2016 Medicare Part D Plan Formulary Information |
United American - Select (PDP) (S5755-081-0)
Benefit Details
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The United American - Select (PDP) (S5755-081-0) Formulary Drugs Starting with the Letter T in CMS PDP Region 10 which includes: GA Plan Monthly Premium: $59.90 Deductible: $360 Qualifies for LIS: No |
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 GA cover TABLOID 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | None |
Tacrolimus 0.03% ointment ![Compare how all Medicare Part D PDP plans in GA cover Tacrolimus 0.03% ointment.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | P |
Tacrolimus 0.1% ointment ![Compare how all Medicare Part D PDP plans in GA cover Tacrolimus 0.1% ointment.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | P |
Tacrolimus 0.5mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in GA cover Tacrolimus 0.5mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | P |
Tacrolimus 1mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in GA cover Tacrolimus 1mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | P |
Tacrolimus 5mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in GA cover Tacrolimus 5mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | P |
TAFINLAR 50 MG CAPSULE ![Compare how all Medicare Part D PDP plans in GA cover TAFINLAR 50 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | P |
TAFINLAR 75 MG CAPSULE ![Compare how all Medicare Part D PDP plans in GA cover TAFINLAR 75 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | P |
TAGRISSO 40 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TAGRISSO 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | P |
TAGRISSO 80 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TAGRISSO 80 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TAMIFLU 30 MG 1 BLISTER PACK per CARTON / 10 CAPSULE per BLISTER PACK ![Compare how all Medicare Part D PDP plans in GA cover TAMIFLU 30 MG 1 BLISTER PACK per CARTON / 10 CAPSULE per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
TAMIFLU 45 MG 1 BLISTER PACK per CARTON / 10 CAPSULE per BLISTER PACK ![Compare how all Medicare Part D PDP plans in GA cover TAMIFLU 45 MG 1 BLISTER PACK per CARTON / 10 CAPSULE per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
TAMIFLU 6 MG/ML SUSPENSION ![Compare how all Medicare Part D PDP plans in GA cover TAMIFLU 6 MG/ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
TAMIFLU 75 MG CAPSULE UD ![Compare how all Medicare Part D PDP plans in GA cover TAMIFLU 75 MG CAPSULE UD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
TAMOXIFEN CITRATE 20MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in GA cover TAMOXIFEN CITRATE 20MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
TAMOXIFEN CITRATE TABLETS 10MG 180 BOT ![Compare how all Medicare Part D PDP plans in GA cover TAMOXIFEN CITRATE TABLETS 10MG 180 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
TAMSULOSIN HCL 0.4 MG CAPSULE ![Compare how all Medicare Part D PDP plans in GA cover TAMSULOSIN HCL 0.4 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
TARCEVA 100MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TARCEVA 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | P |
TARCEVA 150MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TARCEVA 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | P |
TARCEVA 25MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TARCEVA 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | P |
TARGRETIN 1% GEL ![Compare how all Medicare Part D PDP plans in GA cover TARGRETIN 1% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Tarina Fe 1-20 tablet ![Compare how all Medicare Part D PDP plans in GA cover Tarina Fe 1-20 tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$3.00 | $33.00 | None |
Tasigna 150mg/1 4 BLISTER PACK per CARTON / 28 CAPSULE per BLISTER PACK ![Compare how all Medicare Part D PDP plans in GA 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 |
Tier 5 |
25% | N/A | P |
TASIGNA 200MG CAPSULE 28 BLPK ![Compare how all Medicare Part D PDP plans in GA cover TASIGNA 200MG CAPSULE 28 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | P |
TAZICEF 1GM VIAL ![Compare how all Medicare Part D PDP plans in GA cover TAZICEF 1GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | None |
TAZICEF 2 GRAM VIAL ![Compare how all Medicare Part D PDP plans in GA cover TAZICEF 2 GRAM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | None |
