2026 SilverScript Choice (PDP) formulary (drug list)
Contract S5601, plan 004 · Rhode Island · 3,637 drugs on file · formulary ID 00026008. Each drug links to its cost in every CMS PDP Region 02 plan.
104 drugs starting with O.
| Drug name | Tier | 30-day preferred pharmacy | 90-day mail order | Usage management |
|---|---|---|---|---|
| OCTAGAM IMMUNE GLOBULIN (HUMAN) 100 mg/mL SolutionImmune Globulin | 5Specialty Tier | 25% | N/A |
|
| OCTREOTIDE 100 ug/mL Injection, SolutionOctreotide Acetate | 4Non-Preferred Drug | 35% | 35% |
|
| OCTREOTIDE 1000 ug/mL Injection, SolutionOctreotide Acetate | 5Specialty Tier | 25% | N/A |
|
| OCTREOTIDE 500 ug/mL Injection, SolutionOctreotide Acetate | 5Specialty Tier | 25% | N/A |
|
| OCTREOTIDE ACETATE 200 ug/mL Injection, Solution | 4Non-Preferred Drug | 35% | 35% |
|
| OCTREOTIDE ACETATE 50 ug/mL Injection, Solution | 4Non-Preferred Drug | 35% | 35% |
|
| ODEFSEY 200/25/25 mg TabletEmtricitabine, Rilpivirine Hydrochloride, And Tenofovir Alafenamide | 5Specialty Tier | 25% | N/A | None |
| ODOMZO 200 mg CapsuleSonidegib | 5Specialty Tier | 25% | N/A |
|
| OFEV 100 mg CapsuleNintedanib | 5Specialty Tier | 25% | N/A |
|
| OFEV 150 mg CapsuleNintedanib | 5Specialty Tier | 25% | N/A |
|
| OFLOXACIN 3 mg/mL Solution | 2Generic | $10.00 | $30.00 |
|
| OFLOXACIN 3 mg/mL SolutionOfloxacin Otic | 2Generic | $10.00 | $30.00 | None |
| OGSIVEO 100 mg Tablet, Film CoatedNirogacestat | 5Specialty Tier | 25% | N/A |
|
| OGSIVEO 150 mg Tablet, Film CoatedNirogacestat | 5Specialty Tier | 25% | N/A |
|
| OJEMDA 100 mg Tablet, Film CoatedTovorafenib | 5Specialty Tier | 25% | N/A |
|
| OJEMDA 100 mg Tablet, Film CoatedTovorafenib | 5Specialty Tier | 25% | N/A |
|
| OJEMDA 100 mg Tablet, Film CoatedTovorafenib | 5Specialty Tier | 25% | N/A |
|
| OJEMDA KitTovorafenib | 5Specialty Tier | 25% | N/A |
|
| OJJAARA 100 mg TabletMomelotinib | 5Specialty Tier | 25% | N/A |
|
| OJJAARA 150 mg TabletMomelotinib | 5Specialty Tier | 25% | N/A |
|
| OJJAARA 200 mg TabletMomelotinib | 5Specialty Tier | 25% | N/A |
|
| OLANZAPINE 10 mg Tablet, Film Coated | 3Preferred Brand | 19% | 19% |
|
| OLANZAPINE 10 mg Tablet, Orally Disintegrating | 4Non-Preferred Drug | 35% | 35% |
|
| OLANZAPINE 10 mg/2mL Injection, Powder, Lyophilized, For Solution | 4Non-Preferred Drug | 35% | 35% |
|
| OLANZAPINE 15 mg Tablet, Film Coated | 3Preferred Brand | 19% | 19% |
|
| OLANZAPINE 15 mg Tablet, Orally Disintegrating | 4Non-Preferred Drug | 35% | 35% |
|
| OLANZAPINE 2.5 mg Tablet, Film Coated | 3Preferred Brand | 19% | 19% |
|
| OLANZAPINE 20 mg Tablet, Film Coated | 3Preferred Brand | 19% | 19% |
|
| OLANZAPINE 20 mg Tablet, Orally Disintegrating | 4Non-Preferred Drug | 35% | 35% |
|
| OLANZAPINE 5 mg Tablet, Film Coated | 3Preferred Brand | 19% | 19% |
|
| OLANZAPINE 5 mg Tablet, Orally Disintegrating | 4Non-Preferred Drug | 35% | 35% |
|
| OLANZAPINE 7.5 mg Tablet, Film Coated | 3Preferred Brand | 19% | 19% |
|
| OLMESARTAN MEDOXOMIL / AMLODIPINE BESYLATE / HYDROCHLOROTHIAZIDE 40/10/12.5 mg Tablet, Film Coated | 1Preferred Generic | $2.00 | $6.00 |
|
| OLMESARTAN MEDOXOMIL / AMLODIPINE BESYLATE / HYDROCHLOROTHIAZIDE 40/10/25 mg Tablet, Film Coated | 1Preferred Generic | $2.00 | $6.00 |
|
| OLMESARTAN MEDOXOMIL 20 mg Tablet, Film Coated | 1Preferred Generic | $2.00 | $6.00 |
