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2017 Medicare Part D Formulary Search By Drug Letter

Select a Letter below:

Drug Names Containing the Letter O in Alphabetical Order.
Example: Lipitor® is found on letter page "L" as well as letter page "A" for Atorvastatin.

Drug Name
Packaging NDC On This Nbr of 2017 Formularies
PDPs MAPDs
ALOGLIPTIN-PIOGLIT 12.5-15 MG [Oseni]
(Alogliptin / Pioglitazone)
    45802023865 3
PDPs
50
MAPDs
ALOGLIPTIN-PIOGLIT 12.5-30 MG [Oseni]
(Alogliptin / Pioglitazone)
    45802026065 3
PDPs
50
MAPDs
ALOGLIPTIN-PIOGLIT 12.5-45 MG [Oseni]
(Alogliptin / Pioglitazone)
    45802030465 3
PDPs
50
MAPDs
ALOGLIPTIN-PIOGLIT 25-15 MG TABLET [Oseni]
(Alogliptin / Pioglitazone)
    45802035165 3
PDPs
50
MAPDs
ALOGLIPTIN-PIOGLIT 25-30 MG TABLET [Oseni]
(Alogliptin / Pioglitazone)
    45802040265 3
PDPs
50
MAPDs
ALOGLIPTIN-PIOGLIT 25-45 MG TABLET [Oseni]
(Alogliptin / Pioglitazone)
    45802049965 3
PDPs
50
MAPDs
ANADROL-50 TABLET
(Oxymetholone)
100 EA   68220005510 59
PDPs
339
MAPDs
BENICAR 20MG TABLET
(Olmesartan Medoxomil)
90 BOT 65597010390 22
PDPs
110
MAPDs
BENICAR 40MG TABLET
(Olmesartan Medoxomil)
90 BOT 65597010490 22
PDPs
110
MAPDs
BENICAR 5MG TABLET
(Olmesartan Medoxomil)
30 BOT 65597010130 22
PDPs
110
MAPDs
BENICAR HCT 20-12.5MG TABLET
(Olmesartan Medoxomil-Hydrochlorothiazide)
90 BOT 65597010590 22
PDPs
108
MAPDs
BENICAR HCT TABLET 12.5-40MG (30 CT)
(Olmesartan Medoxomil-Hydrochlorothiazide)
30 BOT 65597010630 22
PDPs
108
MAPDs
BENICAR HCT 40-25MG TABLET
(Olmesartan Medoxomil-Hydrochlorothiazide)
90 BOT 65597010790 22
PDPs
108
MAPDs
DAYPRO 600MG CAPLET
(Oxaprozin)
100 BOT 00025138131 4
PDPs
8
MAPDs
DIPENTUM 250 MG CAPSULE
(Olsalazine Sodium)
    00037686010 44
PDPs
309
MAPDs
DITROPAN XL 10 MG TABLET
(Oxybutynin Chloride)
100 EA   50458081001 4
PDPs
9
MAPDs
DITROPAN XL 15 MG TABLET
(Oxybutynin Chloride)
100 EA   50458081501 4
PDPs
9
MAPDs
DITROPAN XL 5 MG TABLET
(Oxybutynin Chloride)
100 EA   50458080501 4
PDPs
9
MAPDs
ENDOCET 10MG-325MG TABLET
(Oxycodone w/ Acetaminophen)
100 BOT 60951071270 59
PDPs
314
MAPDs
ENDOCET 5/325 TABLET
(Oxycodone w/ Acetaminophen)
500 BOT 60951060285 59
PDPs
321
MAPDs
ENDOCET 7.5-325MG TABLET
(Oxycodone w/ Acetaminophen)
100 BOT 60951070070 59
PDPs
313
MAPDs
GELNIQUE 100mg/g 30 PACKET per CARTON / 1 g in 1 PACKET
(Oxybutynin Chloride)
30 PACKET in 1 CARTON / 1   52544008430 5
PDPs
54
MAPDs
LARTRUVO 500 MG/50 ML VIAL
(Olaratumab)
    00002892601 45
PDPs
273
MAPDs
LOVAZA 1 GM CAPSULE
(Omega-3-acid Ethyl Esters)
120 EA   00173088408 4
PDPs
20
MAPDs
LYNPARZA 50 MG CAPSULE
(Olaparib)
    00310065758 59
PDPs
341
MAPDs
OCALIVA 10 MG TABLET
(OBETICHOLIC ACID)
30.000 EA   69516001030 22
PDPs
164
MAPDs
OCALIVA 5 MG TABLET
(OBETICHOLIC ACID)
30.000 EA   69516000530 22
PDPs
164
MAPDs
OCELLA 3MG/0.03MG TABLET
(Drospirenone-Ethinyl Estradiol)
3 X 28 PKG 00555913167 51
PDPs
268
MAPDs
OCTAGAM 10% VIAL
(Immune Globulin (Human) IV)
    68982085001 35
PDPs
206
MAPDs
OCTAGAM 5% VIAL
(Immune Globulin (Human) IV)
    68982084001 35
PDPs
204
MAPDs
OCTREOTIDE 1,000 mcg/ml vial
(Octreotide Acetate)
    00703334301 59
PDPs
336
MAPDs
OCTREOTIDE ACETATE 100 mcg/ml amp
(Octreotide Acetate)
    00703331101 59
PDPs
332
MAPDs
OCTREOTIDE ACETATE 200 mcg/ml vl
(Octreotide Acetate)
    00703333301 59
PDPs
332
MAPDs
OCTREOTIDE ACETATE 50 mcg/ml amp
(Octreotide Acetate)
    00703330101 59
PDPs
332
MAPDs
OCTREOTIDE ACETATE 500 mcg/ml amp
(Octreotide Acetate)
    00703332101 59
PDPs
330
MAPDs
OCUFEN 0.03% EYE DROPS
(Flurbiprofen Sodium Ophth)
2.5 ML BOT 11980080103 1
PDPs
8
MAPDs
OCUFLOX 0.3% EYE DROPS
(Ofloxacin Ophth)
5 ML BOT 11980077905 4
PDPs
9
MAPDs
OCUTRICIN EYE OINTMENT 400UNT/3.5MG/10UNT
(Bacitracin-Polymyxin-Neomycin Ophth)
3.5 GRAM TUBE 24208078055 57
PDPs
335
MAPDs
