atropine sulfate 0.005 MG/ML / diphenoxylate hydrochloride 0.5 MG/ML Oral Solution

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atropine sulfate

RxCUI: 1190568

Important: Drug coverage and costs vary by plan and location. Verify coverage directly with your Medicare plan before filling a prescription. This is informational data only and should not replace advice from your healthcare provider or pharmacist.
39.8%
Plan Coverage
2,015
Plans Covering
T2.8
Avg Tier
16.3%
Prior Auth Required

What the CMS Formulary Data Shows for atropine sulfate 0.005 MG/ML / diphenoxylate hydrochloride 0.5 MG/ML Oral Solution

Per the CMS 2026 Part D formulary file, atropine sulfate 0.005 MG/ML / diphenoxylate hydrochloride 0.5 MG/ML Oral Solution (RxNorm concept RXCUI 1190568, generic name atropine sulfate) appears on 104 distinct formulary files spanning 2,015 Medicare Part D plan offerings - 39.8% 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 2.8.

Real-world access to atropine sulfate 0.005 MG/ML / diphenoxylate hydrochloride 0.5 MG/ML Oral Solution depends on utilization management as much as tier placement: 16.3% 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 0.005 MG/ML / diphenoxylate hydrochloride 0.5 MG/ML Oral Solution in 2023, with total plan-and-beneficiary spending of $9,184,134 and an average per-beneficiary annual cost of $83.85. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry atropine sulfate 0.005 MG/ML / diphenoxylate hydrochloride 0.5 MG/ML Oral Solution today.

Coverage Details

Formularies covering
104
Plans covering
2,015
Coverage rate
39.8%
Tier range
Tier 1 – Tier 4
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
16.3% of formularies
Step therapy required
0% of formularies
Quantity limits
0% of formularies

2023 Medicare Spending

Beneficiaries
109,532
Total spending
$9,184,134
Avg per beneficiary
$83.85

Tier Distribution Across Plans

100 plans
Tier 1, Preferred Generic

Standalone Drug Plans (PDP) Covering atropine sulfate 0.005 MG/ML / diphenoxylate hydrochloride 0.5 MG/ML Oral Solution

5 standalone prescription drug plans include this drug.

Plan Insurer Tier PA ST Premium States
Anthem Full Dual Advantage (PPO D-SNP) ANTHEM HEALTH PLANS, INC. T1 No No $0 CT
Anthem Dual Advantage (PPO D-SNP) ANTHEM HEALTH PLANS, INC. T1 No No $0 CT
Anthem Kidney Care (HMO-POS C-SNP) ANTHEM HEALTH PLANS, INC. T1 No No $0 CT
Anthem Full Dual Advantage Select (HMO D-SNP) ANTHEM HEALTH PLANS, INC. T1 No No $0 CT
Anthem Dual Advantage (HMO D-SNP) ANTHEM HEALTH PLANS, INC. T1 No No $0 CT

Medicare Advantage Plans (MA-PD) Covering atropine sulfate 0.005 MG/ML / diphenoxylate hydrochloride 0.5 MG/ML Oral Solution

