hydrochlorothiazide 12.5 MG Oral Capsule
hydrochlorothiazide
RxCUI: 199903
What the CMS Formulary Data Shows for hydrochlorothiazide 12.5 MG Oral Capsule
Per the CMS 2026 Part D formulary file, hydrochlorothiazide 12.5 MG Oral Capsule (RxNorm concept RXCUI 199903, generic name hydrochlorothiazide) 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 6, with a cross-plan average of Tier 1.1.
Real-world access to hydrochlorothiazide 12.5 MG Oral Capsule depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 4,902,174 Part D beneficiaries filled hydrochlorothiazide 12.5 MG Oral Capsule in 2023, with total plan-and-beneficiary spending of $98,660,150 and an average per-beneficiary annual cost of $20.13. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry hydrochlorothiazide 12.5 MG Oral Capsule today.
Coverage Details
- Formularies covering
- 330
- Plans covering
- 5,067
- Coverage rate
- 100%
- Tier range
- Tier 1 – Tier 6
- Average tier
- Tier 1, Preferred Generic
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 4,902,174
- Total spending
- $98,660,150
- Avg per beneficiary
- $20.13
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering hydrochlorothiazide 12.5 MG Oral Capsule
5 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP) | UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY | T1 | No | No | $0 | - |
| AARP Medicare Rx Preferred from UHC (PDP) | UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY | T1 | No | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY | T1 | No | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY | T1 | No | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY | T1 | No | No | $0 | - |
Medicare Advantage Plans (MA-PD) Covering hydrochlorothiazide 12.5 MG Oral Capsule
95 Medicare Advantage plans with Part D drug coverage include this drug.
Frequently Asked Questions
Is hydrochlorothiazide 12.5 MG Oral Capsule covered by Medicare Part D?
Yes, hydrochlorothiazide 12.5 MG Oral Capsule is covered by 5,067 Medicare Part D plans (100% of all Part D formularies).
What tier is hydrochlorothiazide 12.5 MG Oral Capsule on Medicare Part D plans?
hydrochlorothiazide 12.5 MG Oral Capsule averages Tier 1.1 across Part D plans, ranging from Tier 1 to Tier 6.
Does hydrochlorothiazide 12.5 MG Oral Capsule require prior authorization?
0% of Part D formularies require prior authorization for hydrochlorothiazide 12.5 MG Oral Capsule. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on hydrochlorothiazide 12.5 MG Oral Capsule?
In 2023, total Medicare Part D spending on hydrochlorothiazide 12.5 MG Oral Capsule was $98,660,150, covering 4,902,174 beneficiaries. The average spend per beneficiary was $20.13.
Read our methodology - how this data is sourced, computed, and verified.