Oxistat

Generic: oxiconazole

10 MG — Lotion

Antifungals

Also known as: oxiconazole
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Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: CMS QHP JSON  ·  Formulary date: Jan 1, 2026  ·  Checked: 20 hours, 1 minute ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Standard Gold with Atrium Health
via oxiconazole 		Tier 2 - Generic — — ✓ QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental
via oxiconazole 		Tier 2 - Generic — — ✓ QL
Complete Gold + Vision + Adult Dental
via oxiconazole 		Tier 2 - Generic — — ✓ QL
Everyday Bronze + Vision + Adult Dental
via oxiconazole 		Tier 2 - Generic — — ✓ QL
Elite Bronze + Vision + Adult Dental
via oxiconazole 		Tier 2 - Generic — — ✓ QL
Everyday Bronze with Atrium Health + Vision + Adult Dental
via oxiconazole 		Tier 2 - Generic — — ✓ QL
Elite Bronze with Atrium Health + Vision + Adult Dental
via oxiconazole 		Tier 2 - Generic — — ✓ QL
Standard Gold with Atrium Health + Vision + Adult Dental
via oxiconazole 		Tier 2 - Generic — — ✓ QL
Standard Silver with Atrium Health + Vision + Adult Dental
via oxiconazole 		Tier 2 - Generic — — ✓ QL
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental
via oxiconazole 		Tier 2 - Generic — — ✓ QL
Standard Gold + Vision + Adult Dental
via oxiconazole 		Tier 2 - Generic — — ✓ QL
Standard Silver
via oxiconazole 		Tier 2 - Generic — — ✓ QL
Standard Expanded Bronze
via oxiconazole 		Tier 2 - Generic — — ✓ QL
Clear Silver with $0 Insulin Options
via oxiconazole 		Tier 2 - Generic — — ✓ QL
Elite Bronze
via oxiconazole 		Tier 2 - Generic — — ✓ QL
Everyday Bronze
via oxiconazole 		Tier 2 - Generic — — ✓ QL
Standard Silver + Vision + Adult Dental
via oxiconazole 		Tier 2 - Generic — — ✓ QL
Standard Expanded Bronze + Vision + Adult Dental
via oxiconazole 		Tier 2 - Generic — — ✓ QL
Complete Gold with Atrium Health + Vision + Adult Dental
via oxiconazole 		Tier 2 - Generic — — ✓ QL
Focused Silver with Atrium Health + Vision + Adult Dental
via oxiconazole 		Tier 2 - Generic — — ✓ QL
Complete Gold
via oxiconazole 		Tier 2 - Generic — — ✓ QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options
via oxiconazole 		Tier 2 - Generic — — ✓ QL
Standard Gold
via oxiconazole 		Tier 2 - Generic — — ✓ QL
Everyday Bronze with Atrium Health
via oxiconazole 		Tier 2 - Generic — — ✓ QL
Elite Bronze with Atrium Health
via oxiconazole 		Tier 2 - Generic — — ✓ QL
Focused Silver with Atrium Health
via oxiconazole 		Tier 2 - Generic — — ✓ QL
Complete Gold with Atrium Health
via oxiconazole 		Tier 2 - Generic — — ✓ QL
Standard Expanded Bronze with Atrium Health
via oxiconazole 		Tier 2 - Generic — — ✓ QL
Standard Silver with Atrium Health
via oxiconazole 		Tier 2 - Generic — — ✓ QL
Elite Bronze Tier 3 - Preferred Brand — — ✓ QL
Standard Expanded Bronze + Vision + Adult Dental Tier 3 - Preferred Brand — — ✓ QL
Standard Silver + Vision + Adult Dental Tier 3 - Preferred Brand — — ✓ QL
Standard Gold + Vision + Adult Dental Tier 3 - Preferred Brand — — ✓ QL
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental Tier 3 - Preferred Brand — — ✓ QL
Standard Silver with Atrium Health + Vision + Adult Dental Tier 3 - Preferred Brand — — ✓ QL
Standard Gold with Atrium Health + Vision + Adult Dental Tier 3 - Preferred Brand — — ✓ QL
Standard Silver Tier 3 - Preferred Brand — — ✓ QL
Standard Gold Tier 3 - Preferred Brand — — ✓ QL
Everyday Bronze with Atrium Health + Vision + Adult Dental Tier 3 - Preferred Brand — — ✓ QL
Elite Bronze with Atrium Health + Vision + Adult Dental Tier 3 - Preferred Brand — — ✓ QL
Focused Silver with Atrium Health + Vision + Adult Dental Tier 3 - Preferred Brand — — ✓ QL
