24 HR glipizide 5 MG Extended Release Oral Tablet [Glucotrol]
glipizide
RxCUI: 865573
What the CMS Formulary Data Shows for 24 HR glipizide 5 MG Extended Release Oral Tablet [Glucotrol]
Per the CMS 2026 Part D formulary file, 24 HR glipizide 5 MG Extended Release Oral Tablet [Glucotrol] (RxNorm concept RXCUI 865573, generic name glipizide) appears on 1 distinct formulary file spanning 2 Medicare Part D plan offerings - 0% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 1, with a cross-plan average of Tier 1.
Real-world access to 24 HR glipizide 5 MG Extended Release Oral Tablet [Glucotrol] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 100% apply quantity limits.
Medicare Part D spending dashboard figures are not published for this drug. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 24 HR glipizide 5 MG Extended Release Oral Tablet [Glucotrol] today.
Coverage Details
- Formularies covering
- 1
- Plans covering
- 2
- Coverage rate
- 0%
- Tier range
- Tier 1, Preferred Generic
- Average tier
- Tier 1, Preferred Generic
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 100% of formularies
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 24 HR glipizide 5 MG Extended Release Oral Tablet [Glucotrol]
2 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Hamaspik Medicare Choice (HMO D-SNP) | HAMASPIK, INC. | T1 | No | $0 | NY |
| Hamaspik Medicare Select (HMO D-SNP) | HAMASPIK, INC. | T1 | No | $34.50 | NY |
Frequently Asked Questions
Is 24 HR glipizide 5 MG Extended Release Oral Tablet [Glucotrol] covered by Medicare Part D?
Yes, 24 HR glipizide 5 MG Extended Release Oral Tablet [Glucotrol] is covered by 2 Medicare Part D plans (0% of all Part D formularies).
What tier is 24 HR glipizide 5 MG Extended Release Oral Tablet [Glucotrol] on Medicare Part D plans?
24 HR glipizide 5 MG Extended Release Oral Tablet [Glucotrol] averages Tier 1 across Part D plans, ranging from Tier 1 to Tier 1.
Does 24 HR glipizide 5 MG Extended Release Oral Tablet [Glucotrol] require prior authorization?
0% of Part D formularies require prior authorization for 24 HR glipizide 5 MG Extended Release Oral Tablet [Glucotrol]. Step therapy: 0%. Quantity limits: 100%.
Read our methodology - how this data is sourced, computed, and verified.