Medicare Part D coverage · ambrisentan · RxCUI 722122
ambrisentan 5 MG Oral Tablet
Per the CMS 2026 Part D formulary file, ambrisentan 5 MG Oral Tablet is covered by 4,903 Medicare Part D plans (97.1% of enrollable products), averaging Tier 4.1, with prior authorization required on 98.9% of covering formularies.
- 97.1%
- Plan coverage
- 4,903
- Plans covering
- T4.1
- Avg tier
- 98.9%
- Prior auth required
What the CMS Formulary Data Shows for ambrisentan 5 MG Oral Tablet
Per the CMS 2026 Part D formulary file, ambrisentan 5 MG Oral Tablet (RxNorm concept RXCUI 722122, generic name ambrisentan) appears on 281 distinct formulary files spanning 4,903 Medicare Part D plan offerings - 97.1% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 6, with a cross-plan average of Tier 4.1.
Real-world access to ambrisentan 5 MG Oral Tablet depends on utilization management as much as tier placement: 98.9% of covering formularies require prior authorization. 0% require step therapy. 92.9% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 6,456 Part D beneficiaries filled ambrisentan 5 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $246,059,319 and an average per-beneficiary annual cost of $38,113.28. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry ambrisentan 5 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 281
- Plans covering
- 4,903
- Coverage rate
- 97.1%
- Tier range
- Tier 1 – Tier 6
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 98.9% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 92.9% of formularies
2023 Medicare Spending
- Beneficiaries
- 6,456
- Total spending
- $246,059,319
- Avg per beneficiary
- $38,113.28
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering ambrisentan 5 MG Oral Tablet
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 | Yes | $0 | VA |
| Sentara Community Complete (HMO D-SNP) | Sentara Health Plans | T1 | Yes | $0 | VA |
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) | Hpmp OF Florida, Inc. | T1 | Yes | $0 | FL |
| ElderServe MAP (HMO D-SNP) | Elderserve Health, Inc. | T1 | Yes | $0 | NY |
| Cooperative Advantage (HMO D-SNP) | Group Health Cooperative OF EAU Claire | T1 | Yes | $0 | WI |
| Longevity Health Plan (PPO I-SNP) | Longevity Health Plan OF NEW Jersey Insurance Comp | T1 | Yes | $0 | NJ |
| 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 |
| Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) | Upper Peninsula Health Plan, LLC | T1 | Yes | $0 | MI |
| CareSource Dual Advantage (HMO D-SNP) | Caresource Georgia Co. | T1 | Yes | $0 | GA |
| 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 |
Show the next 30 plans
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP Caresource | T1 | Yes | $0 | MI |
| PruittHealth Premier D-SNP (HMO D-SNP) | Pruitthealth Premier, Inc. | T1 | Yes | $0 | GA |
| Simpra Advantage Dual Care (PPO D-SNP) | Simpra Advantage, Inc. | T1 | Yes | $0 | AL |
| CareAdvantage (HMO D-SNP) | SAN Mateo Health Commission | T1 | Yes | $0 | CA |
| 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 |
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | Yes | $0 | MA |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | Yes | $0 | NY |
| SeniorCare Complete (HMO D-SNP) | South Country Health Alliance | T1 | Yes | $0 | MN |
| AbilityCare (HMO D-SNP) | South Country Health Alliance | T1 | Yes | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | Alameda Alliance FOR Health | T1 | Yes | $0 | CA |
| CCA One Care (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | Yes | $0 | MA |
| CCA Senior Care Options (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | Yes | $0 | MA |
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | Yes | $0 | PA |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | Provider Partners Health Plan OF North Carolina | T1 | Yes | $0 | NC |
| Provider Partners Indiana Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Indiana | T1 | Yes | $0 | IN |
| Provider Partners Missouri Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Missouri, Inc. | T1 | Yes | $0 | MO |
| Community Care's Partnership Program (HMO D-SNP) | Community Care Health Plan, Inc. | T1 | No | $0 | WI |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T1 | Yes | $0 | CA |
| Mass General Brigham SCO (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | Yes | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | Yes | $0 | MA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | Yes | $0 | PA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | Yes | $0 | PA |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Health Options West Virginia Inc. | T1 | Yes | $0 | WV |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | Yes | $0 | DE |
| Tufts Health One Care (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | Yes | $0 | MA |
| Tufts Health One Care CW (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | Yes | $0 | MA |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is ambrisentan 5 MG Oral Tablet covered by Medicare Part D?
Yes, ambrisentan 5 MG Oral Tablet is covered by 4,903 Medicare Part D plans (97.1% of all Part D formularies).
What tier is ambrisentan 5 MG Oral Tablet on Medicare Part D plans?
ambrisentan 5 MG Oral Tablet averages Tier 4.1 across Part D plans, ranging from Tier 1 to Tier 6.
Does ambrisentan 5 MG Oral Tablet require prior authorization?
98.9% of Part D formularies require prior authorization for ambrisentan 5 MG Oral Tablet. Step therapy: 0%. Quantity limits: 92.9%.
How much does Medicare spend on ambrisentan 5 MG Oral Tablet?
In 2023, total Medicare Part D spending on ambrisentan 5 MG Oral Tablet was $246,059,319, covering 6,456 beneficiaries. The average spend per beneficiary was $38,113.28.
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
- clozapine 50 MG/ML Oral Suspension [Versacloz] T4.1
- trospium chloride 20 MG / xanomeline 50 MG Oral Capsule [Cobenfy] T4.1
- venetoclax 50 MG Oral Tablet [Venclexta] T4.1
- fidaxomicin 200 MG Oral Tablet T4.1
- entecavir 0.05 MG/ML Oral Solution [Baraclude] T4.1
- belumosudil 200 MG Oral Tablet [Rezurock] T4.1
Similar prior-authorization rate
- 500 ML olive oil 160 MG/ML / soybean oil 40 MG/ML Injection [Clinolipid] 98.9% PA
- 25 ML immunoglobulin G, human 100 MG/ML Injection [Gammagard] 98.9% PA
- 0.8 ML adalimumab-aaty 100 MG/ML Auto-Injector 98.9% PA
- {3 (0.8 ML adalimumab-aaty 100 MG/ML Auto-Injector) } Pack 98.9% PA
- 3 ML liraglutide 6 MG/ML Pen Injector 99% PA
- 500 ML soybean oil 200 MG/ML Injection [Nutrilipid] 99% PA