TAZICEF 6 GRAM VIAL ![Compare how all Medicare Part D PDP plans in GA cover TAZICEF 6 GRAM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | None |
TAZORAC 0.05% CREAM ![Compare how all Medicare Part D PDP plans in GA cover TAZORAC 0.05% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | P |
TAZORAC 0.1% CREAM ![Compare how all Medicare Part D PDP plans in GA cover TAZORAC 0.1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | P |
TAZTIA DILTIAZEM HYDROCHLORIDE 120MG EXTENDED RELEASE CAPSULES ![Compare how all Medicare Part D PDP plans in GA cover TAZTIA DILTIAZEM HYDROCHLORIDE 120MG EXTENDED RELEASE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
TAZTIA DILTIAZEM HYDROCHLORIDE 180MG EXTENDED RELEASE CAPSULES ![Compare how all Medicare Part D PDP plans in GA cover TAZTIA DILTIAZEM HYDROCHLORIDE 180MG EXTENDED RELEASE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
TAZTIA DILTIAZEM HYDROCHLORIDE 300MG EXTENDED RELEASE CAPSULES ![Compare how all Medicare Part D PDP plans in GA cover TAZTIA DILTIAZEM HYDROCHLORIDE 300MG EXTENDED RELEASE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TAZTIA XT 240MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in GA cover TAZTIA XT 240MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
TAZTIA XT 360MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in GA cover TAZTIA XT 360MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
Teflaro 400mg/20mL 10 VIAL, SINGLE-DOSE per CARTON / 20 mL in 1 VIAL, SINGLE-DOSE ![Compare how all Medicare Part D PDP plans in GA cover Teflaro 400mg/20mL 10 VIAL, SINGLE-DOSE per CARTON / 20 mL in 1 VIAL, SINGLE-DOSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | None |
Teflaro 600mg/20mL 10 VIAL, SINGLE-DOSE per CARTON / 20 mL in 1 VIAL, SINGLE-DOSE ![Compare how all Medicare Part D PDP plans in GA cover Teflaro 600mg/20mL 10 VIAL, SINGLE-DOSE per CARTON / 20 mL in 1 VIAL, SINGLE-DOSE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | None |
TEGRETOL SUSPENSION 100MG/5ML 450 ML BOT ![Compare how all Medicare Part D PDP plans in GA cover TEGRETOL SUSPENSION 100MG/5ML 450 ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | None |
TEGRETOL TABLETS 200MG 100 BOT ![Compare how all Medicare Part D PDP plans in GA cover TEGRETOL TABLETS 200MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | None |
TEGRETOL XR TABLETS 100MG 100 BOT ![Compare how all Medicare Part D PDP plans in GA cover TEGRETOL XR TABLETS 100MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | None |
TEGRETOL XR TABLETS 200MG 100 BOT ![Compare how all Medicare Part D PDP plans in GA cover TEGRETOL XR TABLETS 200MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | None |
TEGRETOL XR TABLETS 400MG 100 BOT ![Compare how all Medicare Part D PDP plans in GA cover TEGRETOL XR TABLETS 400MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | None |
TEKTURNA 150MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TEKTURNA 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | Q:30 /30Days |
TEKTURNA 300MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TEKTURNA 300MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TEKTURNA HCT 150-12.5MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TEKTURNA HCT 150-12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | Q:30 /30Days |
TEKTURNA HCT 150MG-25MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TEKTURNA HCT 150MG-25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | Q:60 /30Days |
TEKTURNA HCT 300-12.5MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TEKTURNA HCT 300-12.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | Q:30 /30Days |
TEKTURNA HCT 300MG-25MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TEKTURNA HCT 300MG-25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | 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 GA 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) |
2 |
Tier 2 |
$3.00 | $33.00 | P Q:60 /30Days |
Temazepam 7.5mg/1 100 CAPSULE BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in GA cover Temazepam 7.5mg/1 100 CAPSULE BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$3.00 | $33.00 | P Q:30 /30Days |
TENIVAC SYRINGE ![Compare how all Medicare Part D PDP plans in GA cover TENIVAC SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | P |
TERAZOSIN 1 MG CAPSULE ![Compare how all Medicare Part D PDP plans in GA cover TERAZOSIN 1 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
