2014 Medicare Part D Plan Formulary Information |
Symphonix Rite Aid Value Rx (PDP) (S0522-045-0)
Benefit Details
![Email Prescription and/or Health Benefit details for Symphonix Rite Aid Value Rx (PDP). This function does not email the formulary drug list.](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
The Symphonix Rite Aid Value Rx (PDP) (S0522-045-0) Formulary Drugs Starting with the Letter O in CMS PDP Region 29 which includes: NV Plan Monthly Premium: $32.90 Deductible: $310 Qualifies for LIS: No |
Drugs Starting with Letter O
Drug Name |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
OCELLA 3MG/0.03MG TABLET ![Compare how all Medicare Part D PDP plans in NV cover OCELLA 3MG/0.03MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
OCTREOTIDE ACETATE INJECTION 1000MCG 1X5ML VIALMD ![Compare how all Medicare Part D PDP plans in NV cover OCTREOTIDE ACETATE INJECTION 1000MCG 1X5ML VIALMD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
OCTREOTIDE ACETATE INJECTION 100MCG 10 X1ML AMP ![Compare how all Medicare Part D PDP plans in NV cover OCTREOTIDE ACETATE INJECTION 100MCG 10 X1ML AMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | P |
OCTREOTIDE ACETATE INJECTION 500MCG 10 X1ML AMP ![Compare how all Medicare Part D PDP plans in NV cover OCTREOTIDE ACETATE INJECTION 500MCG 10 X1ML AMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
OCTREOTIDE ACETATE INJECTION SOLUTION 200MCG 1 X 5ML VIALMD ![Compare how all Medicare Part D PDP plans in NV cover OCTREOTIDE ACETATE INJECTION SOLUTION 200MCG 1 X 5ML VIALMD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
OCTREOTIDE ACETATE INJECTION SOLUTION 50MCG 10X1ML AMP ![Compare how all Medicare Part D PDP plans in NV cover OCTREOTIDE ACETATE INJECTION SOLUTION 50MCG 10X1ML AMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | P |
OCUTRICIN EYE OINTMENT 400UNT/3.5MG/10UNT ![Compare how all Medicare Part D PDP plans in NV cover OCUTRICIN EYE OINTMENT 400UNT/3.5MG/10UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
OFLOXACIN 0.3% EYE DROPS ![Compare how all Medicare Part D PDP plans in NV cover OFLOXACIN 0.3% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
Ofloxacin 200mg/1 100 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in NV cover Ofloxacin 200mg/1 100 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
Ofloxacin 300mg/1 100 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in NV cover Ofloxacin 300mg/1 100 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Ofloxacin 3mg/mL ![Compare how all Medicare Part D PDP plans in NV cover Ofloxacin 3mg/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
OFLOXACIN 400MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in NV cover OFLOXACIN 400MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | None |
OGESTREL TABLET 0.05MG/0.5MG ![Compare how all Medicare Part D PDP plans in NV cover OGESTREL TABLET 0.05MG/0.5MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
OLANZAPINE 10 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in NV cover OLANZAPINE 10 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | Q:31 /31Days |
OLANZAPINE 10 MG VIAL [Zyprexa] ![Compare how all Medicare Part D PDP plans in NV cover OLANZAPINE 10 MG VIAL [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | None |
OLANZAPINE 15 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in NV cover OLANZAPINE 15 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | Q:31 /31Days |
OLANZAPINE 2.5 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in NV cover OLANZAPINE 2.5 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | Q:31 /31Days |
OLANZAPINE 20 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in NV cover OLANZAPINE 20 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | Q:31 /31Days |
OLANZAPINE 5 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in NV cover OLANZAPINE 5 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | Q:31 /31Days |
OLANZAPINE 7.5 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in NV cover OLANZAPINE 7.5 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | Q:31 /31Days |
OLANZAPINE ODT 10 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in NV cover OLANZAPINE ODT 10 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | Q:31 /31Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OLANZAPINE ODT 15 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in NV cover OLANZAPINE ODT 15 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | Q:31 /31Days |
OLANZAPINE ODT 20 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in NV cover OLANZAPINE ODT 20 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | Q:31 /31Days |
