2025 Medicare Part D Plan Formulary Information |
AARP Medicare Rx Preferred from UHC (PDP) (S5820-035-0)
Benefits & Contact Info
 Insulin on a Medicare Part D plan's formulary will have a monthly copay of $35 or less. Call drug plan for more details. |
The AARP Medicare Rx Preferred from UHC (PDP) (S5820-035-0) Formulary Drugs Starting with the Letter T in CMS PDP Region 36 which includes: GU
|
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 |
TABRECTA 150 MG TABLET  |
5 |
Tier 5 |
25% | 25% | P Q:112 /28Days |
TABRECTA 200 MG TABLET  |
5 |
Tier 5 |
25% | 25% | P Q:112 /28Days |
TACROLIMUS 0.03% OINTMENT [Protopic] ![Compare how all Medicare Part D PDP plans in GU cover TACROLIMUS 0.03% OINTMENT [Protopic].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | S |
TACROLIMUS 0.1% OINTMENT [Protopic] ![Compare how all Medicare Part D PDP plans in GU cover TACROLIMUS 0.1% OINTMENT [Protopic].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | S |
TACROLIMUS 0.5 MG CAPSULE (IR) [Prograf] ![Compare how all Medicare Part D PDP plans in GU cover TACROLIMUS 0.5 MG CAPSULE (IR) [Prograf].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | P |
TACROLIMUS 1 MG CAPSULE (IR) [Prograf] ![Compare how all Medicare Part D PDP plans in GU cover TACROLIMUS 1 MG CAPSULE (IR) [Prograf].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | P |
TACROLIMUS 5 MG CAPSULE (IR) [Prograf] ![Compare how all Medicare Part D PDP plans in GU cover TACROLIMUS 5 MG CAPSULE (IR) [Prograf].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | P |
TADALAFIL 2.5 MG TABLET [Cialis] ![Compare how all Medicare Part D PDP plans in GU cover TADALAFIL 2.5 MG TABLET [Cialis].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | P Q:30 /30Days |
TADALAFIL 20 MG TABLET [Cialis] ![Compare how all Medicare Part D PDP plans in GU cover TADALAFIL 20 MG TABLET [Cialis].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P Q:60 /30Days |
TADALAFIL 5 MG TABLET [Cialis] ![Compare how all Medicare Part D PDP plans in GU cover TADALAFIL 5 MG TABLET [Cialis].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | P Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TAFINLAR 10 MG TABLET FOR SUSPENSION  |
5 |
Tier 5 |
25% | 25% | P |
TAFINLAR 50 MG CAPSULE  |
5 |
Tier 5 |
25% | 25% | P |
TAFINLAR 75 MG CAPSULE  |
5 |
Tier 5 |
25% | 25% | P |
TAGRISSO 40 MG TABLET  |
5 |
Tier 5 |
25% | 25% | P Q:30 /30Days |
TAGRISSO 80 MG TABLET  |
5 |
Tier 5 |
25% | 25% | P Q:30 /30Days |
TALZENNA 0.1 MG CAPSULE  |
5 |
Tier 5 |
25% | 25% | P Q:30 /30Days |
TALZENNA 0.25 MG CAPSULE  |
5 |
Tier 5 |
25% | 25% | P Q:90 /30Days |
TALZENNA 0.35 MG CAPSULE  |
5 |
Tier 5 |
25% | 25% | P Q:30 /30Days |
TALZENNA 0.5 MG CAPSULE  |
5 |
Tier 5 |
25% | 25% | P Q:30 /30Days |
TALZENNA 0.75 MG CAPSULE  |
5 |
Tier 5 |
25% | 25% | P Q:30 /30Days |
TALZENNA 1 MG CAPSULE  |
5 |
Tier 5 |
25% | 25% | P Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TAMOXIFEN 10 MG TABLET [Nolvadex] ![Compare how all Medicare Part D PDP plans in GU cover TAMOXIFEN 10 MG TABLET [Nolvadex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
TAMOXIFEN 20 MG TABLET [Nolvadex] ![Compare how all Medicare Part D PDP plans in GU cover TAMOXIFEN 20 MG TABLET [Nolvadex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
TAMSULOSIN HCL 0.4 MG CAPSULE [Flomax] ![Compare how all Medicare Part D PDP plans in GU cover TAMSULOSIN HCL 0.4 MG CAPSULE [Flomax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All formulary drugs |
25% | 25% | None |
TARINA 24 FE 1 MG-20 MCG TABLET  |
4 |
Tier 4 |
25% | 25% | None |
TARINA FE 1-20 EQ TABLET  |
4 |
Tier 4 |
25% | 25% | None |
Tasigna 150mg/1 4 BLISTER PACK per CARTON / 28 CAPSULE per BLISTER PACK  |
5 |
Tier 5 |
25% | 25% | P Q:140 /28Days |
TASIGNA 200 MG CAPSULE  |
5 |
Tier 5 |
25% | 25% | P Q:112 /28Days |
TASIGNA 50 MG CAPSULE  |
5 |
Tier 5 |
25% | 25% | P Q:420 /30Days |
TASIMELTEON 20 MG CAPSULE [HETLIOZ] ![Compare how all Medicare Part D PDP plans in GU cover TASIMELTEON 20 MG CAPSULE [HETLIOZ].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | P Q:30 /30Days |
TAZAROTENE 0.1% CREAM [Tazorac] ![Compare how all Medicare Part D PDP plans in GU cover TAZAROTENE 0.1% CREAM [Tazorac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P Q:60 /30Days |
TAZICEF 1GM VIAL  |
4 |
Tier 4 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TAZICEF 2 GRAM VIAL  |
