MedicarePartD.guide

A non-government resource built from CMS public data

2026 Humana Basic Rx Plan (PDP) formulary (drug list)

Contract S5884, plan 111 · Colorado · 2,972 drugs on file · formulary ID 00026399. Each drug links to its cost in every CMS PDP Region 27 plan.

Hide drugs on tiers

90 drugs starting with O.

Drug nameTier30-day preferred pharmacy90-day mail orderUsage management
OCTREOTIDE 100 ug/mL Injection, SolutionOctreotide Acetate4Non-Preferred Drug31%N/A
  • PA
OCTREOTIDE 1000 ug/mL Injection, SolutionOctreotide Acetate4Non-Preferred Drug31%N/A
  • PA
OCTREOTIDE 500 ug/mL Injection, SolutionOctreotide Acetate4Non-Preferred Drug31%N/A
  • PA
OCTREOTIDE ACETATE 200 ug/mL Injection, Solution4Non-Preferred Drug31%N/A
  • PA
OCTREOTIDE ACETATE 50 ug/mL Injection, Solution3Preferred Brand25%20%
  • PA
ODEFSEY 200/25/25 mg TabletEmtricitabine, Rilpivirine Hydrochloride, And Tenofovir Alafenamide5Specialty Tier25%N/A
  • QL 3 per 30 days
ODOMZO 200 mg CapsuleSonidegib5Specialty Tier25%N/A
  • PA
  • QL 3 per 30 days
OFEV 100 mg CapsuleNintedanib5Specialty Tier25%N/A
  • PA
  • QL 6 per 30 days
OFEV 150 mg CapsuleNintedanib5Specialty Tier25%N/A
  • PA
  • QL 6 per 30 days
OFLOXACIN 3 mg/mL Solution2Generic$1.00$0.00None
OFLOXACIN 3 mg/mL SolutionOfloxacin Otic3Preferred Brand25%20%None
OGSIVEO 100 mg Tablet, Film CoatedNirogacestat5Specialty Tier25%N/A
  • PA
  • QL 6 per 30 days
OGSIVEO 150 mg Tablet, Film CoatedNirogacestat5Specialty Tier25%N/A
  • PA
  • QL 6 per 30 days
OJEMDA 100 mg Tablet, Film CoatedTovorafenib5Specialty Tier25%N/A
  • PA
  • QL 16 per 28 days
OJEMDA 100 mg Tablet, Film CoatedTovorafenib5Specialty Tier25%N/A
  • PA
  • QL 2 per 28 days
OJEMDA 100 mg Tablet, Film CoatedTovorafenib5Specialty Tier25%N/A
  • PA
  • QL 24 per 28 days
OJEMDA KitTovorafenib5Specialty Tier25%N/A
  • PA
  • QL 96 per 28 days
OJJAARA 100 mg TabletMomelotinib5Specialty Tier25%N/A
  • PA
  • QL 3 per 30 days
OJJAARA 150 mg TabletMomelotinib5Specialty Tier25%N/A
  • PA
  • QL 3 per 30 days
OJJAARA 200 mg TabletMomelotinib5Specialty Tier25%N/A
  • PA
  • QL 3 per 30 days
OLANZAPINE 10 mg Tablet, Film Coated3Preferred Brand25%20%None
OLANZAPINE 10 mg Tablet, Orally Disintegrating4Non-Preferred Drug31%N/A
  • QL 3 per 30 days
OLANZAPINE 10 mg/2mL Injection, Powder, Lyophilized, For Solution4Non-Preferred Drug31%N/ANone
OLANZAPINE 15 mg Tablet, Film Coated3Preferred Brand25%20%None
OLANZAPINE 15 mg Tablet, Orally Disintegrating4Non-Preferred Drug31%N/A
  • QL 6 per 30 days
OLANZAPINE 2.5 mg Tablet, Film Coated3Preferred Brand25%20%None
OLANZAPINE 20 mg Tablet, Film Coated3Preferred Brand25%20%None
OLANZAPINE 20 mg Tablet, Orally Disintegrating4Non-Preferred Drug31%N/A
  • QL 6 per 30 days
OLANZAPINE 5 mg Tablet, Film Coated3Preferred Brand25%20%None
OLANZAPINE 5 mg Tablet, Orally Disintegrating4Non-Preferred Drug31%N/A
  • QL 3 per 30 days
OLANZAPINE 7.5 mg Tablet, Film Coated3Preferred Brand25%20%None
OLMESARTAN MEDOXOMIL 20 mg Tablet, Film Coated2Generic$1.00$0.00
  • QL 3 per 30 days
OLMESARTAN MEDOXOMIL 40 mg Tablet, Film Coated2Generic$1.00$0.00
  • QL 3 per 30 days
OLMESARTAN MEDOXOMIL 5 mg Tablet, Film Coated2Generic$1.00$0.00
  • QL 6 per 30 days
OLMESARTAN MEDOXOMIL AND HYDROCHLOROTHIAZIDE 20/12.5 mg Tablet2Generic$1.00$0.00
  • QL 3 per 30 days
OLMESARTAN MEDOXOMIL AND HYDROCHLOROTHIAZIDE 40/12.5 mg Tablet2Generic$1.00$0.00
  • QL 3 per 30 days
OLMESARTAN MEDOXOMIL AND HYDROCHLOROTHIAZIDE 40/25 mg Tablet2Generic$1.00$0.00
  • QL 3 per 30 days
OMEGA-3-ACID ETHYL ESTERS 900 mg Capsule3Preferred Brand25%20%
  • QL 12 per 30 days
OMEPRAZOLE 10 mg Capsule, Delayed Release2Generic$1.00$0.00None
OMEPRAZOLE 20 mg Capsule, Delayed Release2Generic$1.00$0.00None
OMEPRAZOLE 40 mg Capsule, Delayed Release2Generic$1.00$0.00None
OMNITROPE 10 mg/1.5mL Injection, SolutionSomatropin5Specialty Tier25%N/A
  • PA
OMNITROPE 5 mg/1.5mL Injection, SolutionSomatropin5Specialty Tier25%N/A
  • PA
OMNITROPE KitSomatropin5Specialty Tier25%N/A
  • PA
ONDANSETRON 4 mg Tablet, Orally Disintegrating2Generic$1.00$0.00
  • PA
ONDANSETRON 8 mg Tablet, Orally Disintegrating2Generic$1.00$0.00
  • PA
ONDANSETRON HYDROCHLORIDE 4 mg Tablet, Film Coated2Generic$1.00$0.00
  • PA
ONDANSETRON HYDROCHLORIDE 4 mg/5mL Solution4Non-Preferred Drug31%N/A
  • PA
  • QL 45 per 30 days
ONDANSETRON HYDROCHLORIDE 8 mg Tablet, Film Coated2Generic$1.00$0.00
  • PA
ONUREG 200 mg Tablet, Film CoatedAzacitidine5Specialty Tier25%N/A
  • PA
  • QL 14 per 28 days
ONUREG 300 mg Tablet, Film CoatedAzacitidine5Specialty Tier25%N/A
  • PA
  • QL 14 per 28 days
OPIPZA 10 mg Film, SolubleAripiprazole5Specialty Tier25%N/A
  • PA
  • QL 9 per 30 days
OPIPZA 2 mg Film, SolubleAripiprazole5Specialty Tier25%N/A
  • PA
  • QL 3 per 30 days
OPIPZA 5 mg Film, SolubleAripiprazole5Specialty Tier25%N/A
  • PA
  • QL 18 per 30 days
OPVEE 2.7 mg/100uL SprayNalmefene Hydrochloride3Preferred Brand25%20%None
ORGOVYX 120 mg Tablet, Film CoatedRelugolix5Specialty Tier25%N/A
  • PA
  • QL 32 per 30 days
ORQUIDEA .35 mg TabletNorethindrone3Preferred Brand25%20%None
ORSERDU 345 mg Tablet, Film CoatedElacestrant5Specialty Tier25%N/A
  • PA
  • QL 3 per 30 days
ORSERDU 86 mg Tablet, Film CoatedElacestrant5Specialty Tier25%N/A
  • PA
  • QL 9 per 30 days
OSELTAMIVIR PHOSPHATE 30 mg Capsule2Generic$1.00$0.00
  • QL 224 per 365 days
OSELTAMIVIR PHOSPHATE 45 mg Capsule2Generic$1.00$0.00
  • QL 112 per 365 days
OSELTAMIVIR PHOSPHATE 6 mg/mL Powder, For Suspension4Non-Preferred Drug31%N/A
  • QL 144 per 365 days