Terazosin Hydrochloride 10mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in GA cover Terazosin Hydrochloride 10mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
Terazosin Hydrochloride 2mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in GA cover Terazosin Hydrochloride 2mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
Terazosin Hydrochloride 5mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in GA cover Terazosin Hydrochloride 5mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Terbinafine HCl 250 MG Tablet ![Compare how all Medicare Part D PDP plans in GA cover Terbinafine HCl 250 MG Tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$3.00 | $33.00 | Q:90 /365Days |
TERBUTALINE SULF 1MG/ML VL ![Compare how all Medicare Part D PDP plans in GA cover TERBUTALINE SULF 1MG/ML VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | None |
TERBUTALINE SULF 2.5MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TERBUTALINE SULF 2.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
TERBUTALINE SULFATE 5MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TERBUTALINE SULFATE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
TERCONAZOLE 0.4% CREAM WITH APPLICATOR ![Compare how all Medicare Part D PDP plans in GA cover TERCONAZOLE 0.4% CREAM WITH APPLICATOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
TERCONAZOLE 0.8% CREAM ![Compare how all Medicare Part D PDP plans in GA cover TERCONAZOLE 0.8% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
TERCONAZOLE 80MG SUPPOSITORY VAGINAL ![Compare how all Medicare Part D PDP plans in GA cover TERCONAZOLE 80MG SUPPOSITORY VAGINAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | None |
Testosterone cyp 100 mg/ml ![Compare how all Medicare Part D PDP plans in GA cover Testosterone cyp 100 mg/ml.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | P |
Testosterone cyp 200 mg/ml ![Compare how all Medicare Part D PDP plans in GA cover Testosterone cyp 200 mg/ml.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | P |
TESTOSTERONE ENANTHATE 200MG/ML INJECTION ![Compare how all Medicare Part D PDP plans in GA cover TESTOSTERONE ENANTHATE 200MG/ML INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | P |
TETANUS DIPHTHERIA TOXOIDS ![Compare how all Medicare Part D PDP plans in GA cover TETANUS DIPHTHERIA TOXOIDS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TETRABENAZINE 12.5 MG TABLET [XENAZINE] ![Compare how all Medicare Part D PDP plans in GA cover TETRABENAZINE 12.5 MG TABLET [XENAZINE].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | P Q:240 /30Days |
TETRABENAZINE 25 MG TABLET [XENAZINE] ![Compare how all Medicare Part D PDP plans in GA cover TETRABENAZINE 25 MG TABLET [XENAZINE].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | P Q:120 /30Days |
THALOMID 100MG CAPSULE 140 BOX ![Compare how all Medicare Part D PDP plans in GA cover THALOMID 100MG CAPSULE 140 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | P |
Thalomid 150mg/1 ![Compare how all Medicare Part D PDP plans in GA cover Thalomid 150mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | P |
Thalomid 200mg/1 ![Compare how all Medicare Part D PDP plans in GA cover Thalomid 200mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | P |
THALOMID 50MG CAPSULE 280 BOX ![Compare how all Medicare Part D PDP plans in GA cover THALOMID 50MG CAPSULE 280 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | P |
Theophylline 100mg/1 500 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in GA cover Theophylline 100mg/1 500 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
Theophylline 200mg/1 500 TABLET, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in GA cover Theophylline 200mg/1 500 TABLET, EXTENDED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
THEOPHYLLINE 400MG TABLET SA ![Compare how all Medicare Part D PDP plans in GA cover THEOPHYLLINE 400MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
THEOPHYLLINE 600MG TABLET SA ![Compare how all Medicare Part D PDP plans in GA cover THEOPHYLLINE 600MG TABLET SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
THEOPHYLLINE TABLET ER 300MG (100 CT) ![Compare how all Medicare Part D PDP plans in GA cover THEOPHYLLINE TABLET ER 300MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | 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 GA cover THEOPHYLLINE TABLET ER 450MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
THIORIDAZINE 100MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover THIORIDAZINE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | P |