ODEFSEY TABLET
(Emtricitabine, Rilpivirine Hydrochloride, and Tenofovir Alafenamide Fumarate)
    61958210101 59
PDPs
341
MAPDs
ODOMZO 200 MG CAPSULE
(Sonidegib)
    00078064515 59
PDPs
341
MAPDs
OFEV 100 MG CAPSULE
(Nintedanib)
60 EA   00597014360 53
PDPs
341
MAPDs
OFEV 150 MG CAPSULE
(Nintedanib)
60 EA   00597014560 59
PDPs
331
MAPDs
OFLOXACIN 0.3% EAR DROPS
(Ofloxacin)
10 ML   60505036302 59
PDPs
335
MAPDs
Ofloxacin 300 mg tablet
(Ofloxacin)
    75834011901 29
PDPs
214
MAPDs
OFLOXACIN 400MG TABLET (100 CT)
(Ofloxacin)
100 BOT 55111016201 37
PDPs
267
MAPDs
OFLOXACIN 0.3 % DRP
(Ofloxacin Ophth)
5 ML   17478071310 59
PDPs
335
MAPDs
OGESTREL TABLET 0.05MG/0.5MG
(Norgestrel & Ethinyl Estradiol)
3X28 BLPK 52544084828 32
PDPs
219
MAPDs
OLANZAPINE 10 MG TABLET [Zyprexa]
(Olanzapine)
    00093577001 59
PDPs
341
MAPDs
OLANZAPINE 10 MG VIAL [Zyprexa]
(Olanzapine)
    00781315972 59
PDPs
340
MAPDs
OLANZAPINE ODT 10 MG TABLET [Zyprexa]
(Olanzapine)
    49884032155 59
PDPs
341
MAPDs
OLANZAPINE 15 MG TABLET [Zyprexa]
(Olanzapine)
    00093577101 59
PDPs
341
MAPDs
OLANZAPINE ODT 15 MG TABLET [Zyprexa]
(Olanzapine)
    49884032255 59
PDPs
341
MAPDs
OLANZAPINE 2.5 MG TABLET [Zyprexa]
(Olanzapine)
1000 EA   00093576710 59
PDPs
341
MAPDs
OLANZAPINE 20 MG TABLET [Zyprexa]
(Olanzapine)
    00093510501 59
PDPs
341
MAPDs
OLANZAPINE ODT 20 MG TABLET [Zyprexa]
(Olanzapine)
    49884032355 59
PDPs
341
MAPDs
OLANZAPINE ODT 5 MG TABLET [Zyprexa]
(Olanzapine)
    49884032055 59
PDPs
341
MAPDs
OLANZAPINE 5 MG TABLET [Zyprexa]
(Olanzapine)
1000 EA   00093576810 59
PDPs
341
MAPDs
OLANZAPINE 7.5 MG TABLET [Zyprexa]
(Olanzapine)
    00093576956 59
PDPs
341
MAPDs
OLANZAPINE-FLUOXETINE 12-25 MG
(Olanzapine-Fluoxetine HCl)
30 EA   00093550656 16
PDPs
180
MAPDs
OLANZAPINE-FLUOXETINE 12-50 MG
(Olanzapine-Fluoxetine HCl)
30 EA   00093550756 16
PDPs
180
MAPDs
olanzapine-fluoxetine 3-25 mg
(Olanzapine-Fluoxetine HCl)
    49884027711 16
PDPs
180
MAPDs
OLANZAPINE-FLUOXETINE 6-25 MG
(Olanzapine-Fluoxetine HCl)
30 EA   00093550456 16
PDPs
174
MAPDs
OLANZAPINE-FLUOXETINE 6-50 MG
(Olanzapine-Fluoxetine HCl)
30 EA   00093550556 16
PDPs
180
MAPDs
OLMESARTAN MEDOXOMIL 20 MG TAB [Benicar]
(Olmesartan Medoxomil)
90.000 EA   00378711277 44
PDPs
257
MAPDs
OLMESARTAN MEDOXOMIL 40 MG TAB [Benicar]
(Olmesartan Medoxomil)
30.000 EA   00378712493 44
PDPs
257
MAPDs
OLMESARTAN MEDOXOMIL 5 MG TAB [Benicar]
(Olmesartan Medoxomil)
30.000 EA   00378701293 44
PDPs
257
MAPDs
olmsrtn-amldpn-hctz 20-5-12.5 [TRIBENZOR]
(Olmesartan-Amlodipine-Hydrochlorothiazide)
    49884078609 36
PDPs
210
MAPDs
olmsrtn-amldpn-hctz 40-10-12.5 [TRIBENZOR]
(Olmesartan-Amlodipine-Hydrochlorothiazide)
    49884078909 36
PDPs
210
MAPDs
olmsrtn-amldpn-hctz 40-10-25mg [TRIBENZOR]
(Olmesartan-Amlodipine-Hydrochlorothiazide)
    49884079009 36
PDPs
210
MAPDs
olmsrtn-amldpn-hctz 40-5-12.5 [TRIBENZOR]
(Olmesartan-Amlodipine-Hydrochlorothiazide)
    49884078709 36
PDPs
210
MAPDs
olmsrtn-amldpn-hctz 40-5-25 mg [TRIBENZOR]
(Olmesartan-Amlodipine-Hydrochlorothiazide)
    49884078809 36
PDPs
210
MAPDs
OLMESARTAN-HCTZ 20-12.5 MG TAB
(OLMESARTAN/HYDROCHLOROTHIAZIDE)
90.000 EA   00378141377 44
PDPs
258
MAPDs
OLMESARTAN-HCTZ 40-12.5 MG TAB
(OLMESARTAN/HYDROCHLOROTHIAZIDE)
90.000 EA   00378142277 44
PDPs
258
MAPDs
OLMESARTAN-HCTZ 40-25 MG TAB
(OLMESARTAN/HYDROCHLOROTHIAZIDE)
90.000 EA   00378142577 44
PDPs
258
MAPDs
OLOPATADINE HCL 0.1% EYE DROPS
(OLOPATADINE HCL)
5 ML   60505057501 34
PDPs
264
MAPDs
Olopatadine 2 MG/ML Ophthalmic Solution
(Olopatadine HCl Nasal)
    00093768432 44
PDPs
228
MAPDs
OLOPATADINE 665 MCG NASAL SPRY
(Olopatadine HCl Nasal)
30.5 GM   60505084505 24
PDPs
178
MAPDs
OLUX 0.05% FOAM
(Clobetasol Propionate)
100 GM   40076003100 1
PDPs
6
MAPDs
OLYSIO 150 MG CAPSULE
(simeprevir)
    59676022528 24
