2017 Medicare Part D Plan Formulary Information |
Peach State Health Plan Medicare Advantage (HMO SNP) (H7173-001-0)
Benefit Details
![Email Prescription and/or Health Benefit details for Peach State Health Plan Medicare Advantage (HMO SNP). This function does not email the formulary drug list.](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
The Peach State Health Plan Medicare Advantage (HMO SNP) (H7173-001-0) Formulary Drugs Starting with the Letter O in White County, GA: CMS MA Region 8 which includes: GA Plan Monthly Premium: $26.40 Deductible: $400 |
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 |
OCALIVA 10 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover OCALIVA 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
OCALIVA 5 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover OCALIVA 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
OCELLA 3MG/0.03MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover OCELLA 3MG/0.03MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$24.00 | N/A | None |
OCTAGAM 10% VIAL ![Compare how all Medicare Part D PDP plans in GA cover OCTAGAM 10% VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
OCTREOTIDE ACETATE 100 mcg/ml amp ![Compare how all Medicare Part D PDP plans in GA cover OCTREOTIDE ACETATE 100 mcg/ml amp.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | None |
OCTREOTIDE ACETATE 200 mcg/ml vl ![Compare how all Medicare Part D PDP plans in GA cover OCTREOTIDE ACETATE 200 mcg/ml vl.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$0.00 | N/A | None |
OCTREOTIDE ACETATE 50 mcg/ml amp ![Compare how all Medicare Part D PDP plans in GA cover OCTREOTIDE ACETATE 50 mcg/ml amp.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$0.00 | N/A | None |
OCUTRICIN EYE OINTMENT 400UNT/3.5MG/10UNT ![Compare how all Medicare Part D PDP plans in GA cover OCUTRICIN EYE OINTMENT 400UNT/3.5MG/10UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$24.00 | N/A | None |
ODEFSEY TABLET ![Compare how all Medicare Part D PDP plans in GA cover ODEFSEY TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ODOMZO 200 MG CAPSULE ![Compare how all Medicare Part D PDP plans in GA cover ODOMZO 200 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OFEV 100 MG CAPSULE ![Compare how all Medicare Part D PDP plans in GA cover OFEV 100 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
OFEV 150 MG CAPSULE ![Compare how all Medicare Part D PDP plans in GA cover OFEV 150 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
OFLOXACIN 0.3 % DRP ![Compare how all Medicare Part D PDP plans in GA cover OFLOXACIN 0.3 % DRP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$14.00 | N/A | None |
OFLOXACIN 0.3% EAR DROPS ![Compare how all Medicare Part D PDP plans in GA cover OFLOXACIN 0.3% EAR DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | None |
OLANZAPINE 10 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in GA cover OLANZAPINE 10 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$14.00 | N/A | None |
OLANZAPINE 10 MG VIAL [Zyprexa] ![Compare how all Medicare Part D PDP plans in GA cover OLANZAPINE 10 MG VIAL [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | None |
OLANZAPINE 15 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in GA cover OLANZAPINE 15 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$14.00 | N/A | None |
OLANZAPINE 2.5 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in GA cover OLANZAPINE 2.5 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$14.00 | N/A | None |
OLANZAPINE 20 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in GA cover OLANZAPINE 20 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$14.00 | N/A | None |
OLANZAPINE 5 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in GA cover OLANZAPINE 5 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$14.00 | N/A | None |
OLANZAPINE 7.5 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in GA cover OLANZAPINE 7.5 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$14.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OLANZAPINE ODT 10 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in GA cover OLANZAPINE ODT 10 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | None |
OLANZAPINE ODT 15 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in GA cover OLANZAPINE ODT 15 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | None |