THIORIDAZINE HCL 10MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in GA cover THIORIDAZINE HCL 10MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | P |
THIORIDAZINE HCL 25MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in GA cover THIORIDAZINE HCL 25MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | 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 GA 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) |
4 |
Tier 4 |
30% | 35% | P |
THIOTHIXENE 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in GA cover THIOTHIXENE 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
THIOTHIXENE 1MG CAPSULE (100 CT) ![Compare how all Medicare Part D PDP plans in GA cover THIOTHIXENE 1MG CAPSULE (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
THIOTHIXENE 2MG CAPSULE ![Compare how all Medicare Part D PDP plans in GA cover THIOTHIXENE 2MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
THIOTHIXENE 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in GA cover THIOTHIXENE 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
tiagabine hcl 2 mg tablet [Gabitril] ![Compare how all Medicare Part D PDP plans in GA cover tiagabine hcl 2 mg tablet [Gabitril].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | None |
tiagabine hcl 4 mg tablet [Gabitril] ![Compare how all Medicare Part D PDP plans in GA cover tiagabine hcl 4 mg tablet [Gabitril].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TIKOSYN .125MG CAPSULE ![Compare how all Medicare Part D PDP plans in GA cover TIKOSYN .125MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | None |
TIKOSYN .250MG CAPSULE ![Compare how all Medicare Part D PDP plans in GA cover TIKOSYN .250MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | None |
TIKOSYN .5MG CAPSULE ![Compare how all Medicare Part D PDP plans in GA cover TIKOSYN .5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | None |
TIMOLOL MAL SOL 0.25% OP 15ML BOT ![Compare how all Medicare Part D PDP plans in GA cover TIMOLOL MAL SOL 0.25% OP 15ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
TIMOLOL MAL SOL 0.5% OP 10ML BOT ![Compare how all Medicare Part D PDP plans in GA cover TIMOLOL MAL SOL 0.5% OP 10ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
TIMOLOL MALEATE 10MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TIMOLOL MALEATE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
TIMOLOL MALEATE 20MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TIMOLOL MALEATE 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | 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 GA 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) |
4 |
Tier 4 |
30% | 35% | None |
TIMOLOL MALEATE 5MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TIMOLOL MALEATE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | 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 GA 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) |
4 |
Tier 4 |
30% | 35% | None |
TIVICAY 10 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TIVICAY 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TIVICAY 25 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TIVICAY 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | None |
TIVICAY 50 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TIVICAY 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | None |
Tizanidine 4mg/1 1000 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in GA cover Tizanidine 4mg/1 1000 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$3.00 | $33.00 | None |
TIZANIDINE HCL 2 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TIZANIDINE HCL 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$3.00 | $33.00 | None |
TOBRADEX EYE OINTMENT ![Compare how all Medicare Part D PDP plans in GA cover TOBRADEX EYE OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
TOBRADEX ST 0.5; 3mg/mL; mg/mL 5 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in GA 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 |
Tier 3 |
20% | 25% | None |
TOBRAMYCIN 10MG/ML VIAL ![Compare how all Medicare Part D PDP plans in GA cover TOBRAMYCIN 10MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
TOBRAMYCIN 300 MG/5 ML AMPULE [Bethkis, Tobi, Tobi Podhaler, Tobramycin Sulfate] ![Compare how all Medicare Part D PDP plans in GA 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 |
Tier 5 |
25% | N/A | P |
TOBRAMYCIN 40MG/ML VIAL ![Compare how all Medicare Part D PDP plans in GA cover TOBRAMYCIN 40MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