PDPs
140
MAPDs
OMEGA-3 ETHYL ESTERS 1 GM CAPSULE [Lovaza]
(Omega-3-acid Ethyl Esters)
120 EA   00093540189 50
PDPs
324
MAPDs
OMEPRAZOLE 10MG CAPSULE DELAYED RELEASE (30 CT)
(Omeprazole)
30 BOT 00378521193 59
PDPs
340
MAPDs
Omeprazole 20mg DELAYED RELEASE 100 CAPSULE BOTTLE
(Omeprazole)
100 CAPSULE BOTTLE   00378615001 59
PDPs
341
MAPDs
OMEPRAZOLE-BICARB 20-1,100 CAP
(Omeprazole)
30 EA   16714050801 8
PDPs
62
MAPDs
Omeprazole-bicarb 20-1,680 pkt
(Omeprazole)
    27241002962 7
PDPs
64
MAPDs
OMEPRAZOLE CAPSULES DELAYED RELEASE 40 MG
(Omeprazole)
30 BOT 62175013632 59
PDPs
339
MAPDs
OMEPRAZOLE-BICARB 40-1,100 CAP
(Omeprazole)
30 EA   13107011630 8
PDPs
62
MAPDs
Omeprazole-bicarb 40-1,680 pkt
(Omeprazole)
    27241003062 7
PDPs
63
MAPDs
OMNARIS 50MCG SPRAY NON-AEROSOL
(Ciclesonide Nasal)
120 METERED ACTUATIONS BOTPU 63402070101 7
PDPs
57
MAPDs
OMNIPRED OPHTHALMIC SUSPENSION 1% 10 ML BOTPL
(Prednisolone Acetate Ophth)
10 ML BOTPL 00065063825 5
PDPs
11
MAPDs
OMNITROPE INJECTION 10MG/1.5ML 10MG X 1.5ML CTG
(Somatropin For)
10MG X 1.5ML CTG 00781300407 28
PDPs
183
MAPDs
OMNITROPE INJECTION 5MG/1.5ML 1.5 ML CTG
(Somatropin For)
1.5 ML CTG 00781300107 28
PDPs
183
MAPDs
OMNITROPE FOR INJECTION KIT 5.8MG 1 BOX PKGCOM
(Somatropin For)
1 BOX PKGCOM 00781400436 27
PDPs
169
MAPDs
Ondansetron 2mg/mL 25 VIAL in 1 CARTON / 2 mL in 1 VIAL
(Ondansetron)
25 VIAL in 1 CARTON / 2 m   00703722104 59
PDPs
339
MAPDs
ONDANSETRON 4 MG/2 ML ISECURE
(Ondansetron)
    00409112011 54
PDPs
312
MAPDs
ONDANSETRON HCL 24 MG TABLET
(Ondansetron HCl)
1 EA   55111015611 59
PDPs
334
MAPDs
ONDANSETRON HCL 4 MG TABLET
(Ondansetron HCl)
30.000 EA   67877016930 59
PDPs
341
MAPDs
ONDANSETRON HCL 4MG/5ML SOLUTION ORAL
(Ondansetron HCl)
50 ML BOT 00054006447 57
PDPs
330
MAPDs
ONDANSETRON HCL 8 MG TABLET
(Ondansetron HCl)
    51079052501 59
PDPs
341
MAPDs
ONDANSETRON ODT 4MG TABLET (30 CT)
(Ondansetron Orally Disintegrating)
30 BOT 00378773293 59
PDPs
341
MAPDs
ONDANSETRON ODT 8MG (10 CT)
(Ondansetron Orally Disintegrating)
10 BOT 00378773497 59
PDPs
341
MAPDs
ONEXTON GEL PUMP
(Clindamycin / Benzoyl Peroxide)
    00187305050 2
PDPs
24
MAPDs
ONFI 10 MG TABLET
(Clobazam)
100 EA   67386031401 59
PDPs
341
MAPDs
ONFI 2.5 MG/ML SUSPENSION
(Clobazam)
120 ML   67386031321 59
PDPs
341
MAPDs
ONFI 20 MG TABLET
(Clobazam)
100 EA   67386031501 59
PDPs
341
MAPDs
ONGLYZA 2.5 MG TABLET
(Saxagliptin HCl)
90 EA   00310610090 25
PDPs
179
MAPDs
ONGLYZA 5 MG TABLET
(Saxagliptin HCl)
90 EA   00310610590 25
PDPs
179
MAPDs
ONMEL 200 MG TABLET
(itraconazole)
    00259142028 10
PDPs
59
MAPDs
ONZETRA XSAIL 11 MG
(Sumatriptan)
    64597031108 3
PDPs
19
MAPDs
OPANA 10MG TABLET
(Oxymorphone HCl)
100 BOT 63481061370 2
PDPs
19
MAPDs
OPANA 5MG TABLET
(Oxymorphone HCl)
100 BOT 63481061270 2
PDPs
19
MAPDs
OPANA ER 10 MG TABLET
(Oxymorphone HCl)
60 EA   63481081460 20
PDPs
106
MAPDs
OPANA ER 15 MG TABLET
(Oxymorphone HCl)
60 EA   63481081560 20
PDPs
106
MAPDs
OPANA ER 20 MG TABLET
(Oxymorphone HCl)
60 EA   63481081660 20
PDPs
106
MAPDs
OPANA ER 30 MG TABLET
(Oxymorphone HCl)
60 EA   63481081760 20
PDPs
106
MAPDs
OPANA ER 40 MG TABLET
(Oxymorphone HCl)
60 EA   63481081860 20
PDPs
107
MAPDs
OPANA ER 5 MG TABLET
(Oxymorphone HCl)
60 EA   63481081260 20
PDPs
106
MAPDs
OPANA ER 7.5 MG TABLET
(Oxymorphone HCl)
60 EA   63481081360 20
PDPs
106
MAPDs
OPDIVO 40 MG/4 ML VIAL
(Nivolumab)
    00003377211 42
PDPs
278
MAPDs
OPSUMIT 10 MG TABLET
(macitentan)
30 EA   66215050130 48
PDPs
319
MAPDs
ORACEA CAPSULES 40MG 30 BOT
(Doxycycline (Rosacea))
30 BOT 00299382230 12
PDPs
70
MAPDs
ORALAIR 300 IR SUBLINGUAL TAB
(Grass Pollen Allergen Extract)
30 EA   59617001502 13
PDPs
64
MAPDs
ORAP 1MG TABLET
(Pimozide)
100 BOT 57844015101 7
PDPs
37
MAPDs
ORAPRED ODT 10 MG TABLET
(Prednisolone Sod Phosphate Oral)
