2018 Medicare Part D Plan Formulary Information |
SCAN Classic (HMO) (H5425-046-0)
Benefit Details
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The SCAN Classic (HMO) (H5425-046-0) Formulary Drugs Starting with the Letter O in Marin County, CA: CMS MA Region 24 which includes: CA Plan Monthly Premium: $80.00 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 |
OCTREOTIDE 1,000 MCG/ML VIAL ![Compare how all Medicare Part D PDP plans in CA cover OCTREOTIDE 1,000 MCG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
OCTREOTIDE ACET 0.05 MG/ML VL ![Compare how all Medicare Part D PDP plans in CA cover OCTREOTIDE ACET 0.05 MG/ML VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
OCTREOTIDE ACET 100 MCG/ML VL ![Compare how all Medicare Part D PDP plans in CA cover OCTREOTIDE ACET 100 MCG/ML VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
OCTREOTIDE ACET 200 MCG/ML VL ![Compare how all Medicare Part D PDP plans in CA cover OCTREOTIDE ACET 200 MCG/ML VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
OCTREOTIDE ACET 500 MCG/ML VL ![Compare how all Medicare Part D PDP plans in CA cover OCTREOTIDE ACET 500 MCG/ML VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
OCUTRICIN EYE OINTMENT 400UNT/3.5MG/10UNT ![Compare how all Medicare Part D PDP plans in CA cover OCUTRICIN EYE OINTMENT 400UNT/3.5MG/10UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
ODEFSEY TABLET ![Compare how all Medicare Part D PDP plans in CA cover ODEFSEY TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | None |
ODOMZO 200 MG CAPSULE ![Compare how all Medicare Part D PDP plans in CA cover ODOMZO 200 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
OFEV 100 MG CAPSULE ![Compare how all Medicare Part D PDP plans in CA cover OFEV 100 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
OFEV 150 MG CAPSULE ![Compare how all Medicare Part D PDP plans in CA cover OFEV 150 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OFLOXACIN 0.3 % DRP ![Compare how all Medicare Part D PDP plans in CA cover OFLOXACIN 0.3 % DRP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
OFLOXACIN 0.3% EAR DROPS ![Compare how all Medicare Part D PDP plans in CA cover OFLOXACIN 0.3% EAR DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
OFLOXACIN 300 MG TABLET ![Compare how all Medicare Part D PDP plans in CA cover OFLOXACIN 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
OFLOXACIN 400 MG TABLET ![Compare how all Medicare Part D PDP plans in CA cover OFLOXACIN 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
OLANZAPINE 10 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in CA cover OLANZAPINE 10 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
OLANZAPINE 10 MG VIAL ![Compare how all Medicare Part D PDP plans in CA cover OLANZAPINE 10 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
OLANZAPINE 15 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in CA cover OLANZAPINE 15 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
OLANZAPINE 2.5 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in CA cover OLANZAPINE 2.5 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
OLANZAPINE 20 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in CA cover OLANZAPINE 20 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
OLANZAPINE 5 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in CA cover OLANZAPINE 5 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
OLANZAPINE 7.5 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in CA cover OLANZAPINE 7.5 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | 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 RAPDIS [Zyprexa Zydis] ![Compare how all Medicare Part D PDP plans in CA cover OLANZAPINE ODT 10 MG TABLET RAPDIS [Zyprexa Zydis].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
OLANZAPINE ODT 15 MG TABLET RAPDIS [Zyprexa Zydis] ![Compare how all Medicare Part D PDP plans in CA cover OLANZAPINE ODT 15 MG TABLET RAPDIS [Zyprexa Zydis].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
OLANZAPINE ODT 20 MG TABLET RAPDIS [Zyprexa Zydis] ![Compare how all Medicare Part D PDP plans in CA cover OLANZAPINE ODT 20 MG TABLET RAPDIS [Zyprexa Zydis].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
