2018 Medicare Part D Plan Formulary Information |
Humana Gold Choice H8145-011 (PFFS) (H8145-011-0)
Benefit Details
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The Humana Gold Choice H8145-011 (PFFS) (H8145-011-0) Formulary Drugs Starting with the Letter O in Huntington County, IN: CMS MA Region 13 which includes: IN Plan Monthly Premium: $93.00 Deductible: $220 |
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 IN cover OCELLA 3MG/0.03MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
OCTREOTIDE 1,000 MCG/ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover OCTREOTIDE 1,000 MCG/ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | P |
OCTREOTIDE ACET 0.05 MG/ML VL ![Compare how all Medicare Part D PDP plans in IN cover OCTREOTIDE ACET 0.05 MG/ML VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | P |
OCTREOTIDE ACET 100 MCG/ML VL ![Compare how all Medicare Part D PDP plans in IN cover OCTREOTIDE ACET 100 MCG/ML VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | P |
OCTREOTIDE ACET 200 MCG/ML VL ![Compare how all Medicare Part D PDP plans in IN cover OCTREOTIDE ACET 200 MCG/ML VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | P |
OCTREOTIDE ACET 500 MCG/ML VL ![Compare how all Medicare Part D PDP plans in IN cover OCTREOTIDE ACET 500 MCG/ML VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | P |
OCUTRICIN EYE OINTMENT 400UNT/3.5MG/10UNT ![Compare how all Medicare Part D PDP plans in IN cover OCUTRICIN EYE OINTMENT 400UNT/3.5MG/10UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | None |
ODEFSEY TABLET ![Compare how all Medicare Part D PDP plans in IN cover ODEFSEY TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | Q:30 /30Days |
ODOMZO 200 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover ODOMZO 200 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P Q:30 /30Days |
OFEV 100 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover OFEV 100 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | 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 IN cover OFEV 150 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P Q:60 /30Days |
OFLOXACIN 0.3 % DRP ![Compare how all Medicare Part D PDP plans in IN cover OFLOXACIN 0.3 % DRP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | None |
OFLOXACIN 0.3% EAR DROPS ![Compare how all Medicare Part D PDP plans in IN cover OFLOXACIN 0.3% EAR DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
OFLOXACIN 300 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover OFLOXACIN 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | None |
OFLOXACIN 400 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover OFLOXACIN 400 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | None |
OGESTREL TABLET 0.05MG/0.5MG ![Compare how all Medicare Part D PDP plans in IN cover OGESTREL TABLET 0.05MG/0.5MG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
OLANZAPINE 10 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in IN cover OLANZAPINE 10 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:30 /30Days |
OLANZAPINE 10 MG VIAL ![Compare how all Medicare Part D PDP plans in IN cover OLANZAPINE 10 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | None |
OLANZAPINE 15 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in IN cover OLANZAPINE 15 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:60 /30Days |
OLANZAPINE 2.5 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in IN cover OLANZAPINE 2.5 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:30 /30Days |
OLANZAPINE 20 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in IN cover OLANZAPINE 20 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | 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 IN cover OLANZAPINE 5 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:30 /30Days |
OLANZAPINE 7.5 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in IN cover OLANZAPINE 7.5 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:30 /30Days |
OLANZAPINE ODT 10 MG TABLET RAPDIS [Zyprexa Zydis] ![Compare how all Medicare Part D PDP plans in IN cover OLANZAPINE ODT 10 MG TABLET RAPDIS [Zyprexa Zydis].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:30 /30Days |
OLANZAPINE ODT 15 MG TABLET RAPDIS [Zyprexa Zydis] ![Compare how all Medicare Part D PDP plans in IN cover OLANZAPINE ODT 15 MG TABLET RAPDIS [Zyprexa Zydis].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:60 /30Days |
