2024 Medicare Part D Plan Formulary Information |
UPMC for Life HMO Rx Enhanced (HMO) (H3907-006-0)
Benefits & Contact Info
![Email Prescription and/or Health Benefit details for UPMC for Life HMO Rx Enhanced (HMO). This function does not email the formulary drug list.](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) Insulin on a Medicare Part D plan's formulary will have a monthly copay of $35 or less. Call drug plan for more details. |
The UPMC for Life HMO Rx Enhanced (HMO) (H3907-006-0) Formulary Drugs Starting with the Letter O in Jefferson County, OH: CMS MA Region 12 which includes: OH
|
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 OH cover OCALIVA 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:30 /30Days |
OCALIVA 5 MG TABLET ![Compare how all Medicare Part D PDP plans in OH cover OCALIVA 5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:30 /30Days |
OCELLA 3MG/0.03MG TABLET ![Compare how all Medicare Part D PDP plans in OH cover OCELLA 3MG/0.03MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
OCTAGAM 10% VIAL ![Compare how all Medicare Part D PDP plans in OH cover OCTAGAM 10% VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
OCTAGAM 5% VIAL ![Compare how all Medicare Part D PDP plans in OH cover OCTAGAM 5% VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
OCTREOTIDE 1,000 MCG/5 ML VIAL [Sandostatin] ![Compare how all Medicare Part D PDP plans in OH cover OCTREOTIDE 1,000 MCG/5 ML VIAL [Sandostatin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
OCTREOTIDE 1,000 MCG/ML VIAL [Sandostatin] ![Compare how all Medicare Part D PDP plans in OH cover OCTREOTIDE 1,000 MCG/ML VIAL [Sandostatin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
OCTREOTIDE ACET 100 MCG/ML VIAL [Sandostatin] ![Compare how all Medicare Part D PDP plans in OH cover OCTREOTIDE ACET 100 MCG/ML VIAL [Sandostatin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
OCTREOTIDE ACET 50 MCG/ML VIAL [Sandostatin] ![Compare how all Medicare Part D PDP plans in OH cover OCTREOTIDE ACET 50 MCG/ML VIAL [Sandostatin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
OCTREOTIDE ACET 500 MCG/ML VL ![Compare how all Medicare Part D PDP plans in OH cover OCTREOTIDE ACET 500 MCG/ML VL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OCUTRICIN EYE OINTMENT 400UNT/3.5MG/10UNT ![Compare how all Medicare Part D PDP plans in OH cover OCUTRICIN EYE OINTMENT 400UNT/3.5MG/10UNT.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
ODACTRA 12 SQ-HDM SUBLIGUAL TABLET ![Compare how all Medicare Part D PDP plans in OH cover ODACTRA 12 SQ-HDM SUBLIGUAL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | P Q:30 /30Days |
ODEFSEY TABLET ![Compare how all Medicare Part D PDP plans in OH cover ODEFSEY TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | None |
ODOMZO 200 MG CAPSULE ![Compare how all Medicare Part D PDP plans in OH cover ODOMZO 200 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:30 /30Days |
OFEV 100 MG CAPSULE ![Compare how all Medicare Part D PDP plans in OH cover OFEV 100 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:60 /30Days |
OFEV 150 MG CAPSULE ![Compare how all Medicare Part D PDP plans in OH cover OFEV 150 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:60 /30Days |
OFLOXACIN 0.3% EAR DROPS [Floxin] ![Compare how all Medicare Part D PDP plans in OH cover OFLOXACIN 0.3% EAR DROPS [Floxin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
OFLOXACIN 0.3% EYE DROPS [Ocuflox] ![Compare how all Medicare Part D PDP plans in OH cover OFLOXACIN 0.3% EYE DROPS [Ocuflox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
OFLOXACIN 300 MG TABLET [Floxin] ![Compare how all Medicare Part D PDP plans in OH cover OFLOXACIN 300 MG TABLET [Floxin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