TOBRAMYCIN OPHTHALMIC SOLUTION 0.3% 5ML BOT ![Compare how all Medicare Part D PDP plans in GA cover TOBRAMYCIN OPHTHALMIC SOLUTION 0.3% 5ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$3.00 | $33.00 | None |
TOBRAMYCIN-DEXAMETH OPTH SUSP ![Compare how all Medicare Part D PDP plans in GA cover TOBRAMYCIN-DEXAMETH OPTH SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Tolterodine Tartrate 1 MG TABLET [Detrol LA] ![Compare how all Medicare Part D PDP plans in GA cover Tolterodine Tartrate 1 MG TABLET [Detrol LA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | None |
Tolterodine Tartrate 2 MG TABLET [Detrol LA] ![Compare how all Medicare Part D PDP plans in GA cover Tolterodine Tartrate 2 MG TABLET [Detrol LA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | None |
Tolterodine Tartrate ER 2 MG CAPSULE [Detrol LA] ![Compare how all Medicare Part D PDP plans in GA cover Tolterodine Tartrate ER 2 MG CAPSULE [Detrol LA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | Q:30 /30Days |
Tolterodine Tartrate ER 4 MG Capsule [Detrol LA] ![Compare how all Medicare Part D PDP plans in GA cover Tolterodine Tartrate ER 4 MG Capsule [Detrol LA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | Q:30 /30Days |
Topiramate 25mg/1 ![Compare how all Medicare Part D PDP plans in GA cover Topiramate 25mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | None |
TOPIRAMATE SPRINKLE CAPSULES 15MG 60 BOT ![Compare how all Medicare Part D PDP plans in GA cover TOPIRAMATE SPRINKLE CAPSULES 15MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | None |
TOPIRAMATE TABLETS 100MG 1000 BOT ![Compare how all Medicare Part D PDP plans in GA cover TOPIRAMATE TABLETS 100MG 1000 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$3.00 | $33.00 | None |
TOPIRAMATE TABLETS 200MG 1000 BOT ![Compare how all Medicare Part D PDP plans in GA cover TOPIRAMATE TABLETS 200MG 1000 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$3.00 | $33.00 | None |
TOPIRAMATE TABLETS 25MG 1000 BOT ![Compare how all Medicare Part D PDP plans in GA cover TOPIRAMATE TABLETS 25MG 1000 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$3.00 | $33.00 | None |
TOPIRAMATE TABLETS 50MG 1000 BOT ![Compare how all Medicare Part D PDP plans in GA cover TOPIRAMATE TABLETS 50MG 1000 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$3.00 | $33.00 | None |
TOPOSAR INJECTION 20MG/ML 50ML VIAL MD CRTN ![Compare how all Medicare Part D PDP plans in GA cover TOPOSAR INJECTION 20MG/ML 50ML VIAL MD CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | P |
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 GA cover TOPOTECAN HCL 4 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | P |
TORSEMIDE 10 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TORSEMIDE 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$3.00 | $33.00 | None |
Torsemide 100mg/1 12 BOTTLE CASE / 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in GA cover Torsemide 100mg/1 12 BOTTLE CASE / 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$3.00 | $33.00 | None |
TORSEMIDE 20mg 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in GA cover TORSEMIDE 20mg 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$3.00 | $33.00 | None |
TORSEMIDE 5 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TORSEMIDE 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$3.00 | $33.00 | None |
TOUJEO SOLOSTAR 300 UNITS/ML ![Compare how all Medicare Part D PDP plans in GA cover TOUJEO SOLOSTAR 300 UNITS/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
TOVIAZ TABLETS 4MG EXTENDED RELEASE ![Compare how all Medicare Part D PDP plans in GA cover TOVIAZ TABLETS 4MG EXTENDED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | Q:30 /30Days |
TOVIAZ TABLETS 8MG EXTENDED RELEASE ![Compare how all Medicare Part D PDP plans in GA cover TOVIAZ TABLETS 8MG EXTENDED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | Q:30 /30Days |
TPN ELECTROLYTES16.5/25.4 VIAL ![Compare how all Medicare Part D PDP plans in GA cover TPN ELECTROLYTES16.5/25.4 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | P |
TRACLEER 125MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TRACLEER 125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | P Q:60 /30Days |
TRACLEER 62.5MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TRACLEER 62.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | P Q:120 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRADJENTA 5mg/1 90 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in GA cover TRADJENTA 5mg/1 90 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | Q:30 /30Days |
TRAMADOL HCL 50 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TRAMADOL HCL 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$3.00 | $33.00 | Q:240 /30Days |
TRANDOLAPRIL 1 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TRANDOLAPRIL 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
TRANDOLAPRIL 2 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TRANDOLAPRIL 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
TRANDOLAPRIL 4 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TRANDOLAPRIL 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
TRANEXAMIC ACID 1,000 MG/10 ML ![Compare how all Medicare Part D PDP plans in GA cover TRANEXAMIC ACID 1,000 MG/10 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
tranexamic acid 650 mg tablet ![Compare how all Medicare Part D PDP plans in GA cover tranexamic acid 650 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | None |
TRANSDERM-SCOP 1.5 MG/72HR ![Compare how all Medicare Part D PDP plans in GA cover TRANSDERM-SCOP 1.5 MG/72HR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | P Q:10 /30Days |
TRANYLCYPROMINE SULFATE 10MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TRANYLCYPROMINE SULFATE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | None |
TRAVASOL 10% SOLUTION VIAFLEX ![Compare how all Medicare Part D PDP plans in GA cover TRAVASOL 10% SOLUTION VIAFLEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | P |
TRAVATAN Z 0.04MG DROPS 2.5ML BOT ![Compare how all Medicare Part D PDP plans in GA cover TRAVATAN Z 0.04MG DROPS 2.5ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRAZODONE HCL TABLET USP 100MG (500 CT) ![Compare how all Medicare Part D PDP plans in GA cover TRAZODONE HCL TABLET USP 100MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
TRAZODONE HCL TABLET USP 150MG (100 CT) ![Compare how all Medicare Part D PDP plans in GA cover TRAZODONE HCL TABLET USP 150MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
TRAZODONE HCL TABLET USP 50MG (500 CT) ![Compare how all Medicare Part D PDP plans in GA cover TRAZODONE HCL TABLET USP 50MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
TRECATOR 250MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TRECATOR 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | None |
TRELSTAR DEPOT MIXJET FOR INJECTION 3.75 MG ![Compare how all Medicare Part D PDP plans in GA cover TRELSTAR DEPOT MIXJET FOR INJECTION 3.75 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | P |
TRELSTAR MIXJET FOR INJECTION 11.25 MG ![Compare how all Medicare Part D PDP plans in GA cover TRELSTAR MIXJET FOR INJECTION 11.25 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | P |
TRESIBA FLEXTOUCH 100 UNITS/ML ![Compare how all Medicare Part D PDP plans in GA cover TRESIBA FLEXTOUCH 100 UNITS/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
TRESIBA FLEXTOUCH 200 UNITS/ML ![Compare how all Medicare Part D PDP plans in GA cover TRESIBA FLEXTOUCH 200 UNITS/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
TRETINOIN 0.01% GEL ![Compare how all Medicare Part D PDP plans in GA cover TRETINOIN 0.01% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | None |
Tretinoin 0.25mg/g 1 TUBE per CARTON / 45 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in GA cover Tretinoin 0.25mg/g 1 TUBE per CARTON / 45 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | None |
Tretinoin 0.25mg/g 1 TUBE per CARTON / 45 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in GA cover Tretinoin 0.25mg/g 1 TUBE per CARTON / 45 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Tretinoin 0.5mg/g 1 TUBE per CARTON / 20 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in GA cover Tretinoin 0.5mg/g 1 TUBE per CARTON / 20 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | None |
TRETINOIN 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in GA cover TRETINOIN 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | None |
Tretinoin 1mg/g 1 TUBE per CARTON / 45 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in GA cover Tretinoin 1mg/g 1 TUBE per CARTON / 45 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | None |
TRI PREVIFEM TABLETS ![Compare how all Medicare Part D PDP plans in GA cover TRI PREVIFEM TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$3.00 | $33.00 | None |
TRI-SPRINTEC 7DAYSX3 28 TABLET ![Compare how all Medicare Part D PDP plans in GA cover TRI-SPRINTEC 7DAYSX3 28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$3.00 | $33.00 | None |