OLANZAPINE ODT 20 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in GA cover OLANZAPINE ODT 20 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | None |
OLANZAPINE ODT 5 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in GA cover OLANZAPINE ODT 5 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | None |
OLANZAPINE-FLUOXETINE 12-25 MG ![Compare how all Medicare Part D PDP plans in GA cover OLANZAPINE-FLUOXETINE 12-25 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | None |
OLANZAPINE-FLUOXETINE 12-50 MG ![Compare how all Medicare Part D PDP plans in GA cover OLANZAPINE-FLUOXETINE 12-50 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | None |
olanzapine-fluoxetine 3-25 mg ![Compare how all Medicare Part D PDP plans in GA cover olanzapine-fluoxetine 3-25 mg.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | None |
OLANZAPINE-FLUOXETINE 6-25 MG ![Compare how all Medicare Part D PDP plans in GA cover OLANZAPINE-FLUOXETINE 6-25 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | None |
OLANZAPINE-FLUOXETINE 6-50 MG ![Compare how all Medicare Part D PDP plans in GA cover OLANZAPINE-FLUOXETINE 6-50 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | None |
OLMESARTAN MEDOXOMIL 20 MG TAB [Benicar] ![Compare how all Medicare Part D PDP plans in GA cover OLMESARTAN MEDOXOMIL 20 MG TAB [Benicar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$14.00 | N/A | None |
OLMESARTAN MEDOXOMIL 40 MG TAB [Benicar] ![Compare how all Medicare Part D PDP plans in GA cover OLMESARTAN MEDOXOMIL 40 MG TAB [Benicar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$14.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OLMESARTAN MEDOXOMIL 5 MG TAB [Benicar] ![Compare how all Medicare Part D PDP plans in GA cover OLMESARTAN MEDOXOMIL 5 MG TAB [Benicar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$14.00 | N/A | None |
OLMESARTAN-HCTZ 20-12.5 MG TAB ![Compare how all Medicare Part D PDP plans in GA cover OLMESARTAN-HCTZ 20-12.5 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$14.00 | N/A | None |
OLMESARTAN-HCTZ 40-12.5 MG TAB ![Compare how all Medicare Part D PDP plans in GA cover OLMESARTAN-HCTZ 40-12.5 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$14.00 | N/A | None |
OLMESARTAN-HCTZ 40-25 MG TAB ![Compare how all Medicare Part D PDP plans in GA cover OLMESARTAN-HCTZ 40-25 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$14.00 | N/A | None |
olmsrtn-amldpn-hctz 20-5-12.5 [TRIBENZOR] ![Compare how all Medicare Part D PDP plans in GA cover olmsrtn-amldpn-hctz 20-5-12.5 [TRIBENZOR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$14.00 | N/A | None |
olmsrtn-amldpn-hctz 40-10-12.5 [TRIBENZOR] ![Compare how all Medicare Part D PDP plans in GA cover olmsrtn-amldpn-hctz 40-10-12.5 [TRIBENZOR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$14.00 | N/A | None |
olmsrtn-amldpn-hctz 40-10-25mg [TRIBENZOR] ![Compare how all Medicare Part D PDP plans in GA cover olmsrtn-amldpn-hctz 40-10-25mg [TRIBENZOR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$14.00 | N/A | None |
olmsrtn-amldpn-hctz 40-5-12.5 [TRIBENZOR] ![Compare how all Medicare Part D PDP plans in GA cover olmsrtn-amldpn-hctz 40-5-12.5 [TRIBENZOR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$14.00 | N/A | None |
olmsrtn-amldpn-hctz 40-5-25 mg [TRIBENZOR] ![Compare how all Medicare Part D PDP plans in GA cover olmsrtn-amldpn-hctz 40-5-25 mg [TRIBENZOR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$14.00 | N/A | None |
Olopatadine 2 MG/ML Ophthalmic Solution ![Compare how all Medicare Part D PDP plans in GA cover Olopatadine 2 MG/ML Ophthalmic Solution.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$14.00 | N/A | None |
OLOPATADINE 665 MCG NASAL SPRY ![Compare how all Medicare Part D PDP plans in GA cover OLOPATADINE 665 MCG NASAL SPRY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OLOPATADINE HCL 0.1% EYE DROPS ![Compare how all Medicare Part D PDP plans in GA cover OLOPATADINE HCL 0.1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$14.00 | N/A | None |
OLYSIO 150 MG CAPSULE ![Compare how all Medicare Part D PDP plans in GA cover OLYSIO 150 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
OMEGA-3 ETHYL ESTERS 1 GM CAPSULE [Lovaza] ![Compare how all Medicare Part D PDP plans in GA cover OMEGA-3 ETHYL ESTERS 1 GM CAPSULE [Lovaza].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | None |