4 |
Tier 4 |
25% | 25% | None |
TAZICEF 6 GRAM VIAL  |
4 |
Tier 4 |
25% | 25% | None |
TAZVERIK 200 MG TABLET  |
5 |
Tier 5 |
25% | 25% | P Q:240 /30Days |
TDVAX VIAL  |
3 |
Tier 3 |
25% | 25% | Q:0.50 /1Days |
Teflaro 400mg/20mL 10 VIAL, SINGLE-DOSE per CARTON / 20 mL in 1 VIAL, SINGLE-DOSE  |
5 |
Tier 5 |
25% | 25% | None |
Teflaro 600mg/20mL 10 VIAL, SINGLE-DOSE per CARTON / 20 mL in 1 VIAL, SINGLE-DOSE  |
5 |
Tier 5 |
25% | 25% | None |
TELMISARTAN 20 MG TABLET [Micardis] ![Compare how all Medicare Part D PDP plans in GU cover TELMISARTAN 20 MG TABLET [Micardis].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | Q:30 /30Days |
TELMISARTAN 40 MG TABLET [Micardis] ![Compare how all Medicare Part D PDP plans in GU cover TELMISARTAN 40 MG TABLET [Micardis].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | Q:30 /30Days |
TELMISARTAN 80 MG TABLET [Micardis] ![Compare how all Medicare Part D PDP plans in GU cover TELMISARTAN 80 MG TABLET [Micardis].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | Q:30 /30Days |
TELMISARTAN-HCTZ 40-12.5 MG TABLET [Micardis HCT] ![Compare how all Medicare Part D PDP plans in GU cover TELMISARTAN-HCTZ 40-12.5 MG TABLET [Micardis HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | Q:30 /30Days |
TELMISARTAN-HCTZ 80-12.5 MG TABLET [Micardis HCT] ![Compare how all Medicare Part D PDP plans in GU cover TELMISARTAN-HCTZ 80-12.5 MG TABLET [Micardis HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TELMISARTAN-HCTZ 80-25 MG TABLET [Micardis HCT] ![Compare how all Medicare Part D PDP plans in GU cover TELMISARTAN-HCTZ 80-25 MG TABLET [Micardis HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | Q:30 /30Days |
TEMAZEPAM 15 MG CAPSULE [Restoril] ![Compare how all Medicare Part D PDP plans in GU cover TEMAZEPAM 15 MG CAPSULE [Restoril].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | Q:30 /30Days |
TEMAZEPAM 30 MG CAPSULE [Restoril] ![Compare how all Medicare Part D PDP plans in GU cover TEMAZEPAM 30 MG CAPSULE [Restoril].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | Q:30 /30Days |
TENIVAC SYRINGE  |
3 |
Tier 3 |
25% | 25% | Q:0.50 /1Days |
TENIVAC VIAL  |
3 |
Tier 3 |
25% | 25% | Q:0.50 /1Days |
TENOFOVIR DISOP FUM 300 MG TABLET [Viread] ![Compare how all Medicare Part D PDP plans in GU cover TENOFOVIR DISOP FUM 300 MG TABLET [Viread].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | Q:30 /30Days |
TEPMETKO 225 MG TABLET  |
5 |
Tier 5 |
25% | 25% | P Q:60 /30Days |
TERAZOSIN 1 MG CAPSULE  |
1 |
All formulary drugs |
25% | 25% | None |
TERAZOSIN 10 MG CAPSULE [Hytrin] ![Compare how all Medicare Part D PDP plans in GU cover TERAZOSIN 10 MG CAPSULE [Hytrin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All formulary drugs |
25% | 25% | None |
TERAZOSIN 2 MG CAPSULE  |
1 |
All formulary drugs |
25% | 25% | None |
TERAZOSIN 5 MG CAPSULE [Hytrin] ![Compare how all Medicare Part D PDP plans in GU cover TERAZOSIN 5 MG CAPSULE [Hytrin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All formulary drugs |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TERBINAFINE HCL 250 MG TABLET [Terbinex] ![Compare how all Medicare Part D PDP plans in GU cover TERBINAFINE HCL 250 MG TABLET [Terbinex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | Q:60 /30Days |
TERCONAZOLE 0.4% CREAM WITH APPLICATOR  |
3 |
Tier 3 |
25% | 25% | None |
TERCONAZOLE 0.8% CREAM  |
3 |
Tier 3 |
25% | 25% | None |
TERCONAZOLE 80MG SUPPOSITORY VAGINAL  |
3 |
Tier 3 |
25% | 25% | None |
TERIFLUNOMIDE 14 MG TABLET [AUBAGIO] ![Compare how all Medicare Part D PDP plans in GU cover TERIFLUNOMIDE 14 MG TABLET [AUBAGIO].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | Q:30 /30Days |
TERIFLUNOMIDE 7 MG TABLET [AUBAGIO] ![Compare how all Medicare Part D PDP plans in GU cover TERIFLUNOMIDE 7 MG TABLET [AUBAGIO].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | Q:30 /30Days |
TERIPARATIDE 620 MCG/2.48 ML PEN INJECTOR [Forteo] ![Compare how all Medicare Part D PDP plans in GU cover TERIPARATIDE 620 MCG/2.48 ML PEN INJECTOR [Forteo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | P Q:2.48 /28Days |
TESTOSTERON ENAN 1,000 MG/5 ML VIAL [Delatestryl] ![Compare how all Medicare Part D PDP plans in GU cover TESTOSTERON ENAN 1,000 MG/5 ML VIAL [Delatestryl].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