OFLOXACIN 400 MG TABLET [Floxin] ![Compare how all Medicare Part D PDP plans in OH cover OFLOXACIN 400 MG TABLET [Floxin].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
OGSIVEO 50 MG TABLET ![Compare how all Medicare Part D PDP plans in OH cover OGSIVEO 50 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:180 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OJJAARA 100 MG TABLET ![Compare how all Medicare Part D PDP plans in OH cover OJJAARA 100 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:30 /30Days |
OJJAARA 150 MG TABLET ![Compare how all Medicare Part D PDP plans in OH cover OJJAARA 150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:30 /30Days |
OJJAARA 200 MG TABLET ![Compare how all Medicare Part D PDP plans in OH cover OJJAARA 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:30 /30Days |
OLANZAPINE 10 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in OH cover OLANZAPINE 10 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | Q:30 /30Days |
OLANZAPINE 10 MG VIAL ![Compare how all Medicare Part D PDP plans in OH cover OLANZAPINE 10 MG VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
OLANZAPINE 15 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in OH cover OLANZAPINE 15 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | Q:30 /30Days |
OLANZAPINE 2.5 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in OH cover OLANZAPINE 2.5 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | Q:30 /30Days |
OLANZAPINE 20 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in OH cover OLANZAPINE 20 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | Q:30 /30Days |
OLANZAPINE 5 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in OH cover OLANZAPINE 5 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | Q:30 /30Days |
OLANZAPINE 7.5 MG TABLET [Zyprexa] ![Compare how all Medicare Part D PDP plans in OH cover OLANZAPINE 7.5 MG TABLET [Zyprexa].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | Q:30 /30Days |
OLANZAPINE ODT 10 MG TABLET RAPDIS [Zyprexa Zydis] ![Compare how all Medicare Part D PDP plans in OH cover OLANZAPINE ODT 10 MG TABLET RAPDIS [Zyprexa Zydis].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | S Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OLANZAPINE ODT 15 MG TABLET RAPDIS [Zyprexa Zydis] ![Compare how all Medicare Part D PDP plans in OH cover OLANZAPINE ODT 15 MG TABLET RAPDIS [Zyprexa Zydis].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | S Q:30 /30Days |
OLANZAPINE ODT 20 MG TABLET RAPDIS [Zyprexa Zydis] ![Compare how all Medicare Part D PDP plans in OH cover OLANZAPINE ODT 20 MG TABLET RAPDIS [Zyprexa Zydis].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | S Q:30 /30Days |
OLANZAPINE ODT 5 MG TABLET RAPDIS [Zyprexa Zydis] ![Compare how all Medicare Part D PDP plans in OH cover OLANZAPINE ODT 5 MG TABLET RAPDIS [Zyprexa Zydis].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | S Q:30 /30Days |
OLMESARTAN MEDOXOMIL 20 MG TABLET [Benicar] ![Compare how all Medicare Part D PDP plans in OH cover OLMESARTAN MEDOXOMIL 20 MG TABLET [Benicar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
OLMESARTAN MEDOXOMIL 40 MG TABLET [Benicar] ![Compare how all Medicare Part D PDP plans in OH cover OLMESARTAN MEDOXOMIL 40 MG TABLET [Benicar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
OLMESARTAN MEDOXOMIL 5 MG TABLET [Benicar] ![Compare how all Medicare Part D PDP plans in OH cover OLMESARTAN MEDOXOMIL 5 MG TABLET [Benicar].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
OLMESARTAN-HCTZ 20-12.5 MG TABLET [Benicar HCT] ![Compare how all Medicare Part D PDP plans in OH cover OLMESARTAN-HCTZ 20-12.5 MG TABLET [Benicar HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
OLMESARTAN-HCTZ 40-12.5 MG TABLET [Benicar HCT] ![Compare how all Medicare Part D PDP plans in OH cover OLMESARTAN-HCTZ 40-12.5 MG TABLET [Benicar HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
OLMESARTAN-HCTZ 40-25 MG TABLET [Benicar HCT] ![Compare how all Medicare Part D PDP plans in OH cover OLMESARTAN-HCTZ 40-25 MG TABLET [Benicar HCT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
OLMSRTN-AMLDPN-HCTZ 20-5-12.5 TABLET [Tribenzor] ![Compare how all Medicare Part D PDP plans in OH cover OLMSRTN-AMLDPN-HCTZ 20-5-12.5 TABLET [Tribenzor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
OLMSRTN-AMLDPN-HCTZ 40-10-12.5 TABLET [Tribenzor] ![Compare how all Medicare Part D PDP plans in OH cover OLMSRTN-AMLDPN-HCTZ 40-10-12.5 TABLET [Tribenzor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OLMSRTN-AMLDPN-HCTZ 40-10-25MG TABLET [Tribenzor] ![Compare how all Medicare Part D PDP plans in OH cover OLMSRTN-AMLDPN-HCTZ 40-10-25MG TABLET [Tribenzor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
OLMSRTN-AMLDPN-HCTZ 40-5-12.5 TABLET [Tribenzor] ![Compare how all Medicare Part D PDP plans in OH cover OLMSRTN-AMLDPN-HCTZ 40-5-12.5 TABLET [Tribenzor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
OLMSRTN-AMLDPN-HCTZ 40-5-25 MG TABLET [Tribenzor] ![Compare how all Medicare Part D PDP plans in OH cover OLMSRTN-AMLDPN-HCTZ 40-5-25 MG TABLET [Tribenzor].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
OLPRUVA 2 GRAM DOSE KIT PELET PACK ![Compare how all Medicare Part D PDP plans in OH cover OLPRUVA 2 GRAM DOSE KIT PELET PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:180 /30Days |
OLPRUVA 3 GRAM DOSE KIT PELET PACK ![Compare how all Medicare Part D PDP plans in OH cover OLPRUVA 3 GRAM DOSE KIT PELET PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:180 /30Days |
OLPRUVA 4 GRAM DOSE KIT PELET PACK ![Compare how all Medicare Part D PDP plans in OH cover OLPRUVA 4 GRAM DOSE KIT PELET PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:270 /30Days |
OLPRUVA 5 GRAM DOSE KIT PELET PACK ![Compare how all Medicare Part D PDP plans in OH cover OLPRUVA 5 GRAM DOSE KIT PELET PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:270 /30Days |
OLPRUVA 6 GRAM DOSE KIT PELET PACK ![Compare how all Medicare Part D PDP plans in OH cover OLPRUVA 6 GRAM DOSE KIT PELET PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:270 /30Days |
OLPRUVA 6.67 GRAM DOSE KIT PELET PACK ![Compare how all Medicare Part D PDP plans in OH cover OLPRUVA 6.67 GRAM DOSE KIT PELET PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:270 /30Days |
OLUMIANT 1 MG TABLET ![Compare how all Medicare Part D PDP plans in OH cover OLUMIANT 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:30 /30Days |
OLUMIANT 2 MG TABLET ![Compare how all Medicare Part D PDP plans in OH cover OLUMIANT 2 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:30 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OLUMIANT 4 MG TABLET ![Compare how all Medicare Part D PDP plans in OH cover OLUMIANT 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:30 /30Days |
OMEGA-3 ETHYL ESTERS 1 GM CAPSULE [Lovaza] ![Compare how all Medicare Part D PDP plans in OH cover OMEGA-3 ETHYL ESTERS 1 GM CAPSULE [Lovaza].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
OMEPRAZOLE DR 10 MG CAPSULE DR [Prilosec] ![Compare how all Medicare Part D PDP plans in OH cover OMEPRAZOLE DR 10 MG CAPSULE DR [Prilosec].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
OMEPRAZOLE DR 20 MG CAPSULE DR [Prilosec] ![Compare how all Medicare Part D PDP plans in OH cover OMEPRAZOLE DR 20 MG CAPSULE DR [Prilosec].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
OMEPRAZOLE DR 40 MG CAPSULE DR [Prilosec] ![Compare how all Medicare Part D PDP plans in OH cover OMEPRAZOLE DR 40 MG CAPSULE DR [Prilosec].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
OMVOH 100 MG/ML PEN INJECTOR ![Compare how all Medicare Part D PDP plans in OH cover OMVOH 100 MG/ML PEN INJECTOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:2 /28Days |