OMEPRAZOLE 10MG CAPSULE DELAYED RELEASE (30 CT) ![Compare how all Medicare Part D PDP plans in GA cover OMEPRAZOLE 10MG CAPSULE DELAYED RELEASE (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$0.00 | N/A | None |
Omeprazole 20mg DELAYED RELEASE 100 CAPSULE BOTTLE ![Compare how all Medicare Part D PDP plans in GA cover Omeprazole 20mg DELAYED RELEASE 100 CAPSULE BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$0.00 | N/A | None |
OMEPRAZOLE CAPSULES DELAYED RELEASE 40 MG ![Compare how all Medicare Part D PDP plans in GA cover OMEPRAZOLE CAPSULES DELAYED RELEASE 40 MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$0.00 | N/A | None |
OMEPRAZOLE-BICARB 20-1,100 CAP ![Compare how all Medicare Part D PDP plans in GA cover OMEPRAZOLE-BICARB 20-1,100 CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$14.00 | N/A | None |
Omeprazole-bicarb 20-1,680 pkt ![Compare how all Medicare Part D PDP plans in GA cover Omeprazole-bicarb 20-1,680 pkt.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$14.00 | N/A | S |
OMEPRAZOLE-BICARB 40-1,100 CAP ![Compare how all Medicare Part D PDP plans in GA cover OMEPRAZOLE-BICARB 40-1,100 CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | None |
Omeprazole-bicarb 40-1,680 pkt ![Compare how all Medicare Part D PDP plans in GA cover Omeprazole-bicarb 40-1,680 pkt.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$14.00 | N/A | None |
OMNARIS 50MCG SPRAY NON-AEROSOL ![Compare how all Medicare Part D PDP plans in GA cover OMNARIS 50MCG SPRAY NON-AEROSOL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OMNITROPE INJECTION 10MG/1.5ML 10MG X 1.5ML CTG ![Compare how all Medicare Part D PDP plans in GA 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% | N/A | P |
OMNITROPE INJECTION 5MG/1.5ML 1.5 ML CTG ![Compare how all Medicare Part D PDP plans in GA 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% | 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 GA 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) |
4 |
Non-Preferred Brand |
$75.00 | N/A | None |
ONDANSETRON 4 MG/2 ML ISECURE ![Compare how all Medicare Part D PDP plans in GA cover ONDANSETRON 4 MG/2 ML ISECURE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | None |
ONDANSETRON HCL 24 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover ONDANSETRON HCL 24 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$24.00 | N/A | P |
ONDANSETRON HCL 4 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover ONDANSETRON HCL 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$24.00 | N/A | P |
ONDANSETRON HCL 4MG/5ML SOLUTION ORAL ![Compare how all Medicare Part D PDP plans in GA cover ONDANSETRON HCL 4MG/5ML SOLUTION ORAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | P |
ONDANSETRON HCL 8 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover ONDANSETRON HCL 8 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$24.00 | N/A | P |
ONDANSETRON ODT 4MG TABLET (30 CT) ![Compare how all Medicare Part D PDP plans in GA cover ONDANSETRON ODT 4MG TABLET (30 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$14.00 | N/A | P |
ONDANSETRON ODT 8MG (10 CT) ![Compare how all Medicare Part D PDP plans in GA cover ONDANSETRON ODT 8MG (10 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$14.00 | N/A | P |
ONFI 10 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover ONFI 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ONFI 2.5 MG/ML SUSPENSION ![Compare how all Medicare Part D PDP plans in GA cover ONFI 2.5 MG/ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | None |
ONFI 20 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover ONFI 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ONGLYZA 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover ONGLYZA 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | P Q:2 /1Days |
ONGLYZA 5 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover ONGLYZA 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | P Q:1 /1Days |
ONMEL 200 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover ONMEL 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | None |
OPANA ER 40 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover OPANA ER 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | Q:2 /1Days |
OPDIVO 40 MG/4 ML VIAL ![Compare how all Medicare Part D PDP plans in GA cover OPDIVO 40 MG/4 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