TRIAMCINOLONE 0.1% OINTMENT ![Compare how all Medicare Part D PDP plans in GA cover TRIAMCINOLONE 0.1% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$3.00 | $33.00 | None |
TRIAMCINOLONE ACETONIDE 0.025% CREAM 80GM TUBE ![Compare how all Medicare Part D PDP plans in GA cover TRIAMCINOLONE ACETONIDE 0.025% CREAM 80GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$3.00 | $33.00 | None |
TRIAMCINOLONE ACETONIDE 0.025% LOTION 2 FL OZ BOT ![Compare how all Medicare Part D PDP plans in GA cover TRIAMCINOLONE ACETONIDE 0.025% LOTION 2 FL OZ BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
TRIAMCINOLONE ACETONIDE 0.05% OINTMENT 15GM TUBE ![Compare how all Medicare Part D PDP plans in GA cover TRIAMCINOLONE ACETONIDE 0.05% OINTMENT 15GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$3.00 | $33.00 | None |
TRIAMCINOLONE ACETONIDE 0.1% CREAM 80GM TUBE ![Compare how all Medicare Part D PDP plans in GA cover TRIAMCINOLONE ACETONIDE 0.1% CREAM 80GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$3.00 | $33.00 | None |
TRIAMCINOLONE ACETONIDE 0.1% LOTION 60ML BOTPL ![Compare how all Medicare Part D PDP plans in GA cover TRIAMCINOLONE ACETONIDE 0.1% LOTION 60ML BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
triamcinolone acetonide 0.25mg/g 80 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in GA cover triamcinolone acetonide 0.25mg/g 80 g in 1 TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$3.00 | $33.00 | None |
Triamcinolone Acetonide 1mg/g 1 TUBE per CARTON / 5 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in GA 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) |
3 |
Tier 3 |
20% | 25% | None |
Triamcinolone Acetonide 5mg/g 1 TUBE per CARTON / 15 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in GA 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 |
Tier 2 |
$3.00 | $33.00 | None |
Triamterene and Hydrochlorothiazide 25; 37.5mg 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in GA cover Triamterene and Hydrochlorothiazide 25; 37.5mg 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
TRIAMTERENE/HCTZ 37.5/25 TABLET ![Compare how all Medicare Part D PDP plans in GA cover TRIAMTERENE/HCTZ 37.5/25 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
TRIAMTERENE/HCTZ 75/50 TABLET ![Compare how all Medicare Part D PDP plans in GA cover TRIAMTERENE/HCTZ 75/50 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
$0.00 | $0.00 | None |
TRIBENZOR 20/5/12.5MG TABLETS ![Compare how all Medicare Part D PDP plans in GA cover TRIBENZOR 20/5/12.5MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | Q:30 /30Days |
TRIBENZOR 40/10/12.5MG TABLETS ![Compare how all Medicare Part D PDP plans in GA cover TRIBENZOR 40/10/12.5MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | Q:30 /30Days |
TRIBENZOR 40/10/25MG TABLETS ![Compare how all Medicare Part D PDP plans in GA cover TRIBENZOR 40/10/25MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
Tribenzor 5; 12.5; 40mg/1; mg/1; mg/1 ![Compare how all Medicare Part D PDP plans in GA cover Tribenzor 5; 12.5; 40mg/1; mg/1; mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | Q:30 /30Days |
Tribenzor 5; 25; 40mg/1; mg/1; mg/1 ![Compare how all Medicare Part D PDP plans in GA cover Tribenzor 5; 25; 40mg/1; mg/1; mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRIDERM 0.1% CREAM ![Compare how all Medicare Part D PDP plans in GA cover TRIDERM 0.1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$3.00 | $33.00 | None |
TRIFLUOPERAZINE 1MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TRIFLUOPERAZINE 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
TRIFLUOPERAZINE HCL 2MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TRIFLUOPERAZINE HCL 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
TRIFLUOPERAZINE HCL 5MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TRIFLUOPERAZINE HCL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
TRIFLUOPERAZINE HCL USP 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in GA cover TRIFLUOPERAZINE HCL USP 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
TRIFLURIDINE 1% OPTH SOLUTION 7.5ML BOT ![Compare how all Medicare Part D PDP plans in GA cover TRIFLURIDINE 1% OPTH SOLUTION 7.5ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | None |
TRILYTE WITH FLAVOR PACKETS ![Compare how all Medicare Part D PDP plans in GA cover TRILYTE WITH FLAVOR PACKETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$3.00 | $33.00 | None |