Complete Gold with Atrium Health + Vision + Adult Dental Tier 3 - Preferred Brand — — ✓ QL
Clear Silver with $0 Insulin Options Tier 3 - Preferred Brand — — ✓ QL
Standard Expanded Bronze Tier 3 - Preferred Brand — — ✓ QL
Everyday Bronze with Atrium Health Tier 3 - Preferred Brand — — ✓ QL
Elite Bronze with Atrium Health Tier 3 - Preferred Brand — — ✓ QL
Focused Silver with Atrium Health Tier 3 - Preferred Brand — — ✓ QL
Complete Gold with Atrium Health Tier 3 - Preferred Brand — — ✓ QL
Standard Expanded Bronze with Atrium Health Tier 3 - Preferred Brand — — ✓ QL
Standard Silver with Atrium Health Tier 3 - Preferred Brand — — ✓ QL
Standard Gold with Atrium Health Tier 3 - Preferred Brand — — ✓ QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental Tier 3 - Preferred Brand — — ✓ QL
Complete Gold + Vision + Adult Dental Tier 3 - Preferred Brand — — ✓ QL
Everyday Bronze + Vision + Adult Dental Tier 3 - Preferred Brand — — ✓ QL
Elite Bronze + Vision + Adult Dental Tier 3 - Preferred Brand — — ✓ QL
Complete Gold Tier 3 - Preferred Brand — — ✓ QL
Enhanced Asthma/COPD Care Silver with $0 Drug Options Tier 3 - Preferred Brand — — ✓ QL
Everyday Bronze Tier 3 - Preferred Brand — — ✓ QL
Source: CMS QHP JSON  ·  Checked: 20 hours, 1 minute ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
AmeriHealth Caritas Next Bronze Signature + No Referrals
via oxiconazole 		Tier 2 - Generic ✓ — — PA
AmeriHealth Caritas Next Gold Signature + No Referrals
via oxiconazole 		Tier 2 - Generic ✓ — — PA
AmeriHealth Caritas Next Bronze Essential + No Referrals
via oxiconazole 		Tier 2 - Generic ✓ — — PA
AmeriHealth Caritas Next Silver Off-Marketplace Low + No Referrals
via oxiconazole 		Tier 2 - Generic ✓ — — PA
AmeriHealth Caritas Next Silver Essential + No Referrals
via oxiconazole 		Tier 2 - Generic ✓ — — PA
AmeriHealth Caritas Next Silver Off-Marketplace High + No Referrals
via oxiconazole 		Tier 2 - Generic ✓ — — PA
AmeriHealth Caritas Next Silver Signature + No Referrals
via oxiconazole 		Tier 2 - Generic ✓ — — PA
AmeriHealth Caritas Next Silver Premier + No Referrals
via oxiconazole 		Tier 2 - Generic ✓ — — PA
AmeriHealth Caritas Next Gold Premier + No Referrals
via oxiconazole 		Tier 2 - Generic ✓ — — PA
AmeriHealth Caritas Next Bronze Premier + No Referrals
via oxiconazole 		Tier 2 - Generic ✓ — — PA
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 20 hours, 1 minute ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBSNC Blue Value 2026 Tier 2 - Medium Cost Generic/Brand ✓ — — Restricted Access PA
BCBSNC Blue Local 2026 Tier 2 - Medium Cost Generic/Brand ✓ — — Restricted Access PA
BCBSNC Blue Care 2026 Tier 2 - Medium Cost Generic/Brand ✓ — — Restricted Access PA
BCBSNC Blue Advantage 2026 Tier 2 - Medium Cost Generic/Brand ✓ — — Restricted Access PA
BCBSNC Blue Home with UNC Health Alliance 2026 Tier 2 - Medium Cost Generic/Brand ✓ — — Restricted Access PA
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 20 hours, 1 minute ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC Medicaid Preferred Drug List 2026
via oxiconazole 		Non-Preferred — — — None
NC Medicaid Preferred Drug List 2026 Non-Preferred — — — None
Source: CMS QHP JSON  ·  Checked: 20 hours, 1 minute ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
AIAN Cost Share
via oxiconazole 		Tier 3 - Preferred Brand ✓ — — PA
Bronze Classic 4700 | with Atrium Health
via oxiconazole 		Tier 3 - Preferred Brand ✓ — — PA
Bronze Elite + PCP Saver Plus | with Atrium Health
via oxiconazole 		Tier 3 - Preferred Brand ✓ — — PA
Silver Classic | with Atrium Health
via oxiconazole 		Tier 3 - Preferred Brand ✓ — — PA
Silver Simple Diabetes | with Atrium Health
