brimonidine tartrate 1 MG/ML Ophthalmic Solution
brimonidine tartrate
RxCUI: 861204
What the CMS Formulary Data Shows for brimonidine tartrate 1 MG/ML Ophthalmic Solution
Per the CMS 2026 Part D formulary file, brimonidine tartrate 1 MG/ML Ophthalmic Solution (RxNorm concept RXCUI 861204, generic name brimonidine tartrate) appears on 213 distinct formulary files spanning 2,219 Medicare Part D plan offerings - 43.8% 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 2.5.
Real-world access to brimonidine tartrate 1 MG/ML Ophthalmic Solution depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 0.9% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 573,214 Part D beneficiaries filled brimonidine tartrate 1 MG/ML Ophthalmic Solution in 2023, with total plan-and-beneficiary spending of $88,900,177 and an average per-beneficiary annual cost of $155.09. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry brimonidine tartrate 1 MG/ML Ophthalmic Solution today.
Coverage Details
- Formularies covering
- 213
- Plans covering
- 2,219
- Coverage rate
- 43.8%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0.9% of formularies
2023 Medicare Spending
- Beneficiaries
- 573,214
- Total spending
- $88,900,177
- Avg per beneficiary
- $155.09
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering brimonidine tartrate 1 MG/ML Ophthalmic 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 |
| Wellpoint Medicare Advantage (HMO-POS) | WELLPOINT WEST VIRGINIA , INC. | T1 | No | $0 | WV |
| Anthem Medicare Advantage 3 (HMO-POS) | HealthKeepers, Inc. | T1 | No | $0 | VA |
| Anthem Medicare Advantage 3 (HMO-POS) | HealthKeepers, Inc. | T1 | No | $0 | VA |
| Anthem Medicare Advantage 3 (HMO-POS) | HealthKeepers, Inc. | T1 | No | $0 | VA |
| Wellpoint Medicare Advantage 2 (HMO-POS) | WELLPOINT TENNESSEE, INC. | T1 | No | $0 | TN |
| Wellpoint Medicare Advantage 2 (HMO-POS) | WELLPOINT TENNESSEE, INC. | T1 | No | $0 | TN |
| Wellpoint Medicare Advantage 2 (HMO-POS) | WELLPOINT TENNESSEE, INC. | T1 | No | $0 | TN |
| Wellpoint Medicare Advantage 2 (HMO-POS) | WELLPOINT TENNESSEE, INC. | T1 | No | $0 | TN |
| ElderServe MAP (HMO D-SNP) | ELDERSERVE HEALTH, INC. | T1 | No | $0 | NY |
| Cooperative Advantage (HMO D-SNP) | GROUP HEALTH COOPERATIVE OF EAU CLAIRE | T1 | No | $0 | WI |
| HAP Medicare Explore (PPO) | ALLIANCE HEALTH AND LIFE INSURANCE COMPANY | T1 | No | $0 | MI |
| HAP Medicare Prime (PPO) | ALLIANCE HEALTH AND LIFE INSURANCE COMPANY | T1 | No | $0 | MI |
| HAP Medicare Connect (HMO) | HEALTH ALLIANCE PLAN OF MICHIGAN | T1 | No | $0 | MI |
| HAP Medicare Complete Duals (HMO D-SNP) | HEALTH ALLIANCE PLAN OF MICHIGAN | T1 | No | $0 | MI |
| HAP Medicare Superior (HMO) | HEALTH ALLIANCE PLAN OF MICHIGAN | T1 | No | $0 | MI |
| Henry Ford Select (HMO) | HEALTH ALLIANCE PLAN OF MICHIGAN | T1 | No | $0 | MI |
| Longevity Health Plan (PPO I-SNP) | LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP | T1 | No | $0 | NJ |
| Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) | UPPER PENINSULA HEALTH PLAN, LLC | T1 | No | $0 | MI |
| CareSource Dual Advantage (HMO D-SNP) | CARESOURCE GEORGIA CO. | T1 | No | $0 | GA |
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP CARESOURCE | T1 | No | $0 | MI |
| PruittHealth Premier D-SNP (HMO D-SNP) | PRUITTHEALTH PREMIER, INC. | T1 | No | $0 | GA |
