citric acid 0.01 MG/MG / lactic acid 0.018 MG/MG / potassium bitartrate 0.004 MG/MG Vaginal Gel [Phexxi]

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citric acid

RxCUI: 2385353

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.
0.3%
Plan Coverage
15
Plans Covering
T4
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for citric acid 0.01 MG/MG / lactic acid 0.018 MG/MG / potassium bitartrate 0.004 MG/MG Vaginal Gel [Phexxi]

Per the CMS 2026 Part D formulary file, citric acid 0.01 MG/MG / lactic acid 0.018 MG/MG / potassium bitartrate 0.004 MG/MG Vaginal Gel [Phexxi] (RxNorm concept RXCUI 2385353, generic name citric acid) appears on 2 distinct formulary files spanning 15 Medicare Part D plan offerings - 0.3% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 4 to Tier 4, with a cross-plan average of Tier 4.

Real-world access to citric acid 0.01 MG/MG / lactic acid 0.018 MG/MG / potassium bitartrate 0.004 MG/MG Vaginal Gel [Phexxi] depends on utilization management as much as tier placement: 0% 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 573 Part D beneficiaries filled citric acid 0.01 MG/MG / lactic acid 0.018 MG/MG / potassium bitartrate 0.004 MG/MG Vaginal Gel [Phexxi] in 2023, with total plan-and-beneficiary spending of $68,819 and an average per-beneficiary annual cost of $120.10. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry citric acid 0.01 MG/MG / lactic acid 0.018 MG/MG / potassium bitartrate 0.004 MG/MG Vaginal Gel [Phexxi] today.

Coverage Details

Formularies covering
2
Plans covering
15
Coverage rate
0.3%
Tier range
Tier 4, Non-Preferred
Average tier
Tier 4, Non-Preferred

Restrictions

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

2023 Medicare Spending

Beneficiaries
573
Total spending
$68,819
Avg per beneficiary
$120.10

Tier Distribution Across Plans

15 plans
Tier 4, Non-Preferred

Medicare Advantage Plans (MA-PD) Covering citric acid 0.01 MG/MG / lactic acid 0.018 MG/MG / potassium bitartrate 0.004 MG/MG Vaginal Gel [Phexxi]

15 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T4 No $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T4 No $0 NV
Select Health Medicare Dual (HMO D-SNP) SELECTHEALTH, INC. T4 No $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T4 No $0 UT
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T4 No $0 NV
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T4 No $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T4 No $0 CO
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T4 No $0 CO
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T4 No $0 CO
Select Health Medicare Flex (HMO) SELECTHEALTH, INC. T4 No $0 CO
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T4 No $0 CO
Select Health Medicare Active (HMO) SELECTHEALTH, INC. T4 No $0 CO
Select Health Medicare Dual (HMO D-SNP) SELECTHEALTH, INC. T4 No $0 NV
Select Health Medicare Wellness (HMO) SELECTHEALTH, INC. T4 No $0 NV
Healthy Mississippi Premier Advantage (HMO-POS) Healthy Mississippi, Inc. T4 No $0 MS

Frequently Asked Questions

Is citric acid 0.01 MG/MG / lactic acid 0.018 MG/MG / potassium bitartrate 0.004 MG/MG Vaginal Gel [Phexxi] covered by Medicare Part D?

Yes, citric acid 0.01 MG/MG / lactic acid 0.018 MG/MG / potassium bitartrate 0.004 MG/MG Vaginal Gel [Phexxi] is covered by 15 Medicare Part D plans (0.3% of all Part D formularies).

What tier is citric acid 0.01 MG/MG / lactic acid 0.018 MG/MG / potassium bitartrate 0.004 MG/MG Vaginal Gel [Phexxi] on Medicare Part D plans?

citric acid 0.01 MG/MG / lactic acid 0.018 MG/MG / potassium bitartrate 0.004 MG/MG Vaginal Gel [Phexxi] averages Tier 4 across Part D plans, ranging from Tier 4 to Tier 4.

Does citric acid 0.01 MG/MG / lactic acid 0.018 MG/MG / potassium bitartrate 0.004 MG/MG Vaginal Gel [Phexxi] require prior authorization?

0% of Part D formularies require prior authorization for citric acid 0.01 MG/MG / lactic acid 0.018 MG/MG / potassium bitartrate 0.004 MG/MG Vaginal Gel [Phexxi]. Step therapy: 0%. Quantity limits: 0%.

How much does Medicare spend on citric acid 0.01 MG/MG / lactic acid 0.018 MG/MG / potassium bitartrate 0.004 MG/MG Vaginal Gel [Phexxi]?

In 2023, total Medicare Part D spending on citric acid 0.01 MG/MG / lactic acid 0.018 MG/MG / potassium bitartrate 0.004 MG/MG Vaginal Gel [Phexxi] was $68,819, covering 573 beneficiaries. The average spend per beneficiary was $120.10.

Read our methodology - how this data is sourced, computed, and verified.

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