2017 Medicare Part D Plan Formulary Information |
UPMC for Life PPO High Deductible with Rx (PPO) (H5533-003-0)
Benefit Details
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The UPMC for Life PPO High Deductible with Rx (PPO) (H5533-003-0) Formulary Drugs Starting with the Letter T in Somerset County, PA: CMS MA Region 6 which includes: PA Plan Monthly Premium: $37.00 Deductible: $0 |
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 PA cover TABLOID 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P |
Tacrolimus 0.03% ointment ![Compare how all Medicare Part D PDP plans in PA cover Tacrolimus 0.03% ointment.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$47.00 | N/A | P |
Tacrolimus 0.1% ointment ![Compare how all Medicare Part D PDP plans in PA cover Tacrolimus 0.1% ointment.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$47.00 | N/A | P |
Tacrolimus 0.5mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Tacrolimus 0.5mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | P |
Tacrolimus 1mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Tacrolimus 1mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | P |
Tacrolimus 5mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Tacrolimus 5mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P |
TAFINLAR 50 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover TAFINLAR 50 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P |
TAFINLAR 75 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover TAFINLAR 75 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P |
TAGRISSO 40 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TAGRISSO 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P |
TAGRISSO 80 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TAGRISSO 80 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TALTZ 80 MG/ML AUTOINJ (3-PK) ![Compare how all Medicare Part D PDP plans in PA cover TALTZ 80 MG/ML AUTOINJ (3-PK).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P Q:3 /28Days |
TALTZ 80 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in PA cover TALTZ 80 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P Q:3 /28Days |
TAMIFLU 6 MG/ML SUSPENSION ![Compare how all Medicare Part D PDP plans in PA cover TAMIFLU 6 MG/ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$47.00 | N/A | Q:525 /180Days |
TAMOXIFEN 10 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TAMOXIFEN 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TAMOXIFEN CITRATE 20MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in PA cover TAMOXIFEN CITRATE 20MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TAMSULOSIN HCL 0.4 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover TAMSULOSIN HCL 0.4 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TARCEVA 100MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TARCEVA 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P |
TARCEVA 150MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TARCEVA 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P |
TARCEVA 25MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TARCEVA 25MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P |
TARGRETIN 1% GEL ![Compare how all Medicare Part D PDP plans in PA cover TARGRETIN 1% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | None |
Tarina Fe 1-20 tablet ![Compare how all Medicare Part D PDP plans in PA cover Tarina Fe 1-20 tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | 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 PA 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) |
4 |
Specialty Tier |
33% | N/A | P |
TASIGNA 200MG CAPSULE 28 BLPK ![Compare how all Medicare Part D PDP plans in PA cover TASIGNA 200MG CAPSULE 28 BLPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P |
Tazarotene 0.1% Cream [Tazorac] ![Compare how all Medicare Part D PDP plans in PA cover Tazarotene 0.1% Cream [Tazorac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P |
TAZORAC 0.05% CREAM ![Compare how all Medicare Part D PDP plans in PA cover TAZORAC 0.05% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P |
TAZORAC 0.05% GEL ![Compare how all Medicare Part D PDP plans in PA cover TAZORAC 0.05% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P |
TAZORAC 0.1% CREAM ![Compare how all Medicare Part D PDP plans in PA cover TAZORAC 0.1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P |
TAZORAC 0.1% GEL ![Compare how all Medicare Part D PDP plans in PA cover TAZORAC 0.1% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P |
