2021 Medicare Part D Plan Formulary Information |
Reid Health Alliance Medicare HMO Rx Plus (HMO) (H1463-012-0)
Benefit Details
![Email Prescription and/or Health Benefit details for Reid Health Alliance Medicare HMO Rx Plus (HMO). This function does not email the formulary drug list.](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) This plan covers select insulin pay $2-$35 copay.
See individual insulin cost-sharing below. |
The Reid Health Alliance Medicare HMO Rx Plus (HMO) (H1463-012-0) Formulary Drugs Starting with the Letter O in Henry County, IN: CMS MA Region 13 which includes: IN Plan Monthly Premium: $91.00 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 |
OCALIVA 10 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover OCALIVA 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P Q:30 /30Days |
OCALIVA 5 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover OCALIVA 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P Q:30 /30Days |
OCTAGAM 10% VIAL ![Compare how all Medicare Part D PDP plans in IN cover OCTAGAM 10% VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
OCTAGAM 5% VIAL ![Compare how all Medicare Part D PDP plans in IN cover OCTAGAM 5% VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
OCTREOTIDE 1,000 MCG/ML VIAL [Sandostatin] ![Compare how all Medicare Part D PDP plans in IN cover OCTREOTIDE 1,000 MCG/ML VIAL [Sandostatin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | 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 |
50% | 50% | P |
OCTREOTIDE ACET 100 MCG/ML VIAL [Sandostatin] ![Compare how all Medicare Part D PDP plans in IN cover OCTREOTIDE ACET 100 MCG/ML VIAL [Sandostatin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | P |
OCTREOTIDE ACET 200 MCG/ML VIAL [Sandostatin] ![Compare how all Medicare Part D PDP plans in IN cover OCTREOTIDE ACET 200 MCG/ML VIAL [Sandostatin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | 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) |
5 |
Specialty Tier |
33% | 33% | 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) |
2 |
Generic |
$15.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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 |
33% | 33% | None |
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 |
33% | 33% | P |
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 |
33% | 33% | P Q:60 /30Days |
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 |
33% | 33% | 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) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
OFLOXACIN 0.3% EAR DROPS [Floxin] ![Compare how all Medicare Part D PDP plans in IN cover OFLOXACIN 0.3% EAR DROPS [Floxin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
OFLOXACIN 300 MG TABLET [Floxin] ![Compare how all Medicare Part D PDP plans in IN cover OFLOXACIN 300 MG TABLET [Floxin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | None |
OFLOXACIN 400 MG TABLET [Floxin] ![Compare how all Medicare Part D PDP plans in IN cover OFLOXACIN 400 MG TABLET [Floxin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$2.00 | $4.00 | 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) |
2 |
Generic |
$15.00 | $30.00 | None |
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 | $94.00 | 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) |
2 |
Generic |
$15.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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) |
2 |
Generic |
$15.00 | $30.00 | None |
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) |
2 |
Generic |
$15.00 | $30.00 | None |
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) |
2 |
Generic |
$15.00 | $30.00 | None |
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) |
2 |
Generic |
$15.00 | $30.00 | None |
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) |
2 |
Generic |
$15.00 | $30.00 | None |
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) |
2 |
Generic |
$15.00 | $30.00 | None |
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) |
2 |
Generic |
$15.00 | $30.00 | None |
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) |
2 |
Generic |
$15.00 | $30.00 | None |
OLANZAPINE-FLUOXETINE 12-25 MG Capsule [Symbyax] ![Compare how all Medicare Part D PDP plans in IN cover OLANZAPINE-FLUOXETINE 12-25 MG Capsule [Symbyax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
OLANZAPINE-FLUOXETINE 12-50 MG Capsule [Symbyax] ![Compare how all Medicare Part D PDP plans in IN cover OLANZAPINE-FLUOXETINE 12-50 MG Capsule [Symbyax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
