2015 Medicare Part D Plan Formulary Information |
Humana Gold Choice H2944-013 (PFFS) (H2944-013-0)
Benefit Details
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The Humana Gold Choice H2944-013 (PFFS) (H2944-013-0) Formulary Drugs Starting with the Letter O in GEARY County, KS: CMS MA Region 18 which includes: KS Plan Monthly Premium: $92.00 Deductible: $0 |
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 KS cover OCELLA 3MG/0.03MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
OCTREOTIDE ACETATE INJECTION 1000MCG 1X5ML VIALMD ![Compare how all Medicare Part D PDP plans in KS cover OCTREOTIDE ACETATE INJECTION 1000MCG 1X5ML VIALMD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
OCTREOTIDE ACETATE INJECTION 100MCG 10 X1ML AMP ![Compare how all Medicare Part D PDP plans in KS cover OCTREOTIDE ACETATE INJECTION 100MCG 10 X1ML AMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | P |
OCTREOTIDE ACETATE INJECTION 500MCG 10 X1ML AMP ![Compare how all Medicare Part D PDP plans in KS cover OCTREOTIDE ACETATE INJECTION 500MCG 10 X1ML AMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
OCTREOTIDE ACETATE INJECTION SOLUTION 200MCG 1 X 5ML VIALMD ![Compare how all Medicare Part D PDP plans in KS cover OCTREOTIDE ACETATE INJECTION SOLUTION 200MCG 1 X 5ML VIALMD.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | P |
OCTREOTIDE ACETATE INJECTION SOLUTION 50MCG 10X1ML AMP ![Compare how all Medicare Part D PDP plans in KS cover OCTREOTIDE ACETATE INJECTION SOLUTION 50MCG 10X1ML AMP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | P |
OCUFEN 0.03% EYE DROPS ![Compare how all Medicare Part D PDP plans in KS cover OCUFEN 0.03% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
OCUFLOX 0.3% EYE DROPS ![Compare how all Medicare Part D PDP plans in KS cover OCUFLOX 0.3% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
OCUTRICIN EYE OINTMENT 400UNT/3.5MG/10UNT ![Compare how all Medicare Part D PDP plans in KS cover OCUTRICIN EYE OINTMENT 400UNT/3.5MG/10UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$14.00 | $0.00 | None |
OFEV 100 MG CAPSULE ![Compare how all Medicare Part D PDP plans in KS cover OFEV 100 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OFEV 150 MG CAPSULE ![Compare how all Medicare Part D PDP plans in KS cover OFEV 150 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:60 /30Days |
OFLOXACIN 0.3% EYE DROPS ![Compare how all Medicare Part D PDP plans in KS cover OFLOXACIN 0.3% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$14.00 | $0.00 | None |
OFLOXACIN 300 MG TABLET (50 CT) ![Compare how all Medicare Part D PDP plans in KS cover OFLOXACIN 300 MG TABLET (50 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$14.00 | $0.00 | None |
Ofloxacin 3mg/mL ![Compare how all Medicare Part D PDP plans in KS cover Ofloxacin 3mg/mL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$14.00 | $0.00 | None |
OFLOXACIN 400MG TABLET (100 CT) ![Compare how all Medicare Part D PDP plans in KS cover OFLOXACIN 400MG TABLET (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$14.00 | $0.00 | None |
OGESTREL TABLET 0.05MG/0.5MG ![Compare how all Medicare Part D PDP plans in KS cover OGESTREL TABLET 0.05MG/0.5MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
OLANZAPINE 10 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in KS cover OLANZAPINE 10 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:30 /30Days |
OLANZAPINE 10 MG VIAL [Zyprexa] ![Compare how all Medicare Part D PDP plans in KS cover OLANZAPINE 10 MG VIAL [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:60 /30Days |
OLANZAPINE 15 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in KS cover OLANZAPINE 15 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:60 /30Days |
OLANZAPINE 2.5 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in KS cover OLANZAPINE 2.5 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:30 /30Days |
OLANZAPINE 20 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in KS cover OLANZAPINE 20 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OLANZAPINE 5 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in KS cover OLANZAPINE 5 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:30 /30Days |
OLANZAPINE 7.5 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in KS cover OLANZAPINE 7.5 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:30 /30Days |