TAZTIA DILTIAZEM HYDROCHLORIDE 120MG EXTENDED RELEASE CAPSULES ![Compare how all Medicare Part D PDP plans in PA cover TAZTIA DILTIAZEM HYDROCHLORIDE 120MG EXTENDED RELEASE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TAZTIA DILTIAZEM HYDROCHLORIDE 180MG EXTENDED RELEASE CAPSULES ![Compare how all Medicare Part D PDP plans in PA cover TAZTIA DILTIAZEM HYDROCHLORIDE 180MG EXTENDED RELEASE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TAZTIA DILTIAZEM HYDROCHLORIDE 300MG EXTENDED RELEASE CAPSULES ![Compare how all Medicare Part D PDP plans in PA cover TAZTIA DILTIAZEM HYDROCHLORIDE 300MG EXTENDED RELEASE CAPSULES.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TAZTIA XT 240MG CAPSULE SA ![Compare how all Medicare Part D PDP plans in PA cover TAZTIA XT 240MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | 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 PA cover TAZTIA XT 360MG CAPSULE SA.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
TECENTRIQ 1,200 MG/20 ML VIAL ![Compare how all Medicare Part D PDP plans in PA cover TECENTRIQ 1,200 MG/20 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | None |
TECFIDERA DR 120 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover TECFIDERA DR 120 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P Q:60 /30Days |
TECFIDERA DR 240 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover TECFIDERA DR 240 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P Q:60 /30Days |
TECFIDERA STARTER PACK ![Compare how all Medicare Part D PDP plans in PA cover TECFIDERA STARTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P Q:120 /365Days |
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 PA 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 |
Specialty Tier |
33% | N/A | 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 PA 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 |
Specialty Tier |
33% | N/A | None |
TEKTURNA 150 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TEKTURNA 150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$47.00 | N/A | S |
TEKTURNA 300 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TEKTURNA 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$47.00 | N/A | S |
TEKTURNA HCT 300-25 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TEKTURNA HCT 300-25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$47.00 | N/A | S |
Telmisartan 20 MG Tablet [Micardis] ![Compare how all Medicare Part D PDP plans in PA cover Telmisartan 20 MG Tablet [Micardis].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Telmisartan 40 MG Tablet [Micardis] ![Compare how all Medicare Part D PDP plans in PA cover Telmisartan 40 MG Tablet [Micardis].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Telmisartan 80 MG Tablet [Micardis] ![Compare how all Medicare Part D PDP plans in PA cover Telmisartan 80 MG Tablet [Micardis].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Telmisartan-Amlodipine 40-10 MG [Micardis] ![Compare how all Medicare Part D PDP plans in PA cover Telmisartan-Amlodipine 40-10 MG [Micardis].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
Telmisartan-Amlodipine 40-5 MG [Micardis] ![Compare how all Medicare Part D PDP plans in PA cover Telmisartan-Amlodipine 40-5 MG [Micardis].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
Telmisartan-Amlodipine 80-10 MG [Micardis] ![Compare how all Medicare Part D PDP plans in PA cover Telmisartan-Amlodipine 80-10 MG [Micardis].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
Telmisartan-Amlodipine 80-5 MG [Micardis] ![Compare how all Medicare Part D PDP plans in PA cover Telmisartan-Amlodipine 80-5 MG [Micardis].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
TELMISARTAN-HCTZ 40-12.5 MG TB [Micardis] ![Compare how all Medicare Part D PDP plans in PA cover TELMISARTAN-HCTZ 40-12.5 MG TB [Micardis].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
Telmisartan-hctz 80-12.5 mg tb [Micardis] ![Compare how all Medicare Part D PDP plans in PA cover Telmisartan-hctz 80-12.5 mg tb [Micardis].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
TELMISARTAN-HCTZ 80-25 MG TAB [Micardis] ![Compare how all Medicare Part D PDP plans in PA cover TELMISARTAN-HCTZ 80-25 MG TAB [Micardis].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
TENIVAC SYRINGE ![Compare how all Medicare Part D PDP plans in PA cover TENIVAC SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$47.00 | N/A | None |
TERAZOSIN 1 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover TERAZOSIN 1 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Terazosin Hydrochloride 10mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Terazosin Hydrochloride 10mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Terazosin Hydrochloride 2mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Terazosin Hydrochloride 2mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Terazosin Hydrochloride 5mg/1 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Terazosin Hydrochloride 5mg/1 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Terbinafine HCl 250 MG Tablet ![Compare how all Medicare Part D PDP plans in PA cover Terbinafine HCl 250 MG Tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TERBUTALINE SULF 1MG/ML VL ![Compare how all Medicare Part D PDP plans in PA cover TERBUTALINE SULF 1MG/ML VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TERBUTALINE SULFATE 2.5 MG TAB ![Compare