    59212070048 3
PDPs
13
MAPDs
ORAPRED ODT 15 MG TABLET
(Prednisolone Sod Phosphate Oral)
    59212070148 1
PDPs
10
MAPDs
ORAPRED ODT 30 MG TABLET
(Prednisolone Sod Phosphate Oral)
    59212070248 1
PDPs
10
MAPDs
ORAVIG 50 MG BUCCAL TABLET
(Miconazole)
    89141025014 3
PDPs
54
MAPDs
ORBACTIV 400 MG VIAL
(Oritavancin)
    65293001503 6
PDPs
61
MAPDs
Orencia 4 SYRINGE, GLASS in 1 CARTON > 0.4 mL in 1 SYRINGE, GLASS
(Abatacept For IV)
    00003281411 27
PDPs
217
MAPDs
Orencia 4 SYRINGE, GLASS in 1 CARTON > 0.7 mL in 1 SYRINGE, GLASS
(Abatacept For IV)
    00003281811 27
PDPs
217
MAPDs
ORENCIA CLICKJECT 125 MG/ML
(Abatacept For IV)
    00003218851 27
PDPs
216
MAPDs
ORENCIA 125 MG/ML SYRINGE
(Abatacept For IV)
1 ML   00003218811 27
PDPs
231
MAPDs
ORENCIA 250MG VIAL
(Abatacept For IV)
1 VIAL 00003218710 26
PDPs
222
MAPDs
Orenitram 100 TABLET, EXTENDED RELEASE in 1 BOTTLE
(treprostinil)
    66302035001 14
PDPs
115
MAPDs
ORENITRAM ER 0.125 MG TABLET
(treprostinil)
    66302030001 14
PDPs
120
MAPDs
ORENITRAM ER 0.25 MG TABLET
(treprostinil)
    66302030201 14
PDPs
121
MAPDs
ORENITRAM ER 1 MG TABLET
(treprostinil)
    66302031001 14
PDPs
121
MAPDs
ORENITRAM ER 2.5 MG TABLET
(treprostinil)
    66302032501 14
PDPs
121
MAPDs
ORFADIN 10 MG CAPSULE
(Nitisinone)
60 EA   66658011060 59
PDPs
314
MAPDs
ORFADIN 2 MG CAPSULE
(Nitisinone)
60 EA   66658010260 59
PDPs
314
MAPDs
ORFADIN 4 MG/ML SUSPENSION
(Nitisinone)
90 ML   66658020490 59
PDPs
280
MAPDs
ORFADIN 5 MG CAPSULE
(Nitisinone)
60 EA   66658010560 59
PDPs
314
MAPDs
ORKAMBI 100 MG-125 MG TABLET
(Lumacaftor and Ivacaftor)
112.000 EA   51167070002 59
PDPs
330
MAPDs
ORKAMBI 200 MG-125 MG TABLET
(Lumacaftor and Ivacaftor)
112 EA   51167080901 59
PDPs
341
MAPDs
Orphenadrine Citrate 100mg/1 500 TABLET, EXTENDED RELEASE in 1 BOTTLE
(Orphenadrine Citrate)
500 TABLET, EXTENDED RELE   43386048026 8
PDPs
134
MAPDs
Orphenadrine 30 mg/ml vial
(Orphenadrine Citrate)
    17478053802 8
PDPs
80
MAPDs
Ortho Micronor 0.35mg/1 6 BLISTER PACK per CARTON / 28 TABLET per BLISTER PACK
(Norethindrone)
6 BLISTER PACK in 1 CARTO   50458019416 5
PDPs
30
MAPDs
Ortho Tri-Cyclen 6 BLISTER PACK per CARTON / 1 KIT per BLISTER PACK
(Norgestimate-Eth Estrad)
6 BLISTER PACK in 1 CARTO   50458019115 4
PDPs
11
MAPDs
ORTHO TRI CYCLEN Lo 6 DIALPACK per CARTON / 1 KIT in 1 DIALPACK
(Norgestimate-Eth Estrad)
6 DIALPACK in 1 CARTON /   50458025115 6
PDPs
27
MAPDs
Ortho Cyclen 6 BLISTER PACK per CARTON / 1 KIT per BLISTER PACK
(Norgestimate & Ethinyl Estradiol)
6 BLISTER PACK in 1 CARTO   50458019715 5
PDPs
25
MAPDs
Ortho Novum 135 6 DIALPACK in 1 CARTON / 1 KIT in 1 DIALPACK
(Norethindrone-Eth Estradiol)
6 DIALPACK in 1 CARTON /   50458017615 5
PDPs
26
MAPDs
Ortho-Novum 777 6 DIALPACK per CARTON / 1 KIT in 1 DIALPACK
(Norethindrone-Eth Estradiol)
6 DIALPACK in 1 CARTON /   50458017815 5
PDPs
26
MAPDs
OSELTAMIVIR PHOS 30 MG CAPSULE [Tamiflu]
(Oseltamivir Phosphate)
10.000 EA   47781046813 59
PDPs
325
MAPDs
OSELTAMIVIR PHOS 45 MG CAPSULE [Tamiflu]
(Oseltamivir Phosphate)
10.000 EA   47781046913 59
PDPs
325
MAPDs
OSELTAMIVIR PHOS 75 MG CAPSULE [Tamiflu]
(Oseltamivir Phosphate)
10.000 EA   47781047013 59
PDPs
326
MAPDs
OSENI 12.5-15 MG TABLET
(alogliptin / pioglitazone)
    64764012103 4
PDPs
61
MAPDs
OSENI 12.5-30 MG TABLET
(alogliptin / pioglitazone)
    64764012303 4
PDPs
61
MAPDs
OSENI 12.5-45 MG TABLET
(alogliptin / pioglitazone)
    64764012403 4
PDPs
61
MAPDs
OSENI 25-15 MG TABLET
(alogliptin / pioglitazone)
    64764025103 4
PDPs
61
MAPDs
OSENI 25-30 MG TABLET
(alogliptin / pioglitazone)
    64764025303 4
PDPs
59
MAPDs
OSENI 25-45 MG TABLET
(alogliptin / pioglitazone)
    64764025403 4
PDPs
59
MAPDs
OSMOPREP TABLET 1.5GM
(Sod Phos Mono-Sod Phos Di)
100 BOT 65649070141 12
PDPs
70
MAPDs
OTEZLA 28 DAY STARTER PACK