OLANZAPINE ODT 10 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in KS cover OLANZAPINE ODT 10 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:30 /30Days |
OLANZAPINE ODT 15 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in KS cover OLANZAPINE ODT 15 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:60 /30Days |
OLANZAPINE ODT 20 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in KS cover OLANZAPINE ODT 20 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:60 /30Days |
OLANZAPINE ODT 5 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in KS cover OLANZAPINE ODT 5 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:30 /30Days |
OLOPATADINE 665 MCG NASAL SPRY ![Compare how all Medicare Part D PDP plans in KS cover OLOPATADINE 665 MCG NASAL SPRY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:31 /30Days |
OMEGA-3 ETHYL ESTERS 1 GM CAPSULE [Lovaza] ![Compare how all Medicare Part D PDP plans in KS cover OMEGA-3 ETHYL ESTERS 1 GM CAPSULE [Lovaza].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:120 /30Days |
OMEPRAZOLE 10MG CAPSULE DELAYED RELEASE (30 CT) ![Compare how all Medicare Part D PDP plans in KS cover OMEPRAZOLE 10MG CAPSULE DELAYED RELEASE (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$14.00 | $0.00 | Q:60 /30Days |
OMEPRAZOLE 20mg DELAYED RELEASE 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in KS cover OMEPRAZOLE 20mg DELAYED RELEASE 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$14.00 | $0.00 | Q:60 /30Days |
OMEPRAZOLE CAPSULES DELAYED RELEASE 40 MG ![Compare how all Medicare Part D PDP plans in KS cover OMEPRAZOLE CAPSULES DELAYED RELEASE 40 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$14.00 | $0.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OMNARIS 50MCG SPRAY NON-AEROSOL ![Compare how all Medicare Part D PDP plans in KS cover OMNARIS 50MCG SPRAY NON-AEROSOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:13 /30Days |
OMNITROPE FOR INJECTION KIT 5.8MG 1 BOX PKGCOM ![Compare how all Medicare Part D PDP plans in KS cover OMNITROPE FOR INJECTION KIT 5.8MG 1 BOX PKGCOM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
OMNITROPE INJECTION 10MG/1.5ML 10MG X 1.5ML CTG ![Compare how all Medicare Part D PDP plans in KS 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 |
33% | N/A | P |
OMNITROPE INJECTION 5MG/1.5ML 1.5 ML CTG ![Compare how all Medicare Part D PDP plans in KS cover OMNITROPE INJECTION 5MG/1.5ML 1.5 ML CTG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | 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 KS 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 |
33% | N/A | P |
ONDANSETRON 2mg/mL 25 VIAL in 1 CARTON / 2 mL in 1 VIAL ![Compare how all Medicare Part D PDP plans in KS cover ONDANSETRON 2mg/mL 25 VIAL in 1 CARTON / 2 mL in 1 VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$14.00 | $0.00 | None |
ONDANSETRON 4 MG/2 ML ISECURE ![Compare how all Medicare Part D PDP plans in KS cover ONDANSETRON 4 MG/2 ML ISECURE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$14.00 | $0.00 | None |
ONDANSETRON HCL 24 MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover ONDANSETRON HCL 24 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$14.00 | $0.00 | P Q:30 /30Days |
ONDANSETRON HCL 4MG/5ML SOLUTION ORAL ![Compare how all Medicare Part D PDP plans in KS cover ONDANSETRON HCL 4MG/5ML SOLUTION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | P Q:450 /30Days |
ONDANSETRON HYDROCHLORIDE 4MG ![Compare how all Medicare Part D PDP plans in KS cover ONDANSETRON HYDROCHLORIDE 4MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$14.00 | $0.00 | P Q:90 /30Days |
ONDANSETRON HYDROCHLORIDE 8MG TABLETS ![Compare how all Medicare Part D PDP plans in KS cover ONDANSETRON HYDROCHLORIDE 8MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$14.00 | $0.00 | P Q:90 /30Days |
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 KS cover ONDANSETRON ODT 4MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$14.00 | $0.00 | P Q:90 /30Days |
ONDANSETRON ODT 8MG (10 CT) ![Compare how all Medicare Part D PDP plans in KS cover ONDANSETRON ODT 8MG (10 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$14.00 | $0.00 | P Q:90 /30Days |
ONFI 10 MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover ONFI 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | P Q:60 /30Days |