via oxiconazole 		Tier 3 - Preferred Brand ✓ — — PA
Silver Simple PCP Saver | with Atrium Health
via oxiconazole 		Tier 3 - Preferred Brand ✓ — — PA
Gold Elite Saver Plus | with Atrium Health
via oxiconazole 		Tier 3 - Preferred Brand ✓ — — PA
Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health
via oxiconazole 		Tier 3 - Preferred Brand ✓ — — PA
Bronze Simple Chronic Care CKM | with Atrium Health
via oxiconazole 		Tier 3 - Preferred Brand ✓ — — PA
Bronze Simple Diabetes | with Atrium Health
via oxiconazole 		Tier 3 - Preferred Brand ✓ — — PA
Silver Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health
via oxiconazole 		Tier 3 - Preferred Brand ✓ — — PA
Silver Simple Chronic Care CKM | with Atrium Health
via oxiconazole 		Tier 3 - Preferred Brand ✓ — — PA
Silver Simple Women's Health with Menopause Benefits | with Atrium Health
via oxiconazole 		Tier 3 - Preferred Brand ✓ — — PA
AIAN Cost Share | with Atrium Health
via oxiconazole 		Tier 3 - Preferred Brand ✓ — — PA
Bronze Classic Standard
via oxiconazole 		Tier 3 - Preferred Brand ✓ — — PA
Silver Classic Standard
via oxiconazole 		Tier 3 - Preferred Brand ✓ — — PA
Gold Classic Standard
via oxiconazole 		Tier 3 - Preferred Brand ✓ — — PA
Bronze Classic Standard | with Atrium Health
via oxiconazole 		Tier 3 - Preferred Brand ✓ — — PA
Silver Classic Standard | with Atrium Health
via oxiconazole 		Tier 3 - Preferred Brand ✓ — — PA
Gold Classic Standard | with Atrium Health
via oxiconazole 		Tier 3 - Preferred Brand ✓ — — PA
Bronze Elite + PCP Saver Plus
via oxiconazole 		Tier 3 - Preferred Brand ✓ — — PA
Silver Classic
via oxiconazole 		Tier 3 - Preferred Brand ✓ — — PA
Secure
via oxiconazole 		Tier 3 - Preferred Brand ✓ — — PA
Bronze Classic 4700
via oxiconazole 		Tier 3 - Preferred Brand ✓ — — PA
Silver Simple PCP Saver
via oxiconazole 		Tier 3 - Preferred Brand ✓ — — PA
Gold Elite Saver Plus
via oxiconazole 		Tier 3 - Preferred Brand ✓ — — PA
Silver Simple Diabetes
via oxiconazole 		Tier 3 - Preferred Brand ✓ — — PA
Secure | with Atrium Health
via oxiconazole 		Tier 3 - Preferred Brand ✓ — — PA
Source: PDF  ·  Formulary date: Jun 23, 2026  ·  Checked: 20 hours, 1 minute ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
UHC Silver Value ($0 Virtual Urgent Care, No Referrals)
via oxiconazole 		Tier 4 - Non-Preferred — — ✓ QL
UHC Silver Standard (No Referrals)
via oxiconazole 		Tier 4 - Non-Preferred — — ✓ QL
UHC Bronze Standard (No Referrals)
via oxiconazole 		Tier 4 - Non-Preferred — — ✓ QL
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals)
via oxiconazole 		Tier 4 - Non-Preferred — — ✓ QL
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals)
via oxiconazole 		Tier 4 - Non-Preferred — — ✓ QL
UHC Gold Standard (No Referrals)
via oxiconazole 		Tier 4 - Non-Preferred — — ✓ QL
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals)
via oxiconazole 		Tier 4 - Non-Preferred — — ✓ QL
UHC Gold Advantage + ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals)
via oxiconazole 		Tier 4 - Non-Preferred — — ✓ QL
UHC Bronze Standard+ Dental + Vision (No Referrals)
via oxiconazole 		Tier 4 - Non-Preferred — — ✓ QL
UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals)
via oxiconazole 		Tier 4 - Non-Preferred — — ✓ QL
UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals
via oxiconazole 		Tier 4 - Non-Preferred — — ✓ QL
UHC Silver Value + ($0 Virtual Urgent Care, Dental + Vision, No Referrals)
via oxiconazole 		Tier 4 - Non-Preferred — — ✓ QL
UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals)
via oxiconazole 		Tier 4 - Non-Preferred — — ✓ QL
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