Medicare Part D coverage · 84 · RxCUI 2110774
84 HR estradiol 0.00104 MG/HR Transdermal System [Dotti]
Per the CMS 2026 Part D formulary file, 84 HR estradiol 0.00104 MG/HR Transdermal System [Dotti] is covered by 3,875 Medicare Part D plans (76.7% of enrollable products), averaging Tier 2.7, with prior authorization required on 3.2% of covering formularies.
- 76.7%
- Plan coverage
- 3,875
- Plans covering
- T2.7
- Avg tier
- 3.2%
- Prior auth required
What the CMS Formulary Data Shows for 84 HR estradiol 0.00104 MG/HR Transdermal System [Dotti]
Per the CMS 2026 Part D formulary file, 84 HR estradiol 0.00104 MG/HR Transdermal System [Dotti] (RxNorm concept RXCUI 2110774, generic name 84) appears on 248 distinct formulary files spanning 3,875 Medicare Part D plan offerings - 76.7% of enrollable Part D products, mid-range placement; shopping across contracts changes access. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.7.
Real-world access to 84 HR estradiol 0.00104 MG/HR Transdermal System [Dotti] depends on utilization management as much as tier placement: 3.2% of covering formularies require prior authorization. 0% require step therapy. 45.6% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 24,304 Part D beneficiaries filled 84 HR estradiol 0.00104 MG/HR Transdermal System [Dotti] in 2023, with total plan-and-beneficiary spending of $9,911,458 and an average per-beneficiary annual cost of $407.81. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 84 HR estradiol 0.00104 MG/HR Transdermal System [Dotti] today.
Coverage Details
- Formularies covering
- 248
- Plans covering
- 3,875
- Coverage rate
- 76.7%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 3.2% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 45.6% of formularies
2023 Medicare Spending
- Beneficiaries
- 24,304
- Total spending
- $9,911,458
- Avg per beneficiary
- $407.81
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 84 HR estradiol 0.00104 MG/HR Transdermal System [Dotti]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Sentara Community Complete Select (HMO D-SNP) | Sentara Health Plans | T1 | No | $0 | VA |
| Sentara Community Complete (HMO D-SNP) | Sentara Health Plans | T1 | No | $0 | VA |
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) | Hpmp OF Florida, Inc. | T1 | No | $0 | FL |
| ElderServe MAP (HMO D-SNP) | Elderserve Health, Inc. | T1 | No | $0 | NY |
| Cooperative Advantage (HMO D-SNP) | Group Health Cooperative OF EAU Claire | T1 | No | $0 | WI |
| Longevity Health Plan (PPO I-SNP) | Longevity Health Plan OF NEW Jersey Insurance Comp | T1 | No | $0 | NJ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Elderplan Plus Long-Term Care (HMO-POS D-SNP) | Elderplan, Inc. | T1 | No | $0 | NY |
| Health Choice Pathway (HMO D-SNP) | Health Choice Arizona, Inc. | T1 | No | $0 | AZ |
| Healthfirst CompleteCare (HMO D-SNP) | Healthfirst Health Plan, Inc. | T1 | No | $0 | NY |
| IMCare Classic (HMO D-SNP) | Itasca Medical Care | T1 | No | $0 | MN |
| Johns Hopkins Advantage MD D-SNP (HMO D-SNP) | Hopkins Health Advantage, Inc. | T1 | No | $0 | MD |
| MetroPlus UltraCare (HMO D-SNP) | Metroplus Health Plan, Inc. | T1 | No | $0 | NY |
| Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) | Upper Peninsula Health Plan, LLC | T1 | No | $0 | MI |
| CareSource Dual Advantage (HMO D-SNP) | Caresource Georgia Co. | T1 | No | $0 | GA |
| Senior Whole Health SCO (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| Senior Whole Health SCO NHC (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| Molina One Care (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
Show the next 30 plans
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP Caresource | T1 | No | $0 | MI |
| PruittHealth Premier D-SNP (HMO D-SNP) | Pruitthealth Premier, Inc. | T1 | No | $0 | GA |
| Simpra Advantage Dual Care (PPO D-SNP) | Simpra Advantage, Inc. | T1 | No | $0 | AL |
| CareAdvantage (HMO D-SNP) | SAN Mateo Health Commission | T1 | No | $0 | CA |