ONFI 2.5 MG/ML SUSPENSION ![Compare how all Medicare Part D PDP plans in KS cover ONFI 2.5 MG/ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | P Q:480 /30Days |
ONFI 20 MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover ONFI 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | P Q:60 /30Days |
ONGLYZA 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover ONGLYZA 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:30 /30Days |
ONGLYZA 5 MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover ONGLYZA 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:30 /30Days |
OPANA ER 10 MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover OPANA ER 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:60 /30Days |
OPANA ER 15 MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover OPANA ER 15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:60 /30Days |
OPANA ER 20 MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover OPANA ER 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:60 /30Days |
OPANA ER 30 MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover OPANA ER 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OPANA ER 40 MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover OPANA ER 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:60 /30Days |
OPANA ER 5 MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover OPANA ER 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:60 /30Days |
OPANA ER 7.5 MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover OPANA ER 7.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:60 /30Days |
OPDIVO 40 MG/4 ML VIAL ![Compare how all Medicare Part D PDP plans in KS cover OPDIVO 40 MG/4 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:80 /28Days |
OPRELVEKIN 5 MG/ML INJECTABLE SOLUTION [NEUMEGA] ![Compare how all Medicare Part D PDP plans in KS cover OPRELVEKIN 5 MG/ML INJECTABLE SOLUTION [NEUMEGA].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:42 /30Days |
OPSUMIT 10 MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover OPSUMIT 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P Q:30 /30Days |
ORAP 1MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover ORAP 1MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
ORAP 2MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover ORAP 2MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
ORFADIN 10 MG CAPSULE ![Compare how all Medicare Part D PDP plans in KS cover ORFADIN 10 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
ORFADIN 2 MG CAPSULE ![Compare how all Medicare Part D PDP plans in KS cover ORFADIN 2 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
ORFADIN 5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in KS cover ORFADIN 5 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | 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 KS cover Orphenadrine Citrate 100mg/1 500 TABLET, EXTENDED RELEASE in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | P |
Orsythia 6 BLISTER PACK per CARTON / 1 KIT per BLISTER PACK ![Compare how all Medicare Part D PDP plans in KS cover Orsythia 6 BLISTER PACK per CARTON / 1 KIT per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
Ortho Cept 6 DIALPACK per CARTON / 1 KIT in 1 DIALPACK ![Compare how all Medicare Part D PDP plans in KS cover Ortho Cept 6 DIALPACK per CARTON / 1 KIT in 1 DIALPACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
Ortho Cyclen 6 BLISTER PACK per CARTON / 1 KIT per BLISTER PACK ![Compare how all Medicare Part D PDP plans in KS cover Ortho Cyclen 6 BLISTER PACK per CARTON / 1 KIT per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
Ortho Micronor 0.35mg/1 6 BLISTER PACK per CARTON / 28 TABLET per BLISTER PACK ![Compare how all Medicare Part D PDP plans in KS cover Ortho Micronor 0.35mg/1 6 BLISTER PACK per CARTON / 28 TABLET per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
Ortho Novum 135 6 DIALPACK in 1 CARTON / 1 KIT in 1 DIALPACK ![Compare how all Medicare Part D PDP plans in KS cover Ortho Novum 135 6 DIALPACK in 1 CARTON / 1 KIT in 1 DIALPACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
ORTHO TRI CYCLEN Lo 6 DIALPACK per CARTON / 1 KIT in 1 DIALPACK ![Compare how all Medicare Part D PDP plans in KS 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 |
$95.00 | $275.00 | None |