OLANZAPINE ODT 5 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in NV cover OLANZAPINE ODT 5 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | Q:31 /31Days |
OLANZAPINE-FLUOXETINE 12-25 MG ![Compare how all Medicare Part D PDP plans in NV cover OLANZAPINE-FLUOXETINE 12-25 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | None |
OLANZAPINE-FLUOXETINE 12-50 MG ![Compare how all Medicare Part D PDP plans in NV cover OLANZAPINE-FLUOXETINE 12-50 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | None |
olanzapine-fluoxetine 3-25 mg ![Compare how all Medicare Part D PDP plans in NV cover olanzapine-fluoxetine 3-25 mg.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | None |
OLANZAPINE-FLUOXETINE 6-25 MG ![Compare how all Medicare Part D PDP plans in NV cover OLANZAPINE-FLUOXETINE 6-25 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | None |
OLANZAPINE-FLUOXETINE 6-50 MG ![Compare how all Medicare Part D PDP plans in NV cover OLANZAPINE-FLUOXETINE 6-50 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | None |
OLSALAZINE 250 MG ORAL CAPSULE [DIPENTUM] ![Compare how all Medicare Part D PDP plans in NV cover OLSALAZINE 250 MG ORAL CAPSULE [DIPENTUM].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
OLYSIO 150 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NV cover OLYSIO 150 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
OMEPRAZOLE 10MG CAPSULE DELAYED RELEASE (30 CT) ![Compare how all Medicare Part D PDP plans in NV cover OMEPRAZOLE 10MG CAPSULE DELAYED RELEASE (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | Q:62 /31Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Omeprazole 20mg DELAYED RELEASE 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in NV cover Omeprazole 20mg DELAYED RELEASE 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | Q:62 /31Days |
OMEPRAZOLE CAPSULES DELAYED RELEASE 40 MG ![Compare how all Medicare Part D PDP plans in NV cover OMEPRAZOLE CAPSULES DELAYED RELEASE 40 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | Q:62 /31Days |
OMNITROPE FOR INJECTION KIT 5.8MG 1 BOX PKGCOM ![Compare how all Medicare Part D PDP plans in NV cover OMNITROPE FOR INJECTION KIT 5.8MG 1 BOX PKGCOM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
OMNITROPE INJECTION 10MG/1.5ML 10MG X 1.5ML CTG ![Compare how all Medicare Part D PDP plans in NV cover OMNITROPE INJECTION 10MG/1.5ML 10MG X 1.5ML CTG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
OMNITROPE INJECTION 5MG/1.5ML 1.5 ML CTG ![Compare how all Medicare Part D PDP plans in NV cover OMNITROPE INJECTION 5MG/1.5ML 1.5 ML CTG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
Oncaspar 750[iU]/mL 1 VIAL, SINGLE-USE per CARTON / 5 mL in 1 VIAL, SINGLE-USE ![Compare how all Medicare Part D PDP plans in NV cover Oncaspar 750[iU]/mL 1 VIAL, SINGLE-USE per CARTON / 5 mL in 1 VIAL, SINGLE-USE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
ONDANSETRON HCL 24 MG TABLET ![Compare how all Medicare Part D PDP plans in NV cover ONDANSETRON HCL 24 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | P |
Ondansetron HCl 4 mg/2 ml vial ![Compare how all Medicare Part D PDP plans in NV cover Ondansetron HCl 4 mg/2 ml vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | None |
ONDANSETRON HCL 4MG/5ML SOLUTION ORAL ![Compare how all Medicare Part D PDP plans in NV cover ONDANSETRON HCL 4MG/5ML SOLUTION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | P |
Ondansetron Hydrochloride 4mg/1 ![Compare how all Medicare Part D PDP plans in NV cover Ondansetron Hydrochloride 4mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | P |
ONDANSETRON HYDROCHLORIDE 8MG TABLETS ![Compare how all Medicare Part D PDP plans in NV cover ONDANSETRON HYDROCHLORIDE 8MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ONDANSETRON ODT 4MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in NV cover ONDANSETRON ODT 4MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | P |
ONDANSETRON ODT 8MG (10 CT) ![Compare how all Medicare Part D PDP plans in NV cover ONDANSETRON ODT 8MG (10 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | P |
ONFI 10 MG TABLET ![Compare how all Medicare Part D PDP plans in NV cover ONFI 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | P |
ONFI 2.5 MG/ML SUSPENSION ![Compare how all Medicare Part D PDP plans in NV cover ONFI 2.5 MG/ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
ONFI 20 MG TABLET ![Compare how all Medicare Part D PDP plans in NV cover ONFI 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | P |
ONGLYZA 2.5mg/1 30 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in NV cover ONGLYZA 2.5mg/1 30 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$31.00 | $93.00 | Q:62 /31Days |
