2017 Medicare Part D Plan Formulary Information |
Gateway Health Medicare Assured Ruby (HMO SNP) (H5932-009-0)
Benefit Details
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The Gateway Health Medicare Assured Ruby (HMO SNP) (H5932-009-0) Formulary Drugs Starting with the Letter T in Armstrong County, PA: CMS MA Region 6 which includes: PA Plan Monthly Premium: $39.40 Deductible: $400 |
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) |
1 |
Tier 1 |
15% | N/A | None |
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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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) |
1 |
Tier 1 |
15% | 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) |
1 |
Tier 1 |
15% | 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) |
1 |
Tier 1 |
15% | N/A | P Q:120 /30Days |
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) |
1 |
Tier 1 |
15% | 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) |
1 |
Tier 1 |
15% | N/A | P |
TALWIN 30MG/ML VIAL ![Compare how all Medicare Part D PDP plans in PA cover TALWIN 30MG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | N/A | P S Q:360 /30Days |
TAMIFLU 30 MG 1 BLISTER PACK per CARTON / 10 CAPSULE per BLISTER PACK ![Compare how all Medicare Part D PDP plans in PA 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) |
1 |
Tier 1 |
15% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TAMIFLU 45 MG 1 BLISTER PACK per CARTON / 10 CAPSULE per BLISTER PACK ![Compare how all Medicare Part D PDP plans in PA 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) |
1 |
Tier 1 |
15% | N/A | None |
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) |
1 |
Tier 1 |
15% | N/A | Q:700 /365Days |
TAMIFLU 75 MG CAPSULE UD ![Compare how all Medicare Part D PDP plans in PA cover TAMIFLU 75 MG CAPSULE UD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | N/A | Q:28 /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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | N/A | None |
TANZEUM 30 MG PEN INJECT ![Compare how all Medicare Part D PDP plans in PA cover TANZEUM 30 MG PEN INJECT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | N/A | P Q:4 /28Days |
TANZEUM 50 MG PEN INJECT ![Compare how all Medicare Part D PDP plans in PA cover TANZEUM 50 MG PEN INJECT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | N/A | P Q:4 /28Days |
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) |
1 |
Tier 1 |
15% | 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) |
1 |
Tier 1 |
15% | 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) |
1 |
Tier 1 |
15% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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) |
1 |
Tier 1 |
15% | N/A | P |
TARGRETIN 75 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover TARGRETIN 75 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | N/A | None |
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) |
1 |
Tier 1 |
15% | 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) |
1 |
Tier 1 |
15% | N/A | P Q:120 /30Days |
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) |
1 |
Tier 1 |
15% | N/A | None |
TAZICEF 1GM VIAL ![Compare how all Medicare Part D PDP plans in PA cover TAZICEF 1GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | N/A | None |
TAZICEF 2 GRAM VIAL ![Compare how all Medicare Part D PDP plans in PA cover TAZICEF 2 GRAM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | N/A | None |
TAZICEF 6 GRAM VIAL ![Compare how all Medicare Part D PDP plans in PA cover TAZICEF 6 GRAM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | N/A | None |
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) |
1 |
Tier 1 |
15% | N/A | None |
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) |
1 |
Tier 1 |
15% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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) |
1 |
Tier 1 |
15% | N/A | None |
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) |
1 |
Tier 1 |
15% | N/A | None |
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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | N/A | None |
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) |
1 |
Tier 1 |
15% | 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) |
1 |
Tier 1 |
15% | N/A | P |
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) |
1 |
Tier 1 |
15% | 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) |
1 |
Tier 1 |
15% | 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) |
1 |
Tier 1 |
15% | N/A | P Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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) |
1 |
Tier 1 |
15% | N/A | P |
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) |
1 |
Tier 1 |
15% | N/A | P |
Tencon 50-325 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover Tencon 50-325 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | N/A | Q:180 /30Days |
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) |
1 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | N/A | None |
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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | N/A | Q:84 /365Days |
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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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) |
1 |
Tier 1 |
15% | N/A | None |
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 |
Tier 1 |
15% | N/A | None |
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 |
Tier 1 |
15% | N/A | None |
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 |
Tier 1 |
15% | N/A | None |
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) |
1 |
Tier 1 |
15% | 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) |
1 |
Tier 1 |
15% | N/A | P |
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) |
1 |
Tier 1 |
15% | N/A | P |
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) |
1 |
Tier 1 |
15% | N/A | None |
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) |
1 |
Tier 1 |
15% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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) |
1 |
Tier 1 |
15% | N/A | None |
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) |
1 |
Tier 1 |
15% | N/A | None |
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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | N/A | None |
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 |
Tier 1 |
15% | N/A | P |
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 |
Tier 1 |
15% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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 |
Tier 1 |
15% | N/A | 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 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 |
Tier 1 |
15% | N/A | P |
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) |
1 |
Tier 1 |
15% | N/A | P |
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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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) |
1 |
Tier 1 |
15% | N/A | P |
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) |
1 |
Tier 1 |
15% | 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) |
1 |
Tier 1 |
15% | 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) |
1 |
Tier 1 |
15% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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) |
1 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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) |
1 |
Tier 1 |
15% | N/A | None |
TIMOPTIC 0.25% OCUDOSE DROP ![Compare how all Medicare Part D PDP plans in PA cover TIMOPTIC 0.25% OCUDOSE DROP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | N/A | None |
TIMOPTIC 0.5% OCUDOSE DROP ![Compare how all Medicare Part D PDP plans in PA cover TIMOPTIC 0.5% OCUDOSE DROP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 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) |
1 |
Tier 1 |
15% | N/A | Q:30 /30Days |
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) |
1 |
Tier 1 |
15% | N/A | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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) |
1 |
Tier 1 |
15% | N/A | Q:60 /30Days |
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 |
Tier 1 |
15% | N/A | None |