OLANZAPINE ODT 20 MG TABLET RAPDIS [Zyprexa Zydis] ![Compare how all Medicare Part D PDP plans in IN cover OLANZAPINE ODT 20 MG TABLET RAPDIS [Zyprexa Zydis].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:60 /30Days |
OLANZAPINE ODT 5 MG TABLET RAPDIS [Zyprexa Zydis] ![Compare how all Medicare Part D PDP plans in IN cover OLANZAPINE ODT 5 MG TABLET RAPDIS [Zyprexa Zydis].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:30 /30Days |
OLMESARTAN MEDOXOMIL 20 MG TAB [Benicar] ![Compare how all Medicare Part D PDP plans in IN cover OLMESARTAN MEDOXOMIL 20 MG TAB [Benicar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | Q:30 /30Days |
OLMESARTAN MEDOXOMIL 40 MG TAB [Benicar] ![Compare how all Medicare Part D PDP plans in IN cover OLMESARTAN MEDOXOMIL 40 MG TAB [Benicar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | Q:30 /30Days |
OLMESARTAN MEDOXOMIL 5 MG TAB [Benicar] ![Compare how all Medicare Part D PDP plans in IN cover OLMESARTAN MEDOXOMIL 5 MG TAB [Benicar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | Q:30 /30Days |
OLMESARTAN-HCTZ 20-12.5 MG TAB ![Compare how all Medicare Part D PDP plans in IN cover OLMESARTAN-HCTZ 20-12.5 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:30 /30Days |
OLMESARTAN-HCTZ 40-12.5 MG TAB ![Compare how all Medicare Part D PDP plans in IN cover OLMESARTAN-HCTZ 40-12.5 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OLMESARTAN-HCTZ 40-25 MG TAB ![Compare how all Medicare Part D PDP plans in IN cover OLMESARTAN-HCTZ 40-25 MG TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:30 /30Days |
olmsrtn-amldpn-hctz 20-5-12.5 [TRIBENZOR] ![Compare how all Medicare Part D PDP plans in IN cover olmsrtn-amldpn-hctz 20-5-12.5 [TRIBENZOR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:30 /30Days |
olmsrtn-amldpn-hctz 40-10-12.5 [TRIBENZOR] ![Compare how all Medicare Part D PDP plans in IN cover olmsrtn-amldpn-hctz 40-10-12.5 [TRIBENZOR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:30 /30Days |
olmsrtn-amldpn-hctz 40-10-25mg [TRIBENZOR] ![Compare how all Medicare Part D PDP plans in IN cover olmsrtn-amldpn-hctz 40-10-25mg [TRIBENZOR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:30 /30Days |
olmsrtn-amldpn-hctz 40-5-12.5 [TRIBENZOR] ![Compare how all Medicare Part D PDP plans in IN cover olmsrtn-amldpn-hctz 40-5-12.5 [TRIBENZOR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:30 /30Days |
olmsrtn-amldpn-hctz 40-5-25 mg [TRIBENZOR] ![Compare how all Medicare Part D PDP plans in IN cover olmsrtn-amldpn-hctz 40-5-25 mg [TRIBENZOR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:30 /30Days |
Olopatadine 2 MG/ML Ophthalmic Solution ![Compare how all Medicare Part D PDP plans in IN cover Olopatadine 2 MG/ML Ophthalmic Solution.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
OLOPATADINE 665 MCG NASAL SPRY ![Compare how all Medicare Part D PDP plans in IN cover OLOPATADINE 665 MCG NASAL SPRY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | S Q:31 /30Days |
OLOPATADINE HCL 0.1% EYE DROPS ![Compare how all Medicare Part D PDP plans in IN cover OLOPATADINE HCL 0.1% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | None |
OMEGA-3 ETHYL ESTERS 1 GM CAP [Lovaza] ![Compare how all Medicare Part D PDP plans in IN cover OMEGA-3 ETHYL ESTERS 1 GM CAP [Lovaza].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:120 /30Days |
OMEPRAZOLE DR 10 MG CAPSULE DR [Prilosec] ![Compare how all Medicare Part D PDP plans in IN cover OMEPRAZOLE DR 10 MG CAPSULE DR [Prilosec].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$7.00 | $0.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OMEPRAZOLE DR 20 MG CAPSULE DR [Prilosec] ![Compare how all Medicare Part D PDP plans in IN cover OMEPRAZOLE DR 20 MG CAPSULE DR [Prilosec].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$7.00 | $0.00 | Q:60 /30Days |
OMEPRAZOLE DR 40 MG CAPSULE DR [Prilosec] ![Compare how all Medicare Part D PDP plans in IN cover OMEPRAZOLE DR 40 MG CAPSULE DR [Prilosec].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1* |
Preferred Generic |
$7.00 | $0.00 | Q:60 /30Days |
OMEPRAZOLE-BICARB 20-1,100 CAP [Zegerid] ![Compare how all Medicare Part D PDP plans in IN cover OMEPRAZOLE-BICARB 20-1,100 CAP [Zegerid].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | S Q:30 /30Days |
OMEPRAZOLE-BICARB 20-1,680 PKT PACKET [Zegerid] ![Compare how all Medicare Part D PDP plans in IN cover OMEPRAZOLE-BICARB 20-1,680 PKT PACKET [Zegerid].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | S Q:30 /30Days |
OMEPRAZOLE-BICARB 40-1,100 CAP [Zegerid] ![Compare how all Medicare Part D PDP plans in IN cover OMEPRAZOLE-BICARB 40-1,100 CAP [Zegerid].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | S Q:30 /30Days |