how all Medicare Part D PDP plans in PA cover TERBUTALINE SULFATE 2.5 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TERBUTALINE SULFATE 5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TERBUTALINE SULFATE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TERCONAZOLE 0.4% CREAM WITH APPLICATOR ![Compare how all Medicare Part D PDP plans in PA cover TERCONAZOLE 0.4% CREAM WITH APPLICATOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TERCONAZOLE 0.8% CREAM ![Compare how all Medicare Part D PDP plans in PA cover TERCONAZOLE 0.8% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TERCONAZOLE 80MG SUPPOSITORY VAGINAL ![Compare how all Medicare Part D PDP plans in PA cover TERCONAZOLE 80MG SUPPOSITORY VAGINAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
TESTIM 1%(50MG) GEL ![Compare how all Medicare Part D PDP plans in PA cover TESTIM 1%(50MG) GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TESTOSTERONE 12.5 MG/1.25 GRAM ![Compare how all Medicare Part D PDP plans in PA cover TESTOSTERONE 12.5 MG/1.25 GRAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P |
TESTOSTERONE 25 MG/2.5 GM PKT ![Compare how all Medicare Part D PDP plans in PA cover TESTOSTERONE 25 MG/2.5 GM PKT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P |
TESTOSTERONE 50 MG/5 GRAM PKT ![Compare how all Medicare Part D PDP plans in PA cover TESTOSTERONE 50 MG/5 GRAM PKT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P |
Testosterone cyp 100 mg/ml ![Compare how all Medicare Part D PDP plans in PA cover Testosterone cyp 100 mg/ml.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | P |
Testosterone cyp 200 mg/ml ![Compare how all Medicare Part D PDP plans in PA cover Testosterone cyp 200 mg/ml.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | P |
TESTOSTERONE ENANTHATE 200MG/ML INJECTION ![Compare how all Medicare Part D PDP plans in PA cover TESTOSTERONE ENANTHATE 200MG/ML INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | P |
TETANUS DIPHTHERIA TOXOIDS ![Compare how all Medicare Part D PDP plans in PA cover TETANUS DIPHTHERIA TOXOIDS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$47.00 | N/A | None |
TETRABENAZINE 12.5 MG TABLET [XENAZINE] ![Compare how all Medicare Part D PDP plans in PA cover TETRABENAZINE 12.5 MG TABLET [XENAZINE].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P Q:240 /30Days |
TETRABENAZINE 25 MG TABLET [XENAZINE] ![Compare how all Medicare Part D PDP plans in PA cover TETRABENAZINE 25 MG TABLET [XENAZINE].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P Q:120 /30Days |
TETRACYCLINE 250 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover TETRACYCLINE 250 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
TETRACYCLINE 500 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover TETRACYCLINE 500 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
THALOMID 100MG CAPSULE 140 BOX ![Compare how all Medicare Part D PDP plans in PA cover THALOMID 100MG CAPSULE 140 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P |
Thalomid 150mg/1 ![Compare how all Medicare Part D PDP plans in PA cover Thalomid 150mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P |
Thalomid 200mg/1 ![Compare how all Medicare Part D PDP plans in PA cover Thalomid 200mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P |
THALOMID 50MG CAPSULE 280 BOX ![Compare how all Medicare Part D PDP plans in PA cover THALOMID 50MG CAPSULE 280 BOX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P |
Theophylline 100mg/1 500 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Theophylline 100mg/1 500 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Theophylline 200mg/1 500 TABLET, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Theophylline 200mg/1 500 TABLET, EXTENDED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Theophylline 80mg/15mL 473 mL in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in PA cover Theophylline 80mg/15mL 473 mL in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Theophylline er 400 mg tablet ![Compare how all Medicare Part D PDP plans in PA cover Theophylline er 400 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Theophylline er 600 mg tablet ![Compare how all Medicare Part D PDP plans in PA cover Theophylline er 600 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
THEOPHYLLINE TABLET ER 300MG (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover THEOPHYLLINE TABLET ER 300MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
THEOPHYLLINE TABLET ER 450MG (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover THEOPHYLLINE TABLET ER 450MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
THIOLA 100 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover THIOLA 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P |
THIORIDAZINE 100MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover THIORIDAZINE 100MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
