Medicare Part D coverage · oxycodone hydrochloride · RxCUI 1049615
oxycodone hydrochloride 20 MG/ML Oral Solution
Per the CMS 2026 Part D formulary file, oxycodone hydrochloride 20 MG/ML Oral Solution is covered by 4,264 Medicare Part D plans (84.4% of enrollable products), averaging Tier 3.1, with prior authorization required on 6.2% of covering formularies.
- 84.4%
- Plan coverage
- 4,264
- Plans covering
- T3.1
- Avg tier
- 6.2%
- Prior auth required
What the CMS Formulary Data Shows for oxycodone hydrochloride 20 MG/ML Oral Solution
Per the CMS 2026 Part D formulary file, oxycodone hydrochloride 20 MG/ML Oral Solution (RxNorm concept RXCUI 1049615, generic name oxycodone hydrochloride) appears on 162 distinct formulary files spanning 4,264 Medicare Part D plan offerings - 84.4% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 3.1.
Real-world access to oxycodone hydrochloride 20 MG/ML Oral Solution depends on utilization management as much as tier placement: 6.2% of covering formularies require prior authorization. 0% require step therapy. 93.2% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 2,133,988 Part D beneficiaries filled oxycodone hydrochloride 20 MG/ML Oral Solution in 2023, with total plan-and-beneficiary spending of $262,998,163 and an average per-beneficiary annual cost of $123.24. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry oxycodone hydrochloride 20 MG/ML Oral Solution today.
Coverage Details
- Formularies covering
- 162
- Plans covering
- 4,264
- Coverage rate
- 84.4%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 6.2% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 93.2% of formularies
2023 Medicare Spending
- Beneficiaries
- 2,133,988
- Total spending
- $262,998,163
- Avg per beneficiary
- $123.24
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering oxycodone hydrochloride 20 MG/ML Oral Solution
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Sentara Community Complete Select (HMO D-SNP) | Sentara Health Plans | T1 | No | $0 | VA |
| Sentara Community Complete (HMO D-SNP) | Sentara Health Plans | T1 | No | $0 | VA |
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) | Hpmp OF Florida, Inc. | T1 | No | $0 | FL |
| ElderServe MAP (HMO D-SNP) | Elderserve Health, Inc. | T1 | No | $0 | NY |
| Cooperative Advantage (HMO D-SNP) | Group Health Cooperative OF EAU Claire | T1 | No | $0 | WI |
| Longevity Health Plan (PPO I-SNP) | Longevity Health Plan OF NEW Jersey Insurance Comp | T1 | No | $0 | NJ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Elderplan Plus Long-Term Care (HMO-POS D-SNP) | Elderplan, Inc. | T1 | No | $0 | NY |
| Health Choice Pathway (HMO D-SNP) | Health Choice Arizona, Inc. | T1 | No | $0 | AZ |
| Healthfirst CompleteCare (HMO D-SNP) | Healthfirst Health Plan, Inc. | T1 | No | $0 | NY |
| IMCare Classic (HMO D-SNP) | Itasca Medical Care | T1 | No | $0 | MN |
| Johns Hopkins Advantage MD D-SNP (HMO D-SNP) | Hopkins Health Advantage, Inc. | T1 | No | $0 | MD |
| MetroPlus UltraCare (HMO D-SNP) | Metroplus Health Plan, Inc. | T1 | No | $0 | NY |
| Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) | Upper Peninsula Health Plan, LLC | T1 | No | $0 | MI |
| CareSource Dual Advantage (HMO D-SNP) | Caresource Georgia Co. | T1 | No | $0 | GA |
| Senior Whole Health SCO (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| Senior Whole Health SCO NHC (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| Molina One Care (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
Show the next 30 plans
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP Caresource | T1 | No | $0 | MI |
| PHP (HMO C-snp) | Aids Healthcare Foundation | T1 | Yes | $0 | CA |
| CCA One Care (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | No | $0 | MA |
| CCA Senior Care Options (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | No | $0 | MA |