| Simpra Advantage Dual Care (PPO D-SNP) | SIMPRA ADVANTAGE, INC. | T1 | No | $0 | AL |
| Gold Coast Health Plan Total Care Advantage (HMO D-SNP) | Ventura County Medi-Cal Managed Care Commission | T1 | No | $0 | CA |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | No | $0 | MN |
| NaviCare (HMO D-SNP) | FALLON COMMUNITY HEALTH PLAN | T1 | No | $0 | MA |
| Hamaspik Medicare Choice (HMO D-SNP) | HAMASPIK, INC. | T1 | No | $0 | NY |
| SeniorCare Complete (HMO D-SNP) | SOUTH COUNTRY HEALTH ALLIANCE | T1 | No | $0 | MN |
| AbilityCare (HMO D-SNP) | SOUTH COUNTRY HEALTH ALLIANCE | T1 | No | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | ALAMEDA ALLIANCE FOR HEALTH | T1 | No | $0 | CA |
| PHP (HMO C-SNP) | AIDS HEALTHCARE FOUNDATION | T1 | No | $0 | CA |
| Elevate Medicare Choice (HMO D-SNP) | DENVER HEALTH MEDICAL PLAN, INC. | T1 | No | $0 | CO |
| AllCare Advantage Redwood Rx (HMO D-SNP) | ALLCARE HEALTH PLAN, INC. | T1 | No | $0 | OR |
| PrimeWest Senior Health Complete (HMO D-SNP) | PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE | T1 | No | $0 | MN |
| Prime Health Complete (HMO D-SNP) | PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE | T1 | No | $0 | MN |
| DualConnect (HMO D-SNP) | SANTA CLARA COUNTY HEALTH AUTHORITY | T1 | No | $0 | CA |
| VNS Health Total (HMO D-SNP) | VNS CHOICE | T1 | No | $0 | NY |
| Alterwood Advantage Dual Secure (HMO D-SNP) | ALTERWOOD ADVANTAGE, INC. | T1 | No | $0 | MD |
| Nascentia Dual Advantage (HMO D-SNP) | VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK | T1 | No | $0 | NY |
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC | T1 | No | $0 | PA |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA | T1 | No | $0 | NC |
| Provider Partners Indiana Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF INDIANA | T1 | No | $0 | IN |
| Provider Partners Maryland Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN, INC. | T1 | No | $0 | MD |
| Provider Partners Missouri Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC. | T1 | No | $0 | MO |
| Abilis Health Community (HMO I-SNP) | SIGNATURE ADVANTAGE, LLC | T1 | No | $0 | KY, TN |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) | ARKANSAS SUPERIOR SELECT, INC. | T1 | No | $0 | AR |
| Community Care's Partnership Program (HMO D-SNP) | COMMUNITY CARE HEALTH PLAN, INC. | T1 | No | $0 | WI |
Frequently Asked Questions
Is brimonidine tartrate 1 MG/ML Ophthalmic Solution covered by Medicare Part D?
Yes, brimonidine tartrate 1 MG/ML Ophthalmic Solution is covered by 2,219 Medicare Part D plans (43.8% of all Part D formularies).
What tier is brimonidine tartrate 1 MG/ML Ophthalmic Solution on Medicare Part D plans?
brimonidine tartrate 1 MG/ML Ophthalmic Solution averages Tier 2.5 across Part D plans, ranging from Tier 1 to Tier 4.
Does brimonidine tartrate 1 MG/ML Ophthalmic Solution require prior authorization?
0% of Part D formularies require prior authorization for brimonidine tartrate 1 MG/ML Ophthalmic Solution. Step therapy: 0%. Quantity limits: 0.9%.
How much does Medicare spend on brimonidine tartrate 1 MG/ML Ophthalmic Solution?
In 2023, total Medicare Part D spending on brimonidine tartrate 1 MG/ML Ophthalmic Solution was $88,900,177, covering 573,214 beneficiaries. The average spend per beneficiary was $155.09.
Read our methodology - how this data is sourced, computed, and verified.