OSELTAMIVIR PHOSPHATE 75 mg CapsuleOseltamivir3Preferred Brand25%20%
  • QL 112 per 365 days
OTULFI 45 mg/.5mL Injection, SolutionUstekinumab-Aauz3Preferred Brand25%20%
  • PA
  • QL 1.5 per 84 days
OTULFI 45 mg/.5mL Injection, SolutionUstekinumab-Aauz3Preferred Brand25%20%
  • PA
  • QL 1.5 per 84 days
OTULFI 90 mg/mL Injection, SolutionUstekinumab-Aauz5Specialty Tier25%N/A
  • PA
  • QL 3 per 84 days
OXCARBAZEPINE 150 mg Tablet, Film Coated3Preferred Brand25%20%None
OXCARBAZEPINE 300 mg Tablet, Film Coated3Preferred Brand25%20%None
OXCARBAZEPINE 300 mg/5mL Suspension4Non-Preferred Drug31%N/ANone
OXCARBAZEPINE 600 mg Tablet, Film Coated3Preferred Brand25%20%None
OXYBUTYNIN 10 mg Tablet, Film Coated, Extended Release3Preferred Brand25%20%
  • QL 6 per 30 days
OXYBUTYNIN 5 mg Tablet, Film Coated, Extended Release3Preferred Brand25%20%
  • QL 6 per 30 days
OXYBUTYNIN CHLORIDE 15 mg Tablet, Extended Release3Preferred Brand25%20%
  • QL 6 per 30 days
OXYBUTYNIN CHLORIDE 5 mg Tablet2Generic$1.00$0.00None
OXYBUTYNIN CHLORIDE 5 mg/5mL Syrup2Generic$1.00$0.00None
OXYCODONE AND ACETAMINOPHEN 10/325 mg TabletOxycodone Hydrochloride And Acetaminophen4Non-Preferred Drug31%N/A
  • QL 36 per 30 days
OXYCODONE AND ACETAMINOPHEN 2.5/325 mg Tablet4Non-Preferred Drug31%N/A
  • QL 36 per 30 days
OXYCODONE AND ACETAMINOPHEN 5/325 mg TabletOxycodone Hydrochloride And Acetaminophen4Non-Preferred Drug31%N/A
  • QL 36 per 30 days
OXYCODONE AND ACETAMINOPHEN 7.5/325 mg TabletOxycodone Hydrochloride And Acetaminophen4Non-Preferred Drug31%N/A
  • QL 36 per 30 days
OXYCODONE HYDROCHLORIDE 10 mg Tablet3Preferred Brand25%20%
  • QL 36 per 30 days
OXYCODONE HYDROCHLORIDE 100 mg/5mL Solution4Non-Preferred Drug31%N/A
  • QL 27 per 30 days
OXYCODONE HYDROCHLORIDE 15 mg Tablet3Preferred Brand25%20%
  • QL 36 per 30 days
OXYCODONE HYDROCHLORIDE 20 mg Tablet3Preferred Brand25%20%
  • QL 36 per 30 days
OXYCODONE HYDROCHLORIDE 30 mg Tablet3Preferred Brand25%20%
  • QL 36 per 30 days
OXYCODONE HYDROCHLORIDE 5 mg Capsule4Non-Preferred Drug31%N/A
  • QL 36 per 30 days
OXYCODONE HYDROCHLORIDE 5 mg Tablet3Preferred Brand25%20%
  • QL 36 per 30 days
OXYCODONE HYDROCHLORIDE 5 mg/5mL Solution4Non-Preferred Drug31%N/A
  • QL 54 per 30 days
OZEMPIC .68 mg/mL Injection, SolutionSemaglutide3Preferred Brand25%20%
  • PA
  • QL 3 per 28 days
OZEMPIC 1.34 mg/mL Injection, SolutionSemaglutide3Preferred Brand25%20%
  • PA
  • QL 3 per 28 days
OZEMPIC 2.68 mg/mL Injection, SolutionSemaglutide3Preferred Brand25%20%
  • PA
  • QL 3 per 28 days

PA = prior authorization, ST = step therapy, QL = quantity limit. Costs are the plan’s initial-coverage cost-sharing from the CMS 2026 formulary files; a drug not listed here is not on this plan’s formulary, though a formulary exception may still be possible.