Medicare Part D coverage · flurbiprofen sodium · RxCUI 1243585
flurbiprofen sodium 0.3 MG/ML Ophthalmic Solution
Per the CMS 2026 Part D formulary file, flurbiprofen sodium 0.3 MG/ML Ophthalmic Solution is covered by 4,939 Medicare Part D plans (97.8% of enrollable products), averaging Tier 2.1, with prior authorization required on 0% of covering formularies.
- 97.8%
- Plan coverage
- 4,939
- 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 324 distinct formulary files spanning 4,939 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
- 324
- Plans covering
- 4,939
- 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
Medicare Advantage Plans (MA-PD) Covering flurbiprofen sodium 0.3 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 |
| 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 |
Show the next 30 plans
Showing top 50 of 100 plans.
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 4,939 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.
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
- amantadine hydrochloride 100 MG Oral Capsule T2.1
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- 24 HR propranolol hydrochloride 160 MG Extended Release Oral Capsule T2.1
- {21 (desogestrel 0.15 MG / ethinyl estradiol 0.03 MG Oral Tablet) / 7 (inert ingredients 1 MG Oral Tablet) } Pack [Apri 28 Day] T2.1
- {21 (desogestrel 0.15 MG / ethinyl estradiol 0.03 MG Oral Tablet) / 7 (inert ingredients 1 MG Oral Tablet) } Pack [Reclipsen 28 Day] T2.1
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