Medicare Part D coverage · 72 · RxCUI 1603498
72 HR fentanyl 0.0625 MG/HR Transdermal System
Per the CMS 2026 Part D formulary file, 72 HR fentanyl 0.0625 MG/HR Transdermal System is covered by 1,860 Medicare Part D plans (36.8% of enrollable products), averaging Tier 3.2, with prior authorization required on 80% of covering formularies.
- 36.8%
- Plan coverage
- 1,860
- Plans covering
- T3.2
- Avg tier
- 80%
- Prior auth required
What the CMS Formulary Data Shows for 72 HR fentanyl 0.0625 MG/HR Transdermal System
Per the CMS 2026 Part D formulary file, 72 HR fentanyl 0.0625 MG/HR Transdermal System (RxNorm concept RXCUI 1603498, generic name 72) appears on 115 distinct formulary files spanning 1,860 Medicare Part D plan offerings - 36.8% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 3.2.
Real-world access to 72 HR fentanyl 0.0625 MG/HR Transdermal System depends on utilization management as much as tier placement: 80% of covering formularies require prior authorization. 0% require step therapy. 96.5% 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 72 HR fentanyl 0.0625 MG/HR Transdermal System today.
Coverage Details
- Formularies covering
- 115
- Plans covering
- 1,860
- Coverage rate
- 36.8%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 80% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 96.5% of formularies
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 72 HR fentanyl 0.0625 MG/HR Transdermal System
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) | Hpmp OF Florida, Inc. | T1 | Yes | $0 | FL |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Elderplan Plus Long-Term Care (HMO-POS D-SNP) | Elderplan, Inc. | T1 | Yes | $0 | NY |
| Health Choice Pathway (HMO D-SNP) | Health Choice Arizona, Inc. | T1 | Yes | $0 | AZ |
| Healthfirst CompleteCare (HMO D-SNP) | Healthfirst Health Plan, Inc. | T1 | Yes | $0 | NY |
| IMCare Classic (HMO D-SNP) | Itasca Medical Care | T1 | Yes | $0 | MN |
| Johns Hopkins Advantage MD D-SNP (HMO D-SNP) | Hopkins Health Advantage, Inc. | T1 | Yes | $0 | MD |
| MetroPlus UltraCare (HMO D-SNP) | Metroplus Health Plan, Inc. | T1 | Yes | $0 | NY |
| Senior Whole Health SCO (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
| Senior Whole Health SCO NHC (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
| Molina One Care (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
| Gold Coast Health Plan Total Care Advantage (HMO D-SNP) | Ventura County Medi-Cal Managed Care Commission | T1 | Yes | $0 | CA |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Health Care Service Corporation | T1 | Yes | $0 | NM |
| Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) | Health Care Service Corporation | T1 | Yes | $0 | NM |
| Horizon NJ TotalCare (HMO D-SNP) | Horizon Healthcare OF NEW Jersey, Inc. | T1 | Yes | $0 | NJ |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | Yes | $0 | MN |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | Yes | $0 | NY |
| SeniorCare Complete (HMO D-SNP) | South Country Health Alliance | T1 | No | $0 | MN |
Show the next 30 plans
Showing top 50 of 100 plans.
Frequently Asked Questions
Is 72 HR fentanyl 0.0625 MG/HR Transdermal System covered by Medicare Part D?
Yes, 72 HR fentanyl 0.0625 MG/HR Transdermal System is covered by 1,860 Medicare Part D plans (36.8% of all Part D formularies).
What tier is 72 HR fentanyl 0.0625 MG/HR Transdermal System on Medicare Part D plans?
72 HR fentanyl 0.0625 MG/HR Transdermal System averages Tier 3.2 across Part D plans, ranging from Tier 1 to Tier 4.
Does 72 HR fentanyl 0.0625 MG/HR Transdermal System require prior authorization?
80% of Part D formularies require prior authorization for 72 HR fentanyl 0.0625 MG/HR Transdermal System. Step therapy: 0%. Quantity limits: 96.5%.
Read our methodology - how this data is sourced, computed, and verified.
Nationwide similar Part D drugs
Data-derived peers across the CMS Part D formulary extract: nearest average tier placement and nearest prior-authorization rate. Not therapeutic alternatives or same-generic strengths.
Closest average formulary tier
- betaxolol 2.5 MG/ML Ophthalmic Suspension [Betoptic S] T3.2
- 24 HR lacosamide 200 MG Extended Release Oral Capsule [Motpoly] T3.2
- 0.25 ML paliperidone palmitate 156 MG/ML Prefilled Syringe [Invega] T3.2
- collagenase 0.25 UNT/MG Topical Ointment [Santyl] T3.2
- caspofungin acetate 70 MG Injection T3.2
- 2 ML penicillin G benzathine 450000 UNT/ML / penicillin G procaine 150000 UNT/ML Prefilled Syringe [Bicillin] T3.2
Similar prior-authorization rate
- 1 ML meperidine hydrochloride 50 MG/ML Injection 80% PA
- sofosbuvir 200 MG Oral Tablet [Sovaldi] 80% PA
- sacrosidase 8500 UNT/ML Oral Solution [Sucraid] 80% PA
- 24 HR diazoxide choline 150 MG Extended Release Oral Tablet [Vykat] 80% PA
- 24 HR hydromorphone hydrochloride 32 MG Extended Release Oral Tablet 80% PA
- 0.6 ML pegfilgrastim-jmdb 10 MG/ML Prefilled Syringe [Fulphila] 79.9% PA