THIORIDAZINE HCL 10MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in PA cover THIORIDAZINE HCL 10MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
THIORIDAZINE HCL 25MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in PA cover THIORIDAZINE HCL 25MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | 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 PA 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 |
$14.00 | N/A | None |
THIOTEPA 15 MG VIAL ![Compare how all Medicare Part D PDP plans in PA cover THIOTEPA 15 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | None |
THIOTHIXENE 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover THIOTHIXENE 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
THIOTHIXENE 1MG CAPSULE (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover THIOTHIXENE 1MG CAPSULE (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
THIOTHIXENE 2MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover THIOTHIXENE 2MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
THIOTHIXENE 5MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover THIOTHIXENE 5MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
THYMOGLOBULIN 25MG VIAL ![Compare how all Medicare Part D PDP plans in PA cover THYMOGLOBULIN 25MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
tiagabine hcl 2 mg tablet [Gabitril] ![Compare how all Medicare Part D PDP plans in PA cover tiagabine hcl 2 mg tablet [Gabitril].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
tiagabine hcl 4 mg tablet [Gabitril] ![Compare how all Medicare Part D PDP plans in PA cover tiagabine hcl 4 mg tablet [Gabitril].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
TIGECYCLINE 50 MG VIAL [Tygacil] ![Compare how all Medicare Part D PDP plans in PA cover TIGECYCLINE 50 MG VIAL [Tygacil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | None |
TIMOLOL 0.25% GFS GEL-SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover TIMOLOL 0.25% GFS GEL-SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
TIMOLOL MAL SOL 0.25% OP 15ML BOT ![Compare how all Medicare Part D PDP plans in PA cover TIMOLOL MAL SOL 0.25% OP 15ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TIMOLOL MAL SOL 0.5% OP 10ML BOT ![Compare how all Medicare Part D PDP plans in PA cover TIMOLOL MAL SOL 0.5% OP 10ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TIMOLOL MALEATE 10MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TIMOLOL MALEATE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TIMOLOL MALEATE 20MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TIMOLOL MALEATE 20MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TIMOLOL MALEATE 5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TIMOLOL MALEATE 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | 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 PA 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) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
tinidazole 250 mg tablet ![Compare how all Medicare Part D PDP plans in PA cover tinidazole 250 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
tinidazole 500 mg tablet ![Compare how all Medicare Part D PDP plans in PA cover tinidazole 500 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
TIVICAY 10 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TIVICAY 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
TIVICAY 25 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TIVICAY 25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | None |
TIVICAY 50 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TIVICAY 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | None |
Tizanidine 4mg/1 1000 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Tizanidine 4mg/1 1000 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TIZANIDINE HCL 2 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TIZANIDINE HCL 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TOBI PODHALER 28 MG INHALE CAP ![Compare how all Medicare Part D PDP plans in PA cover TOBI PODHALER 28 MG INHALE CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | Q:224 /56Days |
TOBRADEX EYE OINTMENT ![Compare how all Medicare Part D PDP plans in PA cover TOBRADEX EYE OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
TOBRAMYCIN 10 MG/ML VIAL [Bethkis, Tobi, Tobi Podhaler, Tobramycin Sulfate] ![Compare how all Medicare Part D PDP plans in PA cover TOBRAMYCIN 10 MG/ML VIAL [Bethkis, Tobi, Tobi Podhaler, Tobramycin Sulfate].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TOBRAMYCIN 300 MG/5 ML AMPULE [Bethkis, Tobi, Tobi Podhaler, Tobramycin Sulfate] ![Compare how all Medicare Part D PDP plans in PA cover TOBRAMYCIN 300 MG/5 ML AMPULE [Bethkis, Tobi, Tobi Podhaler, Tobramycin Sulfate].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P Q:280 /56Days |