TIZANIDINE HCL 2 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover TIZANIDINE HCL 2 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | N/A | None |
TIZANIDINE HCL 4 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover TIZANIDINE HCL 4 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | N/A | None |
TIZANIDINE HCL 6 MG CAPSULE ![Compare how all Medicare Part D PDP plans in PA cover TIZANIDINE HCL 6 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | N/A | None |
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) |
1 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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) |
1 |
Tier 1 |
15% | N/A | P |
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) |
1 |
Tier 1 |
15% | N/A | None |
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 |
Tier 1 |
15% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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) |
1 |
Tier 1 |
15% | 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) |
1 |
Tier 1 |
15% | N/A | None |
Tolcapone 100 MG TABLET [Tasmar] ![Compare how all Medicare Part D PDP plans in PA cover Tolcapone 100 MG TABLET [Tasmar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | N/A | None |
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) |
1 |
Tier 1 |
15% | 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) |
1 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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) |
1 |
Tier 1 |
15% | N/A | P |
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) |
1 |
Tier 1 |
15% | N/A | P |
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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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) |
1 |
Tier 1 |
15% | N/A | Q:30 /30Days |
TOVIAZ TABLETS 4MG EXTENDED RELEASE ![Compare how all Medicare Part D PDP plans in PA cover TOVIAZ TABLETS 4MG EXTENDED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | N/A | Q:30 /30Days |
TOVIAZ TABLETS 8MG EXTENDED RELEASE ![Compare how all Medicare Part D PDP plans in PA cover TOVIAZ TABLETS 8MG EXTENDED RELEASE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | N/A | Q:30 /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) |
1 |
Tier 1 |
15% | N/A | P |
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) |
1 |
Tier 1 |
15% | N/A | Q:30 /30Days |
TRAMADOL ER 300 MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TRAMADOL ER 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | N/A | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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 |
Tier 1 |
15% | N/A | Q:240 /30Days |
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 |
Tier 1 |
15% | N/A | Q:240 /30Days |
TRAMADOL HYDROCHLORIDE 100mg/1 30 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in PA cover TRAMADOL HYDROCHLORIDE 100mg/1 30 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | N/A | Q:90 /30Days |
TRAMADOL HYDROCHLORIDE 200mg/1 30 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in PA cover TRAMADOL HYDROCHLORIDE 200mg/1 30 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | N/A | Q:30 /30Days |
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 |
Tier 1 |
15% | 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) |
1 |
Tier 1 |
15% | N/A | None |
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) |
1 |
Tier 1 |
15% | 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) |
1 |
Tier 1 |
15% | 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) |
1 |
Tier 1 |
15% | 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) |
1 |
Tier 1 |
15% | N/A | None |
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) |
1 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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) |
1 |
Tier 1 |
15% | N/A | P |
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) |
1 |
Tier 1 |
15% | 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) |
1 |
Tier 1 |
15% | N/A | P |
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) |
1 |
Tier 1 |
15% | N/A | P |
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) |
1 |
Tier 1 |
15% | N/A | Q:30 /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) |
1 |
Tier 1 |
15% | N/A | Q:30 /30Days |
Tretinoin 0.0005 MG/MG Topical Gel ![Compare how all Medicare Part D PDP plans in PA cover Tretinoin 0.0005 MG/MG Topical Gel.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | N/A | None |
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) |
1 |
Tier 1 |
15% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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) |
1 |
Tier 1 |
15% | N/A | None |
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) |
1 |
Tier 1 |
15% | N/A | None |
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) |
1 |
Tier 1 |
15% | N/A | None |
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) |
1 |
Tier 1 |
15% | N/A | None |
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) |
1 |
Tier 1 |
15% | N/A | None |
TREXALL 10MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TREXALL 10MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | N/A | P |
TREXALL 15MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TREXALL 15MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | N/A | P |
TREXALL 5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TREXALL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | N/A | P |
TREXALL 7.5MG TABLET ![Compare how all Medicare Part D PDP plans in PA cover TREXALL 7.5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | N/A | P |
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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | N/A | None |
Triamcinolone 0.147 MG/G Spray ![Compare how all Medicare Part D PDP plans in PA cover Triamcinolone 0.147 MG/G Spray.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | N/A | None |
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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | N/A | None |
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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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 |
Tier 1 |
15% | N/A | P |
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 |
Tier 1 |
15% | N/A | P |
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 |
Tier 1 |
15% | N/A | P |
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 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | N/A | None |
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) |
1 |
Tier 1 |
15% | 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) |
1 |
Tier 1 |
15% | 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) |
1 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | 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) |
1 |
Tier 1 |
15% | N/A | Q:30 /30Days |
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) |
1 |
Tier 1 |
15% | N/A | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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) |
1 |
Tier 1 |
15% | N/A | Q:30 /30Days |
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) |
1 |
Tier 1 |
15% | N/A | P |
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) |
1 |
Tier 1 |
15% | N/A | P |
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) |
1 |
Tier 1 |
15% | 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 |
Tier 1 |
15% | N/A | None |
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) |
1 |
Tier 1 |
15% | N/A | P |
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) |
1 |
Tier 1 |
15% | 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) |
1 |
Tier 1 |
15% | 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) |
1 |
Tier 1 |
15% | 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) |
1 |
Tier 1 |
15% | N/A | None |
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) |
1 |
Tier 1 |
15% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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) |
1 |
Tier 1 |
15% | 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) |
1 |
Tier 1 |
15% | 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) |
1 |
Tier 1 |
15% | N/A | P Q:150 /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) |
1 |
Tier 1 |
15% | 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) |
1 |
Tier 1 |
15% | 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) |
1 |
Tier 1 |
15% | N/A | P |