95 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
Anthem Medicare Advantage (HMO-POS) BLUE CROSS OF CALIFORNIA T1 No $0 CA
Anthem Medicare Advantage (HMO-POS) BLUE CROSS OF CALIFORNIA T1 No $0 CA
Anthem Medicare Advantage (HMO-POS) BLUE CROSS OF CALIFORNIA T1 No $0 CA
Anthem Medicare Advantage (HMO-POS) BLUE CROSS OF CALIFORNIA T1 No $0 CA
Anthem Full Dual Advantage (HMO D-SNP) ANTHEM INSURANCE COMPANIES, INC. T1 No $0 IN
Anthem I PathWays Dual Care Advantage (HMO D-SNP) ANTHEM INSURANCE COMPANIES, INC. T1 No $0 IN
Anthem I PathWays Dual Care Advantage NFLOC (HMO D-SNP) ANTHEM INSURANCE COMPANIES, INC. T1 No $0 IN
Wellpoint Full Dual Advantage (HMO-POS D-SNP) WELLPOINT IOWA, INC. T1 No $0 IA
Wellpoint Full Dual Advantage 2 (HMO-POS D-SNP) WELLPOINT IOWA, INC. T1 No $0 IA
Wellpoint Full Dual Advantage (HMO D-SNP) WELLPOINT WEST VIRGINIA , INC. T1 No $0 WV
Wellpoint Full Dual Advantage (HMO D-SNP) WELLPOINT WASHINGTON, INC. T1 No $0 WA
Wellpoint Dual Advantage (HMO D-SNP) WELLPOINT WASHINGTON, INC. T1 No $0 WA
Healthy Blue Dual Advantage (HMO D-SNP) COMMUNITY CARE HEALTH PLAN OF LOUISIANA, INC. T1 No $0 LA
Healthy Blue Dual Advantage 2 (HMO D-SNP) COMMUNITY CARE HEALTH PLAN OF LOUISIANA, INC. T1 No $0 LA
Anthem Dual Advantage (PPO D-SNP) ANTHEM INSURANCE COMPANIES, INC. T1 No $0 VA
Wellpoint Medicare Advantage 2 (HMO-POS) WELLPOINT TEXAS, INC. T1 No $0 TX
Wellpoint Kidney Care (HMO-POS C-SNP) WELLPOINT TEXAS, INC. T1 No $0 TX
Wellpoint Dual Advantage 2 (HMO D-SNP) WELLPOINT TEXAS, INC. T1 No $0 TX
Wellpoint Kidney Care (HMO-POS C-SNP) WELLPOINT TEXAS, INC. T1 No $0 TX
Wellpoint Full Dual Advantage Aligned (HMO D-SNP) WELLPOINT TEXAS, INC. T1 No $0 TX
Wellpoint Full Dual Advantage Aligned (HMO D-SNP) WELLPOINT TEXAS, INC. T1 No $0 TX
Wellpoint Full Dual Advantage Aligned (HMO D-SNP) WELLPOINT TEXAS, INC. T1 No $0 TX
Wellpoint Full Dual Advantage Aligned (HMO D-SNP) WELLPOINT TEXAS, INC. T1 No $0 TX
Wellpoint Full Dual Advantage 2 (HMO D-SNP) WELLPOINT TEXAS, INC. T1 No $0 TX
Wellpoint Full Dual Advantage 2 (HMO D-SNP) WELLPOINT TEXAS, INC. T1 No $0 TX
Wellpoint Full Dual Advantage (HMO D-SNP) WELLPOINT TEXAS, INC. T1 No $0 TX
Anthem I MyCare Ohio Full Dual Advantage (HMO D-SNP) COMMUNITY INSURANCE COMPANY T1 No $0 OH
Anthem Full Dual Advantage (HMO D-SNP) COMMUNITY INSURANCE COMPANY T1 No $0 OH
Anthem Full Dual Advantage 2 (HMO D-SNP) COMMUNITY INSURANCE COMPANY T1 No $0 OH
Wellpoint Full Dual Advantage (HMO D-SNP) WELLPOINT NEW JERSEY, INC. T1 No $0 NJ
Wellpoint Kidney Care (HMO-POS C-SNP) WELLPOINT NEW JERSEY, INC. T1 No $0 NJ
Wellpoint Full Dual Advantage Secure (HMO-POS D-SNP) WELLPOINT NEW JERSEY, INC. T1 No $0 NJ
Anthem Medicare Advantage (HMO-POS) HealthKeepers, Inc. T1 No $0 VA
Anthem Full Dual Advantage (HMO D-SNP) HealthKeepers, Inc. T1 No $0 MO
Anthem Medicare Advantage 2 (HMO-POS) HealthKeepers, Inc. T1 No $0 VA
Anthem Kidney Care (HMO-POS C-SNP) HealthKeepers, Inc. T1 No $0 VA
Anthem Medicare Advantage (HMO-POS) HealthKeepers, Inc. T1 No $0 MO
Anthem Medicare Advantage 4 (HMO-POS) HealthKeepers, Inc. T1 No $0 VA
Anthem Medicare Advantage (HMO-POS) HealthKeepers, Inc. T1 No $0 IN
Anthem Full Dual Advantage 2 (HMO D-SNP) HealthKeepers, Inc. T1 No $0 MO
Anthem Chronic Care (HMO-POS C-SNP) HealthKeepers, Inc. T1 No $0 MO
Anthem Medicare Advantage (HMO-POS) COMMUNITY INSURANCE COMPANY T1 No $0 OH
Anthem Medicare Advantage (HMO) HMO COLORADO, INC. T1 No $0 CO
Anthem Full Dual Advantage Aligned (HMO D-SNP) BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC. T1 No $0 CA
Anthem Full Dual Advantage 2 (HMO D-SNP) HealthKeepers, Inc. T1 No $0 VA
Anthem Dual Advantage (HMO D-SNP) HealthKeepers, Inc. T1 No $0 VA
Anthem Full Dual Advantage Support (HMO D-SNP) HealthKeepers, Inc. T1 No $0 VA
Anthem Full Dual Advantage (HMO D-SNP) HealthKeepers, Inc. T1 No $0 VA

Frequently Asked Questions

Is atropine sulfate 0.005 MG/ML / diphenoxylate hydrochloride 0.5 MG/ML Oral Solution covered by Medicare Part D?

Yes, atropine sulfate 0.005 MG/ML / diphenoxylate hydrochloride 0.5 MG/ML Oral Solution is covered by 2,015 Medicare Part D plans (39.8% of all Part D formularies).

What tier is atropine sulfate 0.005 MG/ML / diphenoxylate hydrochloride 0.5 MG/ML Oral Solution on Medicare Part D plans?

atropine sulfate 0.005 MG/ML / diphenoxylate hydrochloride 0.5 MG/ML Oral Solution averages Tier 2.8 across Part D plans, ranging from Tier 1 to Tier 4.

Does atropine sulfate 0.005 MG/ML / diphenoxylate hydrochloride 0.5 MG/ML Oral Solution require prior authorization?

16.3% of Part D formularies require prior authorization for atropine sulfate 0.005 MG/ML / diphenoxylate hydrochloride 0.5 MG/ML Oral Solution. Step therapy: 0%. Quantity limits: 0%.

How much does Medicare spend on atropine sulfate 0.005 MG/ML / diphenoxylate hydrochloride 0.5 MG/ML Oral Solution?

In 2023, total Medicare Part D spending on atropine sulfate 0.005 MG/ML / diphenoxylate hydrochloride 0.5 MG/ML Oral Solution was $9,184,134, covering 109,532 beneficiaries. The average spend per beneficiary was $83.85.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial