flurbiprofen sodium 0.3 MG/ML Ophthalmic Solution

Verify with CMS →

flurbiprofen sodium

RxCUI: 1243585

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.
97.8%
Plan Coverage
4,954
Plans Covering
T2.1
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for flurbiprofen sodium 0.3 MG/ML Ophthalmic Solution

Per the CMS 2026 Part D formulary file, flurbiprofen sodium 0.3 MG/ML Ophthalmic Solution (RxNorm concept RXCUI 1243585, generic name flurbiprofen sodium) appears on 326 distinct formulary files spanning 4,954 Medicare Part D plan offerings - 97.8% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.1.

Real-world access to flurbiprofen sodium 0.3 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 8,299 Part D beneficiaries filled flurbiprofen sodium 0.3 MG/ML Ophthalmic Solution in 2023, with total plan-and-beneficiary spending of $681,212 and an average per-beneficiary annual cost of $82.08. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry flurbiprofen sodium 0.3 MG/ML Ophthalmic Solution today.

Coverage Details

Formularies covering
326
Plans covering
4,954
Coverage rate
97.8%
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
8,299
Total spending
$681,212
Avg per beneficiary
$82.08

Tier Distribution Across Plans

100 plans
Tier 1, Preferred Generic

Standalone Drug Plans (PDP) Covering flurbiprofen sodium 0.3 MG/ML Ophthalmic Solution

5 standalone prescription drug plans include this drug.

Plan Insurer Tier PA ST Premium States
Anthem Full Dual Advantage (PPO D-SNP) ANTHEM HEALTH PLANS, INC. T1 No No $0 CT
Anthem Dual Advantage (PPO D-SNP) ANTHEM HEALTH PLANS, INC. T1 No No $0 CT
Anthem Kidney Care (HMO-POS C-SNP) ANTHEM HEALTH PLANS, INC. T1 No No $0 CT
Anthem Full Dual Advantage Select (HMO D-SNP) ANTHEM HEALTH PLANS, INC. T1 No No $0 CT
Anthem Dual Advantage (HMO D-SNP) ANTHEM HEALTH PLANS, INC. T1 No No $0 CT

Medicare Advantage Plans (MA-PD) Covering flurbiprofen sodium 0.3 MG/ML Ophthalmic Solution