TOBRAMYCIN 40MG/ML VIAL ![Compare how all Medicare Part D PDP plans in PA cover TOBRAMYCIN 40MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TOBRAMYCIN OPHTHALMIC SOLUTION 0.3% 5ML BOT ![Compare how all Medicare Part D PDP plans in PA cover TOBRAMYCIN OPHTHALMIC SOLUTION 0.3% 5ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TOBRAMYCIN-DEXAMETH OPTH SUSP ![Compare how all Medicare Part D PDP plans in PA cover TOBRAMYCIN-DEXAMETH OPTH SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
TOBREX 0.3% EYE OINTMENT ![Compare how all Medicare Part D PDP plans in PA cover TOBREX 0.3% EYE OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
TOLAZAMIDE TABLETS 250MG 100 BOT ![Compare how all Medicare Part D PDP plans in PA cover TOLAZAMIDE TABLETS 250MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | Q:120 /30Days |
TOLAZAMIDE TABLETS 500MG 100 BOT ![Compare how all Medicare Part D PDP plans in PA cover TOLAZAMIDE TABLETS 500MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | Q:60 /30Days |
TOLBUTAMIDE 500MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TOLBUTAMIDE 500MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | Q:180 /30Days |
TOLMETIN SODIUM 400 MG CAP ![Compare how all Medicare Part D PDP plans in PA cover TOLMETIN SODIUM 400 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
TOLMETIN SODIUM 600MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TOLMETIN SODIUM 600MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
Tolterodine Tartrate 1 MG Oral Tablet [Detrol LA] ![Compare how all Medicare Part D PDP plans in PA cover Tolterodine Tartrate 1 MG Oral Tablet [Detrol LA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Tolterodine Tartrate 2 MG TABLET [Detrol LA] ![Compare how all Medicare Part D PDP plans in PA cover Tolterodine Tartrate 2 MG TABLET [Detrol LA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Tolterodine Tartrate ER 2 MG CAPSULE [Detrol LA] ![Compare how all Medicare Part D PDP plans in PA cover Tolterodine Tartrate ER 2 MG CAPSULE [Detrol LA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Tolterodine Tartrate ER 4 MG Capsule [Detrol LA] ![Compare how all Medicare Part D PDP plans in PA cover Tolterodine Tartrate ER 4 MG Capsule [Detrol LA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TOLVAPTAN 15 MG ORAL TABLET [SAMSCA] ![Compare how all Medicare Part D PDP plans in PA cover TOLVAPTAN 15 MG ORAL TABLET [SAMSCA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
TOLVAPTAN 30 MG ORAL TABLET [SAMSCA] ![Compare how all Medicare Part D PDP plans in PA cover TOLVAPTAN 30 MG ORAL TABLET [SAMSCA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P Q:60 /30Days |
Topiramate 25mg/1 ![Compare how all Medicare Part D PDP plans in PA cover Topiramate 25mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
TOPIRAMATE SPRINKLE CAPSULES 15MG 60 BOT ![Compare how all Medicare Part D PDP plans in PA cover TOPIRAMATE SPRINKLE CAPSULES 15MG 60 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
TOPIRAMATE TABLETS 100MG 1000 BOT ![Compare how all Medicare Part D PDP plans in PA cover TOPIRAMATE TABLETS 100MG 1000 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TOPIRAMATE TABLETS 200MG 1000 BOT ![Compare how all Medicare Part D PDP plans in PA cover TOPIRAMATE TABLETS 200MG 1000 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TOPIRAMATE TABLETS 25MG 1000 BOT ![Compare how all Medicare Part D PDP plans in PA cover TOPIRAMATE TABLETS 25MG 1000 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TOPIRAMATE TABLETS 50MG 1000 BOT ![Compare how all Medicare Part D PDP plans in PA cover TOPIRAMATE TABLETS 50MG 1000 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TOPOSAR INJECTION 20MG/ML 50ML VIAL MD CRTN ![Compare how all Medicare Part D PDP plans in PA cover TOPOSAR INJECTION 20MG/ML 50ML VIAL MD CRTN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TOPOTECAN HCL 4 MG VIAL ![Compare how all Medicare Part D PDP plans in PA cover TOPOTECAN HCL 4 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Torisel 1 KIT per CARTON ![Compare how all Medicare Part D PDP plans in PA cover Torisel 1 KIT per CARTON.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | None |
TORSEMIDE 10 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TORSEMIDE 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Torsemide 100mg/1 12 BOTTLE CASE / 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Torsemide 100mg/1 12 BOTTLE CASE / 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TORSEMIDE 20mg 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover TORSEMIDE 20mg 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TORSEMIDE 5 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TORSEMIDE 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TOUJEO SOLOSTAR 300 UNITS/ML ![Compare how all Medicare Part D PDP plans in PA cover TOUJEO SOLOSTAR 300 UNITS/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$47.00 | N/A | Q:9 /30Days |
TPN ELECTROLYTES16.5/25.4 VIAL ![Compare how all Medicare Part D PDP plans in PA cover TPN ELECTROLYTES16.5/25.4 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