OMEPRAZOLE-BICARB 40-1,680 PACKET [Zegerid] ![Compare how all Medicare Part D PDP plans in IN cover OMEPRAZOLE-BICARB 40-1,680 PACKET [Zegerid].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | S Q:30 /30Days |
OMNIPRED OPHTHALMIC SUSPENSION 1% 10 ML BOTPL ![Compare how all Medicare Part D PDP plans in IN cover OMNIPRED OPHTHALMIC SUSPENSION 1% 10 ML BOTPL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | S |
OMNITROPE FOR INJECTION KIT 5.8MG 1 BOX PKGCOM ![Compare how all Medicare Part D PDP plans in IN cover OMNITROPE FOR INJECTION KIT 5.8MG 1 BOX PKGCOM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P |
OMNITROPE INJECTION 10MG/1.5ML 10MG X 1.5ML CTG ![Compare how all Medicare Part D PDP plans in IN 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 |
28% | N/A | P |
OMNITROPE INJECTION 5MG/1.5ML 1.5 ML CTG ![Compare how all Medicare Part D PDP plans in IN cover OMNITROPE INJECTION 5MG/1.5ML 1.5 ML CTG.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P |
ONDANSETRON 4 MG/2 ML ISECURE ![Compare how all Medicare Part D PDP plans in IN cover ONDANSETRON 4 MG/2 ML ISECURE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ONDANSETRON 4 MG/5 ML SOLUTION ![Compare how all Medicare Part D PDP plans in IN cover ONDANSETRON 4 MG/5 ML SOLUTION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | P Q:450 /30Days |
ONDANSETRON HCL 24 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ONDANSETRON HCL 24 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | P Q:30 /30Days |
ONDANSETRON HCL 4 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ONDANSETRON HCL 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | P Q:90 /30Days |
ONDANSETRON HCL 4 MG/2 ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover ONDANSETRON HCL 4 MG/2 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | None |
ONDANSETRON HCL 8 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ONDANSETRON HCL 8 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | P Q:90 /30Days |
ONDANSETRON ODT 4 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ONDANSETRON ODT 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | P Q:90 /30Days |
ONDANSETRON ODT 8 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ONDANSETRON ODT 8 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | P Q:90 /30Days |
ONFI 10 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ONFI 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | P Q:60 /30Days |
ONFI 2.5 MG/ML SUSPENSION ![Compare how all Medicare Part D PDP plans in IN cover ONFI 2.5 MG/ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | P Q:480 /30Days |
ONFI 20 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ONFI 20 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | P Q:60 /30Days |
ONGLYZA 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ONGLYZA 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ONGLYZA 5 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ONGLYZA 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:30 /30Days |
OPDIVO 100 MG/10 ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover OPDIVO 100 MG/10 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P Q:80 /28Days |
OPDIVO 40 MG/4 ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover OPDIVO 40 MG/4 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P Q:80 /28Days |
OPSUMIT 10 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover OPSUMIT 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P Q:30 /30Days |
ORBACTIV 400 MG VIAL ![Compare how all Medicare Part D PDP plans in IN cover ORBACTIV 400 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | Q:3 /28Days |
ORFADIN 10 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover ORFADIN 10 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
ORFADIN 2 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover ORFADIN 2 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
ORFADIN 20 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover ORFADIN 20 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
ORFADIN 4 MG/ML SUSPENSION ![Compare how all Medicare Part D PDP plans in IN cover ORFADIN 4 MG/ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
ORFADIN 5 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover ORFADIN 5 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