ONDANSETRON 4 MG/5 ML SOLUTION [Zofran Solution] ![Compare how all Medicare Part D PDP plans in OH cover ONDANSETRON 4 MG/5 ML SOLUTION [Zofran Solution].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | P |
ONDANSETRON HCL 4 MG TABLET [Zofran] ![Compare how all Medicare Part D PDP plans in OH cover ONDANSETRON HCL 4 MG TABLET [Zofran].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | P |
ONDANSETRON HCL 8 MG TABLET [Zofran] ![Compare how all Medicare Part D PDP plans in OH cover ONDANSETRON HCL 8 MG TABLET [Zofran].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | P |
ONDANSETRON ODT 4 MG TABLET ![Compare how all Medicare Part D PDP plans in OH cover ONDANSETRON ODT 4 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | P |
ONDANSETRON ODT 8 MG TABLET RAPDIS [Zofran ODT] ![Compare how all Medicare Part D PDP plans in OH cover ONDANSETRON ODT 8 MG TABLET RAPDIS [Zofran ODT].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | P |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ONGENTYS 25 MG CAPSULE ![Compare how all Medicare Part D PDP plans in OH cover ONGENTYS 25 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | P Q:30 /30Days |
ONGENTYS 50 MG CAPSULE ![Compare how all Medicare Part D PDP plans in OH cover ONGENTYS 50 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | P Q:30 /30Days |
ONUREG 200 MG TABLET ![Compare how all Medicare Part D PDP plans in OH cover ONUREG 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:14 /28Days |
ONUREG 300 MG TABLET ![Compare how all Medicare Part D PDP plans in OH cover ONUREG 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:14 /28Days |
OPSUMIT 10 MG TABLET ![Compare how all Medicare Part D PDP plans in OH cover OPSUMIT 10 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:30 /30Days |
OPVEE 2.7 MG NASAL SPRAY ![Compare how all Medicare Part D PDP plans in OH cover OPVEE 2.7 MG NASAL SPRAY.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
OPZELURA 1.5% CREAM (G) ![Compare how all Medicare Part D PDP plans in OH cover OPZELURA 1.5% CREAM (G).](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:240 /30Days |
ORALAIR 300 IR SUBLINGUAL TABLET ![Compare how all Medicare Part D PDP plans in OH cover ORALAIR 300 IR SUBLINGUAL TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | P Q:30 /30Days |
ORENCIA 125 MG/ML SYRINGE ![Compare how all Medicare Part D PDP plans in OH cover ORENCIA 125 MG/ML SYRINGE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:4 /28Days |
Orencia 4 SYRINGE, GLASS in 1 CARTON > 0.4 mL in 1 SYRINGE, GLASS ![Compare how all Medicare Part D PDP plans in OH 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 |
Tier 5 |
33% | N/A | P Q:1.6 /28Days |
Orencia 4 SYRINGE, GLASS in 1 CARTON > 0.7 mL in 1 SYRINGE, GLASS ![Compare how all Medicare Part D PDP plans in OH 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 |
Tier 5 |
33% | N/A | P Q:2.8 /28Days |
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 OH cover ORENCIA CLICKJECT 125 MG/ML.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:4 /28Days |
Orenitram 100 TABLET, EXTENDED RELEASE in 1 BOTTLE ![Compare how all Medicare Part D PDP plans in OH cover Orenitram 100 TABLET, EXTENDED RELEASE in 1 BOTTLE .](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
ORENITRAM ER 0.125 MG TABLET ![Compare how all Medicare Part D PDP plans in OH cover ORENITRAM ER 0.125 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | P |
ORENITRAM ER 0.25 MG TABLET ![Compare how all Medicare Part D PDP plans in OH cover ORENITRAM ER 0.25 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
ORENITRAM ER 1 MG TABLET ![Compare how all Medicare Part D PDP plans in OH cover ORENITRAM ER 1 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
