diflunisal 500 MG Oral Tablet

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diflunisal

RxCUI: 197603

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.
72.2%
Plan Coverage
3,659
Plans Covering
T2.3
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for diflunisal 500 MG Oral Tablet

Per the CMS 2026 Part D formulary file, diflunisal 500 MG Oral Tablet (RxNorm concept RXCUI 197603, generic name diflunisal) appears on 210 distinct formulary files spanning 3,659 Medicare Part D plan offerings - 72.2% of enrollable Part D products, mid-range placement; shopping across contracts changes access. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.3.

Real-world access to diflunisal 500 MG Oral Tablet depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 19.5% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 3,325 Part D beneficiaries filled diflunisal 500 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $859,181 and an average per-beneficiary annual cost of $258.40. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry diflunisal 500 MG Oral Tablet today.

Coverage Details

Formularies covering
210
Plans covering
3,659
Coverage rate
72.2%
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
19.5% of formularies

2023 Medicare Spending

Beneficiaries
3,325
Total spending
$859,181
Avg per beneficiary
$258.40

Tier Distribution Across Plans

100 plans
Tier 1, Preferred Generic

Medicare Advantage Plans (MA-PD) Covering diflunisal 500 MG Oral Tablet

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
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
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
NaviCare (HMO D-SNP) FALLON COMMUNITY HEALTH PLAN T1 No $0 MA
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
VNS Health Total (HMO D-SNP) VNS CHOICE T1 No $0 NY
Mass General Brigham SCO (HMO D-SNP) MASS GENERAL BRIGHAM HEALTH PLAN, INC T1 No $0 MA
Mass General Brigham One Care (HMO D-SNP) MASS GENERAL BRIGHAM HEALTH PLAN, INC T1 No $0 MA
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 No $0 PA
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 No $0 PA
Highmark Health Options Duals (HMO D-SNP) HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC. T1 No $0 WV
Highmark Health Options Duals (HMO D-SNP) HIGHMARK BCBSD, INC. T1 No $0 DE
Tufts Health One Care (HMO D-SNP) TUFTS HEALTH PUBLIC PLANS, INC. T1 No $0 MA
Tufts Health One Care CW (HMO D-SNP) TUFTS HEALTH PUBLIC PLANS, INC. T1 No $0 MA
Tufts Health Plan Senior Care Options (HMO D-SNP) TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION T1 No $0 MA
Tufts Health Plan Senior Care Options CW (HMO D-SNP) TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION T1 No $0 MA
Leon MediExtra (HMO) LEON HEALTH, INC. T1 No $0 FL
Leon MediDual (HMO D-SNP) LEON HEALTH, INC. T1 No $0 FL
Leon MediMore (HMO) LEON HEALTH, INC. T1 No $0 FL
Leon MediMax (HMO D-SNP) LEON HEALTH, INC. T1 No $0 FL
Florida Complete Care (HMO I-SNP) HPMP OF FLORIDA, INC. T1 No $4.80 FL
Florida Complete Care- In The Community (HMO-POS I-SNP) HPMP OF FLORIDA, INC. T1 No $4.80 FL
Longevity Health Plan (HMO I-SNP) LONGEVITY HEALTH PLAN OF FLORIDA, INC. T1 No $4.80 FL
Senior Care (HMO I-SNP) ALIGN SENIOR CARE FLORIDA, INC. T1 No $4.80 FL

Frequently Asked Questions

Is diflunisal 500 MG Oral Tablet covered by Medicare Part D?

Yes, diflunisal 500 MG Oral Tablet is covered by 3,659 Medicare Part D plans (72.2% of all Part D formularies).

What tier is diflunisal 500 MG Oral Tablet on Medicare Part D plans?

diflunisal 500 MG Oral Tablet averages Tier 2.3 across Part D plans, ranging from Tier 1 to Tier 4.

Does diflunisal 500 MG Oral Tablet require prior authorization?

0% of Part D formularies require prior authorization for diflunisal 500 MG Oral Tablet. Step therapy: 0%. Quantity limits: 19.5%.

How much does Medicare spend on diflunisal 500 MG Oral Tablet?

In 2023, total Medicare Part D spending on diflunisal 500 MG Oral Tablet was $859,181, covering 3,325 beneficiaries. The average spend per beneficiary was $258.40.

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