OPSUMIT 10 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover OPSUMIT 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ORACEA CAPSULES 40MG 30 BOT ![Compare how all Medicare Part D PDP plans in GA cover ORACEA CAPSULES 40MG 30 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | None |
ORALAIR 300 IR SUBLINGUAL TAB ![Compare how all Medicare Part D PDP plans in GA cover ORALAIR 300 IR SUBLINGUAL TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | P |
ORAPRED ODT 10 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover ORAPRED ODT 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ORBACTIV 400 MG VIAL ![Compare how all Medicare Part D PDP plans in GA cover ORBACTIV 400 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
ORENCIA 125 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in GA cover ORENCIA 125 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
ORENCIA 250MG VIAL ![Compare how all Medicare Part D PDP plans in GA cover ORENCIA 250MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
Orencia 4 SYRINGE, GLASS in 1 CARTON > 0.4 mL in 1 SYRINGE, GLASS ![Compare how all Medicare Part D PDP plans in GA cover Orencia 4 SYRINGE, GLASS in 1 CARTON > 0.4 mL in 1 SYRINGE, GLASS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
Orencia 4 SYRINGE, GLASS in 1 CARTON > 0.7 mL in 1 SYRINGE, GLASS ![Compare how all Medicare Part D PDP plans in GA cover Orencia 4 SYRINGE, GLASS in 1 CARTON > 0.7 mL in 1 SYRINGE, GLASS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
ORENCIA CLICKJECT 125 MG/ML ![Compare how all Medicare Part D PDP plans in GA cover ORENCIA CLICKJECT 125 MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
Orenitram 100 TABLET, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in GA cover Orenitram 100 TABLET, EXTENDED RELEASE in 1 BOTTLE .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
ORENITRAM ER 0.125 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover ORENITRAM ER 0.125 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | P |
ORENITRAM ER 0.25 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover ORENITRAM ER 0.25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
ORENITRAM ER 1 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover ORENITRAM ER 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
ORENITRAM ER 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover ORENITRAM ER 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ORFADIN 10 MG CAPSULE ![Compare how all Medicare Part D PDP plans in GA cover ORFADIN 10 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$24.00 | N/A | None |
ORFADIN 2 MG CAPSULE ![Compare how all Medicare Part D PDP plans in GA cover ORFADIN 2 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$24.00 | N/A | None |
ORFADIN 5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in GA cover ORFADIN 5 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$24.00 | N/A | None |
ORKAMBI 100 MG-125 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover ORKAMBI 100 MG-125 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
ORKAMBI 200 MG-125 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover ORKAMBI 200 MG-125 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
Orphenadrine 30 mg/ml vial ![Compare how all Medicare Part D PDP plans in GA cover Orphenadrine 30 mg/ml vial.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$14.00 | N/A | P |
Orphenadrine Citrate 100mg/1 500 TABLET, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in GA 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 |
$24.00 | N/A | P |
Orsythia 6 BLISTER PACK per CARTON / 1 KIT per BLISTER PACK ![Compare how all Medicare Part D PDP plans in GA cover Orsythia 6 BLISTER PACK per CARTON / 1 KIT per BLISTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$14.00 | N/A | None |
OSELTAMIVIR PHOS 30 MG CAPSULE [Tamiflu] ![Compare how all Medicare Part D PDP plans in GA cover OSELTAMIVIR PHOS 30 MG CAPSULE [Tamiflu].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$14.00 | N/A | None |
OSELTAMIVIR PHOS 45 MG CAPSULE [Tamiflu] ![Compare how all Medicare Part D PDP plans in GA cover OSELTAMIVIR PHOS 45 MG CAPSULE [Tamiflu].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$14.00 | N/A | None |
OSELTAMIVIR PHOS 75 MG CAPSULE [Tamiflu] ![Compare how all Medicare Part D PDP plans in GA cover OSELTAMIVIR PHOS 75 MG CAPSULE [Tamiflu].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$14.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OSENI 12.5-15 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover OSENI 12.5-15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | P |