ORENITRAM ER 2.5 MG TABLET ![Compare how all Medicare Part D PDP plans in OH cover ORENITRAM ER 2.5 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
ORENITRAM MONTH 1 TITRATION KIT ER DSPK ![Compare how all Medicare Part D PDP plans in OH cover ORENITRAM MONTH 1 TITRATION KIT ER DSPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:336 /365Days |
ORENITRAM MONTH 2 TITRATION KIT ER DSPK ![Compare how all Medicare Part D PDP plans in OH cover ORENITRAM MONTH 2 TITRATION KIT ER DSPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:672 /365Days |
ORENITRAM MONTH 3 TITRATION KIT ER DSPK ![Compare how all Medicare Part D PDP plans in OH cover ORENITRAM MONTH 3 TITRATION KIT ER DSPK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:504 /365Days |
ORFADIN 4 MG/ML SUSPENSION ![Compare how all Medicare Part D PDP plans in OH cover ORFADIN 4 MG/ML SUSPENSION.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P |
ORGOVYX 120 MG TABLET ![Compare how all Medicare Part D PDP plans in OH cover ORGOVYX 120 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:30 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ORIAHNN 300-1-0.5MG/300MG CAPSULE SEQ ![Compare how all Medicare Part D PDP plans in OH cover ORIAHNN 300-1-0.5MG/300MG CAPSULE SEQ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:56 /28Days |
ORILISSA 150 MG TABLET ![Compare how all Medicare Part D PDP plans in OH cover ORILISSA 150 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:30 /30Days |
ORILISSA 200 MG TABLET ![Compare how all Medicare Part D PDP plans in OH cover ORILISSA 200 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:60 /30Days |
ORKAMBI 100 MG-125 MG TABLET ![Compare how all Medicare Part D PDP plans in OH cover ORKAMBI 100 MG-125 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:112 /28Days |
ORKAMBI 100-125 MG GRANULE PKT GRAN PACK ![Compare how all Medicare Part D PDP plans in OH cover ORKAMBI 100-125 MG GRANULE PKT GRAN PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:56 /28Days |
ORKAMBI 150-188 MG GRANULE PKT GRAN PACK ![Compare how all Medicare Part D PDP plans in OH cover ORKAMBI 150-188 MG GRANULE PKT GRAN PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:56 /28Days |
ORKAMBI 200 MG-125 MG TABLET ![Compare how all Medicare Part D PDP plans in OH cover ORKAMBI 200 MG-125 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:112 /28Days |
ORKAMBI 75-94 MG GRANULE PACK ![Compare how all Medicare Part D PDP plans in OH cover ORKAMBI 75-94 MG GRANULE PACK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:56 /28Days |
ORLADEYO 110 MG CAPSULE ![Compare how all Medicare Part D PDP plans in OH cover ORLADEYO 110 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:28 /28Days |
ORLADEYO 150 MG CAPSULE ![Compare how all Medicare Part D PDP plans in OH cover ORLADEYO 150 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:28 /28Days |
ORPHENADRINE ER 100 MG TABLET [Norflex] ![Compare how all Medicare Part D PDP plans in OH cover ORPHENADRINE ER 100 MG TABLET [Norflex].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
ORSERDU 345 MG TABLET ![Compare how all Medicare Part D PDP plans in OH cover ORSERDU 345 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:30 /30Days |
ORSERDU 86 MG TABLET ![Compare how all Medicare Part D PDP plans in OH cover ORSERDU 86 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:90 /30Days |
OSELTAMIVIR 6 MG/ML ORAL SUSPENSION [Tamiflu] ![Compare how all Medicare Part D PDP plans in OH cover OSELTAMIVIR 6 MG/ML ORAL SUSPENSION [Tamiflu].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:525 /180Days |
OSELTAMIVIR PHOS 30 MG CAPSULE [Tamiflu] ![Compare how all Medicare Part D PDP plans in OH cover OSELTAMIVIR PHOS 30 MG CAPSULE [Tamiflu].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | Q:84 /180Days |