(Apremilast)
    59572063255 10
PDPs
152
MAPDs
OTEZLA 30 MG TABLET
(Apremilast)
60 EA   59572063106 11
PDPs
161
MAPDs
OTOVEL 0.3%-0.025% EAR DROPS
(Ciprofloxacin and fluocinolone otic)
    24338008014 4
PDPs
59
MAPDs
OTREXUP 10 MG/0.4 ML AUTO-INJ
(Methotrexate)
    54436001002 7
PDPs
79
MAPDs
OTREXUP 12.5 MG/0.4 ML AUTOINJ
(methotrexate)
    54436001204 7
PDPs
80
MAPDs
OTREXUP 15 MG/0.4 ML AUTO-INJ
(Methotrexate)
    54436001502 7
PDPs
79
MAPDs
OTREXUP 17.5 MG/0.4 ML AUTOINJ
(methotrexate)
    54436001704 7
PDPs
80
MAPDs
OTREXUP 20 MG/0.4 ML AUTO-INJ
(Methotrexate)
    54436002002 7
PDPs
79
MAPDs
OTREXUP 22.5 MG/0.4 ML AUTOINJ
(methotrexate)
    54436002204 7
PDPs
80
MAPDs
OTREXUP 25 MG/0.4 ML AUTO-INJ
(Methotrexate)
    54436002502 7
PDPs
79
MAPDs
OVCON 35 72 CARTON in 1 CASE / 3 CELLO PACK per CARTON / 1 BLISTER PACK in 1 CELLO PACK / 1 KIT i
(Norethindrone & Ethinyl Estradiol)
72 CARTON in 1 CASE / 3 C   00430058045 5
PDPs
29
MAPDs
OVIDE 0.5% LOTION
(Malathion)
59 ML   51672529304 4
PDPs
16
MAPDs
OXACILLIN 10 GM VIAL
(Oxacillin Sodium For)
1 EA   25021016399 38
PDPs
266
MAPDs
OXACILLIN 1GM/50ML INJ
(Oxacillin Sodium For)
50 ML BAG 00338101341 26
PDPs
181
MAPDs
OXACILLIN 2GM/50ML INJ
(Oxacillin Sodium For)
50 ML BAG 00338101541 26
PDPs
180
MAPDs
OXALIPLATIN 5 MG/ML INJECTABLE SOLUTION
(Oxaliplatin IV)
    61703036322 50
PDPs
302
MAPDs
oxandrolone 10mg/1 60 TABLET BOTTLE
(Oxandrolone)
60 TABLET in 1 BOTTLE   00245027206 59
PDPs
340
MAPDs
OXANDROLONE 2.5MG TABLETS
(Oxandrolone)
100 BOT 00245027111 59
PDPs
341
MAPDs
OXAPROZIN 600MG TABLET
(Oxaprozin)
100 BOT 00093092401 34
PDPs
214
MAPDs
oxazepam 10 mg capsule
(Oxazepam)
  62584081201 17
PDPs
155
MAPDs
Oxazepam 15mg/1
(Oxazepam)
    62584081301 17
PDPs
155
MAPDs
oxazepam 30 mg capsule
(Oxazepam)
  62584081401 17
PDPs
152
MAPDs
OXCARBAZEPINE 150MG TABLET
(Oxcarbazepine)
100 CRC BOT 62756018388 59
PDPs
341
MAPDs
OXCARBAZEPINE 300MG TABLET 500 NCRC BOT
(Oxcarbazepine)
500 NCRC BOT 62756018413 59
PDPs
341
MAPDs
OXCARBAZEPINE 300 MG/5 ML SUSP
(Oxcarbazepine)
    65162064978 59
PDPs
339
MAPDs
OXCARBAZEPINE 600MG TABLET 500 NCRC BOT
(Oxcarbazepine)
500 NCRC BOT 62756018513 59
PDPs
341
MAPDs
OXICONAZOLE NITRATE 1% CREAM [Oxistat]
(Oxiconazole Nitrate)
60 GM   51672135903 15
PDPs
102
MAPDs
OXISTAT 1% CREAM
(Oxiconazole Nitrate)
    10337035830 8
PDPs
32
MAPDs
OXISTAT 1% LOTION
(Oxiconazole Nitrate)
    10337035960 13
PDPs
89
MAPDs
OXSORALEN-ULTRA 10MG CAP
(Methoxsalen)
50 BOT 00187065042 4
PDPs
28
MAPDs
OXTELLAR XR 150 MG TABLET
(oxcarbazepine)
100 EA   17772012101 7
PDPs
134
MAPDs
OXTELLAR XR 300 MG TABLET
(oxcarbazepine)
100 EA   17772012201 7
PDPs
134
MAPDs
OXTELLAR XR 600 MG TABLET
(oxcarbazepine)
100 EA   17772012301 7
PDPs
134
MAPDs
OXYBUTYNIN 5MG TABLET
(Oxybutynin)
500 BOT 00603497528 59
PDPs
340
MAPDs
OXYBUTYNIN 5 MG/5 ML SYRUP
(Oxybutynin)
473.000 ML   60432009216 59
PDPs
322
MAPDs
Oxybutynin Chloride 10mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 TABLET, FILM COATED, EXTENDED R
(Oxybutynin Chloride)
100 BLISTER PACK in 1 BOX   51079072320 57
PDPs
335
MAPDs
OXYBUTYNIN CHLORIDE TABLET ER 15MG (100 CT)
(Oxybutynin Chloride)
100 BOT 00093520801 57
PDPs
335
MAPDs
Oxybutynin Chloride 5mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 TABLET, FILM COATED, EXTENDED RE
(Oxybutynin Chloride)
100 BLISTER PACK in 1 BOX   51079072220 57
PDPs
335
MAPDs
OXYCODONE HCL ER 10 MG TABLET
(Oxycodone HCl)
100 EA   00781570301 5
PDPs
126
MAPDs
OXYCODONE HYDROCHLORIDE 10mg/1 100 TABLET BOTTLE
(Oxycodone HCl)
100 TABLET in 1 BOTTLE   10702005601 59
PDPs
335
MAPDs
OXYCODONE HCL 100 MG/5 ML SOLN
(Oxycodone HCl)
30 ML   66689002530 39
PDPs
272
MAPDs
OXYCODONE HCL ER 15 MG TABLET
(Oxycodone HCl)
    00115155701 5
PDPs
120
MAPDs
OXYCODONE HYDROCHLORIDE TABLETS 15MG 100 TABLETS BOTPL
