Medicare Part D coverage · atropine sulfate · RxCUI 1190568
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 is covered by 2,015 Medicare Part D plans (39.9% of enrollable products), averaging Tier 2.8, with prior authorization required on 16.3% of covering formularies.
- 39.9%
- 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 - 39.9% 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 $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 0.005 MG/ML / diphenoxylate hydrochloride 0.5 MG/ML Oral Solution today.
Coverage Details
- Formularies covering
- 104
- Plans covering
- 2,015
- Coverage rate
- 39.9%
- 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
- $8,217,428
- Avg per beneficiary
- $75.02
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering atropine sulfate 0.005 MG/ML / diphenoxylate hydrochloride 0.5 MG/ML Oral Solution
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 |
| 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 |
Show the next 30 plans
Showing top 50 of 100 plans.
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 (39.9% 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 $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
- bromocriptine 2.5 MG Oral Tablet T2.8
- cyclosporine 25 MG Oral Capsule T2.8
- emtricitabine 200 MG / tenofovir disoproxil fumarate 300 MG Oral Tablet T2.8
- ampicillin 1000 MG Injection T2.8
- estradiol 0.01 MG Vaginal Insert T2.8
- acetaminophen 21.7 MG/ML / hydrocodone bitartrate 0.5 MG/ML Oral Solution T2.8
Similar prior-authorization rate
- olanzapine 10 MG Injection 16.2% PA
- 1000 ML glucose 100 MG/ML / sodium chloride 4.5 MG/ML Injection 16.5% PA
- chlorpromazine hydrochloride 100 MG Oral Tablet 16.5% PA
- chlorpromazine hydrochloride 50 MG Oral Tablet 16.5% PA
- quetiapine 150 MG Oral Tablet 16.7% PA
- naldemedine 0.2 MG Oral Tablet [Symproic] 16.7% PA