atropine sulfate 0.005 MG/ML / diphenoxylate hydrochloride 0.5 MG/ML Oral Solution
atropine sulfate
RxCUI: 1190568
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
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.
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.
Read our methodology - how this data is sourced, computed, and verified.