OLANZAPINE ODT 5 MG TABLET RAPDIS [Zyprexa Zydis] ![Compare how all Medicare Part D PDP plans in CA cover OLANZAPINE ODT 5 MG TABLET RAPDIS [Zyprexa Zydis].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
OLMESARTAN MEDOXOMIL 20 MG TAB [Benicar] ![Compare how all Medicare Part D PDP plans in CA cover OLMESARTAN MEDOXOMIL 20 MG TAB [Benicar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
OLMESARTAN MEDOXOMIL 40 MG TAB [Benicar] ![Compare how all Medicare Part D PDP plans in CA cover OLMESARTAN MEDOXOMIL 40 MG TAB [Benicar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
OLMESARTAN MEDOXOMIL 5 MG TAB [Benicar] ![Compare how all Medicare Part D PDP plans in CA cover OLMESARTAN MEDOXOMIL 5 MG TAB [Benicar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
OLMESARTAN-HCTZ 20-12.5 MG TAB ![Compare how all Medicare Part D PDP plans in CA cover OLMESARTAN-HCTZ 20-12.5 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
OLMESARTAN-HCTZ 40-12.5 MG TAB ![Compare how all Medicare Part D PDP plans in CA cover OLMESARTAN-HCTZ 40-12.5 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
OLMESARTAN-HCTZ 40-25 MG TAB ![Compare how all Medicare Part D PDP plans in CA cover OLMESARTAN-HCTZ 40-25 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
Olopatadine 2 MG/ML Ophthalmic Solution ![Compare how all Medicare Part D PDP plans in CA cover Olopatadine 2 MG/ML Ophthalmic Solution.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | 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 CA cover OLOPATADINE HCL 0.1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | Q:15 /30Days |
OMEGA-3 ETHYL ESTERS 1 GM CAP [Lovaza] ![Compare how all Medicare Part D PDP plans in CA cover OMEGA-3 ETHYL ESTERS 1 GM CAP [Lovaza].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | None |
OMEPRAZOLE DR 10 MG CAPSULE DR [Prilosec] ![Compare how all Medicare Part D PDP plans in CA cover OMEPRAZOLE DR 10 MG CAPSULE DR [Prilosec].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
OMEPRAZOLE DR 20 MG CAPSULE DR [Prilosec] ![Compare how all Medicare Part D PDP plans in CA cover OMEPRAZOLE DR 20 MG CAPSULE DR [Prilosec].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
OMEPRAZOLE DR 40 MG CAPSULE DR [Prilosec] ![Compare how all Medicare Part D PDP plans in CA cover OMEPRAZOLE DR 40 MG CAPSULE DR [Prilosec].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
ONDANSETRON 4 MG/2 ML ISECURE ![Compare how all Medicare Part D PDP plans in CA cover ONDANSETRON 4 MG/2 ML ISECURE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
ONDANSETRON 4 MG/5 ML SOLUTION ![Compare how all Medicare Part D PDP plans in CA cover ONDANSETRON 4 MG/5 ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | P |
ONDANSETRON HCL 24 MG TABLET ![Compare how all Medicare Part D PDP plans in CA cover ONDANSETRON HCL 24 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | P |
ONDANSETRON HCL 4 MG TABLET ![Compare how all Medicare Part D PDP plans in CA cover ONDANSETRON HCL 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | P |
ONDANSETRON HCL 4 MG/2 ML VIAL ![Compare how all Medicare Part D PDP plans in CA cover ONDANSETRON HCL 4 MG/2 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
ONDANSETRON HCL 8 MG TABLET ![Compare how all Medicare Part D PDP plans in CA cover ONDANSETRON HCL 8 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ONDANSETRON ODT 4 MG TABLET ![Compare how all Medicare Part D PDP plans in CA cover ONDANSETRON ODT 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | P |
ONDANSETRON ODT 8 MG TABLET ![Compare how all Medicare Part D PDP plans in CA cover ONDANSETRON ODT 8 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | P |
ONFI 10 MG TABLET ![Compare how all Medicare Part D PDP plans in CA cover ONFI 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$80.00 | N/A | None |
ONFI 2.5 MG/ML SUSPENSION ![Compare how all Medicare Part D PDP plans in CA cover ONFI 2.5 MG/ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$80.00 | N/A | None |
ONFI 20 MG TABLET ![Compare how all Medicare Part D PDP plans in CA cover ONFI 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$80.00 | N/A | None |
ONGLYZA 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in CA cover ONGLYZA 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | None |
ONGLYZA 5 MG TABLET ![Compare how all Medicare Part D PDP plans in CA cover ONGLYZA 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | None |
