINESSA TABLET ![Compare how all Medicare Part D PDP plans in MA cover TRINESSA TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TRISENOX 10MG/10ML AMPULE ![Compare how all Medicare Part D PDP plans in MA cover TRISENOX 10MG/10ML AMPULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | P |
Trivora 6 BLISTER PACK per CARTON / 1 KIT per BLISTER PACK ![Compare how all Medicare Part D PDP plans in MA cover Trivora 6 BLISTER PACK per CARTON / 1 KIT per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | 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 MA 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) |
5 |
Specialty Tier |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TROSPIUM CHLORIDE 20MG TABLETS ![Compare how all Medicare Part D PDP plans in MA cover TROSPIUM CHLORIDE 20MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TROSPIUM CHLORIDE ER 60 MG CAP ![Compare how all Medicare Part D PDP plans in MA cover TROSPIUM CHLORIDE ER 60 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$5.00 | $15.00 | None |
TRUVADA 200/300MG TABLET ![Compare how all Medicare Part D PDP plans in MA cover TRUVADA 200/300MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
TWINRIX TF PF VACCINE 720UNT/20ML 10 X 1ML VIALSD ![Compare how all Medicare Part D PDP plans in MA cover TWINRIX TF PF VACCINE 720UNT/20ML 10 X 1ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$32.00 | $96.00 | None |
Tygacil 50mg/5mL 10 VIAL, SINGLE-USE per CARTON / 50 mL in 1 VIAL, SINGLE-USE ![Compare how all Medicare Part D PDP plans in MA cover Tygacil 50mg/5mL 10 VIAL, SINGLE-USE per CARTON / 50 mL in 1 VIAL, SINGLE-USE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | P |
TYKERB 250MG TABLET ![Compare how all Medicare Part D PDP plans in MA cover TYKERB 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
TYPHIM VI 25MCG/0.5ML VIAL ![Compare how all Medicare Part D PDP plans in MA cover TYPHIM VI 25MCG/0.5ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | None |
TYSABRI 300 MG/15 ML VIAL ![Compare how all Medicare Part D PDP plans in MA cover TYSABRI 300 MG/15 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$76.00 | $228.00 | P |
TYZEKA 600MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in MA cover TYZEKA 600MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
TYZINE PEDIATRIC 0.05% DROP ![Compare how all Medicare Part D PDP plans in MA cover TYZINE PEDIATRIC 0.05% DROP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$32.00 | $96.00 | None |