OSENI 12.5-30 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover OSENI 12.5-30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | P |
OSENI 12.5-45 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover OSENI 12.5-45 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | P |
OSENI 25-15 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover OSENI 25-15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | P |
OSENI 25-30 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover OSENI 25-30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | P |
OSENI 25-45 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover OSENI 25-45 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | P |
OSMOPREP TABLET 1.5GM ![Compare how all Medicare Part D PDP plans in GA cover OSMOPREP TABLET 1.5GM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | None |
OTEZLA 28 DAY STARTER PACK ![Compare how all Medicare Part D PDP plans in GA cover OTEZLA 28 DAY STARTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
OTEZLA 30 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover OTEZLA 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | P |
OTREXUP 10 MG/0.4 ML AUTO-INJ ![Compare how all Medicare Part D PDP plans in GA cover OTREXUP 10 MG/0.4 ML AUTO-INJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | P |
OTREXUP 12.5 MG/0.4 ML AUTOINJ ![Compare how all Medicare Part D PDP plans in GA cover OTREXUP 12.5 MG/0.4 ML AUTOINJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OTREXUP 15 MG/0.4 ML AUTO-INJ ![Compare how all Medicare Part D PDP plans in GA cover OTREXUP 15 MG/0.4 ML AUTO-INJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | P |
OTREXUP 17.5 MG/0.4 ML AUTOINJ ![Compare how all Medicare Part D PDP plans in GA cover OTREXUP 17.5 MG/0.4 ML AUTOINJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | P |
OTREXUP 20 MG/0.4 ML AUTO-INJ ![Compare how all Medicare Part D PDP plans in GA cover OTREXUP 20 MG/0.4 ML AUTO-INJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | P |
OTREXUP 22.5 MG/0.4 ML AUTOINJ ![Compare how all Medicare Part D PDP plans in GA cover OTREXUP 22.5 MG/0.4 ML AUTOINJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | P |
OTREXUP 25 MG/0.4 ML AUTO-INJ ![Compare how all Medicare Part D PDP plans in GA cover OTREXUP 25 MG/0.4 ML AUTO-INJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | P |
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 GA 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) |
1* |
Preferred Generic |
$0.00 | N/A | None |
OVIDE 0.5% LOTION ![Compare how all Medicare Part D PDP plans in GA cover OVIDE 0.5% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$24.00 | N/A | None |
OXALIPLATIN 5 MG/ML INJECTABLE SOLUTION ![Compare how all Medicare Part D PDP plans in GA cover OXALIPLATIN 5 MG/ML INJECTABLE SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$14.00 | N/A | None |
oxandrolone 10mg/1 60 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in GA cover oxandrolone 10mg/1 60 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
OXANDROLONE 2.5MG TABLETS ![Compare how all Medicare Part D PDP plans in GA cover OXANDROLONE 2.5MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$14.00 | N/A | None |
OXAPROZIN 600MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover OXAPROZIN 600MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
oxazepam 10 mg capsule ![Compare how all Medicare Part D PDP plans in GA cover oxazepam 10 mg capsule.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$24.00 | N/A | None |
Oxazepam 15mg/1 ![Compare how all Medicare Part D PDP plans in GA cover Oxazepam 15mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$24.00 | N/A | None |
oxazepam 30 mg capsule ![Compare how all Medicare Part D PDP plans in GA cover oxazepam 30 mg capsule.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$24.00 | N/A | None |
OXCARBAZEPINE 150MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover OXCARBAZEPINE 150MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$24.00 | N/A | None |
OXCARBAZEPINE 300 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in GA cover OXCARBAZEPINE 300 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$24.00 | N/A | None |