TESTOSTERONE 1.62% (2.5 G) GEL PACKET [AndroGel] ![Compare how all Medicare Part D PDP plans in GU cover TESTOSTERONE 1.62% (2.5 G) GEL PACKET [AndroGel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
TESTOSTERONE 1.62% GEL MD PUMP [AndroGel] ![Compare how all Medicare Part D PDP plans in GU cover TESTOSTERONE 1.62% GEL MD PUMP [AndroGel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
TESTOSTERONE 1.62%(1.25 G) GEL PACKET [AndroGel] ![Compare how all Medicare Part D PDP plans in GU cover TESTOSTERONE 1.62%(1.25 G) GEL PACKET [AndroGel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TESTOSTERONE 12.5 MG/1.25 GRAM GEL MD PMP [Vogelxo] ![Compare how all Medicare Part D PDP plans in GU cover TESTOSTERONE 12.5 MG/1.25 GRAM GEL MD PMP [Vogelxo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
TESTOSTERONE 25 MG/2.5 GM GEL PACKET [Vogelxo] ![Compare how all Medicare Part D PDP plans in GU cover TESTOSTERONE 25 MG/2.5 GM GEL PACKET [Vogelxo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
TESTOSTERONE 50 MG/5 GRAM GEL PACKET [Vogelxo] ![Compare how all Medicare Part D PDP plans in GU cover TESTOSTERONE 50 MG/5 GRAM GEL PACKET [Vogelxo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
Testosterone cyp 100 mg/ml  |
2 |
Tier 2 |
25% | 25% | None |
TESTOSTERONE CYP 2,000 MG/10ML VIAL [Virilon] ![Compare how all Medicare Part D PDP plans in GU cover TESTOSTERONE CYP 2,000 MG/10ML VIAL [Virilon].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
TESTOSTERONE CYP 200 MG/ML VIAL [Virilon] ![Compare how all Medicare Part D PDP plans in GU cover TESTOSTERONE CYP 200 MG/ML VIAL [Virilon].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
TETRABENAZINE 12.5 MG TABLET [Xenazine] ![Compare how all Medicare Part D PDP plans in GU cover TETRABENAZINE 12.5 MG TABLET [Xenazine].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P Q:90 /30Days |
TETRABENAZINE 25 MG TABLET [Xenazine] ![Compare how all Medicare Part D PDP plans in GU cover TETRABENAZINE 25 MG TABLET [Xenazine].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P Q:120 /30Days |
TETRACYCLINE 250 MG CAPSULE [Panmycin] ![Compare how all Medicare Part D PDP plans in GU cover TETRACYCLINE 250 MG CAPSULE [Panmycin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
TETRACYCLINE 500 MG CAPSULE [Sumycin] ![Compare how all Medicare Part D PDP plans in GU cover TETRACYCLINE 500 MG CAPSULE [Sumycin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
THALOMID 100 MG CAPSULE  |
5 |
Tier 5 |
25% | 25% | P Q:112 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
THALOMID 150 MG CAPSULE  |
5 |
Tier 5 |
25% | 25% | P Q:56 /28Days |
THALOMID 200 MG CAPSULE  |
5 |
Tier 5 |
25% | 25% | P Q:56 /28Days |
THALOMID 50 MG CAPSULE  |
5 |
Tier 5 |
25% | 25% | P Q:84 /28Days |
THEOPHYLLINE 80 MG/15 ML SOLUTION  |
2 |
Tier 2 |
25% | 25% | None |
THEOPHYLLINE ER 100 MG TABLET 12H [Theochron] ![Compare how all Medicare Part D PDP plans in GU cover THEOPHYLLINE ER 100 MG TABLET 12H [Theochron].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
THEOPHYLLINE ER 200 MG TABLET 12H [Theochron] ![Compare how all Medicare Part D PDP plans in GU cover THEOPHYLLINE ER 200 MG TABLET 12H [Theochron].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
THEOPHYLLINE ER 300 MG TABLET  |
2 |
Tier 2 |
25% | 25% | None |
THEOPHYLLINE ER 400 MG TABLET 24H [Uniphyl] ![Compare how all Medicare Part D PDP plans in GU cover THEOPHYLLINE ER 400 MG TABLET 24H [Uniphyl].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
THEOPHYLLINE ER 450 MG TABLET 12H  |
2 |
Tier 2 |
25% | 25% | None |
THEOPHYLLINE ER 600 MG TABLET 24H [Uniphyl] ![Compare how all Medicare Part D PDP plans in GU cover THEOPHYLLINE ER 600 MG TABLET 24H [Uniphyl].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
THIORIDAZINE 10 MG TABLET  |
3 |
Tier 3 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
THIORIDAZINE 100MG TABLET  |
3 |
Tier 3 |
25% | 25% | None |
THIORIDAZINE 25 MG TABLET  |
3 |
Tier 3 |
25% | 25% | None |
THIORIDAZINE 50 MG TABLET  |
3 |
Tier 3 |
25% | 25% | None |
THIOTHIXENE 1 MG CAPSULE [Navane] ![Compare how all Medicare Part D PDP plans in GU cover THIOTHIXENE 1 MG CAPSULE [Navane].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
THIOTHIXENE 10 MG CAPSULE [Navane] ![Compare how all Medicare Part D PDP plans in GU cover THIOTHIXENE 10 MG CAPSULE [Navane].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
