Medicare Part D coverage · diclofenac sodium · RxCUI 857700
diclofenac sodium 15 MG/ML Topical Solution
Per the CMS 2026 Part D formulary file, diclofenac sodium 15 MG/ML Topical Solution is covered by 5,026 Medicare Part D plans (99.5% of enrollable products), averaging Tier 2.5, with prior authorization required on 26.6% of covering formularies.
- 99.5%
- Plan coverage
- 5,026
- Plans covering
- T2.5
- Avg tier
- 26.6%
- Prior auth required
What the CMS Formulary Data Shows for diclofenac sodium 15 MG/ML Topical Solution
Per the CMS 2026 Part D formulary file, diclofenac sodium 15 MG/ML Topical Solution (RxNorm concept RXCUI 857700, generic name diclofenac sodium) appears on 323 distinct formulary files spanning 5,026 Medicare Part D plan offerings - 99.5% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.5.
Real-world access to diclofenac sodium 15 MG/ML Topical Solution depends on utilization management as much as tier placement: 26.6% of covering formularies require prior authorization. 0% require step therapy. 66.3% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 3,196,668 Part D beneficiaries filled diclofenac sodium 15 MG/ML Topical Solution in 2023, with total plan-and-beneficiary spending of $395,688,978 and an average per-beneficiary annual cost of $123.78. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry diclofenac sodium 15 MG/ML Topical Solution today.
Coverage Details
- Formularies covering
- 323
- Plans covering
- 5,026
- Coverage rate
- 99.5%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 26.6% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 66.3% of formularies
2023 Medicare Spending
- Beneficiaries
- 3,196,668
- Total spending
- $395,688,978
- Avg per beneficiary
- $123.78
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering diclofenac sodium 15 MG/ML Topical 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 | Yes | $0 | VA |
| Sentara Community Complete (HMO D-SNP) | Sentara Health Plans | T1 | Yes | $0 | VA |
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) | Hpmp OF Florida, Inc. | T1 | No | $0 | FL |
| 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 |
| Longevity Health Plan (PPO I-SNP) | Longevity Health Plan OF NEW Jersey Insurance Comp | T1 | No | $0 | NJ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Elderplan Plus Long-Term Care (HMO-POS D-SNP) | Elderplan, Inc. | T1 | No | $0 | NY |
| Health Choice Pathway (HMO D-SNP) | Health Choice Arizona, Inc. | T1 | No | $0 | AZ |
| Healthfirst CompleteCare (HMO D-SNP) | Healthfirst Health Plan, Inc. | T1 | No | $0 | NY |
| IMCare Classic (HMO D-SNP) | Itasca Medical Care | T1 | No | $0 | MN |
| Johns Hopkins Advantage MD D-SNP (HMO D-SNP) | Hopkins Health Advantage, Inc. | T1 | No | $0 | MD |
| MetroPlus UltraCare (HMO D-SNP) | Metroplus Health Plan, Inc. | T1 | No | $0 | NY |
| 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 |
| Senior Whole Health SCO (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| Senior Whole Health SCO NHC (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| Molina One Care (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
Show the next 30 plans
| 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 |
| CareAdvantage (HMO D-SNP) | SAN Mateo Health Commission | T1 | No | $0 | CA |
| DrMax (HMO) | Doctors Healthcare Plans, Inc. | T1 | No | $0 | FL |
| DrExtraCare (HMO C-SNP) | Doctors Healthcare Plans, Inc. | T1 | No | $0 | FL |
| DrSelect (HMO) | Doctors Healthcare Plans, Inc. | T1 | No | $0 | FL |
| DrSelect-CFL (HMO) | Doctors Healthcare Plans, Inc. | T1 | No | $0 | FL |
| DrPlatinum-CFL (HMO D-SNP) | Doctors Healthcare Plans, Inc. | T1 | No | $0 | FL |
| DrTotalCare-CFL (HMO C-SNP) | Doctors Healthcare Plans, Inc. | T1 | No | $0 | FL |
| DrElite-SFL (HMO) | Doctors Healthcare Plans, Inc. | T1 | No | $0 | FL |
| Gold Coast Health Plan Total Care Advantage (HMO D-SNP) | Ventura County Medi-Cal Managed Care Commission | T1 | Yes | $0 | CA |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Health Care Service Corporation | T1 | Yes | $0 | NM |
| Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) | Health Care Service Corporation | T1 | Yes | $0 | NM |
| Horizon NJ TotalCare (HMO D-SNP) | Horizon Healthcare OF NEW Jersey, Inc. | T1 | Yes | $0 | NJ |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | Yes | $0 | MN |
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | Yes | $0 | MA |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | Yes | $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 |
| CCA One Care (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | No | $0 | MA |
| CCA Senior Care Options (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | No | $0 | MA |
| 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 |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is diclofenac sodium 15 MG/ML Topical Solution covered by Medicare Part D?
Yes, diclofenac sodium 15 MG/ML Topical Solution is covered by 5,026 Medicare Part D plans (99.5% of all Part D formularies).
What tier is diclofenac sodium 15 MG/ML Topical Solution on Medicare Part D plans?
diclofenac sodium 15 MG/ML Topical Solution averages Tier 2.5 across Part D plans, ranging from Tier 1 to Tier 4.
Does diclofenac sodium 15 MG/ML Topical Solution require prior authorization?
26.6% of Part D formularies require prior authorization for diclofenac sodium 15 MG/ML Topical Solution. Step therapy: 0%. Quantity limits: 66.3%.
How much does Medicare spend on diclofenac sodium 15 MG/ML Topical Solution?
In 2023, total Medicare Part D spending on diclofenac sodium 15 MG/ML Topical Solution was $395,688,978, covering 3,196,668 beneficiaries. The average spend per beneficiary was $123.78.
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
Similar prior-authorization rate
- 24 HR paroxetine hydrochloride 12.5 MG Extended Release Oral Tablet 26.6% PA
- phenoxybenzamine hydrochloride 10 MG Oral Capsule 26.7% PA
- 24 HR paroxetine hydrochloride 37.5 MG Extended Release Oral Tablet 26.7% PA
- lorazepam 2 MG/ML Oral Solution 26.8% PA
- calcium acetate 667 MG Oral Tablet 26.8% PA
- calcipotriene 0.05 MG/ML Topical Solution 26.8% PA