Medicare Part D coverage · cromolyn sodium · RxCUI 831109
cromolyn sodium 40 MG/ML Ophthalmic Solution
Per the CMS 2026 Part D formulary file, cromolyn sodium 40 MG/ML Ophthalmic Solution is covered by 5,052 Medicare Part D plans (100% of enrollable products), averaging Tier 1.6, with prior authorization required on 0% of covering formularies.
- 100%
- Plan coverage
- 5,052
- Plans covering
- T1.6
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for cromolyn sodium 40 MG/ML Ophthalmic Solution
Per the CMS 2026 Part D formulary file, cromolyn sodium 40 MG/ML Ophthalmic Solution (RxNorm concept RXCUI 831109, generic name cromolyn sodium) appears on 328 distinct formulary files spanning 5,052 Medicare Part D plan offerings - 100% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 1.6.
Real-world access to cromolyn sodium 40 MG/ML Ophthalmic Solution depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 0.6% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 37,634 Part D beneficiaries filled cromolyn sodium 40 MG/ML Ophthalmic Solution in 2023, with total plan-and-beneficiary spending of $9,058,332 and an average per-beneficiary annual cost of $240.70. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry cromolyn sodium 40 MG/ML Ophthalmic Solution today.
Coverage Details
- Formularies covering
- 328
- Plans covering
- 5,052
- Coverage rate
- 100%
- 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
- 0.6% of formularies
2023 Medicare Spending
- Beneficiaries
- 37,634
- Total spending
- $9,058,332
- Avg per beneficiary
- $240.70
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering cromolyn sodium 40 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 |
| Freedom VIP Care (HMO C-SNP) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Diamond Savings (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Diamond (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Freedom Medi-Medi Partial (HMO D-SNP) | Freedom Health, Inc. | T1 | No | $0 | FL |
Show the next 30 plans
| Freedom Medi-Medi Full (HMO D-SNP) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Optimum Emerald Partial (HMO D-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Emerald Full (HMO D-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Máximo (HMO-POS) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Freedom Máximo (HMO-POS) | Freedom Health, Inc. | T1 | No | $0 | FL |
| Optimum Gold Rewards Plan (HMO) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Platinum Plan (HMO) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Gold Plan (HMO) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Gold Rewards Plan (HMO) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Gold Rewards Plan (HMO) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Diamond Rewards COPD (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Diamond Savings COPD (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Gold Plus Plan (HMO) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| Optimum Diamond Rewards COPD (HMO C-SNP) | Optimum Healthcare, Inc. | T1 | No | $0 | FL |
| HealthSun HealthAdvantage Plan (HMO) | Healthsun Health Plans, Inc. | T1 | No | $0 | FL |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is cromolyn sodium 40 MG/ML Ophthalmic Solution covered by Medicare Part D?
Yes, cromolyn sodium 40 MG/ML Ophthalmic Solution is covered by 5,052 Medicare Part D plans (100% of all Part D formularies).
What tier is cromolyn sodium 40 MG/ML Ophthalmic Solution on Medicare Part D plans?
cromolyn sodium 40 MG/ML Ophthalmic Solution averages Tier 1.6 across Part D plans, ranging from Tier 1 to Tier 4.
Does cromolyn sodium 40 MG/ML Ophthalmic Solution require prior authorization?
0% of Part D formularies require prior authorization for cromolyn sodium 40 MG/ML Ophthalmic Solution. Step therapy: 0%. Quantity limits: 0.6%.
How much does Medicare spend on cromolyn sodium 40 MG/ML Ophthalmic Solution?
In 2023, total Medicare Part D spending on cromolyn sodium 40 MG/ML Ophthalmic Solution was $9,058,332, covering 37,634 beneficiaries. The average spend per beneficiary was $240.70.
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
- clindamycin 150 MG Oral Capsule T1.6
- propranolol hydrochloride 60 MG Oral Tablet T1.6
- montelukast 5 MG Chewable Tablet T1.6
- clindamycin 75 MG Oral Capsule T1.6
- polyethylene glycol 3350 240000 MG / potassium chloride 2980 MG / sodium bicarbonate 6720 MG / sodium chloride 5840 MG / sodium sulfate 22720 MG Powder for Oral Solution [GaviLyte-C] T1.6
- furosemide 8 MG/ML Oral Solution T1.6
Similar prior-authorization rate
- metronidazole 10 MG/ML Topical Cream [Noritate] 0% PA
- 24 HR minocycline 40 MG Extended Release Oral Capsule [Emrosi] 0% PA
- buspirone hydrochloride 10 MG Oral Capsule [Bucapsol] 0% PA
- diflunisal 375 MG Oral Tablet [Dolobid] 0% PA
- hydrocortisone 1 MG/ML Oral Solution [Khindivi] 0% PA
- indomethacin 50 MG Rectal Suppository [Indocin] 0% PA