THIOTHIXENE 2 MG CAPSULE [Navane] ![Compare how all Medicare Part D PDP plans in GU cover THIOTHIXENE 2 MG CAPSULE [Navane].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
THIOTHIXENE 5 MG CAPSULE [Navane] ![Compare how all Medicare Part D PDP plans in GU cover THIOTHIXENE 5 MG CAPSULE [Navane].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
TIADYLT ER 120 MG CAPSULE SA 24H [Tiazac] ![Compare how all Medicare Part D PDP plans in GU cover TIADYLT ER 120 MG CAPSULE SA 24H [Tiazac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
TIADYLT ER 180 MG CAPSULE SA 24H [Tiazac] ![Compare how all Medicare Part D PDP plans in GU cover TIADYLT ER 180 MG CAPSULE SA 24H [Tiazac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
TIADYLT ER 240 MG CAPSULE SA 24H [Tiazac] ![Compare how all Medicare Part D PDP plans in GU cover TIADYLT ER 240 MG CAPSULE SA 24H [Tiazac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
TIADYLT ER 300 MG CAPSULE SA 24H [Tiazac] ![Compare how all Medicare Part D PDP plans in GU cover TIADYLT ER 300 MG CAPSULE SA 24H [Tiazac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TIADYLT ER 360 MG CAPSULE SA 24H [Tiazac] ![Compare how all Medicare Part D PDP plans in GU cover TIADYLT ER 360 MG CAPSULE SA 24H [Tiazac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
TIADYLT ER 420 MG CAPSULE SA 24H [Tiazac] ![Compare how all Medicare Part D PDP plans in GU cover TIADYLT ER 420 MG CAPSULE SA 24H [Tiazac].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
TIAGABINE HCL 12 MG TABLET [Gabitril] ![Compare how all Medicare Part D PDP plans in GU cover TIAGABINE HCL 12 MG TABLET [Gabitril].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
TIAGABINE HCL 16 MG TABLET [Gabitril] ![Compare how all Medicare Part D PDP plans in GU cover TIAGABINE HCL 16 MG TABLET [Gabitril].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
TIAGABINE HCL 2 MG TABLET [Gabitril] ![Compare how all Medicare Part D PDP plans in GU cover TIAGABINE HCL 2 MG TABLET [Gabitril].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
TIAGABINE HCL 4 MG TABLET [Gabitril] ![Compare how all Medicare Part D PDP plans in GU cover TIAGABINE HCL 4 MG TABLET [Gabitril].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
TIBSOVO 250 MG TABLET  |
5 |
Tier 5 |
25% | 25% | P Q:60 /30Days |
TICOVAC 1.2 MCG/0.25 ML SYRINGE  |
3 |
Tier 3 |
25% | 25% | Q:0.25 /1Days |
TICOVAC 2.4 MCG/0.5 ML SYRINGE  |
3 |
Tier 3 |
25% | 25% | Q:0.50 /1Days |
TIGECYCLINE 50 MG VIAL [Tygacil] ![Compare how all Medicare Part D PDP plans in GU cover TIGECYCLINE 50 MG VIAL [Tygacil].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | None |
TILIA FE 28 TABLET [Tri-Legest Fe] ![Compare how all Medicare Part D PDP plans in GU cover TILIA FE 28 TABLET [Tri-Legest Fe].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TIMOLOL 0.25% GEL-SOLUTION [Timoptic-XE] ![Compare how all Medicare Part D PDP plans in GU cover TIMOLOL 0.25% GEL-SOLUTION [Timoptic-XE].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
TIMOLOL 0.5% GEL-SOLUTION [Timoptic-XE] ![Compare how all Medicare Part D PDP plans in GU cover TIMOLOL 0.5% GEL-SOLUTION [Timoptic-XE].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
TIMOLOL MALEATE 0.25% EYE DROPS [Timoptic Ocumeter] ![Compare how all Medicare Part D PDP plans in GU cover TIMOLOL MALEATE 0.25% EYE DROPS [Timoptic Ocumeter].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All formulary drugs |
25% | 25% | None |
TIMOLOL MALEATE 0.5% EYE DROPS [Timoptic Ocumeter] ![Compare how all Medicare Part D PDP plans in GU cover TIMOLOL MALEATE 0.5% EYE DROPS [Timoptic Ocumeter].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All formulary drugs |
25% | 25% | None |
TIMOLOL MALEATE 10MG TABLET  |
3 |
Tier 3 |
25% | 25% | None |
TIMOLOL MALEATE 20MG TABLET  |
3 |
Tier 3 |
25% | 25% | None |
TIMOLOL MALEATE 5MG TABLET  |
3 |
Tier 3 |
25% | 25% | None |
TINIDAZOLE 250 MG TABLET [Tindamax] ![Compare how all Medicare Part D PDP plans in GU cover TINIDAZOLE 250 MG TABLET [Tindamax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
TINIDAZOLE 500 MG TABLET [Tindamax] ![Compare how all Medicare Part D PDP plans in GU cover TINIDAZOLE 500 MG TABLET [Tindamax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
TIVICAY 10 MG TABLET  |
4 |
Tier 4 |
25% | 25% | Q:30 /30Days |
TIVICAY 25 MG TABLET  |