OXCARBAZEPINE 300MG TABLET 500 NCRC BOT ![Compare how all Medicare Part D PDP plans in GA cover OXCARBAZEPINE 300MG TABLET 500 NCRC BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$24.00 | N/A | None |
OXCARBAZEPINE 600MG TABLET 500 NCRC BOT ![Compare how all Medicare Part D PDP plans in GA cover OXCARBAZEPINE 600MG TABLET 500 NCRC BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$24.00 | N/A | None |
OXICONAZOLE NITRATE 1% CREAM [Oxistat] ![Compare how all Medicare Part D PDP plans in GA cover OXICONAZOLE NITRATE 1% CREAM [Oxistat].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$14.00 | N/A | None |
OXISTAT 1% CREAM ![Compare how all Medicare Part D PDP plans in GA cover OXISTAT 1% CREAM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | None |
OXISTAT 1% LOTION ![Compare how all Medicare Part D PDP plans in GA cover OXISTAT 1% LOTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | None |
OXSORALEN-ULTRA 10MG CAP ![Compare how all Medicare Part D PDP plans in GA cover OXSORALEN-ULTRA 10MG CAP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
25% | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OXYBUTYNIN 5 MG/5 ML SYRUP ![Compare how all Medicare Part D PDP plans in GA cover OXYBUTYNIN 5 MG/5 ML SYRUP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$14.00 | N/A | None |
OXYBUTYNIN 5MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover OXYBUTYNIN 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$24.00 | N/A | 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 GA 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 |
$24.00 | N/A | 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 GA 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 |
$24.00 | N/A | None |
OXYBUTYNIN CHLORIDE TABLET ER 15MG (100 CT) ![Compare how all Medicare Part D PDP plans in GA cover OXYBUTYNIN CHLORIDE TABLET ER 15MG (100 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$24.00 | N/A | None |
OXYCODONE AND ACETAMINOPHEN 325-5MG TABLET USP (500 CT) ![Compare how all Medicare Part D PDP plans in GA cover OXYCODONE AND ACETAMINOPHEN 325-5MG TABLET USP (500 CT).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$14.00 | N/A | None |
OXYCODONE AND ACETAMINOPHEN TABLETS 2.5;325MG;MG 100 BOT ![Compare how all Medicare Part D PDP plans in GA cover OXYCODONE AND ACETAMINOPHEN TABLETS 2.5;325MG;MG 100 BOT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$14.00 | N/A | None |
OXYCODONE HCL 100 MG/5 ML SOLN ![Compare how all Medicare Part D PDP plans in GA cover OXYCODONE HCL 100 MG/5 ML SOLN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | Q:7 /1Days |
OXYCODONE HCL 30MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover OXYCODONE HCL 30MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$24.00 | N/A | Q:4 /1Days |
OXYCODONE HCL 5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in GA cover OXYCODONE HCL 5 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | Q:27 /1Days |
OXYCODONE HCL 5MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover OXYCODONE HCL 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$24.00 | N/A | Q:27 /1Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OXYCODONE HCL ER 10 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover OXYCODONE HCL ER 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$24.00 | N/A | Q:13 /1Days |
OXYCODONE HCL ER 15 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover OXYCODONE HCL ER 15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$24.00 | N/A | Q:9 /1Days |
OXYCODONE HCL ER 20 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover OXYCODONE HCL ER 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$24.00 | N/A | Q:7 /1Days |
OXYCODONE HCL ER 30 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover OXYCODONE HCL ER 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$24.00 | N/A | Q:4 /1Days |
OXYCODONE HCL ER 40 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover OXYCODONE HCL ER 40 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$24.00 | N/A | Q:2 /1Days |
OXYCODONE HCL ER 60 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover OXYCODONE HCL ER 60 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$24.00 | N/A | Q:2 /1Days |
OXYCODONE HCL ER 80 MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover OXYCODONE HCL ER 80 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$24.00 | N/A | Q:2 /1Days |
OXYCODONE HCL-ACETAMINOPHEN 10MG-325MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover OXYCODONE HCL-ACETAMINOPHEN 10MG-325MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$24.00 | N/A | None |
