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Effective DatePolicy NameReviewed Date
1/20/2017 Obizur [antihemophilic (recombinant), porcine sequence]
4/15/2026
1/1/2024 Ocaliva® (obeticholic acid)
1/21/2026
1/1/2026 Ocrevus® (ocrelizumab) & Ocrevus Zunovo™ (ocrelizumab and hyaluronidase-ocsq)
6/18/2025
1/1/2024 Octreotide Products
7/17/2024
10/29/2015 Odomzo® (sonidegib)
4/15/2026
1/1/2021 Ofev® (nintedanib)
6/18/2025
2/28/2024 Ogsiveo (nirogacestat)
1/29/2026
10/23/2024 Ohtuvayre ™(ensifentrine)
10/15/2025
6/26/2024 Ojemda (tovorafenib)
1/21/2026
1/1/2026 Ojjaara (momelotinib)
5/21/2025
1/1/2026 Olumiant (baricitinib)
7/16/2025
1/1/2017 Omeprazole/Sodium Bicarbonate Products
12/10/2025
1/1/2025 Omvoh (mirikizumab)
6/18/2025
5/28/2025 Onapgo® (apomorphine)
1/21/2026
1/1/2018 Oncaspar® (pegaspargase)
12/10/2025
2/1/2026 Oncaspar® (pegaspargase)
12/10/2025
2/1/2026 Oncaspar® (pegaspargase)
12/10/2025
2/1/2026 Oncaspar® (pegaspargase)
12/10/2025
1/1/2026 Onfi® (clobazam)
4/15/2026
12/9/2020 Ongentys® (opicapone)
8/20/2025
1/20/2016 Onivyde (liposomal irinotecan)
7/16/2025
9/1/2025 Onivyde (liposomal irinotecan)
7/16/2025
9/1/2025 Onivyde (liposomal irinotecan)
7/16/2025
9/1/2025 Onivyde (liposomal irinotecan)
7/16/2025
1/1/2023 Onpattro® (patisiran)
3/18/2026
1/1/2026 Onureg™ (azacitidine)
5/21/2025
4/13/2022 Opdualag™ (nivolumab and relatlimab-rmbw)
3/18/2026
1/1/2023 Opdualag™ (nivolumab and relatlimab-rmbw)
3/18/2026
3/27/2024 Opfolda® (miglustat)
12/10/2025
1/1/2026 Ophthalmic Antibiotics
5/21/2025
1/1/2025 Ophthalmic Beta Blockers
3/18/2026
1/1/2025 Ophthalmic Cyclosporine (Cequa®, Restasis®, Restasis MultiDose®, Vevye®)
6/18/2025
1/1/2020 Ophthalmic Non-Steroidal Anti-Inflammatory Drugs
8/20/2025
1/1/2024 Ophthalmic Prostaglandins
9/17/2025
1/1/2024 Ophthalmic Steroids
2/18/2026
10/1/2025 Opioid Days Supply
11/13/2025
1/1/2019 Opioid Days' Supply Limitation
10/24/2024
4/1/2024 Opioid Days' Supply Limitation
11/21/2024
7/1/2024 Opioid Days' Supply Limitation
6/13/2024
1/1/2025 Opioid Overdose Reversal Medications (Zimhi™)
3/18/2026
1/1/2026 Opioid Use Disorder (Suboxone Film)
3/18/2026
2/1/2021 Opioid Utilization Program - Concurrent Use of Opioids and Benzodiazepines (COB) edits
11/21/2024
7/1/2024 Opioid Utilization Program - Concurrent Use of Opioids and Benzodiazepines (COB) edits
6/17/2025
10/1/2025 Opioid Utilization Program - Concurrent Use of Opioids/Benzodiazepines and Buprenorphine
5/15/2025
10/1/2025 Opioid Utilization Program - Morphine Milligram Equivalent (MME)
5/15/2025
7/1/2025 Opioid Utilization Program - Morphine Milligram Equivalent (MME)
5/29/2025
1/1/2021 Opioid Utilization Program - Morphine Milligram Equivalent (MME) edits
11/21/2024
1/1/2021 Opioid Utilization Program - Morphine Milligram Equivalents (MME) edits
11/21/2024
7/1/2021 Opioid Utilization Program - Morphine Milligram Equivalents (MME) edits
12/11/2025
3/12/2026 Opioid Utilization Program - Morphine Milligram Equivalents (MME) edits
3/12/2026
4/1/2024 Opioid Utilization Program - Morphine Milligram Equivalent (MME) edits
11/13/2025
1/1/2026 Opipza™ oral film
10/15/2025
1/1/2026 Opsumit® (macitentan)/Opsynvi® (macitentan and tadalfil)
8/20/2025
1/1/2026 Opsumit® (macitentan)/Opsynvi® (macitentan and tadalfil)
11/19/2025
1/1/2026 Opzelura™ (ruxolitinib)
5/21/2025
1/1/2020 Oral Acne Antibiotics
7/16/2025
1/1/2022 Oral Acne Antibiotics
4/17/2024
1/1/2021 Oral Isotretinoin Products
2/18/2026
1/1/2021 Oral Penicillamine Products
11/19/2025
1/1/2026 Orencia (abatacept) Intravenous
7/16/2025
1/1/2026 Orencia (abatacept) Subcutaneous
7/16/2025
1/1/2026 Orenitram® (treprostinil)
8/20/2025
1/1/2026 Orgovyx (relugolix)
4/15/2026
10/17/2018 Orilissa® (elagolix)
4/15/2026
1/1/2025 Orladeyo (berotralstat)
8/20/2025
1/1/2026 Orphenadrine Products
3/18/2026
4/19/2023 Orserdu (elacestrant)
10/15/2025
6/20/2018 Osmolex ER™ (amantadine extended release)
11/19/2025
1/1/2026 Osphena® (ospemifene)
5/21/2025
1/1/2026 Osphena® (ospemifene)
4/15/2026
1/1/2026 Otezla (apremilast)
9/17/2025
1/1/2022 Otic Antibiotics
2/21/2024
1/1/2025 Overactive Bladder Agents
5/21/2025
1/1/2026 Oxervate® (cenegermin) ophthalmic solution
5/21/2025
1/1/2026 Oxervate® (cenegermin) ophthalmic solution
2/18/2026
4/21/2021 Oxlumo® (lumasiran)
9/17/2025
1/1/2020 Oxtellar XR® (oxcarbazepine extended release)
10/15/2025
1/1/2026 Oxycodone-Acetaminophen (300mg) Products
3/18/2026
10/14/2009 Ozurdex® (dexamethasone intravitreal implant)
11/19/2025
1/1/2026 Ozurdex® (dexamethasone intravitreal implant)
11/19/2025
1/1/2026 Ozurdex® (dexamethasone intravitreal implant)
11/19/2025
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