4 |
Tier 4 |
25% | 25% | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TIVICAY 50 MG TABLET  |
5 |
Tier 5 |
25% | 25% | Q:60 /30Days |
TIVICAY PD 5 MG TABLET FOR SUSPENSION  |
5 |
Tier 5 |
25% | 25% | Q:180 /30Days |
TIZANIDINE HCL 2 MG TABLET  |
2 |
Tier 2 |
25% | 25% | None |
TIZANIDINE HCL 4 MG TABLET  |
2 |
Tier 2 |
25% | 25% | None |
TOBI PODHALER 28 MG INHALE CAPSULE W/DEV  |
5 |
Tier 5 |
25% | 25% | P Q:224 /28Days |
TOBRADEX EYE OINTMENT  |
3 |
Tier 3 |
25% | 25% | None |
TOBRAMYCIN 0.3% EYE DROPS [Tobrex] ![Compare how all Medicare Part D PDP plans in GU cover TOBRAMYCIN 0.3% EYE DROPS [Tobrex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
TOBRAMYCIN 10 MG/ML VIAL [Bethkis, Tobi, Tobi Podhaler, Tobramycin Sulfate] ![Compare how all Medicare Part D PDP plans in GU cover TOBRAMYCIN 10 MG/ML VIAL [Bethkis, Tobi, Tobi Podhaler, Tobramycin Sulfate].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
TOBRAMYCIN 300 MG/5 ML AMPULE [Bethkis, Tobi, Tobi Podhaler, Tobramycin Sulfate] ![Compare how all Medicare Part D PDP plans in GU cover TOBRAMYCIN 300 MG/5 ML AMPULE [Bethkis, Tobi, Tobi Podhaler, Tobramycin Sulfate].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | P Q:280 /28Days |
TOBRAMYCIN 40 MG/ML VIAL [Bethkis, Tobi, Tobi Podhaler, Tobramycin Sulfate] ![Compare how all Medicare Part D PDP plans in GU cover TOBRAMYCIN 40 MG/ML VIAL [Bethkis, Tobi, Tobi Podhaler, Tobramycin Sulfate].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
TOBRAMYCIN-DEXAMETH OPTH SUSP  |
3 |
Tier 3 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TOBREX 0.3% EYE OINTMENT  |
4 |
Tier 4 |
25% | 25% | None |
TOLTERODINE TART ER 2 MG CAPSULE 24H [Detrol LA] ![Compare how all Medicare Part D PDP plans in GU cover TOLTERODINE TART ER 2 MG CAPSULE 24H [Detrol LA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
TOLTERODINE TART ER 4 MG CAPSULE 24H [Detrol LA] ![Compare how all Medicare Part D PDP plans in GU cover TOLTERODINE TART ER 4 MG CAPSULE 24H [Detrol LA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
TOLTERODINE TARTRATE 1 MG TABLET [Detrol] ![Compare how all Medicare Part D PDP plans in GU cover TOLTERODINE TARTRATE 1 MG TABLET [Detrol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
TOLTERODINE TARTRATE 2 MG TABLET [Detrol] ![Compare how all Medicare Part D PDP plans in GU cover TOLTERODINE TARTRATE 2 MG TABLET [Detrol].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
TOPIRAMATE 100 MG TABLET [Topiragen] ![Compare how all Medicare Part D PDP plans in GU cover TOPIRAMATE 100 MG TABLET [Topiragen].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
TOPIRAMATE 15 MG SPRINKLE CAPSULE  |
2 |
Tier 2 |
25% | 25% | None |
TOPIRAMATE 200 MG TABLET [Topiragen] ![Compare how all Medicare Part D PDP plans in GU cover TOPIRAMATE 200 MG TABLET [Topiragen].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
TOPIRAMATE 25 MG TABLET [Topiragen] ![Compare how all Medicare Part D PDP plans in GU cover TOPIRAMATE 25 MG TABLET [Topiragen].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
Topiramate 25mg/1  |
2 |
Tier 2 |
25% | 25% | None |
TOPIRAMATE 50 MG TABLET [Topiragen] ![Compare how all Medicare Part D PDP plans in GU cover TOPIRAMATE 50 MG TABLET [Topiragen].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TOREMIFENE CITRATE 60 MG TABLET [Fareston] ![Compare how all Medicare Part D PDP plans in GU cover TOREMIFENE CITRATE 60 MG TABLET [Fareston].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
TORPENZ 10 MG TABLET  |
5 |
Tier 5 |
25% | 25% | P |
TORPENZ 2.5 MG TABLET  |
5 |
Tier 5 |
25% | 25% | P |
TORPENZ 5 MG TABLET  |
5 |
Tier 5 |
25% | 25% | P |
TORPENZ 7.5 MG TABLET  |
5 |
Tier 5 |
25% | 25% | P |
TORSEMIDE 10 MG TABLET  |
2 |
Tier 2 |
25% | 25% | None |
TORSEMIDE 100 MG TABLET  |
2 |
Tier 2 |
25% | 25% | None |
TORSEMIDE 20 MG TABLET [SOAANZ] ![Compare how all Medicare Part D PDP plans in GU cover TORSEMIDE 20 MG TABLET [SOAANZ].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
TORSEMIDE 5 MG TABLET [Demadex] ![Compare how all Medicare Part D PDP plans in GU cover TORSEMIDE 5 MG TABLET [Demadex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
TOUJEO MAX SOLOSTAR 300UNIT/ML INSULN PEN  |
3 |
Tier 3 |
25% | 25% | None |
TOUJEO SOLOSTAR 300 UNITS/ML  |
3 |
Tier 3 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TPN ELECTROLYTES16.5/25.4 VIAL  |