ONGLYZA 5mg/1 30 FILM COATED TABLETS in BOTTLE, PLASTIC ![Compare how all Medicare Part D PDP plans in NV cover ONGLYZA 5mg/1 30 FILM COATED TABLETS in BOTTLE, PLASTIC.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$31.00 | $93.00 | Q:31 /31Days |
ONMEL 200 MG TABLET ![Compare how all Medicare Part D PDP plans in NV cover ONMEL 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P Q:31 /31Days |
OPRELVEKIN 5 MG/ML INJECTABLE SOLUTION [NEUMEGA] ![Compare how all Medicare Part D PDP plans in NV cover OPRELVEKIN 5 MG/ML INJECTABLE SOLUTION [NEUMEGA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
OPSUMIT 10 MG TABLET ![Compare how all Medicare Part D PDP plans in NV cover OPSUMIT 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P Q:31 /31Days |
ORACEA CAPSULES 40MG 30 BOT ![Compare how all Medicare Part D PDP plans in NV cover ORACEA CAPSULES 40MG 30 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ORAP 1MG TABLET ![Compare how all Medicare Part D PDP plans in NV cover ORAP 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$31.00 | $93.00 | None |
ORAP 2MG TABLET ![Compare how all Medicare Part D PDP plans in NV cover ORAP 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$31.00 | $93.00 | None |
ORENCIA 125 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in NV cover ORENCIA 125 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P Q:4 /28Days |
ORENCIA 250MG VIAL ![Compare how all Medicare Part D PDP plans in NV cover ORENCIA 250MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P Q:4 /28Days |
ORENITRAM ER 0.125 MG TABLET ![Compare how all Medicare Part D PDP plans in NV cover ORENITRAM ER 0.125 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | P |
ORENITRAM ER 0.25 MG TABLET ![Compare how all Medicare Part D PDP plans in NV cover ORENITRAM ER 0.25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | P |
ORENITRAM ER 1 MG TABLET ![Compare how all Medicare Part D PDP plans in NV cover ORENITRAM ER 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
ORENITRAM ER 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in NV cover ORENITRAM ER 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
ORFADIN 10 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NV cover ORFADIN 10 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
ORFADIN 2 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NV cover ORFADIN 2 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
ORFADIN 5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NV cover ORFADIN 5 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Orphenadrine Citrate 100mg/1 500 TABLET, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in NV cover Orphenadrine Citrate 100mg/1 500 TABLET, EXTENDED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | Q:62 /31Days |
Orsythia 6 BLISTER PACK per CARTON / 1 KIT per BLISTER PACK ![Compare how all Medicare Part D PDP plans in NV cover Orsythia 6 BLISTER PACK per CARTON / 1 KIT per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
Ortho Evra 0.75; 6mg/7d; mg/7d 7 d in 1 PATCH ![Compare how all Medicare Part D PDP plans in NV cover Ortho Evra 0.75; 6mg/7d; mg/7d 7 d in 1 PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | None |
ORTHO TRI CYCLEN Lo 6 DIALPACK per CARTON / 1 KIT in 1 DIALPACK ![Compare how all Medicare Part D PDP plans in NV cover ORTHO TRI CYCLEN Lo 6 DIALPACK per CARTON / 1 KIT in 1 DIALPACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | None |
OSENI 12.5-15 MG TABLET ![Compare how all Medicare Part D PDP plans in NV cover OSENI 12.5-15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | S Q:31 /31Days |
OSENI 12.5-30 MG TABLET ![Compare how all Medicare Part D PDP plans in NV cover OSENI 12.5-30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | S Q:31 /31Days |
OSENI 12.5-45 MG TABLET ![Compare how all Medicare Part D PDP plans in NV cover OSENI 12.5-45 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | S Q:31 /31Days |
OSENI 25-15 MG TABLET ![Compare how all Medicare Part D PDP plans in NV cover OSENI 25-15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | S Q:31 /31Days |
OSENI 25-30 MG TABLET ![Compare how all Medicare Part D PDP plans in NV cover OSENI 25-30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | S Q:31 /31Days |
OSENI 25-45 MG TABLET ![Compare how all Medicare Part D PDP plans in NV cover OSENI 25-45 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | S Q:31 /31Days |
OXACILLIN 1GM/50ML INJ ![Compare how all Medicare Part D PDP plans in NV cover OXACILLIN 1GM/50ML INJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OXACILLIN 2GM/50ML INJ ![Compare how all Medicare Part D PDP plans in NV cover OXACILLIN 2GM/50ML INJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