OPSUMIT 10 MG TABLET ![Compare how all Medicare Part D PDP plans in CA cover OPSUMIT 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
ORAVIG 50 MG BUCCAL TABLET ![Compare how all Medicare Part D PDP plans in CA cover ORAVIG 50 MG BUCCAL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$80.00 | N/A | None |
ORENCIA 125 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in CA cover ORENCIA 125 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 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 CA 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 |
33% | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Orencia 4 SYRINGE, GLASS in 1 CARTON > 0.7 mL in 1 SYRINGE, GLASS ![Compare how all Medicare Part D PDP plans in CA 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 |
33% | N/A | P |
ORENCIA CLICKJECT 125 MG/ML ![Compare how all Medicare Part D PDP plans in CA cover ORENCIA CLICKJECT 125 MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
ORFADIN 10 MG CAPSULE ![Compare how all Medicare Part D PDP plans in CA cover ORFADIN 10 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
ORFADIN 2 MG CAPSULE ![Compare how all Medicare Part D PDP plans in CA cover ORFADIN 2 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
ORFADIN 20 MG CAPSULE ![Compare how all Medicare Part D PDP plans in CA cover ORFADIN 20 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
ORFADIN 4 MG/ML SUSPENSION ![Compare how all Medicare Part D PDP plans in CA cover ORFADIN 4 MG/ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
ORFADIN 5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in CA cover ORFADIN 5 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
ORKAMBI 100 MG-125 MG TABLET ![Compare how all Medicare Part D PDP plans in CA cover ORKAMBI 100 MG-125 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
ORKAMBI 200 MG-125 MG TABLET ![Compare how all Medicare Part D PDP plans in CA cover ORKAMBI 200 MG-125 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
Orsythia 6 BLISTER PACK per CARTON / 1 KIT per BLISTER PACK ![Compare how all Medicare Part D PDP plans in CA 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 |
$2.00 | N/A | None |
OSELTAMIVIR 6 MG/ML SUSPENSION [Tamiflu] ![Compare how all Medicare Part D PDP plans in CA cover OSELTAMIVIR 6 MG/ML SUSPENSION [Tamiflu].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OSELTAMIVIR PHOS 30 MG CAPSULE [Tamiflu] ![Compare how all Medicare Part D PDP plans in CA cover OSELTAMIVIR PHOS 30 MG CAPSULE [Tamiflu].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
OSELTAMIVIR PHOS 45 MG CAPSULE [Tamiflu] ![Compare how all Medicare Part D PDP plans in CA cover OSELTAMIVIR PHOS 45 MG CAPSULE [Tamiflu].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
OSELTAMIVIR PHOS 75 MG CAPSULE [Tamiflu] ![Compare how all Medicare Part D PDP plans in CA cover OSELTAMIVIR PHOS 75 MG CAPSULE [Tamiflu].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
OSMOPREP TABLET 1.5GM ![Compare how all Medicare Part D PDP plans in CA cover OSMOPREP TABLET 1.5GM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | None |
OTEZLA 28 DAY STARTER PACK ![Compare how all Medicare Part D PDP plans in CA cover OTEZLA 28 DAY STARTER PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
OTEZLA 30 MG TABLET ![Compare how all Medicare Part D PDP plans in CA cover OTEZLA 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | N/A | P |
OXANDROLONE 10 MG TABLET ![Compare how all Medicare Part D PDP plans in CA cover OXANDROLONE 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$80.00 | N/A | None |
OXANDROLONE 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in CA cover OXANDROLONE 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$80.00 | N/A | None |
OXAZEPAM 10 MG CAPSULE ![Compare how all Medicare Part D PDP plans in CA cover OXAZEPAM 10 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | P |
OXAZEPAM 15 MG CAPSULE ![Compare how all Medicare Part D PDP plans in CA cover OXAZEPAM 15 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | P |
OXAZEPAM 30 MG CAPSULE ![Compare how all Medicare Part D PDP plans in CA cover OXAZEPAM 30 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OXCARBAZEPINE 150 MG TABLET ![Compare how all Medicare Part D PDP plans in CA cover OXCARBAZEPINE 150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