4 |
Tier 4 |
25% | 25% | None |
TRADJENTA 5 MG TABLET  |
3 |
Tier 3 |
25% | 25% | Q:30 /30Days |
TRAMADOL ER 100 MG TABLET TBMP 24HR [Ultram ER] ![Compare how all Medicare Part D PDP plans in GU cover TRAMADOL ER 100 MG TABLET TBMP 24HR [Ultram ER].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | Q:30 /30Days |
TRAMADOL ER 200 MG TABLET TBMP 24HR [Ultram ER] ![Compare how all Medicare Part D PDP plans in GU cover TRAMADOL ER 200 MG TABLET TBMP 24HR [Ultram ER].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | Q:30 /30Days |
TRAMADOL ER 300 MG TABLET TBMP 24HR [Ultram ER] ![Compare how all Medicare Part D PDP plans in GU cover TRAMADOL ER 300 MG TABLET TBMP 24HR [Ultram ER].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | Q:30 /30Days |
TRAMADOL HCL 50 MG TABLET [Ultram] ![Compare how all Medicare Part D PDP plans in GU cover TRAMADOL HCL 50 MG TABLET [Ultram].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | Q:240 /30Days |
TRAMADOL HCL ER 100 MG TABLET  |
3 |
Tier 3 |
25% | 25% | Q:30 /30Days |
TRAMADOL HCL ER 200 MG TABLET  |
3 |
Tier 3 |
25% | 25% | Q:30 /30Days |
TRAMADOL HCL ER 300 MG Tablet ER 24H [Ultram ER] ![Compare how all Medicare Part D PDP plans in GU cover TRAMADOL HCL ER 300 MG Tablet ER 24H [Ultram ER].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | Q:30 /30Days |
TRAMADOL-ACETAMINOPHN 37.5-325 TABLET [Ultracet] ![Compare how all Medicare Part D PDP plans in GU cover TRAMADOL-ACETAMINOPHN 37.5-325 TABLET [Ultracet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | Q:240 /30Days |
TRANDOLAPRIL 1 MG TABLET  |
2 |
Tier 2 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRANDOLAPRIL 2 MG TABLET [Mavik] ![Compare how all Medicare Part D PDP plans in GU cover TRANDOLAPRIL 2 MG TABLET [Mavik].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
TRANDOLAPRIL 4 MG TABLET [Mavik] ![Compare how all Medicare Part D PDP plans in GU cover TRANDOLAPRIL 4 MG TABLET [Mavik].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
TRANEXAMIC ACID 650 MG TABLET [Lysteda] ![Compare how all Medicare Part D PDP plans in GU cover TRANEXAMIC ACID 650 MG TABLET [Lysteda].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
TRANYLCYPROMINE SULF 10 MG TABLET [Parnate] ![Compare how all Medicare Part D PDP plans in GU cover TRANYLCYPROMINE SULF 10 MG TABLET [Parnate].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
TRAVASOL 10% SOLUTION VIAFLEX  |
4 |
Tier 4 |
25% | 25% | P |
TRAVOPROST 0.004% EYE DROPS [Travatan Z] ![Compare how all Medicare Part D PDP plans in GU cover TRAVOPROST 0.004% EYE DROPS [Travatan Z].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
TRAZODONE 100 MG TABLET [Desyrel] ![Compare how all Medicare Part D PDP plans in GU cover TRAZODONE 100 MG TABLET [Desyrel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All formulary drugs |
25% | 25% | None |
TRAZODONE 150 MG TABLET [Desyrel] ![Compare how all Medicare Part D PDP plans in GU cover TRAZODONE 150 MG TABLET [Desyrel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All formulary drugs |
25% | 25% | None |
TRAZODONE 300 MG TABLET [Desyrel] ![Compare how all Medicare Part D PDP plans in GU cover TRAZODONE 300 MG TABLET [Desyrel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
TRAZODONE 50 MG TABLET [Desyrel] ![Compare how all Medicare Part D PDP plans in GU cover TRAZODONE 50 MG TABLET [Desyrel].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All formulary drugs |
25% | 25% | None |
TRECATOR 250MG TABLET  |
4 |
Tier 4 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRELEGY ELLIPTA 100-62.5-25  |
3 |
Tier 3 |
25% | 25% | Q:60 /30Days |
TRELEGY ELLIPTA 200-62.5-25 BLST W/DEV  |
3 |
Tier 3 |
25% | 25% | Q:60 /30Days |
TRESIBA 100 UNIT/ML VIAL  |
3 |
Tier 3 |
25% | 25% | None |
TRESIBA FLEXTOUCH 100 UNITS/ML  |
3 |
Tier 3 |
25% | 25% | None |
TRESIBA FLEXTOUCH 200 UNITS/ML  |
3 |
Tier 3 |
25% | 25% | None |
Tretinoin 0.0004 MG/MG Topical Gel  |
4 |
Tier 4 |
25% | 25% | P |
TRETINOIN 0.01% GEL [Tretin-X] ![Compare how all Medicare Part D PDP plans in GU cover TRETINOIN 0.01% GEL [Tretin-X].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P |
TRETINOIN 0.025% CREAM (G) [Tretin-X] ![Compare how all Medicare Part D PDP plans in GU cover TRETINOIN 0.025% CREAM (G) [Tretin-X].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P |
