Prilosec Otc

Generic: omeprazole OTC / ODT

20 MG — TABLET, ENTERIC COATED

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.

1 plan

Source: PDF · Formulary date: Oct 1, 2026 · Checked: 6 hours, 19 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC Medicaid Preferred Drug List 2026 via omeprazole OTC capsule / ODT	Non-Preferred	—	—	—	None

1 plan

Source: Excel (XLSX) · Formulary date: Sep 23, 2026 · Checked: 6 hours, 19 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
TRICARE Uniform Formulary 2026	Tier 4 - Not Covered	—	—	—	None