| Gold Coast Health Plan Total Care Advantage (HMO D-SNP) | Ventura County Medi-Cal Managed Care Commission | T1 | No | $0 | CA |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| Horizon NJ TotalCare (HMO D-SNP) | Horizon Healthcare OF NEW Jersey, Inc. | T1 | No | $0 | NJ |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | No | $0 | MN |
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | No | $0 | MA |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $0 | NY |
| PHP (HMO C-snp) | Aids Healthcare Foundation | T1 | No | $0 | CA |
| CCA One Care (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | No | $0 | MA |
| CCA Senior Care Options (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | No | $0 | MA |
| VNS Health Total (HMO D-SNP) | VNS Choice | T1 | No | $0 | NY |
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | No | $0 | PA |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | Provider Partners Health Plan OF North Carolina | T1 | No | $0 | NC |
| Provider Partners Indiana Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Indiana | T1 | No | $0 | IN |
| Provider Partners Missouri Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Missouri, Inc. | T1 | No | $0 | MO |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T1 | No | $0 | CA |
| Mass General Brigham SCO (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| Tufts Health One Care (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
| Tufts Health One Care CW (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options CW (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | No | $0 | MA |
| Florida Complete Care (HMO I-SNP) | Hpmp OF Florida, Inc. | T1 | No | $4.80 | FL |
| Florida Complete Care- In The Community (HMO-POS I-SNP) | Hpmp OF Florida, Inc. | T1 | No | $4.80 | FL |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Florida, Inc. | T1 | No | $4.80 | FL |
| Senior Care (HMO I-SNP) | Align Senior Care Florida, Inc. | T1 | No | $4.80 | FL |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is 84 HR estradiol 0.00104 MG/HR Transdermal System [Dotti] covered by Medicare Part D?
Yes, 84 HR estradiol 0.00104 MG/HR Transdermal System [Dotti] is covered by 3,875 Medicare Part D plans (76.7% of all Part D formularies).
What tier is 84 HR estradiol 0.00104 MG/HR Transdermal System [Dotti] on Medicare Part D plans?
84 HR estradiol 0.00104 MG/HR Transdermal System [Dotti] averages Tier 2.7 across Part D plans, ranging from Tier 1 to Tier 4.
Does 84 HR estradiol 0.00104 MG/HR Transdermal System [Dotti] require prior authorization?
3.2% of Part D formularies require prior authorization for 84 HR estradiol 0.00104 MG/HR Transdermal System [Dotti]. Step therapy: 0%. Quantity limits: 45.6%.
How much does Medicare spend on 84 HR estradiol 0.00104 MG/HR Transdermal System [Dotti]?
In 2023, total Medicare Part D spending on 84 HR estradiol 0.00104 MG/HR Transdermal System [Dotti] was $9,911,458, covering 24,304 beneficiaries. The average spend per beneficiary was $407.81.
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
- cyclosporine, modified 25 MG Oral Capsule T2.7
- insulin aspart, human 100 UNT/ML Injectable Solution [NovoLog] T2.7
- insulin glargine 100 UNT/ML Injectable Solution [Lantus] T2.7
- theophylline 450 MG Extended Release Oral Tablet T2.7
- 24 HR amphetamine aspartate 1.25 MG / amphetamine sulfate 1.25 MG / dextroamphetamine saccharate 1.25 MG / dextroamphetamine sulfate 1.25 MG Extended Release Oral Capsule T2.7
- ampicillin 1000 MG / sulbactam 500 MG Injection T2.7
Similar prior-authorization rate
- sevelamer hydrochloride 400 MG Oral Tablet 3.2% PA
- 0.3 ML methotrexate 50 MG/ML Auto-Injector [Rasuvo] 3.2% PA
- 0.35 ML methotrexate 50 MG/ML Auto-Injector [Rasuvo] 3.2% PA
- 0.4 ML methotrexate 50 MG/ML Auto-Injector [Rasuvo] 3.2% PA
- 0.5 ML methotrexate 50 MG/ML Auto-Injector [Rasuvo] 3.2% PA
- acetaminophen 325 MG / hydrocodone bitartrate 2.5 MG Oral Tablet 3.2% PA