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| OLMESARTAN MEDOXOMIL 40 mg Tablet, Film Coated | 1Preferred Generic | $2.00 | $6.00 |
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| OLMESARTAN MEDOXOMIL 5 mg Tablet, Film Coated | 1Preferred Generic | $2.00 | $6.00 |
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| OLMESARTAN MEDOXOMIL AND HYDROCHLOROTHIAZIDE 20/12.5 mg Tablet | 1Preferred Generic | $2.00 | $6.00 |
|
| OLMESARTAN MEDOXOMIL AND HYDROCHLOROTHIAZIDE 40/12.5 mg Tablet | 1Preferred Generic | $2.00 | $6.00 |
|
| OLMESARTAN MEDOXOMIL AND HYDROCHLOROTHIAZIDE 40/25 mg Tablet | 1Preferred Generic | $2.00 | $6.00 |
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| OLMESARTAN MEDOXOMIL, AMLODIPINE AND HYDROCHLOROTHIAZIDE 20/5/12.5 mg Tablet, Film Coated | 1Preferred Generic | $2.00 | $6.00 |
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| OLMESARTAN MEDOXOMIL, AMLODIPINE AND HYDROCHLOROTHIAZIDE 40/5/12.5 mg Tablet, Film Coated | 1Preferred Generic | $2.00 | $6.00 |
|
| OLMESARTAN MEDOXOMIL, AMLODIPINE AND HYDROCHLOROTHIAZIDE 40/5/25 mg Tablet, Film Coated | 1Preferred Generic | $2.00 | $6.00 |
|
| OLOPATADINE HYDROCHLORIDE 665 ug Spray | 4Non-Preferred Drug | 35% | 35% |
|
| OMEGA-3-ACID ETHYL ESTERS 900 mg Capsule | 4Non-Preferred Drug | 35% | 35% |
|
| OMEPRAZOLE 10 mg Capsule, Delayed Release | 1Preferred Generic | $2.00 | $6.00 |
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| OMEPRAZOLE 20 mg Capsule, Delayed Release | 1Preferred Generic | $2.00 | $6.00 |
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| OMEPRAZOLE 40 mg Capsule, Delayed Release | 1Preferred Generic | $2.00 | $6.00 |
|
| ONDANSETRON 4 mg Tablet, Orally Disintegrating | 2Generic | $10.00 | $30.00 |
|
| ONDANSETRON 8 mg Tablet, Orally Disintegrating | 2Generic | $10.00 | $30.00 |
|
| ONDANSETRON HYDROCHLORIDE 4 mg Tablet, Film Coated | 2Generic | $10.00 | $30.00 |
|
| ONDANSETRON HYDROCHLORIDE 4 mg/5mL Solution | 2Generic | $10.00 | $30.00 |
|
| ONDANSETRON HYDROCHLORIDE 8 mg Tablet, Film Coated | 2Generic | $10.00 | $30.00 |
|
| ONUREG 200 mg Tablet, Film CoatedAzacitidine | 5Specialty Tier | 25% | N/A |
|
| ONUREG 300 mg Tablet, Film CoatedAzacitidine | 5Specialty Tier | 25% | N/A |
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| OPIPZA 10 mg Film, SolubleAripiprazole | 5Specialty Tier | 25% | N/A |
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| OPIPZA 2 mg Film, SolubleAripiprazole | 5Specialty Tier | 25% | N/A |
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| OPIPZA 5 mg Film, SolubleAripiprazole | 5Specialty Tier | 25% | N/A |
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| OPSUMIT 10 mg Tablet, Film CoatedMacitentan | 5Specialty Tier | 25% | N/A |
|
| ORGOVYX 120 mg Tablet, Film CoatedRelugolix | 5Specialty Tier | 25% | N/A |
|
| ORKAMBI 100/125 mg GranuleLumacaftor And Ivacaftor | 5Specialty Tier | 25% | N/A |
|
| ORKAMBI 100/125 mg Tablet, Film CoatedLumacaftor And Ivacaftor | 5Specialty Tier | 25% | N/A |
|
| ORKAMBI 150/188 mg GranuleLumacaftor And Ivacaftor | 5Specialty Tier | 25% | N/A |
|
| ORKAMBI 200/125 mg Tablet, Film CoatedLumacaftor And Ivacaftor | 5Specialty Tier | 25% | N/A |
|
| ORKAMBI 75/94 mg GranuleLumacaftor And Ivacaftor | 5Specialty Tier | 25% | N/A |
|