OXCARBAZEPINE 300 MG TABLET ![Compare how all Medicare Part D PDP plans in CA cover OXCARBAZEPINE 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
OXCARBAZEPINE 300 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in CA cover OXCARBAZEPINE 300 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
OXCARBAZEPINE 600 MG TABLET ![Compare how all Medicare Part D PDP plans in CA cover OXCARBAZEPINE 600 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
OXYBUTYNIN 5 MG/5 ML SYRUP ![Compare how all Medicare Part D PDP plans in CA cover OXYBUTYNIN 5 MG/5 ML SYRUP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
OXYBUTYNIN 5MG TABLET ![Compare how all Medicare Part D PDP plans in CA cover OXYBUTYNIN 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
OXYBUTYNIN CL ER 10 MG TABLET ![Compare how all Medicare Part D PDP plans in CA cover OXYBUTYNIN CL ER 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | Q:60 /30Days |
OXYBUTYNIN CL ER 15 MG TABLET ![Compare how all Medicare Part D PDP plans in CA cover OXYBUTYNIN CL ER 15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | Q:60 /30Days |
OXYBUTYNIN CL ER 5 MG TABLET ![Compare how all Medicare Part D PDP plans in CA cover OXYBUTYNIN CL ER 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | Q:30 /30Days |
OXYCODON-ACETAMINOPHEN 2.5-325 ![Compare how all Medicare Part D PDP plans in CA cover OXYCODON-ACETAMINOPHEN 2.5-325.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | Q:360 /30Days |
OXYCODON-ACETAMINOPHEN 7.5-325 ![Compare how all Medicare Part D PDP plans in CA cover OXYCODON-ACETAMINOPHEN 7.5-325.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | Q:240 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OXYCODONE HCL 10 MG TABLET [Dazidox] ![Compare how all Medicare Part D PDP plans in CA cover OXYCODONE HCL 10 MG TABLET [Dazidox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
OXYCODONE HCL 100 MG/5 ML SOLN ORAL CONC [Roxicodone] ![Compare how all Medicare Part D PDP plans in CA cover OXYCODONE HCL 100 MG/5 ML SOLN ORAL CONC [Roxicodone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
OXYCODONE HCL 15 MG TABLET [Roxybond] ![Compare how all Medicare Part D PDP plans in CA cover OXYCODONE HCL 15 MG TABLET [Roxybond].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
OXYCODONE HCL 20 MG TABLET [Roxicodone] ![Compare how all Medicare Part D PDP plans in CA cover OXYCODONE HCL 20 MG TABLET [Roxicodone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
OXYCODONE HCL 30 MG TABLET [Roxybond] ![Compare how all Medicare Part D PDP plans in CA cover OXYCODONE HCL 30 MG TABLET [Roxybond].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
OXYCODONE HCL 5 MG CAPSULE [OxyIR] ![Compare how all Medicare Part D PDP plans in CA cover OXYCODONE HCL 5 MG CAPSULE [OxyIR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
OXYCODONE HCL 5 MG TABLET [Roxybond] ![Compare how all Medicare Part D PDP plans in CA cover OXYCODONE HCL 5 MG TABLET [Roxybond].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
OXYCODONE HCL 5 MG/5 ML SOLN Solution [Roxicodone] ![Compare how all Medicare Part D PDP plans in CA cover OXYCODONE HCL 5 MG/5 ML SOLN Solution [Roxicodone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | None |
OXYCODONE HCL ER 10 MG TABLET 12H [OxyContin] ![Compare how all Medicare Part D PDP plans in CA cover OXYCODONE HCL ER 10 MG TABLET 12H [OxyContin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$80.00 | N/A | Q:60 /30Days |
OXYCODONE HCL ER 15 MG TABLET 12H [OxyContin] ![Compare how all Medicare Part D PDP plans in CA cover OXYCODONE HCL ER 15 MG TABLET 12H [OxyContin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$80.00 | N/A | Q:60 /30Days |
OXYCODONE HCL ER 20 MG TABLET 12H [OxyContin] ![Compare how all Medicare Part D PDP plans in CA cover OXYCODONE HCL ER 20 MG TABLET 12H [OxyContin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$80.00 | N/A | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OXYCODONE HCL ER 30 MG TABLET 12H [OxyContin] ![Compare how all Medicare Part D PDP plans in CA cover OXYCODONE HCL ER 30 MG TABLET 12H [OxyContin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$80.00 | N/A | Q:60 /30Days |