(Oxycodone HCl)
100 TABLETS BOTPL 00603499121 59
PDPs
338
MAPDs
OXYCODONE HCL ER 20 MG TABLET
(Oxycodone HCl)
100 EA   00781572601 5
PDPs
126
MAPDs
OXYCODONE HYDROCHLORIDE 20mg/1 100 TABLET BOTTLE
(Oxycodone HCl)
100 TABLET in 1 BOTTLE   10702005701 59
PDPs
335
MAPDs
OXYCODONE HCL ER 30 MG TABLET
(Oxycodone HCl)
    00115155901 5
PDPs
120
MAPDs
OXYCODONE HCL 30MG TABLET
(Oxycodone HCl)
100 BOT 00406853001 59
PDPs
336
MAPDs
OXYCODONE HCL ER 40 MG TABLET
(Oxycodone HCl)
100 EA   00781576701 5
PDPs
126
MAPDs
OXYCODONE HCL 5MG TABLET
(Oxycodone HCl)
100 BOT 00406055201 59
PDPs
338
MAPDs
OXYCODONE HCL 5 MG CAPSULE
(Oxycodone HCl)
100 EA   68308014501 41
PDPs
255
MAPDs
OXYCODONE HCL 5 MG/5 ML SOLN
(Oxycodone HCl)
500 ML   00054039063 49
PDPs
273
MAPDs
OXYCODONE HCL ER 60 MG TABLET
(Oxycodone HCl)
    00115156101 5
PDPs
117
MAPDs
OXYCODONE HCL ER 80 MG TABLET
(Oxycodone HCl)
100 EA   00781578501 5
PDPs
123
MAPDs
Oxycodone-Acetaminophen 5-325/5
(Oxycodone-Acetaminophen )
    00406855350 29
PDPs
232
MAPDs
OXYCODONE AND ACETAMINOPHEN TABLETS 2.5;325MG;MG 100 BOT
(Oxycodone w/ Acetaminophen)
100 BOT 00378710301 58
PDPs
322
MAPDs
OXYCODONE HCL-ACETAMINOPHEN 10MG-325MG TABLET
(Oxycodone HCl)
100 BOT 00406052301 59
PDPs
340
MAPDs
OXYCODONE AND ACETAMINOPHEN 325-5MG TABLET USP (500 CT)
(Oxycodone HCl)
500 BOT 00603499828 59
PDPs
341
MAPDs
OXYCODONE-ACETAMINOPHEN 7.5-325MG TABLET
(Oxycodone)
100 BOT 00406052201 59
PDPs
339
MAPDs
OXYCODONE-ASPIRIN 4.8355-325
(Oxycodone w/ Aspirin)
100 EA   00591355101 43
PDPs
259
MAPDs
OXYCODONE-IBUPROFEN 5-400 TAB
(Oxycodone-Ibuprofen)
100 EA   00228402911 30
PDPs
195
MAPDs
OxyContin 10mg/1
(Oxycodone HCl)
    59011041010 18
PDPs
152
MAPDs
OxyContin 15mg/1
(Oxycodone HCl)
    59011041510 18
PDPs
170
MAPDs
OxyContin 20mg/1
(Oxycodone HCl)
    59011042010 18
PDPs
152
MAPDs
OxyContin 30mg/1
(Oxycodone HCl)
    59011043010 18
PDPs
170
MAPDs
OxyContin 40mg/1
(Oxycodone HCl)
    59011044010 18
PDPs
152
MAPDs
OxyContin 60mg/1
(Oxycodone HCl)
    59011046010 16
PDPs
168
MAPDs
OxyContin 80mg/1
(Oxycodone HCl)
    59011048010 16
PDPs
152
MAPDs
oxymorphone hcl er 10 mg tab
(Oxymorphone HCl)
    00115123201 10
PDPs
155
MAPDs
OXYMORPHONE HYDROCHLORIDE 10MG TABLETS
(Oxymorphone HCl)
100 BOT 00054028425 9
PDPs
161
MAPDs
OXYMORPHONE HCL ER 15 MG TAB
(Oxymorphone HCl)
    00115131601 10
PDPs
155
MAPDs
oxymorphone hcl er 20 mg tab
(Oxymorphone HCl)
    00115123301 10
PDPs
155
MAPDs
oxymorphone hcl er 30 mg tab
(Oxymorphone HCl)
    00115131701 10
PDPs
155
MAPDs
oxymorphone hcl er 40 mg tab
(Oxymorphone HCl)
    00115123401 10
PDPs
155
MAPDs
oxymorphone hcl er 5 mg tablet
(Oxymorphone HCl)
    00115123101 10
PDPs
155
MAPDs
OXYMORPHONE HYDROCHLORIDE 5MG TABLETS
(Oxymorphone HCl)
100 BOT 00054028325 9
PDPs
161
MAPDs
OXYMORPHONE HCL ER 7.5 MG TAB
(Oxymorphone HCl)
    00115131513 10
PDPs
155
MAPDs
OXYTROL 3.9mg/d 8 POUCH in 1 BOX / 1 PATCH in 1 POUCH / 4 d in 1 PATCH
(Oxybutynin TD)
8 POUCH in 1 BOX / 1 PATC   52544092008 4
PDPs
43
MAPDs
PATADAY 0.2% DROPS
(Olopatadine HCl Ophth)
2.5 ML BOTPL 00065027225 52
PDPs
280
MAPDs
PATANASE 665ug/1 240 SPRAY, METERED in 1 BOTTLE
(Olopatadine HCl Nasal)
240 SPRAY, METERED in 1 B   00065033230 5
PDPs
28
MAPDs
PATANOL 0.1% EYE DROPS
(Olopatadine HCl Ophth)
5 ML BOT 00065027105 9
PDPs
63
MAPDs
PAZEO 0.7% EYE DROPS
(Olopatadine)
    00065427325 50
PDPs
202
MAPDs
PERCOCET 10/325MG TABLET
(Oxycodone w/ Acetaminophen)
100 BOT 63481062970 2
PDPs
13
MAPDs
PERCOCET 2.5/325MG TABLET
(Oxycodone w/ Acetaminophen)
100 BOT 63481062770 2
PDPs
11
MAPDs
PERCOCET TABLET 5-325MG
(Oxycodone w/ Acetaminophen)
500 BOT 63481062385 2
PDPs
13
MAPDs
PERCOCET 7.5/325MG TABLET
(Oxycodone w/ Acetaminophen)
100 BOT 63481062870 2
PDPs
11
MAPDs
PIMOZIDE 1 MG TABLET [Orap]