TRETINOIN 0.025% GEL [Tretin-X] ![Compare how all Medicare Part D PDP plans in GU cover TRETINOIN 0.025% GEL [Tretin-X].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P |
TRETINOIN 0.05% CREAM  |
4 |
Tier 4 |
25% | 25% | P |
TRETINOIN 0.1% CREAM  |
4 |
Tier 4 |
25% | 25% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRETINOIN 10MG CAPSULE  |
5 |
Tier 5 |
25% | 25% | None |
TRETINOIN GEL MICRO 0.1% TUBE [Retin-A Micro] ![Compare how all Medicare Part D PDP plans in GU cover TRETINOIN GEL MICRO 0.1% TUBE [Retin-A Micro].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | P |
TREXALL 10MG TABLET  |
4 |
Tier 4 |
25% | 25% | None |
TREXALL 15MG TABLET  |
4 |
Tier 4 |
25% | 25% | None |
TREXALL 5MG TABLET  |
4 |
Tier 4 |
25% | 25% | None |
TREXALL 7.5MG TABLET  |
4 |
Tier 4 |
25% | 25% | None |
TRI-ESTARYLLA TABLET [Trinessa] ![Compare how all Medicare Part D PDP plans in GU cover TRI-ESTARYLLA TABLET [Trinessa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
TRI-LEGEST FE 5-7-9-7 TABLET  |
4 |
Tier 4 |
25% | 25% | None |
TRI-LO-ESTARYLLA TABLET [Trinessa Lo] ![Compare how all Medicare Part D PDP plans in GU cover TRI-LO-ESTARYLLA TABLET [Trinessa Lo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
TRI-LO-SPRINTEC TABLET  |
4 |
Tier 4 |
25% | 25% | None |
TRI-MILI 28 TABLET [Trinessa] ![Compare how all Medicare Part D PDP plans in GU cover TRI-MILI 28 TABLET [Trinessa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRI-NYMYO 28 TABLET [Trinessa] ![Compare how all Medicare Part D PDP plans in GU cover TRI-NYMYO 28 TABLET [Trinessa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
TRI-SPRINTEC 7DAYSX3 28 TABLET  |
4 |
Tier 4 |
25% | 25% | None |
TRI-VYLIBRA 28 TABLET [Trinessa] ![Compare how all Medicare Part D PDP plans in GU cover TRI-VYLIBRA 28 TABLET [Trinessa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
TRI-VYLIBRA LO TABLET [Trinessa Lo] ![Compare how all Medicare Part D PDP plans in GU cover TRI-VYLIBRA LO TABLET [Trinessa Lo].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
TRIAMCINOLONE 0.025% CREAM  |
2 |
Tier 2 |
25% | 25% | None |
TRIAMCINOLONE 0.025% LOTION [Kenalog] ![Compare how all Medicare Part D PDP plans in GU cover TRIAMCINOLONE 0.025% LOTION [Kenalog].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
TRIAMCINOLONE 0.025% OINT  |
2 |
Tier 2 |
25% | 25% | None |
TRIAMCINOLONE 0.1% CREAM (G) [Triderm] ![Compare how all Medicare Part D PDP plans in GU cover TRIAMCINOLONE 0.1% CREAM (G) [Triderm].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
TRIAMCINOLONE 0.1% LOTION [Kenalog] ![Compare how all Medicare Part D PDP plans in GU cover TRIAMCINOLONE 0.1% LOTION [Kenalog].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
TRIAMCINOLONE 0.1% OINTMENT [Triderm] ![Compare how all Medicare Part D PDP plans in GU cover TRIAMCINOLONE 0.1% OINTMENT [Triderm].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
TRIAMCINOLONE 0.1% PASTE (G) [Oralone] ![Compare how all Medicare Part D PDP plans in GU cover TRIAMCINOLONE 0.1% PASTE (G) [Oralone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRIAMCINOLONE ACETONIDE 0.05% OINTMENT 15GM TUBE  |
2 |
Tier 2 |
25% | 25% | None |
Triamcinolone Acetonide 1 MG/ML Topical Cream [Triderm] ![Compare how all Medicare Part D PDP plans in GU cover Triamcinolone Acetonide 1 MG/ML Topical Cream [Triderm].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
Triamcinolone Acetonide 5mg/g 1 TUBE per CARTON / 15 g in 1 TUBE  |
2 |
Tier 2 |
25% | 25% | None |
TRIAMTERENE 100 MG CAPSULE [Dyrenium] ![Compare how all Medicare Part D PDP plans in GU cover TRIAMTERENE 100 MG CAPSULE [Dyrenium].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
TRIAMTERENE 50 MG CAPSULE [Dyrenium] ![Compare how all Medicare Part D PDP plans in GU cover TRIAMTERENE 50 MG CAPSULE [Dyrenium].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
TRIAMTERENE-HCTZ 37.5-25 MG CAPSULE [Dyazide] ![Compare how all Medicare Part D PDP plans in GU cover TRIAMTERENE-HCTZ 37.5-25 MG CAPSULE [Dyazide].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All formulary drugs |
25% | 25% | None |
TRIAMTERENE-HCTZ 37.5-25 MG TABLET [Maxzide-25] ![Compare how all Medicare Part D PDP plans in GU cover TRIAMTERENE-HCTZ 37.5-25 MG TABLET [Maxzide-25].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
All formulary drugs |
25% | 25% | None |
TRIAMTERENE-HCTZ 75-50 MG TABLET  |
1 |
