oxycodone hcl
10 mg, 15 mg, 30 mg, 5 mg, 7.5 mg — Solution
Also known as:
oxycodone hcl oral capsule
oxycodone hcl oral concentrate
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oxycodone hcl oral tablet
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ROXYBOND
OXAYDO
oxycodone hcl caps 5mg; soln 5mg/5ml; tabs
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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.
Blue Cross Blue Shield Federal
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| BCBS Federal Basic Option 2026 | Tier 1 - Generic | — | — | ✓ | QL |
| BCBS Federal Focus 2026 | Tier 1 - Generic | — | — | ✓ | QL |
| BCBS Federal Standard Option 2026 | Tier 1 - Generic | — | — | ✓ | QL |
Blue Cross Blue Shield of NC
5 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| BCBSNC Blue Local 2026 | Tier 1 - Lowest Cost Generic | — | — | ✓ | QL |
| BCBSNC Blue Care 2026 | Tier 1 - Lowest Cost Generic | — | — | ✓ | QL |
| BCBSNC Blue Value 2026 | Tier 1 - Lowest Cost Generic | — | — | ✓ | QL |
| BCBSNC Blue Advantage 2026 | Tier 1 - Lowest Cost Generic | — | — | ✓ | QL |
| BCBSNC Blue Home with UNC Health Alliance 2026 | Tier 1 - Lowest Cost Generic | — | — | ✓ | QL |
NC Medicaid PDL
1 planNC State Health Plan
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| NC State Health Plan - 80/20 Plus PPO 2026 | Tier 1 - Preferred Generic | ✓ | — | ✓ | PA | QL |
| NC State Health Plan - HDHP 2026 | Tier 1 - Preferred Generic | ✓ | — | ✓ | PA | QL |
| NC State Health Plan - 70/30 Standard PPO 2026 | Tier 1 - Preferred Generic | ✓ | — | ✓ | PA | QL |