indomethacin 5 MG/ML Oral Suspension
indomethacin
RxCUI: 310991
What the CMS Formulary Data Shows for indomethacin 5 MG/ML Oral Suspension
Per the CMS 2026 Part D formulary file, indomethacin 5 MG/ML Oral Suspension (RxNorm concept RXCUI 310991, generic name indomethacin) appears on 2 distinct formulary files spanning 11 Medicare Part D plan offerings - 0.2% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.5.
Real-world access to indomethacin 5 MG/ML Oral Suspension 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 123,532 Part D beneficiaries filled indomethacin 5 MG/ML Oral Suspension in 2023, with total plan-and-beneficiary spending of $3,235,993 and an average per-beneficiary annual cost of $26.20. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry indomethacin 5 MG/ML Oral Suspension today.
Coverage Details
- Formularies covering
- 2
- Plans covering
- 11
- Coverage rate
- 0.2%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 123,532
- Total spending
- $3,235,993
- Avg per beneficiary
- $26.20
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering indomethacin 5 MG/ML Oral Suspension
2 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| Blue Rx PDP Complete (PDP) | HM HEALTH INSURANCE COMPANY | T4 | No | No | $164.80 | - |
| Blue Rx PDP Plus (PDP) | HM HEALTH INSURANCE COMPANY | T4 | No | No | $193.20 | - |
Medicare Advantage Plans (MA-PD) Covering indomethacin 5 MG/ML Oral Suspension
9 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| CareAdvantage (HMO D-SNP) | SAN MATEO HEALTH COMMISSION | T1 | No | $0 | CA |
| Security Blue HMO-POS Standard (HMO-POS) | HIGHMARK CHOICE COMPANY | T4 | No | $51.80 | PA |
| Freedom Blue PPO Select (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T4 | No | $95.70 | PA |
| Security Blue HMO-POS Deluxe (HMO-POS) | HIGHMARK CHOICE COMPANY | T4 | No | $95.90 | PA |
| Freedom Blue PPO Standard (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T4 | No | $98.20 | PA |
| Freedom Blue PPO Select (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T4 | No | $115.70 | PA |
| Freedom Blue PPO Deluxe (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T4 | No | $122.40 | PA |
| Freedom Blue PPO Classic (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T4 | No | $140.90 | PA |
| Freedom Blue PPO Classic (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T4 | No | $145.40 | PA |
Frequently Asked Questions
Is indomethacin 5 MG/ML Oral Suspension covered by Medicare Part D?
Yes, indomethacin 5 MG/ML Oral Suspension is covered by 11 Medicare Part D plans (0.2% of all Part D formularies).
What tier is indomethacin 5 MG/ML Oral Suspension on Medicare Part D plans?
indomethacin 5 MG/ML Oral Suspension averages Tier 2.5 across Part D plans, ranging from Tier 1 to Tier 4.
Does indomethacin 5 MG/ML Oral Suspension require prior authorization?
0% of Part D formularies require prior authorization for indomethacin 5 MG/ML Oral Suspension. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on indomethacin 5 MG/ML Oral Suspension?
In 2023, total Medicare Part D spending on indomethacin 5 MG/ML Oral Suspension was $3,235,993, covering 123,532 beneficiaries. The average spend per beneficiary was $26.20.
Read our methodology - how this data is sourced, computed, and verified.