| VNS Health Total (HMO D-SNP) | VNS Choice | T1 | Yes | $0 | NY |
| Community Care's Partnership Program (HMO D-SNP) | Community Care Health Plan, Inc. | T1 | No | $0 | WI |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T1 | No | $0 | CA |
| Mass General Brigham SCO (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $0 | PA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $0 | PA |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Health Options West Virginia Inc. | T1 | No | $0 | WV |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | No | $0 | DE |
| Tufts Health One Care (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
| Tufts Health One Care CW (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options CW (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | No | $0 | MA |
| Leon MediExtra (HMO) | Leon Health, Inc. | T1 | Yes | $0 | FL |
| Leon MediDual (HMO D-SNP) | Leon Health, Inc. | T1 | Yes | $0 | FL |
| Leon MediMore (HMO) | Leon Health, Inc. | T1 | Yes | $0 | FL |
| Leon MediMax (HMO D-SNP) | Leon Health, Inc. | T1 | Yes | $0 | FL |
| Florida Complete Care (HMO I-SNP) | Hpmp OF Florida, Inc. | T1 | No | $4.80 | FL |
| Florida Complete Care- In The Community (HMO-POS I-SNP) | Hpmp OF Florida, Inc. | T1 | No | $4.80 | FL |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Florida, Inc. | T1 | No | $4.80 | FL |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T1 | Yes | $4.80 | FL |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Michigan, Inc. | T1 | No | $8.80 | MI |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $13.10 | PA |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Illinois, Inc. | T1 | No | $15.20 | IL |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Arizona | T1 | Yes | $17.00 | AZ |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $17.60 | PA |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is oxycodone hydrochloride 20 MG/ML Oral Solution covered by Medicare Part D?
Yes, oxycodone hydrochloride 20 MG/ML Oral Solution is covered by 4,264 Medicare Part D plans (84.4% of all Part D formularies).
What tier is oxycodone hydrochloride 20 MG/ML Oral Solution on Medicare Part D plans?
oxycodone hydrochloride 20 MG/ML Oral Solution averages Tier 3.1 across Part D plans, ranging from Tier 1 to Tier 4.
Does oxycodone hydrochloride 20 MG/ML Oral Solution require prior authorization?
6.2% of Part D formularies require prior authorization for oxycodone hydrochloride 20 MG/ML Oral Solution. Step therapy: 0%. Quantity limits: 93.2%.
How much does Medicare spend on oxycodone hydrochloride 20 MG/ML Oral Solution?
In 2023, total Medicare Part D spending on oxycodone hydrochloride 20 MG/ML Oral Solution was $262,998,163, covering 2,133,988 beneficiaries. The average spend per beneficiary was $123.24.
Read our methodology - how this data is sourced, computed, and verified.
Nationwide similar Part D drugs
Data-derived peers across the CMS Part D formulary extract: nearest average tier placement and nearest prior-authorization rate. Not therapeutic alternatives or same-generic strengths.
Closest average formulary tier
- paroxetine hydrochloride 2 MG/ML Oral Suspension T3.1
- isotretinoin 40 MG Oral Capsule T3.1
- griseofulvin 500 MG Oral Tablet T3.1
- erythromycin 333 MG Delayed Release Oral Tablet T3.1
- 20 ACTUAT zanamivir 5 MG/ACTUAT Dry Powder Inhaler [Relenza] T3.1
- {4 (risedronate sodium 35 MG Delayed Release Oral Tablet) } Pack T3.1
Similar prior-authorization rate
- flurazepam hydrochloride 15 MG Oral Capsule 6.3% PA
- ceftolozane 1000 MG / tazobactam 500 MG Injection [Zerbaxa] 6.3% PA
- meropenem 500 MG Injection 6.1% PA
- meropenem 1000 MG Injection 6.1% PA
- ertapenem 1000 MG Injection 6.1% PA
- 0.88 ML paliperidone palmitate 310 MG/ML Prefilled Syringe [Invega] 6.4% PA