OXYCODONE HYDROCHLORIDE 10mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in GA cover OXYCODONE HYDROCHLORIDE 10mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$24.00 | N/A | Q:11 /1Days |
OXYCODONE HYDROCHLORIDE 20mg/1 100 TABLET BOTTLE ![Compare how all Medicare Part D PDP plans in GA cover OXYCODONE HYDROCHLORIDE 20mg/1 100 TABLET BOTTLE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$24.00 | N/A | Q:7 /1Days |
OXYCODONE HYDROCHLORIDE TABLETS 15MG 100 TABLETS BOTPL ![Compare how all Medicare Part D PDP plans in GA cover OXYCODONE HYDROCHLORIDE TABLETS 15MG 100 TABLETS BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$24.00 | N/A | Q:9 /1Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Oxycodone-Acetaminophen 5-325/5 ![Compare how all Medicare Part D PDP plans in GA cover Oxycodone-Acetaminophen 5-325/5.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$14.00 | N/A | None |
OXYCODONE-ACETAMINOPHEN 7.5-325MG TABLET ![Compare how all Medicare Part D PDP plans in GA cover OXYCODONE-ACETAMINOPHEN 7.5-325MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$14.00 | N/A | None |
OXYCODONE-ASPIRIN 4.8355-325 ![Compare how all Medicare Part D PDP plans in GA cover OXYCODONE-ASPIRIN 4.8355-325.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$24.00 | N/A | None |
OxyContin 10mg/1 ![Compare how all Medicare Part D PDP plans in GA cover OxyContin 10mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$24.00 | N/A | Q:13 /1Days |
OxyContin 15mg/1 ![Compare how all Medicare Part D PDP plans in GA cover OxyContin 15mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$24.00 | N/A | Q:9 /1Days |
OxyContin 20mg/1 ![Compare how all Medicare Part D PDP plans in GA cover OxyContin 20mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$24.00 | N/A | Q:7 /1Days |
OxyContin 30mg/1 ![Compare how all Medicare Part D PDP plans in GA cover OxyContin 30mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$24.00 | N/A | Q:4 /1Days |
OxyContin 40mg/1 ![Compare how all Medicare Part D PDP plans in GA cover OxyContin 40mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$24.00 | N/A | Q:2 /1Days |
OxyContin 60mg/1 ![Compare how all Medicare Part D PDP plans in GA cover OxyContin 60mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$24.00 | N/A | Q:2 /1Days |
OxyContin 80mg/1 ![Compare how all Medicare Part D PDP plans in GA cover OxyContin 80mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$24.00 | N/A | Q:2 /1Days |
oxymorphone hcl er 10 mg tab ![Compare how all Medicare Part D PDP plans in GA cover oxymorphone hcl er 10 mg tab.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | Q:6 /1Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OXYMORPHONE HCL ER 15 MG TAB ![Compare how all Medicare Part D PDP plans in GA cover OXYMORPHONE HCL ER 15 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | Q:4 /1Days |
oxymorphone hcl er 20 mg tab ![Compare how all Medicare Part D PDP plans in GA cover oxymorphone hcl er 20 mg tab.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | Q:3 /1Days |
oxymorphone hcl er 30 mg tab ![Compare how all Medicare Part D PDP plans in GA cover oxymorphone hcl er 30 mg tab.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | Q:2 /1Days |
oxymorphone hcl er 40 mg tab ![Compare how all Medicare Part D PDP plans in GA cover oxymorphone hcl er 40 mg tab.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | Q:2 /1Days |
oxymorphone hcl er 5 mg tablet ![Compare how all Medicare Part D PDP plans in GA cover oxymorphone hcl er 5 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | Q:13 /1Days |
OXYMORPHONE HCL ER 7.5 MG TAB ![Compare how all Medicare Part D PDP plans in GA cover OXYMORPHONE HCL ER 7.5 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | Q:9 /1Days |
OXYMORPHONE HYDROCHLORIDE 10MG TABLETS ![Compare how all Medicare Part D PDP plans in GA cover OXYMORPHONE HYDROCHLORIDE 10MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | Q:7 /1Days |
OXYMORPHONE HYDROCHLORIDE 5MG TABLETS ![Compare how all Medicare Part D PDP plans in GA cover OXYMORPHONE HYDROCHLORIDE 5MG TABLETS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Brand |
$75.00 | N/A | Q:13 /1Days |
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 GA 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) |
4 |
Non-Preferred Brand |
$75.00 | N/A | None |