ORKAMBI 100 MG-125 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ORKAMBI 100 MG-125 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P Q:112 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ORKAMBI 200 MG-125 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ORKAMBI 200 MG-125 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P Q:112 /28Days |
Orsythia 6 BLISTER PACK per CARTON / 1 KIT per BLISTER PACK ![Compare how all Medicare Part D PDP plans in IN 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 Drug |
$97.00 | $281.00 | None |
ORTHO-NOVUM 7-7-7-28 TABLET ![Compare how all Medicare Part D PDP plans in IN cover ORTHO-NOVUM 7-7-7-28 TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
OSELTAMIVIR 6 MG/ML SUSPENSION [Tamiflu] ![Compare how all Medicare Part D PDP plans in IN cover OSELTAMIVIR 6 MG/ML SUSPENSION [Tamiflu].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:720 /365Days |
OSELTAMIVIR PHOS 30 MG CAPSULE [Tamiflu] ![Compare how all Medicare Part D PDP plans in IN cover OSELTAMIVIR PHOS 30 MG CAPSULE [Tamiflu].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:112 /365Days |
OSELTAMIVIR PHOS 45 MG CAPSULE [Tamiflu] ![Compare how all Medicare Part D PDP plans in IN cover OSELTAMIVIR PHOS 45 MG CAPSULE [Tamiflu].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:56 /365Days |
OSELTAMIVIR PHOS 75 MG CAPSULE [Tamiflu] ![Compare how all Medicare Part D PDP plans in IN cover OSELTAMIVIR PHOS 75 MG CAPSULE [Tamiflu].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:56 /365Days |
OSENI 12.5-15 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover OSENI 12.5-15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:30 /30Days |
OSENI 12.5-30 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover OSENI 12.5-30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:30 /30Days |
OSENI 12.5-45 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover OSENI 12.5-45 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:30 /30Days |
OSENI 25-15 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover OSENI 25-15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OSENI 25-30 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover OSENI 25-30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:30 /30Days |
OSENI 25-45 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover OSENI 25-45 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:30 /30Days |
OXACILLIN 1 GM VIAL ![Compare how all Medicare Part D PDP plans in IN cover OXACILLIN 1 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
Oxacillin 100 MG/ML Injectable Solution ![Compare how all Medicare Part D PDP plans in IN cover Oxacillin 100 MG/ML Injectable Solution.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
OXACILLIN 1GM/50ML INJ ![Compare how all Medicare Part D PDP plans in IN cover OXACILLIN 1GM/50ML INJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
Oxacillin 2000 MG Injection ![Compare how all Medicare Part D PDP plans in IN cover Oxacillin 2000 MG Injection.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
OXACILLIN 2GM/50ML INJ ![Compare how all Medicare Part D PDP plans in IN cover OXACILLIN 2GM/50ML INJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | None |
OXALIPLATIN 100 MG VIAL ![Compare how all Medicare Part D PDP plans in IN cover OXALIPLATIN 100 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | P |
OXALIPLATIN 100 MG/20 ML VIAL ![Compare how all Medicare Part D PDP plans in IN cover OXALIPLATIN 100 MG/20 ML VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | P |
OXANDROLONE 10 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover OXANDROLONE 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
28% | N/A | P Q:60 /30Days |
OXANDROLONE 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover OXANDROLONE 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | P Q:120 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OXAPROZIN 600 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover OXAPROZIN 600 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
OXAZEPAM 10 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover OXAZEPAM 10 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
OXAZEPAM 15 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover OXAZEPAM 15 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
OXAZEPAM 30 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover OXAZEPAM 30 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
OXCARBAZEPINE 150 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover OXCARBAZEPINE 150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | None |