OXYCODONE HCL ER 40 MG TABLET 12H [OxyContin] ![Compare how all Medicare Part D PDP plans in CA cover OXYCODONE HCL ER 40 MG TABLET 12H [OxyContin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$80.00 | N/A | Q:60 /30Days |
OXYCODONE HCL ER 60 MG TABLET 12H [OxyContin] ![Compare how all Medicare Part D PDP plans in CA cover OXYCODONE HCL ER 60 MG TABLET 12H [OxyContin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$80.00 | N/A | Q:60 /30Days |
OXYCODONE HCL ER 80 MG TABLET 12H [OxyContin] ![Compare how all Medicare Part D PDP plans in CA cover OXYCODONE HCL ER 80 MG TABLET 12H [OxyContin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$80.00 | N/A | Q:60 /30Days |
OXYCODONE-ACETAMINOPHEN 10-325 ![Compare how all Medicare Part D PDP plans in CA cover OXYCODONE-ACETAMINOPHEN 10-325.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | Q:180 /30Days |
OXYCODONE-ACETAMINOPHEN 5-325 ![Compare how all Medicare Part D PDP plans in CA cover OXYCODONE-ACETAMINOPHEN 5-325.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | Q:360 /30Days |
OXYCODONE-ASPIRIN 4.8355-325 ![Compare how all Medicare Part D PDP plans in CA cover OXYCODONE-ASPIRIN 4.8355-325.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | Q:360 /30Days |
OXYCODONE-IBUPROFEN 5-400 TAB ![Compare how all Medicare Part D PDP plans in CA cover OXYCODONE-IBUPROFEN 5-400 TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$2.00 | N/A | Q:120 /30Days |
OxyContin 10mg/1 ![Compare how all Medicare Part D PDP plans in CA cover OxyContin 10mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$80.00 | N/A | Q:60 /30Days |
OxyContin 15mg/1 ![Compare how all Medicare Part D PDP plans in CA cover OxyContin 15mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$80.00 | N/A | Q:60 /30Days |
OxyContin 20mg/1 ![Compare how all Medicare Part D PDP plans in CA cover OxyContin 20mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$80.00 | N/A | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OxyContin 30mg/1 ![Compare how all Medicare Part D PDP plans in CA cover OxyContin 30mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$80.00 | N/A | Q:60 /30Days |
OxyContin 40mg/1 ![Compare how all Medicare Part D PDP plans in CA cover OxyContin 40mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$80.00 | N/A | Q:60 /30Days |
OxyContin 60mg/1 ![Compare how all Medicare Part D PDP plans in CA cover OxyContin 60mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$80.00 | N/A | Q:60 /30Days |
OxyContin 80mg/1 ![Compare how all Medicare Part D PDP plans in CA cover OxyContin 80mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$80.00 | N/A | Q:60 /30Days |
oxymorphone hcl er 10 mg tab ![Compare how all Medicare Part D PDP plans in CA cover oxymorphone hcl er 10 mg tab.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | Q:60 /30Days |
OXYMORPHONE HCL ER 15 MG TAB ![Compare how all Medicare Part D PDP plans in CA cover OXYMORPHONE HCL ER 15 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | Q:60 /30Days |
oxymorphone hcl er 20 mg tab ![Compare how all Medicare Part D PDP plans in CA cover oxymorphone hcl er 20 mg tab.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | Q:60 /30Days |
oxymorphone hcl er 30 mg tab ![Compare how all Medicare Part D PDP plans in CA cover oxymorphone hcl er 30 mg tab.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | Q:60 /30Days |
oxymorphone hcl er 40 mg tab ![Compare how all Medicare Part D PDP plans in CA cover oxymorphone hcl er 40 mg tab.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | Q:60 /30Days |
oxymorphone hcl er 5 mg tablet ![Compare how all Medicare Part D PDP plans in CA cover oxymorphone hcl er 5 mg tablet.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | Q:60 /30Days |
OXYMORPHONE HCL ER 7.5 MG TAB ![Compare how all Medicare Part D PDP plans in CA cover OXYMORPHONE HCL ER 7.5 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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 CA 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 Drug |
$80.00 | N/A | None |
OZEMPIC 0.25-0.5 MG DOSE PEN ![Compare how all Medicare Part D PDP plans in CA cover OZEMPIC 0.25-0.5 MG DOSE PEN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | P |
OZEMPIC 1 MG DOSE PEN ![Compare how all Medicare Part D PDP plans in CA cover OZEMPIC 1 MG DOSE PEN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$40.00 | N/A | P |