OSELTAMIVIR PHOS 45 MG CAPSULE [Tamiflu] ![Compare how all Medicare Part D PDP plans in OH cover OSELTAMIVIR PHOS 45 MG CAPSULE [Tamiflu].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | Q:42 /180Days |
OSELTAMIVIR PHOS 75 MG CAPSULE [Tamiflu] ![Compare how all Medicare Part D PDP plans in OH cover OSELTAMIVIR PHOS 75 MG CAPSULE [Tamiflu].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | Q:42 /180Days |
OTEZLA 28 DAY STARTER PACK TABLET DS PK ![Compare how all Medicare Part D PDP plans in OH cover OTEZLA 28 DAY STARTER PACK TABLET DS PK.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:110 /365Days |
OTEZLA 30 MG TABLET ![Compare how all Medicare Part D PDP plans in OH cover OTEZLA 30 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:60 /30Days |
OTREXUP 10 MG/0.4 ML AUTO-INJ ![Compare how all Medicare Part D PDP plans in OH cover OTREXUP 10 MG/0.4 ML AUTO-INJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | P Q:1.6 /28Days |
OTREXUP 12.5 MG/0.4 ML AUTOINJ ![Compare how all Medicare Part D PDP plans in OH cover OTREXUP 12.5 MG/0.4 ML AUTOINJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | P Q:1.6 /28Days |
OTREXUP 15 MG/0.4 ML AUTO-INJ ![Compare how all Medicare Part D PDP plans in OH cover OTREXUP 15 MG/0.4 ML AUTO-INJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | P Q:1.6 /28Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OTREXUP 17.5 MG/0.4 ML AUTOINJ ![Compare how all Medicare Part D PDP plans in OH cover OTREXUP 17.5 MG/0.4 ML AUTOINJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | P Q:1.6 /28Days |
OTREXUP 20 MG/0.4 ML AUTO-INJ ![Compare how all Medicare Part D PDP plans in OH cover OTREXUP 20 MG/0.4 ML AUTO-INJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | P Q:1.6 /28Days |
OTREXUP 22.5 MG/0.4 ML AUTOINJ ![Compare how all Medicare Part D PDP plans in OH cover OTREXUP 22.5 MG/0.4 ML AUTOINJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | P Q:1.6 /28Days |
OTREXUP 25 MG/0.4 ML AUTO-INJ ![Compare how all Medicare Part D PDP plans in OH cover OTREXUP 25 MG/0.4 ML AUTO-INJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | P Q:1.6 /28Days |
OXACILLIN 1 GM VIAL ![Compare how all Medicare Part D PDP plans in OH cover OXACILLIN 1 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
OXACILLIN 10 GM VIAL ![Compare how all Medicare Part D PDP plans in OH cover OXACILLIN 10 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
OXACILLIN 1GM/50ML INJ ![Compare how all Medicare Part D PDP plans in OH cover OXACILLIN 1GM/50ML INJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
OXACILLIN 2 GM VIAL ![Compare how all Medicare Part D PDP plans in OH cover OXACILLIN 2 GM VIAL.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
OXACILLIN 2GM/50ML INJ ![Compare how all Medicare Part D PDP plans in OH cover OXACILLIN 2GM/50ML INJ.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
OXAPROZIN 600 MG TABLET ![Compare how all Medicare Part D PDP plans in OH cover OXAPROZIN 600 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
OXAZEPAM 10 MG CAPSULE ![Compare how all Medicare Part D PDP plans in OH cover OXAZEPAM 10 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | Q:120 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OXAZEPAM 15 MG CAPSULE ![Compare how all Medicare Part D PDP plans in OH cover OXAZEPAM 15 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | Q:120 /30Days |
OXAZEPAM 30 MG CAPSULE ![Compare how all Medicare Part D PDP plans in OH cover OXAZEPAM 30 MG CAPSULE.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | Q:120 /30Days |
OXBRYTA 300 MG TABLET ![Compare how all Medicare Part D PDP plans in OH cover OXBRYTA 300 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:90 /30Days |
OXBRYTA 300 MG TABLET FOR SUSP ![Compare how all Medicare Part D PDP plans in OH cover OXBRYTA 300 MG TABLET FOR SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:150 /30Days |