Ortho Tri-Cyclen 6 BLISTER PACK per CARTON / 1 KIT per BLISTER PACK ![Compare how all Medicare Part D PDP plans in KS cover Ortho Tri-Cyclen 6 BLISTER PACK per CARTON / 1 KIT per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
Ortho-Novum 777 6 DIALPACK per CARTON / 1 KIT in 1 DIALPACK ![Compare how all Medicare Part D PDP plans in KS cover Ortho-Novum 777 6 DIALPACK per CARTON / 1 KIT in 1 DIALPACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
OSENI 12.5-15 MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover OSENI 12.5-15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:30 /30Days |
OSENI 12.5-30 MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover OSENI 12.5-30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OSENI 12.5-45 MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover OSENI 12.5-45 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:30 /30Days |
OSENI 25-15 MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover OSENI 25-15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:30 /30Days |
OSENI 25-30 MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover OSENI 25-30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:30 /30Days |
OSENI 25-45 MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover OSENI 25-45 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:30 /30Days |
OSMOPREP TABLET 1.5GM ![Compare how all Medicare Part D PDP plans in KS cover OSMOPREP TABLET 1.5GM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
OVCON 35 72 CARTON in 1 CASE / 3 CELLO PACK per CARTON / 1 BLISTER PACK in 1 CELLO PACK / 1 KIT i ![Compare how all Medicare Part D PDP plans in KS cover OVCON 35 72 CARTON in 1 CASE / 3 CELLO PACK per CARTON / 1 BLISTER PACK in 1 CELLO PACK / 1 KIT i.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
OVIDE 0.5% LOTION ![Compare how all Medicare Part D PDP plans in KS cover OVIDE 0.5% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | P |
OXACILLIN 10 GM VIAL ![Compare how all Medicare Part D PDP plans in KS cover OXACILLIN 10 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
OXACILLIN 1GM/50ML INJ ![Compare how all Medicare Part D PDP plans in KS cover OXACILLIN 1GM/50ML INJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
Oxacillin 2 gm add-vantage vl ![Compare how all Medicare Part D PDP plans in KS cover Oxacillin 2 gm add-vantage vl.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
OXACILLIN 2GM/50ML INJ ![Compare how all Medicare Part D PDP plans in KS cover OXACILLIN 2GM/50ML INJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OXALIPLATIN 5 MG/ML INJECTABLE SOLUTION ![Compare how all Medicare Part D PDP plans in KS cover OXALIPLATIN 5 MG/ML INJECTABLE SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
oxandrolone 10mg/1 60 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in KS cover oxandrolone 10mg/1 60 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | Q:60 /30Days |
OXANDROLONE 2.5MG TABLETS ![Compare how all Medicare Part D PDP plans in KS cover OXANDROLONE 2.5MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:120 /30Days |
OXAPROZIN 600MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover OXAPROZIN 600MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
oxazepam 10 mg capsule ![Compare how all Medicare Part D PDP plans in KS cover oxazepam 10 mg capsule.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
Oxazepam 15mg/1 ![Compare how all Medicare Part D PDP plans in KS cover Oxazepam 15mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
oxazepam 30 mg capsule ![Compare how all Medicare Part D PDP plans in KS cover oxazepam 30 mg capsule.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
OXCARBAZEPINE 150MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover OXCARBAZEPINE 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
OXCARBAZEPINE 300 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in KS cover OXCARBAZEPINE 300 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
OXCARBAZEPINE 300MG TABLET 500 NCRC BOT ![Compare how all Medicare Part D PDP plans in KS cover OXCARBAZEPINE 300MG TABLET 500 NCRC BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
OXCARBAZEPINE 600MG TABLET 500 NCRC BOT ![Compare how all Medicare Part D PDP plans in KS cover OXCARBAZEPINE 600MG TABLET 500 NCRC BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OXISTAT 1% CREAM ![Compare how all Medicare Part D PDP plans in KS cover OXISTAT 1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