All formulary drugs |
25% | 25% | None |
TRIDERM 0.5% CREAM (G)  |
2 |
Tier 2 |
25% | 25% | None |
TRIENTINE HCL 250 MG CAPSULE [Syprine] ![Compare how all Medicare Part D PDP plans in GU cover TRIENTINE HCL 250 MG CAPSULE [Syprine].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
25% | 25% | P Q:240 /30Days |
TRIENTINE HCL 500 MG CAPSULE  |
5 |
Tier 5 |
25% | 25% | P Q:120 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRIFLUOPERAZINE 1 MG TABLET  |
3 |
Tier 3 |
25% | 25% | None |
TRIFLUOPERAZINE HCL 2MG TABLET  |
3 |
Tier 3 |
25% | 25% | None |
TRIFLUOPERAZINE HCL 5MG TABLET  |
3 |
Tier 3 |
25% | 25% | None |
TRIFLUOPERAZINE HCL USP 10MG TABLET (100 CT)  |
3 |
Tier 3 |
25% | 25% | None |
TRIFLURIDINE 1% OPTH SOLUTION 7.5ML BOTTLE  |
3 |
Tier 3 |
25% | 25% | None |
TRIHEXYPHENIDYL 2 MG TABLET [Artane] ![Compare how all Medicare Part D PDP plans in GU cover TRIHEXYPHENIDYL 2 MG TABLET [Artane].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
TRIHEXYPHENIDYL 5 MG TABLET [Artane] ![Compare how all Medicare Part D PDP plans in GU cover TRIHEXYPHENIDYL 5 MG TABLET [Artane].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
Trihexyphenidyl Hydrochloride 2mg/5mL 473 mL in 1 BOTTLE  |
2 |
Tier 2 |
25% | 25% | None |
TRIJARDY XR 10-5-1,000 MG TABLET BP 24H  |
3 |
Tier 3 |
25% | 25% | Q:30 /30Days |
TRIJARDY XR 12.5-2.5-1,000 MG TABLET BP 24H  |
3 |
Tier 3 |
25% | 25% | Q:60 /30Days |
TRIJARDY XR 25-5-1,000 MG TABLET BP 24H  |
3 |
Tier 3 |
25% | 25% | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TRIJARDY XR 5-2.5-1,000 MG TABLET BP 24H  |
3 |
Tier 3 |
25% | 25% | Q:60 /30Days |
TRIMETHOPRIM 100 MG TABLET [Proloprim] ![Compare how all Medicare Part D PDP plans in GU cover TRIMETHOPRIM 100 MG TABLET [Proloprim].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Tier 2 |
25% | 25% | None |
TRIMIPRAMINE MALEATE 100 MG CAPSULE  |
4 |
Tier 4 |
25% | 25% | None |
TRIMIPRAMINE MALEATE 25 MG CAPSULE  |
4 |
Tier 4 |
25% | 25% | None |
TRIMIPRAMINE MALEATE 50 MG CAPSULE  |
4 |
Tier 4 |
25% | 25% | None |
TRINTELLIX 10 MG TABLET  |
4 |
Tier 4 |
25% | 25% | Q:30 /30Days |
TRINTELLIX 20 MG TABLET  |
4 |
Tier 4 |
25% | 25% | Q:30 /30Days |
TRINTELLIX 5 MG TABLET  |
4 |
Tier 4 |
25% | 25% | Q:30 /30Days |
TRIUMEQ PD 60-5-30 MG TABLET SUSP  |
4 |
Tier 4 |
25% | 25% | Q:180 /30Days |
TRIUMEQ TABLET  |
5 |
Tier 5 |
25% | 25% | Q:30 /30Days |
TRIVORA-28 TABLET [Trivora] ![Compare how all Medicare Part D PDP plans in GU cover TRIVORA-28 TABLET [Trivora].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Tier 4 |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TROPHAMINE 10% IV SOLUTION  |
4 |
Tier 4 |
25% | 25% | P |
TROSPIUM CHLORIDE 20 MG TABLET [Sanctura] ![Compare how all Medicare Part D PDP plans in GU cover TROSPIUM CHLORIDE 20 MG TABLET [Sanctura].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Tier 3 |
25% | 25% | None |
TRULANCE 3 MG TABLET  |
3 |
Tier 3 |
25% | 25% | Q:30 /30Days |
TRULICITY 0.75 MG/0.5 ML PEN  |
3 |
Tier 3 |
25% | 25% | P Q:2 /28Days |
TRULICITY 1.5 MG/0.5 ML PEN  |
3 |
Tier 3 |
25% | 25% | P Q:2 /28Days |
TRULICITY 3 MG/0.5 ML PEN INJECTOR  |
3 |
Tier 3 |
25% | 25% | P Q:2 /28Days |
TRULICITY 4.5 MG/0.5 ML PEN INJECTOR  |
3 |
Tier 3 |
25% | 25% | P Q:2 /28Days |
TRUMENBA 120 MCG/0.5 ML VACCIN Syringe  |
3 |
Tier 3 |
25% | 25% | P Q:0.50 /1Days |
TRUQAP 160 MG TABLET  |
5 |
Tier 5 |
25% | 25% | P Q:64 /28Days |
TRUQAP 200 MG TABLET  |
5 |
Tier 5 |
25% | 25% | P Q:64 /28Days |
TUKYSA 150 MG TABLET  |
5 |
Tier 5 |
25% | 25% | P Q:120 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
TUKYSA 50 MG TABLET  |
5 |
Tier 5 |
25% | 25% | P Q:360 /30Days |
TURALIO 125 MG CAPSULE  |
5 |
Tier 5 |
25% | 25% | P Q:120 /30Days |
TURQOZ-28 TABLET  |
4 |
Tier 4 |
25% | 25% | None |
TWINRIX VACCINE SYRINGE  |
3 |
Tier 3 |
25% | 25% | Q:1 /1Days |
TYBOST 150 MG TABLET  |
3 |
Tier 3 |
25% | 25% | Q:30 /30Days |
TYENNE 162 MG/0.9 ML AUTOINJCT PEN INJECTOR  |
5 |
Tier 5 |
25% | 25% | P Q:3.60 /28Days |
TYENNE 162 MG/0.9 ML SYRINGE  |
5 |
Tier 5 |
25% | 25% | P Q:3.60 /28Days |
TYMLOS 80 MCG DOSE PEN INJECTR  |
5 |
Tier 5 |
25% | 25% | P Q:1.56 /30Days |
TYPHIM VI 25 MCG/0.5 ML SYRINGE  |
3 |
Tier 3 |
25% | 25% | Q:0.50 /1Days |
TYPHIM VI 25MCG/0.5ML VIAL  |
3 |
Tier 3 |
25% | 25% | Q:0.50 /1Days |
TYRVAYA 0.03 MG NASAL SPRAY METR  |
4 |
Tier 4 |
25% | 25% | Q:8.40 /30Days |