95 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
Anthem Medicare Advantage (HMO-POS) BLUE CROSS OF CALIFORNIA T1 No $0 CA
Anthem Medicare Advantage (HMO-POS) BLUE CROSS OF CALIFORNIA T1 No $0 CA
Anthem Medicare Advantage (HMO-POS) BLUE CROSS OF CALIFORNIA T1 No $0 CA
Anthem Medicare Advantage (HMO-POS) BLUE CROSS OF CALIFORNIA T1 No $0 CA
Anthem Full Dual Advantage (HMO D-SNP) ANTHEM INSURANCE COMPANIES, INC. T1 No $0 IN
Anthem I PathWays Dual Care Advantage (HMO D-SNP) ANTHEM INSURANCE COMPANIES, INC. T1 No $0 IN
Anthem I PathWays Dual Care Advantage NFLOC (HMO D-SNP) ANTHEM INSURANCE COMPANIES, INC. T1 No $0 IN
Wellpoint Full Dual Advantage (HMO-POS D-SNP) WELLPOINT IOWA, INC. T1 No $0 IA
Wellpoint Full Dual Advantage 2 (HMO-POS D-SNP) WELLPOINT IOWA, INC. T1 No $0 IA
Wellpoint Full Dual Advantage (HMO D-SNP) WELLPOINT WEST VIRGINIA , INC. T1 No $0 WV
Wellpoint Full Dual Advantage (HMO D-SNP) WELLPOINT WASHINGTON, INC. T1 No $0 WA
Wellpoint Dual Advantage (HMO D-SNP) WELLPOINT WASHINGTON, INC. T1 No $0 WA
Healthy Blue Dual Advantage (HMO D-SNP) COMMUNITY CARE HEALTH PLAN OF LOUISIANA, INC. T1 No $0 LA
Healthy Blue Dual Advantage 2 (HMO D-SNP) COMMUNITY CARE HEALTH PLAN OF LOUISIANA, INC. T1 No $0 LA
Anthem Dual Advantage (PPO D-SNP) ANTHEM INSURANCE COMPANIES, INC. T1 No $0 VA
Wellpoint Medicare Advantage 2 (HMO-POS) WELLPOINT TEXAS, INC. T1 No $0 TX
Wellpoint Kidney Care (HMO-POS C-SNP) WELLPOINT TEXAS, INC. T1 No $0 TX
Wellpoint Dual Advantage 2 (HMO D-SNP) WELLPOINT TEXAS, INC. T1 No $0 TX
Wellpoint Kidney Care (HMO-POS C-SNP) WELLPOINT TEXAS, INC. T1 No $0 TX
Wellpoint Full Dual Advantage Aligned (HMO D-SNP) WELLPOINT TEXAS, INC. T1 No $0 TX
Wellpoint Full Dual Advantage Aligned (HMO D-SNP) WELLPOINT TEXAS, INC. T1 No $0 TX
Wellpoint Full Dual Advantage Aligned (HMO D-SNP) WELLPOINT TEXAS, INC. T1 No $0 TX
Wellpoint Full Dual Advantage Aligned (HMO D-SNP) WELLPOINT TEXAS, INC. T1 No $0 TX
Wellpoint Full Dual Advantage 2 (HMO D-SNP) WELLPOINT TEXAS, INC. T1 No $0 TX
Wellpoint Full Dual Advantage 2 (HMO D-SNP) WELLPOINT TEXAS, INC. T1 No $0 TX
Wellpoint Full Dual Advantage (HMO D-SNP) WELLPOINT TEXAS, INC. T1 No $0 TX
Anthem I MyCare Ohio Full Dual Advantage (HMO D-SNP) COMMUNITY INSURANCE COMPANY T1 No $0 OH
Anthem Full Dual Advantage (HMO D-SNP) COMMUNITY INSURANCE COMPANY T1 No $0 OH
Anthem Full Dual Advantage 2 (HMO D-SNP) COMMUNITY INSURANCE COMPANY T1 No $0 OH
Wellpoint Full Dual Advantage (HMO D-SNP) WELLPOINT NEW JERSEY, INC. T1 No $0 NJ
Wellpoint Kidney Care (HMO-POS C-SNP) WELLPOINT NEW JERSEY, INC. T1 No $0 NJ
Wellpoint Full Dual Advantage Secure (HMO-POS D-SNP) WELLPOINT NEW JERSEY, INC. T1 No $0 NJ
Anthem Medicare Advantage (HMO-POS) HealthKeepers, Inc. T1 No $0 VA
Anthem Full Dual Advantage (HMO D-SNP) HealthKeepers, Inc. T1 No $0 MO
Anthem Medicare Advantage 2 (HMO-POS) HealthKeepers, Inc. T1 No $0 VA
Anthem Kidney Care (HMO-POS C-SNP) HealthKeepers, Inc. T1 No $0 VA
Anthem Medicare Advantage (HMO-POS) HealthKeepers, Inc. T1 No $0 MO
Anthem Medicare Advantage 4 (HMO-POS) HealthKeepers, Inc. T1 No $0 VA
Anthem Medicare Advantage (HMO-POS) HealthKeepers, Inc. T1 No $0 IN
Anthem Full Dual Advantage 2 (HMO D-SNP) HealthKeepers, Inc. T1 No $0 MO
Anthem Chronic Care (HMO-POS C-SNP) HealthKeepers, Inc. T1 No $0 MO
Anthem Medicare Advantage (HMO-POS) COMMUNITY INSURANCE COMPANY T1 No $0 OH
Anthem Medicare Advantage (HMO) HMO COLORADO, INC. T1 No $0 CO
Anthem Full Dual Advantage Aligned (HMO D-SNP) BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC. T1 No $0 CA
Anthem Full Dual Advantage 2 (HMO D-SNP) HealthKeepers, Inc. T1 No $0 VA
Anthem Dual Advantage (HMO D-SNP) HealthKeepers, Inc. T1 No $0 VA
Anthem Full Dual Advantage Support (HMO D-SNP) HealthKeepers, Inc. T1 No $0 VA
Anthem Full Dual Advantage (HMO D-SNP) HealthKeepers, Inc. T1 No $0 VA

Frequently Asked Questions

Is flurbiprofen sodium 0.3 MG/ML Ophthalmic Solution covered by Medicare Part D?

Yes, flurbiprofen sodium 0.3 MG/ML Ophthalmic Solution is covered by 4,954 Medicare Part D plans (97.8% of all Part D formularies).

What tier is flurbiprofen sodium 0.3 MG/ML Ophthalmic Solution on Medicare Part D plans?

flurbiprofen sodium 0.3 MG/ML Ophthalmic Solution averages Tier 2.1 across Part D plans, ranging from Tier 1 to Tier 4.

Does flurbiprofen sodium 0.3 MG/ML Ophthalmic Solution require prior authorization?

0% of Part D formularies require prior authorization for flurbiprofen sodium 0.3 MG/ML Ophthalmic Solution. Step therapy: 0%. Quantity limits: 0.6%.

How much does Medicare spend on flurbiprofen sodium 0.3 MG/ML Ophthalmic Solution?

In 2023, total Medicare Part D spending on flurbiprofen sodium 0.3 MG/ML Ophthalmic Solution was $681,212, covering 8,299 beneficiaries. The average spend per beneficiary was $82.08.

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