OLANZAPINE-FLUOXETINE 3-25 MG Capsule [Symbyax] ![Compare how all Medicare Part D PDP plans in IN cover OLANZAPINE-FLUOXETINE 3-25 MG Capsule [Symbyax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OLANZAPINE-FLUOXETINE 6-25 MG Capsule [Symbyax] ![Compare how all Medicare Part D PDP plans in IN cover OLANZAPINE-FLUOXETINE 6-25 MG Capsule [Symbyax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
OLANZAPINE-FLUOXETINE 6-50 MG Capsule [Symbyax] ![Compare how all Medicare Part D PDP plans in IN cover OLANZAPINE-FLUOXETINE 6-50 MG Capsule [Symbyax].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
OLMESARTAN MEDOXOMIL 20 MG TABLET [Benicar] ![Compare how all Medicare Part D PDP plans in IN cover OLMESARTAN MEDOXOMIL 20 MG TABLET [Benicar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
OLMESARTAN MEDOXOMIL 40 MG TABLET [Benicar] ![Compare how all Medicare Part D PDP plans in IN cover OLMESARTAN MEDOXOMIL 40 MG TABLET [Benicar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
OLMESARTAN MEDOXOMIL 5 MG TABLET [Benicar] ![Compare how all Medicare Part D PDP plans in IN cover OLMESARTAN MEDOXOMIL 5 MG TABLET [Benicar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
OLMESARTAN-HCTZ 20-12.5 MG TABLET [Benicar HCT] ![Compare how all Medicare Part D PDP plans in IN cover OLMESARTAN-HCTZ 20-12.5 MG TABLET [Benicar HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
OLMESARTAN-HCTZ 40-12.5 MG TABLET [Benicar HCT] ![Compare how all Medicare Part D PDP plans in IN cover OLMESARTAN-HCTZ 40-12.5 MG TABLET [Benicar HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
OLMESARTAN-HCTZ 40-25 MG TABLET [Benicar HCT] ![Compare how all Medicare Part D PDP plans in IN cover OLMESARTAN-HCTZ 40-25 MG TABLET [Benicar HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
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) |
2 |
Generic |
$15.00 | $30.00 | None |
OLOPATADINE HCL 0.2% EYE DROPS [Pataday] ![Compare how all Medicare Part D PDP plans in IN cover OLOPATADINE HCL 0.2% EYE DROPS [Pataday].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
OMEGA-3 ETHYL ESTERS 1 GM CAPSULE [Lovaza] ![Compare how all Medicare Part D PDP plans in IN cover OMEGA-3 ETHYL ESTERS 1 GM CAPSULE [Lovaza].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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) |
2 |
Generic |
$15.00 | $30.00 | None |
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) |
2 |
Generic |
$15.00 | $30.00 | None |
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) |
2 |
Generic |
$15.00 | $30.00 | None |
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 |
33% | 33% | 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 |
33% | 33% | 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 |
33% | 33% | P |
ONDANSETRON 4 MG/5 ML SOLUTION [Zofran] ![Compare how all Medicare Part D PDP plans in IN cover ONDANSETRON 4 MG/5 ML SOLUTION [Zofran].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | P |
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 |
$15.00 | $30.00 | P |
ONDANSETRON HCL 4 MG TABLET [Zofran] ![Compare how all Medicare Part D PDP plans in IN cover ONDANSETRON HCL 4 MG TABLET [Zofran].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | P |
ONDANSETRON HCL 8 MG TABLET [Zofran] ![Compare how all Medicare Part D PDP plans in IN cover ONDANSETRON HCL 8 MG TABLET [Zofran].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | P |
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 |
$15.00 | $30.00 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ONDANSETRON ODT 8 MG TABLET RAPDIS [Zofran ODT] ![Compare how all Medicare Part D PDP plans in IN cover ONDANSETRON ODT 8 MG TABLET RAPDIS [Zofran ODT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | P |
ONGENTYS 25 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover ONGENTYS 25 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | S |
ONGENTYS 50 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover ONGENTYS 50 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | S |
ONUREG 200 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ONUREG 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
ONUREG 300 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ONUREG 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
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 |
33% | 33% | P |
ORALAIR 300 IR SUBLINGUAL TAB ![Compare how all Medicare Part D PDP plans in IN cover ORALAIR 300 IR SUBLINGUAL TAB.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | None |
ORAVIG 50 MG BUCCAL TABLET ![Compare how all Medicare Part D PDP plans in IN cover ORAVIG 50 MG BUCCAL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | None |
ORENCIA 125 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in IN cover ORENCIA 125 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
Orencia 4 SYRINGE, GLASS in 1 CARTON > 0.4 mL in 1 SYRINGE, GLASS ![Compare how all Medicare Part D PDP plans in IN 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% | 33% | P |
Orencia 4 SYRINGE, GLASS in 1 CARTON > 0.7 mL in 1 SYRINGE, GLASS ![Compare how all Medicare Part D PDP plans in IN 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% | 33% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ORENCIA CLICKJECT 125 MG/ML ![Compare how all Medicare Part D PDP plans in IN cover ORENCIA CLICKJECT 125 MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
Orenitram 100 TABLET, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in IN cover Orenitram 100 TABLET, EXTENDED RELEASE in 1 BOTTLE .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
ORENITRAM ER 0.125 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ORENITRAM ER 0.125 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $94.00 | P |
ORENITRAM ER 0.25 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ORENITRAM ER 0.25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
ORENITRAM ER 1 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ORENITRAM ER 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
ORENITRAM ER 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ORENITRAM ER 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
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 |
33% | 33% | P |
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 |
33% | 33% | P |
ORGOVYX 120 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover ORGOVYX 120 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
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 |
33% | 33% | P |
ORKAMBI 100-125 MG GRANULE PKT GRAN PACK ![Compare how all Medicare Part D PDP plans in IN cover ORKAMBI 100-125 MG GRANULE PKT GRAN PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ORKAMBI 150-188 MG GRANULE PKT GRAN PACK ![Compare how all Medicare Part D PDP plans in IN cover ORKAMBI 150-188 MG GRANULE PKT GRAN PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
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 |
33% | 33% | P |
ORLADEYO 110 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover ORLADEYO 110 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
ORLADEYO 150 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover ORLADEYO 150 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
ORTIKOS ER 6 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover ORTIKOS ER 6 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | None |
ORTIKOS ER 9 MG CAPSULE ![Compare how all Medicare Part D PDP plans in IN cover ORTIKOS ER 9 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | 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) |
2 |
Generic |
$15.00 | $30.00 | Q:1080 /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) |
2 |
Generic |
$15.00 | $30.00 | Q:168 /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) |
2 |
Generic |
$15.00 | $30.00 | Q:84 /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) |
2 |
Generic |
$15.00 | $30.00 | Q:110 /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 |
50% | 50% | S Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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 |
50% | 50% | S 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 |
50% | 50% | S 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 |
50% | 50% | S Q:30 /30Days |
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 |
50% | 50% | S 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 |
50% | 50% | S Q:30 /30Days |
OSMOPREP TABLET 1.5GM ![Compare how all Medicare Part D PDP plans in IN cover OSMOPREP TABLET 1.5GM.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | None |
OSPHENA 60 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover OSPHENA 60 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | P Q:30 /30Days |
OTEZLA 28 DAY STARTER PACK TAB DS PK ![Compare how all Medicare Part D PDP plans in IN cover OTEZLA 28 DAY STARTER PACK TAB DS PK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
OTEZLA 30 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover OTEZLA 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Specialty Tier |
33% | 33% | P |
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) |
2 |
Generic |
$15.00 | $30.00 | None |
OXACILLIN 10 GM VIAL ![Compare how all Medicare Part D PDP plans in IN cover OXACILLIN 10 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
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) |
2 |
Generic |
$15.00 | $30.00 | None |
OXACILLIN 2 GM VIAL ![Compare how all Medicare Part D PDP plans in IN cover OXACILLIN 2 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | 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) |