OXACILLIN FOR INJECTION 1 GM ![Compare how all Medicare Part D PDP plans in NV cover OXACILLIN FOR INJECTION 1 GM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | None |
OXACILLIN INJECTION ![Compare how all Medicare Part D PDP plans in NV cover OXACILLIN INJECTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
OXALIPLATIN 5 MG/ML INJECTABLE SOLUTION ![Compare how all Medicare Part D PDP plans in NV cover OXALIPLATIN 5 MG/ML INJECTABLE SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
oxandrolone 10mg/1 60 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in NV cover oxandrolone 10mg/1 60 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | None |
OXANDROLONE 2.5MG TABLETS ![Compare how all Medicare Part D PDP plans in NV cover OXANDROLONE 2.5MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | P Q:124 /31Days |
OXAPROZIN 600MG TABLET ![Compare how all Medicare Part D PDP plans in NV cover OXAPROZIN 600MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | None |
oxazepam 10 mg capsule ![Compare how all Medicare Part D PDP plans in NV cover oxazepam 10 mg capsule.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | Q:124 /31Days |
Oxazepam 15mg/1 ![Compare how all Medicare Part D PDP plans in NV cover Oxazepam 15mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | Q:124 /31Days |
oxazepam 30 mg capsule ![Compare how all Medicare Part D PDP plans in NV cover oxazepam 30 mg capsule.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | Q:124 /31Days |
OXCARBAZEPINE 150MG TABLET ![Compare how all Medicare Part D PDP plans in NV cover OXCARBAZEPINE 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OXCARBAZEPINE 300 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in NV cover OXCARBAZEPINE 300 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | None |
OXCARBAZEPINE 300MG TABLET 500 NCRC BOT ![Compare how all Medicare Part D PDP plans in NV cover OXCARBAZEPINE 300MG TABLET 500 NCRC BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
OXCARBAZEPINE 600MG TABLET 500 NCRC BOT ![Compare how all Medicare Part D PDP plans in NV cover OXCARBAZEPINE 600MG TABLET 500 NCRC BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
OXISTAT 1% CREAM ![Compare how all Medicare Part D PDP plans in NV cover OXISTAT 1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | None |
OXISTAT 1% LOTION ![Compare how all Medicare Part D PDP plans in NV cover OXISTAT 1% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | None |
OXSORALEN 1% LOTION ![Compare how all Medicare Part D PDP plans in NV cover OXSORALEN 1% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | P |
OXSORALEN-ULTRA 10MG CAP ![Compare how all Medicare Part D PDP plans in NV cover OXSORALEN-ULTRA 10MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | 25% | P |
OXTELLAR XR 150 MG TABLET ![Compare how all Medicare Part D PDP plans in NV cover OXTELLAR XR 150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | None |
OXTELLAR XR 300 MG TABLET ![Compare how all Medicare Part D PDP plans in NV cover OXTELLAR XR 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | None |
OXTELLAR XR 600 MG TABLET ![Compare how all Medicare Part D PDP plans in NV cover OXTELLAR XR 600 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | None |
OXYBUTYNIN 5MG TABLET ![Compare how all Medicare Part D PDP plans in NV cover OXYBUTYNIN 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Oxybutynin Chloride 10mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 TABLET, FILM COATED, EXTENDED R ![Compare how all Medicare Part D PDP plans in NV cover Oxybutynin Chloride 10mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 TABLET, FILM COATED, EXTENDED R.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
Oxybutynin Chloride 5mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 TABLET, FILM COATED, EXTENDED RE ![Compare how all Medicare Part D PDP plans in NV cover Oxybutynin Chloride 5mg/1 100 BLISTER PACK in 1 BOX, UNIT-DOSE / 1 TABLET, FILM COATED, EXTENDED RE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
OXYBUTYNIN CHLORIDE TABLET ER 15MG (100 CT) ![Compare how all Medicare Part D PDP plans in NV cover OXYBUTYNIN CHLORIDE TABLET ER 15MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | None |
OXYCODONE AND ACETAMINOPHEN 325-5MG TABLET USP (500 CT) ![Compare how all Medicare Part D PDP plans in NV cover OXYCODONE AND ACETAMINOPHEN 325-5MG TABLET USP (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | Q:372 /31Days |
OXYCODONE AND ACETAMINOPHEN TABLETS 2.5;325MG;MG 100 BOT ![Compare how all Medicare Part D PDP plans in NV cover OXYCODONE AND ACETAMINOPHEN TABLETS 2.5;325MG;MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | Q:372 /31Days |