TRACLEER 125MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRACLEER 125MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P Q:60 /30Days |
TRACLEER 62.5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRACLEER 62.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P Q:60 /30Days |
TRADJENTA 5mg/1 90 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover TRADJENTA 5mg/1 90 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$47.00 | N/A | None |
TRAMADOL HCL 50 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRAMADOL HCL 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | Q:240 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRAMADOL HCL-ACETAMINOPHEN 37.5-325MG TABLET (1000 CT) ![Compare how all Medicare Part D PDP plans in PA cover TRAMADOL HCL-ACETAMINOPHEN 37.5-325MG TABLET (1000 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | Q:40 /5Days |
TRANDOLAPRIL 1 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRANDOLAPRIL 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Select Care Drugs |
$0.00 | N/A | None |
TRANDOLAPRIL 2 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRANDOLAPRIL 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Select Care Drugs |
$0.00 | N/A | None |
TRANDOLAPRIL 4 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRANDOLAPRIL 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Select Care Drugs |
$0.00 | N/A | None |
TRANEXAMIC ACID 1,000 MG/10 ML ![Compare how all Medicare Part D PDP plans in PA cover TRANEXAMIC ACID 1,000 MG/10 ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
tranexamic acid 650 mg tablet ![Compare how all Medicare Part D PDP plans in PA cover tranexamic acid 650 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$47.00 | N/A | Q:30 /28Days |
TRANSDERM-SCOP 1.5 MG/3 DAY ![Compare how all Medicare Part D PDP plans in PA cover TRANSDERM-SCOP 1.5 MG/3 DAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
TRANYLCYPROMINE SULFATE 10MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRANYLCYPROMINE SULFATE 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
TRAVASOL 10% SOLUTION VIAFLEX ![Compare how all Medicare Part D PDP plans in PA cover TRAVASOL 10% SOLUTION VIAFLEX.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P |
TRAVATAN Z 0.04MG DROPS 2.5ML BOT ![Compare how all Medicare Part D PDP plans in PA cover TRAVATAN Z 0.04MG DROPS 2.5ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | S |
TRAZODONE 300MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRAZODONE 300MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | 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 PA cover TRAZODONE HCL TABLET USP 100MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TRAZODONE HCL TABLET USP 150MG (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover TRAZODONE HCL TABLET USP 150MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TRAZODONE HCL TABLET USP 50MG (500 CT) ![Compare how all Medicare Part D PDP plans in PA cover TRAZODONE HCL TABLET USP 50MG (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TREANDA FOR INJECTION 100MG/VIAL ![Compare how all Medicare Part D PDP plans in PA cover TREANDA FOR INJECTION 100MG/VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | None |
TRECATOR 250MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRECATOR 250MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | None |
TRELSTAR 11.25 MG SYRINGE ![Compare how all Medicare Part D PDP plans in PA cover TRELSTAR 11.25 MG SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P Q:1 /84Days |
TRELSTAR 3.75 MG SYRINGE ![Compare how all Medicare Part D PDP plans in PA cover TRELSTAR 3.75 MG SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P Q:1 /28Days |
TRESIBA FLEXTOUCH 100 UNITS/ML ![Compare how all Medicare Part D PDP plans in PA cover TRESIBA FLEXTOUCH 100 UNITS/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$47.00 | N/A | Q:45 /30Days |
TRESIBA FLEXTOUCH 200 UNITS/ML ![Compare how all Medicare Part D PDP plans in PA cover TRESIBA FLEXTOUCH 200 UNITS/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$47.00 | N/A | Q:27 /30Days |
TRETINOIN 0.01% GEL ![Compare how all Medicare Part D PDP plans in PA cover TRETINOIN 0.01% GEL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P |
TRETINOIN 0.025% CREAM ![Compare how all Medicare Part D PDP plans in PA cover TRETINOIN 0.025% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRETINOIN 0.05% CREAM ![Compare how all Medicare Part D PDP plans in PA cover TRETINOIN 0.05% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P |
TRETINOIN 0.1% CREAM ![Compare how all Medicare Part D PDP plans in PA cover TRETINOIN 0.1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P |
Tretinoin 0.25mg/g 1 TUBE per CARTON / 45 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in PA 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) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P |
TRETINOIN 10MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover TRETINOIN 10MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | None |