2 |
Generic |
$15.00 | $30.00 | None |
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 |
33% | 33% | 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 | $94.00 | P Q:240 /30Days |
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) |
2 |
Generic |
$15.00 | $30.00 | 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) |
2 |
Generic |
$15.00 | $30.00 | Q:120 /30Days |
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) |
2 |
Generic |
$15.00 | $30.00 | Q:120 /30Days |
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) |
2 |
Generic |
$15.00 | $30.00 | Q:120 /30Days |
OXCARBAZEPINE 150 MG TABLET [Trileptal] ![Compare how all Medicare Part D PDP plans in IN cover OXCARBAZEPINE 150 MG TABLET [Trileptal].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
OXCARBAZEPINE 300 MG TABLET [Trileptal] ![Compare how all Medicare Part D PDP plans in IN cover OXCARBAZEPINE 300 MG TABLET [Trileptal].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OXCARBAZEPINE 300 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in IN cover OXCARBAZEPINE 300 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | 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) |
2 |
Generic |
$15.00 | $30.00 | None |
OXTELLAR XR 150 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover OXTELLAR XR 150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | None |
OXTELLAR XR 300 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover OXTELLAR XR 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | None |
OXTELLAR XR 600 MG TABLET ![Compare how all Medicare Part D PDP plans in IN cover OXTELLAR XR 600 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | None |
OXYBUTYNIN 5 MG TABLET [Ditropan] ![Compare how all Medicare Part D PDP plans in IN cover OXYBUTYNIN 5 MG TABLET [Ditropan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | 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 |
$15.00 | $30.00 | None |
OXYBUTYNIN CL ER 10 MG TABLET ER 24 [Ditropan XL] ![Compare how all Medicare Part D PDP plans in IN cover OXYBUTYNIN CL ER 10 MG TABLET ER 24 [Ditropan XL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
OXYBUTYNIN CL ER 15 MG TABLET ER 24 [Ditropan XL] ![Compare how all Medicare Part D PDP plans in IN cover OXYBUTYNIN CL ER 15 MG TABLET ER 24 [Ditropan XL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
OXYBUTYNIN CL ER 5 MG TABLET ER 24 [Ditropan XL] ![Compare how all Medicare Part D PDP plans in IN cover OXYBUTYNIN CL ER 5 MG TABLET ER 24 [Ditropan XL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | None |
OXYCODON-ACETAMINOPHEN 7.5-325 TABLET [Percocet] ![Compare how all Medicare Part D PDP plans in IN cover OXYCODON-ACETAMINOPHEN 7.5-325 TABLET [Percocet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | 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 IN cover OXYCODONE HCL 10 MG TABLET [Dazidox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | Q:180 /30Days |
OXYCODONE HCL 100 MG/5 ML ORAL CONC [Roxicodone] ![Compare how all Medicare Part D PDP plans in IN cover OXYCODONE HCL 100 MG/5 ML ORAL CONC [Roxicodone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | Q:180 /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) |
2 |
Generic |
$15.00 | $30.00 | Q:180 /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) |
2 |
Generic |
$15.00 | $30.00 | Q:180 /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) |
2 |
Generic |
$15.00 | $30.00 | Q:180 /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) |
2 |
Generic |
$15.00 | $30.00 | Q:180 /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) |
2 |
Generic |
$15.00 | $30.00 | Q:180 /30Days |
OXYCODONE HCL 5 MG/5 ML SOLUTION [Roxicodone] ![Compare how all Medicare Part D PDP plans in IN cover OXYCODONE HCL 5 MG/5 ML SOLUTION [Roxicodone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | Q:1300 /30Days |
OXYCODONE HCL ER 10 MG TABLET 12H [OxyContin] ![Compare how all Medicare Part D PDP plans in IN cover OXYCODONE HCL ER 10 MG TABLET 12H [OxyContin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | Q:60 /30Days |
OXYCODONE HCL ER 15 MG TABLET 12H [OxyContin] ![Compare how all Medicare Part D PDP plans in IN cover OXYCODONE HCL ER 15 MG TABLET 12H [OxyContin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | Q:60 /30Days |
OXYCODONE HCL ER 20 MG TABLET 12H [OxyContin] ![Compare how all Medicare Part D PDP plans in IN cover OXYCODONE HCL ER 20 MG TABLET 12H [OxyContin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | 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 IN cover OXYCODONE HCL ER 30 MG TABLET 12H [OxyContin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | Q:60 /30Days |