OXYCODONE HCL 100 MG/5 ML SOLN ![Compare how all Medicare Part D PDP plans in NV cover OXYCODONE HCL 100 MG/5 ML SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | None |
OXYCODONE HCL 30MG TABLET ![Compare how all Medicare Part D PDP plans in NV cover OXYCODONE HCL 30MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | Q:496 /31Days |
OXYCODONE HCL 5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in NV cover OXYCODONE HCL 5 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | Q:496 /31Days |
OXYCODONE HCL 5 MG/5 ML SOLN ![Compare how all Medicare Part D PDP plans in NV cover OXYCODONE HCL 5 MG/5 ML SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | None |
OXYCODONE HCL 5MG TABLET ![Compare how all Medicare Part D PDP plans in NV cover OXYCODONE HCL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | Q:496 /31Days |
OXYCODONE HCL-ACETAMINOPHEN 10MG-325MG TABLET ![Compare how all Medicare Part D PDP plans in NV cover OXYCODONE HCL-ACETAMINOPHEN 10MG-325MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | Q:372 /31Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OXYCODONE HYDROCHLORIDE 10mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in NV cover OXYCODONE HYDROCHLORIDE 10mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | Q:496 /31Days |
OXYCODONE HYDROCHLORIDE 20mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in NV cover OXYCODONE HYDROCHLORIDE 20mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | Q:496 /31Days |
Oxycodone Hydrochloride and Aspirin 325; 4.8355mg 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in NV cover Oxycodone Hydrochloride and Aspirin 325; 4.8355mg 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | Q:372 /31Days |
Oxycodone Hydrochloride and Ibuprofen 400; 5mg/1; mg/1 100 FILM COATED TABLETS in BOTTLE ![Compare how all Medicare Part D PDP plans in NV cover Oxycodone Hydrochloride and Ibuprofen 400; 5mg/1; mg/1 100 FILM COATED TABLETS in BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$10.00 | $30.00 | Q:124 /31Days |
OXYCODONE HYDROCHLORIDE TABLETS 15MG 100 TABLETS BOTPL ![Compare how all Medicare Part D PDP plans in NV cover OXYCODONE HYDROCHLORIDE TABLETS 15MG 100 TABLETS BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | Q:496 /31Days |
OXYCODONE-ACETAMINOPHEN 7.5-325MG TABLET ![Compare how all Medicare Part D PDP plans in NV cover OXYCODONE-ACETAMINOPHEN 7.5-325MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$1.00 | $3.00 | Q:372 /31Days |
oxymorphone hcl er 10 mg tab ![Compare how all Medicare Part D PDP plans in NV cover oxymorphone hcl er 10 mg tab.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | Q:124 /31Days |
oxymorphone hcl er 20 mg tab ![Compare how all Medicare Part D PDP plans in NV cover oxymorphone hcl er 20 mg tab.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | Q:124 /31Days |
oxymorphone hcl er 30 mg tab ![Compare how all Medicare Part D PDP plans in NV cover oxymorphone hcl er 30 mg tab.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | Q:124 /31Days |
oxymorphone hcl er 40 mg tab ![Compare how all Medicare Part D PDP plans in NV cover oxymorphone hcl er 40 mg tab.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | Q:124 /31Days |
oxymorphone hcl er 5 mg tablet ![Compare how all Medicare Part D PDP plans in NV cover oxymorphone hcl er 5 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | Q:124 /31Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OXYMORPHONE HYDROCHLORIDE 10MG TABLETS ![Compare how all Medicare Part D PDP plans in NV cover OXYMORPHONE HYDROCHLORIDE 10MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | Q:186 /31Days |
Oxymorphone hydrochloride 15mg/1 100 TABLET, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in NV cover Oxymorphone hydrochloride 15mg/1 100 TABLET, EXTENDED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | Q:124 /31Days |
OXYMORPHONE HYDROCHLORIDE 5MG TABLETS ![Compare how all Medicare Part D PDP plans in NV cover OXYMORPHONE HYDROCHLORIDE 5MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | Q:186 /31Days |
Oxymorphone hydrochloride 7.5mg/1 100 TABLET, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in NV cover Oxymorphone hydrochloride 7.5mg/1 100 TABLET, EXTENDED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$85.00 | $255.00 | Q:124 /31Days |
OXYTROL 3.9mg/d 8 POUCH in 1 BOX / 1 PATCH in 1 POUCH / 4 d in 1 PATCH ![Compare how all Medicare Part D PDP plans in NV cover OXYTROL 3.9mg/d 8 POUCH in 1 BOX / 1 PATCH in 1 POUCH / 4 d in 1 PATCH.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$31.00 | $93.00 | Q:8 /28Days |