(Pimozide)
    49884034701 59
PDPs
339
MAPDs
PIMOZIDE 2 MG TABLET [Orap]
(Pimozide)
    49884034801 59
PDPs
339
MAPDs
PRILOSEC 10mg/1 30 GRANULE, DELAYED RELEASE in 1 CARTON
(Omeprazole)
30 GRANULE, DELAYED RELEA   00186061001 4
PDPs
30
MAPDs
PRILOSEC 2.5mg/1 30 GRANULE, DELAYED RELEASE in 1 CARTON
(Omeprazole)
30 GRANULE, DELAYED RELEA   00186062501 4
PDPs
30
MAPDs
PRIMLEV 10-300 MG TABLET
(Oxycodone)
    24090068388 3
PDPs
24
MAPDs
PRIMLEV 5-300 MG TABLET
(Oxycodone)
    24090068188 3
PDPs
24
MAPDs
PRIMLEV 7.5-300 MG TABLET
(Oxycodone)
    24090068288 3
PDPs
24
MAPDs
ROXICODONE 15 MG TABLET
(Oxycodone HCl)
100 EA   23635058110 5
PDPs
10
MAPDs
ROXICODONE 30 MG TABLET
(Oxycodone HCl)
    23635058210 5
PDPs
10
MAPDs
ROXICODONE 5 MG TABLET
(Oxycodone HCl)
100 EA   23635058010 5
PDPs
10
MAPDs
SANDOSTATIN 0.05MG/ML AMPUL
(Octreotide Acetate)
10 AMP 00078018001 1
PDPs
16
MAPDs
SANDOSTATIN 0.2MG/ML VIAL
(Octreotide Acetate)
6 X 5ML VIAL 00078018325 2
PDPs
18
MAPDs
SANDOSTATIN 1MG/ML VIAL
(Octreotide Acetate)
6 X 5ML VIAL 00078018425 2
PDPs
18
MAPDs
Sandostatin 100ug/mL 10 AMPULE in 1 PACKAGE / 1 mL in 1 AMPULE
(Octreotide Acetate)
10 AMPULE in 1 PACKAGE /   00078018101 2
PDPs
19
MAPDs
Sandostatin 500ug/mL 10 AMPULE in 1 PACKAGE / 1 mL in 1 AMPULE
(Octreotide Acetate)
10 AMPULE in 1 PACKAGE /   00078018201 1
PDPs
17
MAPDs
SANDOSTATIN LAR DEPOT 10 MG KT
(Octreotide Acetate)
    00078081181 22
PDPs
260
MAPDs
SANDOSTATIN LAR DEPOT 20 MG KT
(Octreotide Acetate)
    00078081881 22
PDPs
262
MAPDs
SANDOSTATIN LAR DEPOT 30 MG KT
(Octreotide Acetate)
    00078082581 22
PDPs
267
MAPDs
STRIVERDI RESPIMAT INHAL SPRAY
(Olodaterol Respimat)
4 GM   00597019261 17
PDPs
145
MAPDs
Symbyax 25; 3mg/1; mg/1 30 CAPSULE BOTTLE
(Olanzapine-Fluoxetine HCl)
30 CAPSULE in 1 BOTTLE   00002323030 3
PDPs
8
MAPDs
SYMBYAX 12-25MG CAPSULE
(Olanzapine-Fluoxetine HCl)
30 BOT 00002323230 3
PDPs
8
MAPDs
SYMBYAX 6-25MG CAPSULE
(Olanzapine-Fluoxetine HCl)
30 BOT 00002323130 1
PDPs
6
MAPDs
SYMBYAX 12-50MG CAPSULE
(Olanzapine-Fluoxetine HCl)
30 BOT 00002323430 3
PDPs
8
MAPDs
SYMBYAX 6-50MG CAPSULE
(Olanzapine-Fluoxetine HCl)
30 BOT 00002323330 3
PDPs
8
MAPDs
SYNRIBO 3.5 MG/ML VIAL
(omacetaxine mepesuccinate)
    63459017714 59
PDPs
341
MAPDs
TAGRISSO 40 MG TABLET
(Osimertinib)
    00310134930 59
PDPs
341
MAPDs
TAGRISSO 80 MG TABLET
(Osimertinib)
    00310135030 59
PDPs
341
MAPDs
TAMIFLU 30 MG 1 BLISTER PACK per CARTON / 10 CAPSULE per BLISTER PACK
(Oseltamivir Phosphate)
BLISTER PACK   00004080285 39
PDPs
188
MAPDs
TAMIFLU 45 MG 1 BLISTER PACK per CARTON / 10 CAPSULE per BLISTER PACK
(Oseltamivir Phosphate)
BLISTER PACK   00004080185 39
PDPs
188
MAPDs
TAMIFLU 6 MG/ML SUSPENSION
(Oseltamivir Phosphate)
60 ML   00004082205 59
PDPs
330
MAPDs
TAMIFLU 75 MG CAPSULE UD
(Oseltamivir Phosphate)
10 BLPK 00004080085 39
PDPs
189
MAPDs
TECHNIVIE DOSE PACK
(Ombitasvir and Paritaprevir and Ritonavi)
    00074308228 25
PDPs
131
MAPDs
TRIBENZOR 20/5/12.5MG TABLETS
(Olmesartan-Amlodipine-Hydrochlorothiazide)
30 BOT 65597011430 14
PDPs
59
MAPDs
TRIBENZOR 40/10/12.5MG TABLETS
(Olmesartan-Amlodipine-Hydrochlorothiazide)
30 BOT 65597011730 14
PDPs
59
MAPDs
TRIBENZOR 40/10/25MG TABLETS
(Olmesartan-Amlodipine-Hydrochlorothiazide)
30 BOT 65597011830 14
PDPs
59
MAPDs
Tribenzor 5; 12.5; 40mg/1; mg/1; mg/1
(Olmesartan-Amlodipine-Hydrochlorothiazide)
    65597011530 14
PDPs
59
MAPDs
Tribenzor 5; 25; 40mg/1; mg/1; mg/1
(Olmesartan-Amlodipine-Hydrochlorothiazide)
    65597011630 14
PDPs
59
MAPDs
TRILEPTAL 150MG TABLET
(Oxcarbazepine)
100 BOT 00078045605 5
PDPs
17
MAPDs
TRILEPTAL 300MG TABLET
(Oxcarbazepine)
100 BOT 00078033705 5
PDPs
17
MAPDs
TRILEPTAL 300MG/5ML SUSP
(Oxcarbazepine)
250 ML BOT 00078035752 5
PDPs
21
MAPDs
TRILEPTAL 600MG TABLET
(Oxcarbazepine)
100 BOT 00078045705 5
PDPs