OXYCODONE HCL ER 40 MG TABLET 12H [OxyContin] ![Compare how all Medicare Part D PDP plans in IN cover OXYCODONE HCL ER 40 MG TABLET 12H [OxyContin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | Q:60 /30Days |
OXYCODONE HCL ER 60 MG TABLET 12H [OxyContin] ![Compare how all Medicare Part D PDP plans in IN cover OXYCODONE HCL ER 60 MG TABLET 12H [OxyContin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | Q:60 /30Days |
OXYCODONE HCL ER 80 MG TABLET ER 12H [OxyContin] ![Compare how all Medicare Part D PDP plans in IN cover OXYCODONE HCL ER 80 MG TABLET ER 12H [OxyContin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | Q:60 /30Days |
OXYCODONE-ACETAMINOPHEN 10-325 TABLET [Percocet] ![Compare how all Medicare Part D PDP plans in IN cover OXYCODONE-ACETAMINOPHEN 10-325 TABLET [Percocet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | Q:240 /30Days |
OXYCODONE-ACETAMINOPHEN 5-325 TABLET [Roxicet] ![Compare how all Medicare Part D PDP plans in IN cover OXYCODONE-ACETAMINOPHEN 5-325 TABLET [Roxicet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | Q:240 /30Days |
OXYCODONE-ACETAMINOPHN 2.5-325 TABLET [Percocet] ![Compare how all Medicare Part D PDP plans in IN cover OXYCODONE-ACETAMINOPHN 2.5-325 TABLET [Percocet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | Q:240 /30Days |
OxyContin 10mg/1 ![Compare how all Medicare Part D PDP plans in IN cover OxyContin 10mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | Q:60 /30Days |
OxyContin 15mg/1 ![Compare how all Medicare Part D PDP plans in IN cover OxyContin 15mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | Q:60 /30Days |
OxyContin 20mg/1 ![Compare how all Medicare Part D PDP plans in IN cover OxyContin 20mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | Q:60 /30Days |
OxyContin 30mg/1 ![Compare how all Medicare Part D PDP plans in IN cover OxyContin 30mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OxyContin 40mg/1 ![Compare how all Medicare Part D PDP plans in IN cover OxyContin 40mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | Q:60 /30Days |
OxyContin 60mg/1 ![Compare how all Medicare Part D PDP plans in IN cover OxyContin 60mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | Q:60 /30Days |
OxyContin 80mg/1 ![Compare how all Medicare Part D PDP plans in IN cover OxyContin 80mg/1.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
50% | 50% | Q:60 /30Days |
OXYMORPHONE HCL 10 MG TABLET [Opana] ![Compare how all Medicare Part D PDP plans in IN cover OXYMORPHONE HCL 10 MG TABLET [Opana].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | Q:180 /30Days |
OXYMORPHONE HCL 5 MG TABLET [Opana] ![Compare how all Medicare Part D PDP plans in IN cover OXYMORPHONE HCL 5 MG TABLET [Opana].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | Q:180 /30Days |
OXYMORPHONE HCL ER 10 MG TABLET ER 12H [Opana] ![Compare how all Medicare Part D PDP plans in IN cover OXYMORPHONE HCL ER 10 MG TABLET ER 12H [Opana].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | Q:60 /30Days |
OXYMORPHONE HCL ER 15 MG TABLET ER 12H [Opana] ![Compare how all Medicare Part D PDP plans in IN cover OXYMORPHONE HCL ER 15 MG TABLET ER 12H [Opana].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | Q:60 /30Days |
OXYMORPHONE HCL ER 20 MG TABLET ER 12H [Opana] ![Compare how all Medicare Part D PDP plans in IN cover OXYMORPHONE HCL ER 20 MG TABLET ER 12H [Opana].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | Q:60 /30Days |
OXYMORPHONE HCL ER 30 MG TABLET ER 12H [Opana] ![Compare how all Medicare Part D PDP plans in IN cover OXYMORPHONE HCL ER 30 MG TABLET ER 12H [Opana].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | Q:120 /30Days |
OXYMORPHONE HCL ER 40 MG TABLET ER 12H [Opana] ![Compare how all Medicare Part D PDP plans in IN cover OXYMORPHONE HCL ER 40 MG TABLET ER 12H [Opana].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | Q:120 /30Days |
OXYMORPHONE HCL ER 5 MG TABLET ER 12H [Opana] ![Compare how all Medicare Part D PDP plans in IN cover OXYMORPHONE HCL ER 5 MG TABLET ER 12H [Opana].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OXYMORPHONE HCL ER 7.5 MG TABLET ER 12H [Opana] ![Compare how all Medicare Part D PDP plans in IN cover OXYMORPHONE HCL ER 7.5 MG TABLET ER 12H [Opana].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$15.00 | $30.00 | Q:60 /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 | $94.00 | S |
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 | $94.00 | S |
OZEMPIC 1 MG/DOSE (4 MG/3 ML) PEN INJECTOR ![Compare how all Medicare Part D PDP plans in IN cover OZEMPIC 1 MG/DOSE (4 MG/3 ML) PEN INJECTOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $94.00 | S |