OXBRYTA 500 MG TABLET ![Compare how all Medicare Part D PDP plans in OH cover OXBRYTA 500 MG TABLET.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:90 /30Days |
OXCARBAZEPINE 150 MG TABLET [Trileptal] ![Compare how all Medicare Part D PDP plans in OH cover OXCARBAZEPINE 150 MG TABLET [Trileptal].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
OXCARBAZEPINE 300 MG TABLET [Trileptal] ![Compare how all Medicare Part D PDP plans in OH cover OXCARBAZEPINE 300 MG TABLET [Trileptal].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
OXCARBAZEPINE 300 MG/5 ML SUSP ![Compare how all Medicare Part D PDP plans in OH cover OXCARBAZEPINE 300 MG/5 ML SUSP.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | None |
OXCARBAZEPINE 600 MG TABLET [Trileptal] ![Compare how all Medicare Part D PDP plans in OH cover OXCARBAZEPINE 600 MG TABLET [Trileptal].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
OXERVATE 0.002% EYE DROPS ![Compare how all Medicare Part D PDP plans in OH cover OXERVATE 0.002% EYE DROPS.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
5 |
Tier 5 |
33% | N/A | P Q:56 /56Days |
OXICONAZOLE NITRATE 1% CREAM (g) [Oxistat] ![Compare how all Medicare Part D PDP plans in OH cover OXICONAZOLE NITRATE 1% CREAM (g) [Oxistat].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:90 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OXYBUTYNIN 5 MG TABLET [Ditropan] ![Compare how all Medicare Part D PDP plans in OH cover OXYBUTYNIN 5 MG TABLET [Ditropan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
OXYBUTYNIN 5 MG/5 ML SYRUP [Ditropan] ![Compare how all Medicare Part D PDP plans in OH cover OXYBUTYNIN 5 MG/5 ML SYRUP [Ditropan].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
1 |
Preferred Generic |
$0.00 | $0.00 | None |
OXYBUTYNIN CL ER 10 MG TABLET 24 [Ditropan XL] ![Compare how all Medicare Part D PDP plans in OH cover OXYBUTYNIN CL ER 10 MG TABLET 24 [Ditropan XL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
OXYBUTYNIN CL ER 15 MG TABLET ER 24 [Ditropan XL] ![Compare how all Medicare Part D PDP plans in OH cover OXYBUTYNIN CL ER 15 MG TABLET ER 24 [Ditropan XL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
OXYBUTYNIN CL ER 5 MG TABLET ER 24 [Ditropan XL] ![Compare how all Medicare Part D PDP plans in OH cover OXYBUTYNIN CL ER 5 MG TABLET ER 24 [Ditropan XL].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | None |
OXYCODONE HCL (IR) 20 MG TABLET [Roxicodone] ![Compare how all Medicare Part D PDP plans in OH cover OXYCODONE HCL (IR) 20 MG TABLET [Roxicodone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | Q:180 /30Days |
OXYCODONE HCL (IR) 5 MG TABLET [Roxybond] ![Compare how all Medicare Part D PDP plans in OH cover OXYCODONE HCL (IR) 5 MG TABLET [Roxybond].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | Q:180 /30Days |
OXYCODONE HCL 10 MG TABLET [Dazidox] ![Compare how all Medicare Part D PDP plans in OH cover OXYCODONE HCL 10 MG TABLET [Dazidox].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | Q:180 /30Days |
OXYCODONE HCL 100 MG/5 ML ORAL CONC [Roxicodone] ![Compare how all Medicare Part D PDP plans in OH cover OXYCODONE HCL 100 MG/5 ML ORAL CONC [Roxicodone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:180 /30Days |
OXYCODONE HCL 15 MG TABLET [Roxybond] ![Compare how all Medicare Part D PDP plans in OH cover OXYCODONE HCL 15 MG TABLET [Roxybond].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | Q:180 /30Days |
OXYCODONE HCL 30 MG TABLET [Roxybond] ![Compare how all Medicare Part D PDP plans in OH cover OXYCODONE HCL 30 MG TABLET [Roxybond].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | None |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OXYCODONE HCL 5 MG CAPSULE [OxyIR] ![Compare how all Medicare Part D PDP plans in OH cover OXYCODONE HCL 5 MG CAPSULE [OxyIR].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:180 /30Days |