OXCARBAZEPINE 300 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover OXCARBAZEPINE 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | None |
OXCARBAZEPINE 300 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in IN cover OXCARBAZEPINE 300 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | None |
OXCARBAZEPINE 600 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover OXCARBAZEPINE 600 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | None |
OXYBUTYNIN 5 MG/5 ML SYRUP ![Compare how all Medicare Part D PDP plans in IN cover OXYBUTYNIN 5 MG/5 ML SYRUP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | None |
OXYBUTYNIN 5MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover OXYBUTYNIN 5MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2* |
Generic |
$17.00 | $0.00 | None |
OXYBUTYNIN CL ER 10 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover OXYBUTYNIN CL ER 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OXYBUTYNIN CL ER 15 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover OXYBUTYNIN CL ER 15 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:60 /30Days |
OXYBUTYNIN CL ER 5 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover OXYBUTYNIN CL ER 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:60 /30Days |
OXYCODON-ACETAMINOPHEN 2.5-325 ![Compare how all Medicare Part D PDP plans in IN cover OXYCODON-ACETAMINOPHEN 2.5-325.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:360 /30Days |
OXYCODON-ACETAMINOPHEN 7.5-325 ![Compare how all Medicare Part D PDP plans in IN cover OXYCODON-ACETAMINOPHEN 7.5-325.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:360 /30Days |
OXYCODONE HCL 10 MG TABLET [Dazidox] ![Compare how all Medicare Part D PDP plans in IN cover OXYCODONE HCL 10 MG TABLET [Dazidox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:360 /30Days |
OXYCODONE HCL 100 MG/5 ML SOLN ORAL CONC [Roxicodone] ![Compare how all Medicare Part D PDP plans in IN cover OXYCODONE HCL 100 MG/5 ML SOLN ORAL CONC [Roxicodone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:270 /30Days |
OXYCODONE HCL 15 MG TABLET [Roxybond] ![Compare how all Medicare Part D PDP plans in IN cover OXYCODONE HCL 15 MG TABLET [Roxybond].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:360 /30Days |
OXYCODONE HCL 20 MG TABLET [Roxicodone] ![Compare how all Medicare Part D PDP plans in IN cover OXYCODONE HCL 20 MG TABLET [Roxicodone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:360 /30Days |
OXYCODONE HCL 30 MG TABLET [Roxybond] ![Compare how all Medicare Part D PDP plans in IN cover OXYCODONE HCL 30 MG TABLET [Roxybond].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:360 /30Days |
OXYCODONE HCL 5 MG CAPSULE [OxyIR] ![Compare how all Medicare Part D PDP plans in IN cover OXYCODONE HCL 5 MG CAPSULE [OxyIR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:360 /30Days |
OXYCODONE HCL 5 MG TABLET [Roxybond] ![Compare how all Medicare Part D PDP plans in IN cover OXYCODONE HCL 5 MG TABLET [Roxybond].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:360 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OXYCODONE HCL 5 MG/5 ML SOLN Solution [Roxicodone] ![Compare how all Medicare Part D PDP plans in IN cover OXYCODONE HCL 5 MG/5 ML SOLN Solution [Roxicodone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:5400 /30Days |
OXYCODONE-ACETAMINOPHEN 10-325 ![Compare how all Medicare Part D PDP plans in IN cover OXYCODONE-ACETAMINOPHEN 10-325.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:360 /30Days |
OXYCODONE-ACETAMINOPHEN 5-325 ![Compare how all Medicare Part D PDP plans in IN cover OXYCODONE-ACETAMINOPHEN 5-325.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:360 /30Days |
OXYCODONE-ASPIRIN 4.8355-325 ![Compare how all Medicare Part D PDP plans in IN cover OXYCODONE-ASPIRIN 4.8355-325.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:360 /30Days |
OXYMORPHONE HCL 10 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover OXYMORPHONE HCL 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:360 /30Days |
OXYMORPHONE HCL 5 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover OXYMORPHONE HCL 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$97.00 | $281.00 | Q:360 /30Days |
OZEMPIC 0.25-0.5 MG DOSE PEN ![Compare how all Medicare Part D PDP plans in IN cover OZEMPIC 0.25-0.5 MG DOSE PEN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:2 /28Days |
OZEMPIC 1 MG DOSE PEN ![Compare how all Medicare Part D PDP plans in IN cover OZEMPIC 1 MG DOSE PEN.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $131.00 | Q:3 /28Days |