Medicare Part D coverage · atropine sulfate · RxCUI 1190572
atropine sulfate 0.025 MG / diphenoxylate hydrochloride 2.5 MG Oral Tablet
Per the CMS 2026 Part D formulary file, atropine sulfate 0.025 MG / diphenoxylate hydrochloride 2.5 MG Oral Tablet is covered by 5,023 Medicare Part D plans (99.4% of enrollable products), averaging Tier 2.6, with prior authorization required on 31.9% of covering formularies.
- 99.4%
- Plan coverage
- 5,023
- Plans covering
- T2.6
- Avg tier
- 31.9%
- Prior auth required
What the CMS Formulary Data Shows for atropine sulfate 0.025 MG / diphenoxylate hydrochloride 2.5 MG Oral Tablet
Per the CMS 2026 Part D formulary file, atropine sulfate 0.025 MG / diphenoxylate hydrochloride 2.5 MG Oral Tablet (RxNorm concept RXCUI 1190572, generic name atropine sulfate) appears on 320 distinct formulary files spanning 5,023 Medicare Part D plan offerings - 99.4% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.6.
Real-world access to atropine sulfate 0.025 MG / diphenoxylate hydrochloride 2.5 MG Oral Tablet depends on utilization management as much as tier placement: 31.9% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 109,532 Part D beneficiaries filled atropine sulfate 0.025 MG / diphenoxylate hydrochloride 2.5 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $8,217,428 and an average per-beneficiary annual cost of $75.02. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry atropine sulfate 0.025 MG / diphenoxylate hydrochloride 2.5 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 320
- Plans covering
- 5,023
- Coverage rate
- 99.4%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 31.9% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 109,532
- Total spending
- $8,217,428
- Avg per beneficiary
- $75.02
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering atropine sulfate 0.025 MG / diphenoxylate hydrochloride 2.5 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 | No | $0 | VA |
| Sentara Community Complete (HMO D-SNP) | Sentara Health Plans | T1 | No | $0 | VA |
| Freedom VIP Care (HMO C-SNP) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Diamond Savings (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Diamond (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Freedom Medi-Medi Partial (HMO D-SNP) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Medi-Medi Full (HMO D-SNP) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Optimum Emerald Partial (HMO D-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Emerald Full (HMO D-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
Show the next 30 plans
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Máximo (HMO-POS) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Máximo (HMO-POS) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Optimum Gold Rewards Plan (HMO) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Platinum Plan (HMO) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Gold Plan (HMO) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Gold Rewards Plan (HMO) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Gold Rewards Plan (HMO) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Diamond Rewards COPD (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Diamond Savings COPD (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Gold Plus Plan (HMO) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Diamond Rewards COPD (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| HealthSun HealthAdvantage Plan (HMO) | Healthsun Health Plans, Inc. | T1 | No | $0 | FL |
| HealthSun MediMax (HMO) | Healthsun Health Plans, Inc. | T1 | No | $0 | FL |
| HealthSun HealthAdvantage Plan (HMO) | Healthsun Health Plans, Inc. | T1 | No | $0 | FL |
| HealthSun HealthAdvantage Plan (HMO) | Healthsun Health Plans, Inc. | T1 | No | $0 | FL |
| HealthSun MediSun Plus (HMO D-SNP) | Healthsun Health Plans, Inc. | T1 | No | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | Healthsun Health Plans, Inc. | T1 | No | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | Healthsun Health Plans, Inc. | T1 | No | $0 | FL |
| HealthSun MediSun Extra (HMO D-SNP) | Healthsun Health Plans, Inc. | T1 | No | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | Healthsun Health Plans, Inc. | T1 | No | $0 | FL |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is atropine sulfate 0.025 MG / diphenoxylate hydrochloride 2.5 MG Oral Tablet covered by Medicare Part D?
Yes, atropine sulfate 0.025 MG / diphenoxylate hydrochloride 2.5 MG Oral Tablet is covered by 5,023 Medicare Part D plans (99.4% of all Part D formularies).
What tier is atropine sulfate 0.025 MG / diphenoxylate hydrochloride 2.5 MG Oral Tablet on Medicare Part D plans?
atropine sulfate 0.025 MG / diphenoxylate hydrochloride 2.5 MG Oral Tablet averages Tier 2.6 across Part D plans, ranging from Tier 1 to Tier 4.
Does atropine sulfate 0.025 MG / diphenoxylate hydrochloride 2.5 MG Oral Tablet require prior authorization?
31.9% of Part D formularies require prior authorization for atropine sulfate 0.025 MG / diphenoxylate hydrochloride 2.5 MG Oral Tablet. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on atropine sulfate 0.025 MG / diphenoxylate hydrochloride 2.5 MG Oral Tablet?
In 2023, total Medicare Part D spending on atropine sulfate 0.025 MG / diphenoxylate hydrochloride 2.5 MG Oral Tablet was $8,217,428, covering 109,532 beneficiaries. The average spend per beneficiary was $75.02.
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
- 0.65 ML medroxyprogesterone acetate 160 MG/ML Prefilled Syringe [depo-subQ provera] T2.6
- 100 ML ciprofloxacin 2 MG/ML Injection T2.6
- {42 (rivaroxaban 15 MG Oral Tablet [Xarelto]) / 9 (rivaroxaban 20 MG Oral Tablet [Xarelto]) } Pack [Xarelto Kit] T2.6
- clonazepam 2 MG Disintegrating Oral Tablet T2.6
- etonogestrel 68 MG Drug Implant [Nexplanon] T2.6
- haloperidol decanoate 100 MG/ML Injectable Solution T2.6
Similar prior-authorization rate
- paroxetine hydrochloride 10 MG Oral Tablet 32% PA
- hydroxyzine pamoate 100 MG Oral Capsule 32.1% PA
- methylphenidate hydrochloride 2.5 MG Chewable Tablet 31.6% PA
- {14 (cenobamate 100 MG Oral Tablet [Xcopri]) / 14 (cenobamate 50 MG Oral Tablet [Xcopri]) } Pack [Xcopri Titration Pack - 50 MG (14), 100 MG (14) 28 Count] 32.3% PA
- {28 (cenobamate 150 MG Oral Tablet [Xcopri]) / 28 (cenobamate 200 MG Oral Tablet) } Pack [Xcopri 350 MG Maintenance Pack] 32.3% PA
- cenobamate 50 MG Oral Tablet [Xcopri] 32.3% PA