OXISTAT 1% LOTION ![Compare how all Medicare Part D PDP plans in KS cover OXISTAT 1% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
OXSORALEN 1% LOTION ![Compare how all Medicare Part D PDP plans in KS cover OXSORALEN 1% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | None |
OXSORALEN-ULTRA 10MG CAP ![Compare how all Medicare Part D PDP plans in KS cover OXSORALEN-ULTRA 10MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
OXYBUTYNIN 5MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover OXYBUTYNIN 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$14.00 | $0.00 | None |
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 KS 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) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:60 /30Days |
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 KS 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) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:60 /30Days |
Oxybutynin Chloride 5mg/5mL 473 mL in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in KS cover Oxybutynin Chloride 5mg/5mL 473 mL in 1 BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Non-Preferred Generic |
$14.00 | $0.00 | None |
OXYBUTYNIN CHLORIDE TABLET ER 15MG (100 CT) ![Compare how all Medicare Part D PDP plans in KS cover OXYBUTYNIN CHLORIDE TABLET ER 15MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:60 /30Days |
OXYCODONE AND ACETAMINOPHEN 325-5MG TABLET USP (500 CT) ![Compare how all Medicare Part D PDP plans in KS cover OXYCODONE AND ACETAMINOPHEN 325-5MG TABLET USP (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:360 /30Days |
OXYCODONE AND ACETAMINOPHEN TABLETS 2.5;325MG;MG 100 BOT ![Compare how all Medicare Part D PDP plans in KS cover OXYCODONE AND ACETAMINOPHEN TABLETS 2.5;325MG;MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:360 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OXYCODONE HCL 100 MG/5 ML SOLN ![Compare how all Medicare Part D PDP plans in KS cover OXYCODONE HCL 100 MG/5 ML SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:270 /30Days |
OXYCODONE HCL 30MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover OXYCODONE HCL 30MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:360 /30Days |
OXYCODONE HCL 5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in KS cover OXYCODONE HCL 5 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:360 /30Days |
OXYCODONE HCL 5 MG/5 ML Solution ![Compare how all Medicare Part D PDP plans in KS cover OXYCODONE HCL 5 MG/5 ML Solution.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:5400 /30Days |
OXYCODONE HCL 5MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover OXYCODONE HCL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:360 /30Days |
OXYCODONE HCL-ACETAMINOPHEN 10MG-325MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover OXYCODONE HCL-ACETAMINOPHEN 10MG-325MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:360 /30Days |
OXYCODONE HYDROCHLORIDE 10mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in KS cover OXYCODONE HYDROCHLORIDE 10mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:360 /30Days |
OXYCODONE HYDROCHLORIDE 20mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in KS cover OXYCODONE HYDROCHLORIDE 20mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:360 /30Days |
Oxycodone Hydrochloride and Aspirin 325; 4.8355mg 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in KS cover Oxycodone Hydrochloride and Aspirin 325; 4.8355mg 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$95.00 | $275.00 | Q:360 /30Days |
OXYCODONE HYDROCHLORIDE TABLETS 15MG 100 TABLETS BOTPL ![Compare how all Medicare Part D PDP plans in KS cover OXYCODONE HYDROCHLORIDE TABLETS 15MG 100 TABLETS BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:360 /30Days |
OXYCODONE-ACETAMINOPHEN 7.5-325MG TABLET ![Compare how all Medicare Part D PDP plans in KS cover OXYCODONE-ACETAMINOPHEN 7.5-325MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:360 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OXYCODONE-IBUPROFEN 5-400 TAB ![Compare how all Medicare Part D PDP plans in KS cover OXYCODONE-IBUPROFEN 5-400 TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$45.00 | $125.00 | Q:240 /30Days |