TRIMETHOPRIM 100MG TABLETS ![Compare how all Medicare Part D PDP plans in GA cover TRIMETHOPRIM 100MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$3.00 | $33.00 | None |
TRIMIPRAMINE MALEATE 100 MG CP ![Compare how all Medicare Part D PDP plans in GA cover TRIMIPRAMINE MALEATE 100 MG CP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | P Q:60 /30Days |
TRIMIPRAMINE MALEATE 25 MG CAP ![Compare how all Medicare Part D PDP plans in GA cover TRIMIPRAMINE MALEATE 25 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | P Q:240 /30Days |
TRIMIPRAMINE MALEATE 50 MG CAP ![Compare how all Medicare Part D PDP plans in GA cover TRIMIPRAMINE MALEATE 50 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | P Q:120 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRINESSA TABLET ![Compare how all Medicare Part D PDP plans in GA cover TRINESSA TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$3.00 | $33.00 | None |
TRINTELLIX 10 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TRINTELLIX 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | Q:60 /30Days |
TRINTELLIX 20 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TRINTELLIX 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | Q:30 /30Days |
TRINTELLIX 5 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TRINTELLIX 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | Q:120 /30Days |
TRISENOX 10MG/10ML AMPULE ![Compare how all Medicare Part D PDP plans in GA cover TRISENOX 10MG/10ML AMPULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | P |
TRIUMEQ TABLET ![Compare how all Medicare Part D PDP plans in GA cover TRIUMEQ TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | None |
Trivora 6 BLISTER PACK per CARTON / 1 KIT per BLISTER PACK ![Compare how all Medicare Part D PDP plans in GA cover Trivora 6 BLISTER PACK per CARTON / 1 KIT per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
$3.00 | $33.00 | None |
TROPHAMINE INJECTION SOLUTION ![Compare how all Medicare Part D PDP plans in GA cover TROPHAMINE INJECTION SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | P |
TRULICITY 0.75 MG/0.5 ML PEN ![Compare how all Medicare Part D PDP plans in GA cover TRULICITY 0.75 MG/0.5 ML PEN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | Q:4 /28Days |
TRULICITY 1.5 MG/0.5 ML PEN ![Compare how all Medicare Part D PDP plans in GA cover TRULICITY 1.5 MG/0.5 ML PEN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
30% | 35% | Q:4 /28Days |
TRUMENBA 120 MCG/0.5 ML VACCINE ![Compare how all Medicare Part D PDP plans in GA cover TRUMENBA 120 MCG/0.5 ML VACCINE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRUVADA 100 MG-150 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TRUVADA 100 MG-150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | Q:60 /30Days |
TRUVADA 133 MG-200 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TRUVADA 133 MG-200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | Q:30 /30Days |
TRUVADA 167 MG-250 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TRUVADA 167 MG-250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | Q:30 /30Days |
TRUVADA 200/300MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TRUVADA 200/300MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | Q:30 /30Days |
TWINRIX TF PF VACCINE 720UNT/20ML 10 X 1ML VIALSD ![Compare how all Medicare Part D PDP plans in GA cover TWINRIX TF PF VACCINE 720UNT/20ML 10 X 1ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
TYBOST 150 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TYBOST 150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | 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 GA 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) |
5 |
Tier 5 |
25% | N/A | None |
TYKERB 250MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover TYKERB 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | P |
TYPHIM VI 25 MCG/0.5 ML SYRINGE ![Compare how all Medicare Part D PDP plans in GA cover TYPHIM VI 25 MCG/0.5 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
TYPHIM VI 25MCG/0.5ML VIAL ![Compare how all Medicare Part D PDP plans in GA cover TYPHIM VI 25MCG/0.5ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
20% | 25% | None |
TYSABRI 300 MG/15 ML VIAL ![Compare how all Medicare Part D PDP plans in GA cover TYSABRI 300 MG/15 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TYZEKA 600MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in GA cover TYZEKA 600MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | N/A | None |