| ORQUIDEA .35 mg TabletNorethindrone | 2Generic | $10.00 | $30.00 | None |
| ORSERDU 345 mg Tablet, Film CoatedElacestrant | 5Specialty Tier | 25% | N/A |
|
| ORSERDU 86 mg Tablet, Film CoatedElacestrant | 5Specialty Tier | 25% | N/A |
|
| OSELTAMIVIR PHOSPHATE 30 mg Capsule | 2Generic | $10.00 | $30.00 |
|
| OSELTAMIVIR PHOSPHATE 45 mg Capsule | 2Generic | $10.00 | $30.00 |
|
| OSELTAMIVIR PHOSPHATE 6 mg/mL Powder, For Suspension | 2Generic | $10.00 | $30.00 |
|
| OSELTAMIVIR PHOSPHATE 75 mg CapsuleOseltamivir | 2Generic | $10.00 | $30.00 |
|
| OSPOMYV 60 mg/mL Injection, SolutionDenosumab | 4Non-Preferred Drug | 35% | 35% |
|
| OXACILLIN 1 g/20mL Injection, Powder, For Solution | 4Non-Preferred Drug | 35% | 35% | None |
| OXACILLIN 10 g/100mL Injection, Powder, For SolutionOxacillin Sodium | 4Non-Preferred Drug | 35% | 35% | None |
| OXACILLIN 2 g/20mL Injection, Powder, For Solution | 4Non-Preferred Drug | 35% | 35% | None |
| OXAPROZIN 600 mg Tablet, Film Coated | 2Generic | $10.00 | $30.00 |
|
| OXAZEPAM 10 mg Capsule, Gelatin Coated | 4Non-Preferred Drug | 35% | 35% |
|
| OXAZEPAM 15 mg Capsule, Gelatin Coated | 4Non-Preferred Drug | 35% | 35% |
|
| OXAZEPAM 30 mg Capsule, Gelatin Coated | 4Non-Preferred Drug | 35% | 35% |
|
| OXCARBAZEPINE 150 mg Tablet, Film Coated | 2Generic | $10.00 | $30.00 | None |
| OXCARBAZEPINE 300 mg Tablet, Film Coated | 2Generic | $10.00 | $30.00 | None |
| OXCARBAZEPINE 300 mg/5mL Suspension | 4Non-Preferred Drug | 35% | 35% | None |
| OXCARBAZEPINE 600 mg Tablet, Film Coated | 2Generic | $10.00 | $30.00 | None |
| OXYBUTYNIN 10 mg Tablet, Film Coated, Extended Release | 2Generic | $10.00 | $30.00 |
|
| OXYBUTYNIN 5 mg Tablet, Film Coated, Extended Release | 2Generic | $10.00 | $30.00 |
|
| OXYBUTYNIN CHLORIDE 15 mg Tablet, Extended Release | 2Generic | $10.00 | $30.00 |
|
| OXYBUTYNIN CHLORIDE 5 mg Tablet | 2Generic | $10.00 | $30.00 |
|
| OXYBUTYNIN CHLORIDE 5 mg/5mL Syrup | 2Generic | $10.00 | $30.00 |
|
| OXYCODONE AND ACETAMINOPHEN 10/325 mg TabletOxycodone Hydrochloride And Acetaminophen | 3Preferred Brand | 19% | 19% |
|
| OXYCODONE AND ACETAMINOPHEN 2.5/325 mg Tablet | 3Preferred Brand | 19% | 19% |
|
| OXYCODONE AND ACETAMINOPHEN 5/325 mg TabletOxycodone Hydrochloride And Acetaminophen | 3Preferred Brand | 19% | 19% |
|
| OXYCODONE AND ACETAMINOPHEN 7.5/325 mg TabletOxycodone Hydrochloride And Acetaminophen | 3Preferred Brand | 19% | 19% |
|
| OXYCODONE HYDROCHLORIDE 10 mg Tablet | 3Preferred Brand | 19% | 19% |
|
| OXYCODONE HYDROCHLORIDE 100 mg/5mL Solution | 4Non-Preferred Drug | 35% | 35% |
|
| OXYCODONE HYDROCHLORIDE 15 mg Tablet | 3Preferred Brand | 19% | 19% |
|
| OXYCODONE HYDROCHLORIDE 20 mg Tablet | 3Preferred Brand | 19% | 19% |
|
| OXYCODONE HYDROCHLORIDE 30 mg Tablet | 3Preferred Brand | 19% | 19% |
|
| OXYCODONE HYDROCHLORIDE 5 mg Capsule | 3Preferred Brand | 19% | 19% |
|
| OXYCODONE HYDROCHLORIDE 5 mg Tablet | 3Preferred Brand | 19% | 19% |
|
| OXYCODONE HYDROCHLORIDE 5 mg/5mL Solution | 3Preferred Brand | 19% | 19% |
|
| OZEMPIC .68 mg/mL Injection, SolutionSemaglutide | 3Preferred Brand | 19% | 19% |
|
| OZEMPIC 1.34 mg/mL Injection, SolutionSemaglutide | 3Preferred Brand | 19% | 19% |
|
| OZEMPIC 2.68 mg/mL Injection, SolutionSemaglutide | 3Preferred Brand | 19% | 19% |
|
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.