TRI PREVIFEM TABLETS ![Compare how all Medicare Part D PDP plans in PA cover TRI PREVIFEM TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TRI-LEGEST FE 5-7-9-7 TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRI-LEGEST FE 5-7-9-7 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TRI-LO-ESTARYLLA TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRI-LO-ESTARYLLA TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TRI-LO-SPRINTEC TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRI-LO-SPRINTEC TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TRI-SPRINTEC 7DAYSX3 28 TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRI-SPRINTEC 7DAYSX3 28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TRIAMCINOLONE 0.1% OINTMENT ![Compare how all Medicare Part D PDP plans in PA cover TRIAMCINOLONE 0.1% OINTMENT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TRIAMCINOLONE ACETONIDE 0.025% CREAM 80GM TUBE ![Compare how all Medicare Part D PDP plans in PA cover TRIAMCINOLONE ACETONIDE 0.025% CREAM 80GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRIAMCINOLONE ACETONIDE 0.025% LOTION 2 FL OZ BOT ![Compare how all Medicare Part D PDP plans in PA cover TRIAMCINOLONE ACETONIDE 0.025% LOTION 2 FL OZ BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TRIAMCINOLONE ACETONIDE 0.05% OINTMENT 15GM TUBE ![Compare how all Medicare Part D PDP plans in PA cover TRIAMCINOLONE ACETONIDE 0.05% OINTMENT 15GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TRIAMCINOLONE ACETONIDE 0.1% CREAM 80GM TUBE ![Compare how all Medicare Part D PDP plans in PA cover TRIAMCINOLONE ACETONIDE 0.1% CREAM 80GM TUBE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TRIAMCINOLONE ACETONIDE 0.1% LOTION 60ML BOTPL ![Compare how all Medicare Part D PDP plans in PA cover TRIAMCINOLONE ACETONIDE 0.1% LOTION 60ML BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
triamcinolone acetonide 0.25mg/g 80 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in PA 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 |
$14.00 | N/A | None |
Triamcinolone Acetonide 1mg/g 1 TUBE per CARTON / 5 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in PA 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) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Triamcinolone Acetonide 5mg/g 1 TUBE per CARTON / 15 g in 1 TUBE ![Compare how all Medicare Part D PDP plans in PA 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) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Triamterene and Hydrochlorothiazide 25; 37.5mg 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Triamterene and Hydrochlorothiazide 25; 37.5mg 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TRIAMTERENE-HCTZ 37.5-25 MG TB ![Compare how all Medicare Part D PDP plans in PA cover TRIAMTERENE-HCTZ 37.5-25 MG TB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TRIAMTERENE/HCTZ 50-25 MG CAP ![Compare how all Medicare Part D PDP plans in PA cover TRIAMTERENE/HCTZ 50-25 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TRIAMTERENE/HCTZ 75/50 TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRIAMTERENE/HCTZ 75/50 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
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 PA cover TRIDERM 0.1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TRIFLUOPERAZINE 1MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRIFLUOPERAZINE 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TRIFLUOPERAZINE HCL 2MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRIFLUOPERAZINE HCL 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TRIFLUOPERAZINE HCL 5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRIFLUOPERAZINE HCL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TRIFLUOPERAZINE HCL USP 10MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in PA cover TRIFLUOPERAZINE HCL USP 10MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TRIFLURIDINE 1% OPTH SOLUTION 7.5ML BOT ![Compare how all Medicare Part D PDP plans in PA cover TRIFLURIDINE 1% OPTH SOLUTION 7.5ML BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Trihexyphenidyl 2 mg tablet ![Compare how all Medicare Part D PDP plans in PA cover Trihexyphenidyl 2 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Trihexyphenidyl 5 mg tablet ![Compare how all Medicare Part D PDP plans in PA cover Trihexyphenidyl 5 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Trihexyphenidyl Hydrochloride 2mg/5mL 473 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in PA cover Trihexyphenidyl Hydrochloride 2mg/5mL 473 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TRILYTE WITH FLAVOR PACKETS ![Compare how all Medicare Part D PDP plans in PA cover TRILYTE WITH FLAVOR PACKETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TRIMETHOPRIM 100MG TABLETS ![Compare how all Medicare Part D PDP plans in PA cover TRIMETHOPRIM 100MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRIMIPRAMINE MALEATE 100 MG CP ![Compare how all Medicare Part D PDP plans in PA cover TRIMIPRAMINE MALEATE 100 MG CP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P |
