codeine sulfate 15 MG Oral Tablet
codeine sulfate
RxCUI: 997170
What the CMS Formulary Data Shows for codeine sulfate 15 MG Oral Tablet
Per the CMS 2026 Part D formulary file, codeine sulfate 15 MG Oral Tablet (RxNorm concept RXCUI 997170, generic name codeine sulfate) appears on 50 distinct formulary files spanning 1,162 Medicare Part D plan offerings - 22.9% 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 2.9.
Real-world access to codeine sulfate 15 MG Oral Tablet depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 84% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 3,569 Part D beneficiaries filled codeine sulfate 15 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $1,122,751 and an average per-beneficiary annual cost of $314.58. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry codeine sulfate 15 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 50
- Plans covering
- 1,162
- Coverage rate
- 22.9%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 84% of formularies
2023 Medicare Spending
- Beneficiaries
- 3,569
- Total spending
- $1,122,751
- Avg per beneficiary
- $314.58
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering codeine sulfate 15 MG Oral Tablet
100 Medicare Advantage plans with Part D drug coverage include this drug.
Frequently Asked Questions
Is codeine sulfate 15 MG Oral Tablet covered by Medicare Part D?
Yes, codeine sulfate 15 MG Oral Tablet is covered by 1,162 Medicare Part D plans (22.9% of all Part D formularies).
What tier is codeine sulfate 15 MG Oral Tablet on Medicare Part D plans?
codeine sulfate 15 MG Oral Tablet averages Tier 2.9 across Part D plans, ranging from Tier 1 to Tier 4.
Does codeine sulfate 15 MG Oral Tablet require prior authorization?
0% of Part D formularies require prior authorization for codeine sulfate 15 MG Oral Tablet. Step therapy: 0%. Quantity limits: 84%.
How much does Medicare spend on codeine sulfate 15 MG Oral Tablet?
In 2023, total Medicare Part D spending on codeine sulfate 15 MG Oral Tablet was $1,122,751, covering 3,569 beneficiaries. The average spend per beneficiary was $314.58.
Read our methodology - how this data is sourced, computed, and verified.