OXYCODONE HCL 5 MG/5 ML SOLUTION [Roxicodone] ![Compare how all Medicare Part D PDP plans in OH cover OXYCODONE HCL 5 MG/5 ML SOLUTION [Roxicodone].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | Q:900 /30Days |
OXYCODONE-ACETAMINOPHEN 10-325 TABLET [Percocet] ![Compare how all Medicare Part D PDP plans in OH cover OXYCODONE-ACETAMINOPHEN 10-325 TABLET [Percocet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | Q:360 /30Days |
OXYCODONE-ACETAMINOPHEN 5-325 TABLET [Roxicet] ![Compare how all Medicare Part D PDP plans in OH cover OXYCODONE-ACETAMINOPHEN 5-325 TABLET [Roxicet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | Q:360 /30Days |
OXYCODONE-ACETAMINOPHN 2.5-325 TABLET [Percocet] ![Compare how all Medicare Part D PDP plans in OH cover OXYCODONE-ACETAMINOPHN 2.5-325 TABLET [Percocet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:360 /30Days |
OXYCODONE-ACETAMINOPHN 7.5-325 TABLET [Percocet] ![Compare how all Medicare Part D PDP plans in OH cover OXYCODONE-ACETAMINOPHN 7.5-325 TABLET [Percocet].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
3 |
Preferred Brand |
$47.00 | $117.50 | Q:360 /30Days |
OXYMORPHONE HCL 10 MG TABLET [Opana] ![Compare how all Medicare Part D PDP plans in OH cover OXYMORPHONE HCL 10 MG TABLET [Opana].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:180 /30Days |
OXYMORPHONE HCL 5 MG TABLET [Opana] ![Compare how all Medicare Part D PDP plans in OH cover OXYMORPHONE HCL 5 MG TABLET [Opana].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:180 /30Days |
OXYMORPHONE HCL ER 10 MG TABLET ER 12H ![Compare how all Medicare Part D PDP plans in OH cover OXYMORPHONE HCL ER 10 MG TABLET ER 12H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | P Q:60 /30Days |
OXYMORPHONE HCL ER 15 MG TABLET ER 12H ![Compare how all Medicare Part D PDP plans in OH cover OXYMORPHONE HCL ER 15 MG TABLET ER 12H.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | P Q:60 /30Days |
OXYMORPHONE HCL ER 20 MG TABLET ER 12H [Opana] ![Compare how all Medicare Part D PDP plans in OH cover OXYMORPHONE HCL ER 20 MG TABLET ER 12H [Opana].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | P Q:60 /30Days |
Drug Name |
Tier Nbr. |
Tier Description |
30-Day Preferred Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
OXYMORPHONE HCL ER 30 MG TABLET 12H [Opana ER] ![Compare how all Medicare Part D PDP plans in OH cover OXYMORPHONE HCL ER 30 MG TABLET 12H [Opana ER].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | P Q:60 /30Days |
OXYMORPHONE HCL ER 40 MG TABLET ER 12H [Opana] ![Compare how all Medicare Part D PDP plans in OH cover OXYMORPHONE HCL ER 40 MG TABLET ER 12H [Opana].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | P |
OXYMORPHONE HCL ER 5 MG TABLET ER 12H [Opana] ![Compare how all Medicare Part D PDP plans in OH cover OXYMORPHONE HCL ER 5 MG TABLET ER 12H [Opana].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | P Q:60 /30Days |
OXYMORPHONE HCL ER 7.5 MG TABLET ER 12H [Opana] ![Compare how all Medicare Part D PDP plans in OH cover OXYMORPHONE HCL ER 7.5 MG TABLET ER 12H [Opana].](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | P Q:60 /30Days |
OZEMPIC 0.25-0.5 MG/DOSE PEN PEN INJCTR ![Compare how all Medicare Part D PDP plans in OH cover OZEMPIC 0.25-0.5 MG/DOSE PEN PEN INJCTR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | P Q:3 /28Days |
OZEMPIC 1 MG/DOSE (4 MG/3 ML) PEN INJECTOR ![Compare how all Medicare Part D PDP plans in OH cover OZEMPIC 1 MG/DOSE (4 MG/3 ML) PEN INJECTOR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | P Q:3 /28Days |
OZEMPIC 2 MG/DOSE (8 MG/3 ML) PEN INJCTR ![Compare how all Medicare Part D PDP plans in OH cover OZEMPIC 2 MG/DOSE (8 MG/3 ML) PEN INJCTR.](https://q1medicare.com/pics/ContentPics/compare_partd_plans_by_drug.png) |
2 |
Generic |
$0.00 | $0.00 | P Q:3 /28Days |