17
MAPDs
VIEKIRA XR TABLET
(Ombitasvir and Paritaprevir and Ritonavir and Dasabuvir)
    00074006328 25
PDPs
118
MAPDs
XOLAIR 150MG VIAL
(Omalizumab For)
1 X VIAL 50242004062 59
PDPs
334
MAPDs
XTAMPZA ER 13.5 MG CAPSULE
(Oxycodone)
    24510011510 10
PDPs
71
MAPDs
XTAMPZA ER 18 MG CAPSULE
(Oxycodone)
    24510012010 10
PDPs
71
MAPDs
XTAMPZA ER 27 MG CAPSULE
(Oxycodone)
    24510013010 10
PDPs
71
MAPDs
XTAMPZA ER 36 MG CAPSULE
(Oxycodone)
    24510014010 10
PDPs
71
MAPDs
XTAMPZA ER 9 MG CAPSULE
(Oxycodone)
    24510011010 10
PDPs
71
MAPDs
YOSPRALA DR 325-40 MG TABLET
(Aspirin and omeprazole)
    70347032530 3
PDPs
16
MAPDs
YOSPRALA DR 81-40 MG TABLET
(Aspirin and omeprazole)
    70347008130 3
PDPs
16
MAPDs
ZEGERID 20MG PACKET
(Omeprazole-Sodium Bicarbonate)
30 CRTN 68012005230 2
PDPs
27
MAPDs
ZEGERID 20MG CAPSULE
(Omeprazole-Sodium Bicarbonate)
30 BOTPL 68012010230 2
PDPs
20
MAPDs
ZEGERID 40MG PACKET
(Omeprazole-Sodium Bicarbonate)
30 CRTN 68012005430 2
PDPs
26
MAPDs
ZEGERID 40MG CAPSULE
(Omeprazole-Sodium Bicarbonate)
30 BOTPL 68012010430 2
PDPs
20
MAPDs
ZOFRAN 4mg/1 30 FILM COATED TABLETS in BOTTLE
(Ondansetron HCl)
30 TABLET, FILM COATED in   00173044600 5
PDPs
11
MAPDs
ZOFRAN 4MG/5ML ORAL TUBEX
(Ondansetron HCl)
50 ML BOTGL 00173048900 5
PDPs
9
MAPDs
ZOFRAN 8 MG TABLET
(Ondansetron HCl)
30 EA   00173044700 5
PDPs
11
MAPDs
ZOFRAN ODT 4MG TABLET
(Ondansetron Orally Disintegrating)
30 TABLETS BLPK 00173056900 5
PDPs
11
MAPDs
ZOFRAN ODT 8mg/1 30 TABLET, ORALLY DISINTEGRATING in 1 DOSE PACK
(Ondansetron Orally Disintegrating)
30 TABLET, ORALLY DISINTE   00173057000 5
PDPs
11
MAPDs
ZUPLENZ 4 MG SOLUBLE FILM
(Ondansetron Orally Disintegrating)
    57881044401 3
PDPs
22
MAPDs
ZUPLENZ 8 MG SOLUBLE FILM
(Ondansetron Orally Disintegrating)
    57881044801 3
PDPs
22
MAPDs
ZYPREXA 10MG VIAL
(Olanzapine)
1 VIAL 00002759701 4
PDPs
15
MAPDs
ZYPREXA 10 MG TABLET
(Olanzapine)
30 EA   00002411730 5
PDPs
9
MAPDs
ZYPREXA 15 MG TABLET
(Olanzapine)
30 EA   00002441530 5
PDPs
9
MAPDs
ZYPREXA 2.5MG 30 TABLET BOTTLE
(Olanzapine)
30 TABLET in 1 BOTTLE   00002411230 5
PDPs
9
MAPDs
ZYPREXA 20MG TABLET
(Olanzapine)
30 BOT 00002442030 5
PDPs
9
MAPDs
ZYPREXA 5MG TABLET (30 BOT)
(Olanzapine)
30 BOT 00002411530 5
PDPs
9
MAPDs
ZYPREXA 7.5 MG TABLET
(Olanzapine)
30 EA   00002411630 5
PDPs
9
MAPDs
ZYPREXA Relprevv 1 KIT in 1 CARTON
(Olanzapine Pamoate)
1 KIT in 1 CARTON   00002763511 59
PDPs
336
MAPDs
ZYPREXA ZYDIS 10MG TABLET
(Olanzapine)
30 BLPK 00002445485 4
PDPs
9
MAPDs
ZYPREXA ZYDIS 15MG TABLET
(Olanzapine)
30 BLPK 00002445585 4
PDPs
9
MAPDs
ZYPREXA ZYDIS 20MG TABLET
(Olanzapine)
30 BLPK 00002445685 4
PDPs
9
MAPDs
ZYPREXA ZYDIS 5MG TABLET (30 BLPK)
(Olanzapine)
30 BLPK 00002445385 4
PDPs
9
MAPDs



(Chart Source: Centers for Medicare and Medicaid files: CMS Data )


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  • Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
  • You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Members may enroll in a Medicare Advantage plan only during specific times of the year. Contact the Medicare plan for more information.
  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
  • Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.
  • A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Providers who do not contract with the plan are not required to see you except in an emergency.
  • Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home.
  • Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
  • Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition.
  • Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.
  • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
  • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
  • Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.