budesonide 4 MG Delayed Release Oral Capsule [Tarpeyo]
budesonide
RxCUI: 2587889
What the CMS Formulary Data Shows for budesonide 4 MG Delayed Release Oral Capsule [Tarpeyo]
Per the CMS 2026 Part D formulary file, budesonide 4 MG Delayed Release Oral Capsule [Tarpeyo] (RxNorm concept RXCUI 2587889, generic name budesonide) appears on 19 distinct formulary files spanning 61 Medicare Part D plan offerings - 1.2% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 4.4.
Real-world access to budesonide 4 MG Delayed Release Oral Capsule [Tarpeyo] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 36.8% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 61,841 Part D beneficiaries filled budesonide 4 MG Delayed Release Oral Capsule [Tarpeyo] in 2023, with total plan-and-beneficiary spending of $33,914,751 and an average per-beneficiary annual cost of $548.42. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry budesonide 4 MG Delayed Release Oral Capsule [Tarpeyo] today.
Coverage Details
- Formularies covering
- 19
- Plans covering
- 61
- Coverage rate
- 1.2%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 100% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 36.8% of formularies
2023 Medicare Spending
- Beneficiaries
- 61,841
- Total spending
- $33,914,751
- Avg per beneficiary
- $548.42
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering budesonide 4 MG Delayed Release Oral Capsule [Tarpeyo]
61 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| SeniorCare Complete (HMO D-SNP) | SOUTH COUNTRY HEALTH ALLIANCE | T1 | Yes | $0 | MN |
| AbilityCare (HMO D-SNP) | SOUTH COUNTRY HEALTH ALLIANCE | T1 | Yes | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | ALAMEDA ALLIANCE FOR HEALTH | T1 | Yes | $0 | CA |
| CalOptima Health OneCare Complete (HMO D-SNP) | ORANGE COUNTY HEALTH AUTHORITY | T2 | Yes | $0 | CA |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T5 | Yes | $0 | UT |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T5 | Yes | $0 | NV |
| Select Health Medicare Dual (HMO D-SNP) | SELECTHEALTH, INC. | T5 | Yes | $0 | UT |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T5 | Yes | $0 | UT |
| Select Health Medicare + Kroger (HMO) | SELECTHEALTH, INC. | T5 | Yes | $0 | NV |
| Select Health Medicare + Kroger (HMO) | SELECTHEALTH, INC. | T5 | Yes | $0 | UT |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T5 | Yes | $0 | CO |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T5 | Yes | $0 | CO |
| Select Health Medicare + Kroger (HMO) | SELECTHEALTH, INC. | T5 | Yes | $0 | CO |
| Select Health Medicare Flex (HMO) | SELECTHEALTH, INC. | T5 | Yes | $0 | CO |
| Select Health Medicare + Kroger (HMO) | SELECTHEALTH, INC. | T5 | Yes | $0 | CO |
| Select Health Medicare Active (HMO) | SELECTHEALTH, INC. | T5 | Yes | $0 | CO |
| Select Health Medicare Dual (HMO D-SNP) | SELECTHEALTH, INC. | T5 | Yes | $0 | NV |
| Select Health Medicare Wellness (HMO) | SELECTHEALTH, INC. | T5 | Yes | $0 | NV |
| Medicare BlueEssential (PPO) | EXCELLUS HEALTH PLAN, INC. | T5 | Yes | $0 | NY |
| Medicare BlueActive (PPO) | EXCELLUS HEALTH PLAN, INC. | T5 | Yes | $0 | NY |
| Medicare BlueVital (PPO) | EXCELLUS HEALTH PLAN, INC. | T5 | Yes | $0 | NY |
| Univera SeniorChoice Basic (HMO) | EXCELLUS HEALTH PLAN, INC. | T5 | Yes | $0 | NY |
| Univera SeniorChoice Extra (HMO) | EXCELLUS HEALTH PLAN, INC. | T5 | Yes | $0 | NY |
| Medicare Blue Choice Core (HMO) | EXCELLUS HEALTH PLAN, INC. | T5 | Yes | $0 | NY |
| Univera Medicare Dual (HMO D-SNP) | EXCELLUS HEALTH PLAN COMMUNITY CARE LLC | T5 | Yes | $0 | NY |
