estradiol 0.5 MG Oral Tablet
estradiol
RxCUI: 197657
What the CMS Formulary Data Shows for estradiol 0.5 MG Oral Tablet
Per the CMS 2026 Part D formulary file, estradiol 0.5 MG Oral Tablet (RxNorm concept RXCUI 197657, generic name estradiol) appears on 330 distinct formulary files spanning 5,067 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 1.5.
Real-world access to estradiol 0.5 MG Oral Tablet 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 1,289,816 Part D beneficiaries filled estradiol 0.5 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $239,154,624 and an average per-beneficiary annual cost of $185.42. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry estradiol 0.5 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 330
- Plans covering
- 5,067
- 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
- 1,289,816
- Total spending
- $239,154,624
- Avg per beneficiary
- $185.42
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering estradiol 0.5 MG Oral Tablet
100 Medicare Advantage plans with Part D drug coverage include this drug.
Frequently Asked Questions
Is estradiol 0.5 MG Oral Tablet covered by Medicare Part D?
Yes, estradiol 0.5 MG Oral Tablet is covered by 5,067 Medicare Part D plans (100% of all Part D formularies).
What tier is estradiol 0.5 MG Oral Tablet on Medicare Part D plans?
estradiol 0.5 MG Oral Tablet averages Tier 1.5 across Part D plans, ranging from Tier 1 to Tier 4.
Does estradiol 0.5 MG Oral Tablet require prior authorization?
0% of Part D formularies require prior authorization for estradiol 0.5 MG Oral Tablet. Step therapy: 0%. Quantity limits: 0.6%.
How much does Medicare spend on estradiol 0.5 MG Oral Tablet?
In 2023, total Medicare Part D spending on estradiol 0.5 MG Oral Tablet was $239,154,624, covering 1,289,816 beneficiaries. The average spend per beneficiary was $185.42.
Read our methodology - how this data is sourced, computed, and verified.