TRIMIPRAMINE MALEATE 25 MG CAP ![Compare how all Medicare Part D PDP plans in PA cover TRIMIPRAMINE MALEATE 25 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P |
TRIMIPRAMINE MALEATE 50 MG CAP ![Compare how all Medicare Part D PDP plans in PA cover TRIMIPRAMINE MALEATE 50 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P |
TRINESSA TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRINESSA TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TRINTELLIX 10 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRINTELLIX 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P |
TRINTELLIX 20 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRINTELLIX 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P |
TRINTELLIX 5 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRINTELLIX 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P |
Triptorelin 11.3 MG/ML Injectable Suspension [Trelstar] ![Compare how all Medicare Part D PDP plans in PA cover Triptorelin 11.3 MG/ML Injectable Suspension [Trelstar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P Q:1 /168Days |
TRISENOX 10MG/10ML AMPULE ![Compare how all Medicare Part D PDP plans in PA cover TRISENOX 10MG/10ML AMPULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | None |
TRIUMEQ TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRIUMEQ TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | None |
Trivora-28 tablet ![Compare how all Medicare Part D PDP plans in PA cover Trivora-28 tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TROPHAMINE INJECTION SOLUTION ![Compare how all Medicare Part D PDP plans in PA cover TROPHAMINE INJECTION SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P |
TROPHAMINE INJECTION SOLUTION 6% ![Compare how all Medicare Part D PDP plans in PA cover TROPHAMINE INJECTION SOLUTION 6%.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Non-Preferred Drug |
$100.00 | N/A | P |
TROSPIUM CHLORIDE 20MG TABLETS ![Compare how all Medicare Part D PDP plans in PA cover TROSPIUM CHLORIDE 20MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TROSPIUM CHLORIDE ER 60 MG CAP ![Compare how all Medicare Part D PDP plans in PA cover TROSPIUM CHLORIDE ER 60 MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$14.00 | N/A | None |
TRULICITY 0.75 MG/0.5 ML PEN ![Compare how all Medicare Part D PDP plans in PA cover TRULICITY 0.75 MG/0.5 ML PEN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$47.00 | N/A | Q:2 /28Days |
TRULICITY 1.5 MG/0.5 ML PEN ![Compare how all Medicare Part D PDP plans in PA cover TRULICITY 1.5 MG/0.5 ML PEN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$47.00 | N/A | Q:2 /28Days |
TRUMENBA 120 MCG/0.5 ML VACCINE ![Compare how all Medicare Part D PDP plans in PA cover TRUMENBA 120 MCG/0.5 ML VACCINE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$47.00 | N/A | None |
TRUVADA 100 MG-150 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRUVADA 100 MG-150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | None |
TRUVADA 133 MG-200 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRUVADA 133 MG-200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | None |
TRUVADA 167 MG-250 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRUVADA 167 MG-250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | None |
TRUVADA 200/300MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRUVADA 200/300MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TWINRIX TF PF VACCINE 720UNT/20ML 10 X 1ML VIALSD ![Compare how all Medicare Part D PDP plans in PA cover TWINRIX TF PF VACCINE 720UNT/20ML 10 X 1ML VIALSD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$47.00 | N/A | None |
TYBOST 150 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TYBOST 150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$47.00 | N/A | 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 PA 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 |
Specialty Tier |
33% | N/A | None |
TYKERB 250 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TYKERB 250 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P |
TYMLOS 80 MCG DOSE PEN INJECTR ![Compare how all Medicare Part D PDP plans in PA cover TYMLOS 80 MCG DOSE PEN INJECTR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | S Q:2 /30Days |
TYPHIM VI 25 MCG/0.5 ML SYRINGE ![Compare how all Medicare Part D PDP plans in PA cover TYPHIM VI 25 MCG/0.5 ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$47.00 | N/A | None |
TYPHIM VI 25MCG/0.5ML VIAL ![Compare how all Medicare Part D PDP plans in PA cover TYPHIM VI 25MCG/0.5ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Preferred Brand |
$47.00 | N/A | None |
TYSABRI 300 MG/15 ML VIAL ![Compare how all Medicare Part D PDP plans in PA cover TYSABRI 300 MG/15 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Specialty Tier |
33% | N/A | P Q:15 /28Days |