| Medicare Blue Dual (HMO D-SNP) | EXCELLUS HEALTH PLAN COMMUNITY CARE LLC | T5 | Yes | $0 | NY |
| Network Health Select (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T5 | Yes | $0 | WI |
| Network Health Go (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T5 | Yes | $0 | WI |
| Network Health Anywhere (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T5 | Yes | $0 | WI |
| Network Health Choice (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T5 | Yes | $0 | WI |
| Network Health Zero (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T5 | Yes | $0 | WI |
| Troy Medicare (HMO) | TROY HEALTH, INC. | T5 | Yes | $0 | NC |
| Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | TROY HEALTH, INC. | T5 | Yes | $0 | NC |
| Contra Costa Health Care Plus (HMO D-SNP) | CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH | T5 | Yes | $0 | CA |
| Keystone First VIP Choice (HMO D-SNP) | VISTA HEALTH PLAN, INC. | T5 | Yes | $0 | PA |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | VISTA HEALTH PLAN, INC. | T5 | Yes | $0 | PA |
| First Choice VIP Care (HMO D-SNP) | SELECT HEALTH OF SOUTH CAROLINA, INC. | T5 | Yes | $0 | SC |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | AmeriHealth Caritas VIP Next, Inc. | T5 | Yes | $0 | DE |
| AmeriHealth Caritas VIP Care Choice (HMO D-SNP) | AmeriHealth Caritas VIP Next, Inc. | T5 | Yes | $0 | DE |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | AMERIHEALTH CARITAS FLORIDA INC | T5 | Yes | $0 | FL |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | AMERIHEALTH CARITAS LOUISIANA, INC. | T5 | Yes | $0 | LA |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | AMERIHEALTH CARITAS NORTH CAROLINA, INC. | T5 | Yes | $0 | NC |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | AMERIHEALTH MICHIGAN, INC. | T5 | Yes | $0 | MI |
| Healthy Mississippi Premier Advantage (HMO-POS) | Healthy Mississippi, Inc. | T5 | Yes | $0 | MS |
| CDPHP $0 Medicare Rx (HMO) | CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. | T5 | Yes | $0 | NY |
| CareOregon Advantage Plus (HMO D-SNP) | HEALTH PLAN OF CAREOREGON, INC. | T5 | Yes | $0 | OR |
| Network Health Cares (PPO D-SNP) | NETWORK HEALTH INSURANCE CORPORATION | T5 | Yes | $21.10 | WI |
| Univera SeniorChoice Core (PPO) | EXCELLUS HEALTH PLAN, INC. | T5 | Yes | $33.00 | NY |
| Univera SeniorChoice Advanced (HMO-POS) | EXCELLUS HEALTH PLAN, INC. | T5 | Yes | $36.90 | NY |
| Network Health PlusRx (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T5 | Yes | $38.60 | WI |
Frequently Asked Questions
Is budesonide 4 MG Delayed Release Oral Capsule [Tarpeyo] covered by Medicare Part D?
Yes, budesonide 4 MG Delayed Release Oral Capsule [Tarpeyo] is covered by 61 Medicare Part D plans (1.2% of all Part D formularies).
What tier is budesonide 4 MG Delayed Release Oral Capsule [Tarpeyo] on Medicare Part D plans?
budesonide 4 MG Delayed Release Oral Capsule [Tarpeyo] averages Tier 4.4 across Part D plans, ranging from Tier 1 to Tier 5.
Does budesonide 4 MG Delayed Release Oral Capsule [Tarpeyo] require prior authorization?
100% of Part D formularies require prior authorization for budesonide 4 MG Delayed Release Oral Capsule [Tarpeyo]. Step therapy: 0%. Quantity limits: 36.8%.
How much does Medicare spend on budesonide 4 MG Delayed Release Oral Capsule [Tarpeyo]?
In 2023, total Medicare Part D spending on budesonide 4 MG Delayed Release Oral Capsule [Tarpeyo] was $33,914,751, covering 61,841 beneficiaries. The average spend per beneficiary was $548.42.
Read our methodology - how this data is sourced, computed, and verified.