ketoconazole 20 MG/ML Medicated Shampoo

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ketoconazole

RxCUI: 106336

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.
100%
Plan Coverage
5,067
Plans Covering
T1.7
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for ketoconazole 20 MG/ML Medicated Shampoo

Per the CMS 2026 Part D formulary file, ketoconazole 20 MG/ML Medicated Shampoo (RxNorm concept RXCUI 106336, generic name ketoconazole) 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 1.7.

Real-world access to ketoconazole 20 MG/ML Medicated Shampoo depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 63% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 1,750,875 Part D beneficiaries filled ketoconazole 20 MG/ML Medicated Shampoo in 2023, with total plan-and-beneficiary spending of $96,053,241 and an average per-beneficiary annual cost of $54.86. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry ketoconazole 20 MG/ML Medicated Shampoo 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
63% of formularies

2023 Medicare Spending

Beneficiaries
1,750,875
Total spending
$96,053,241
Avg per beneficiary
$54.86

Tier Distribution Across Plans

100 plans
Tier 1, Preferred Generic

Medicare Advantage Plans (MA-PD) Covering ketoconazole 20 MG/ML Medicated Shampoo

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
Wellpoint Medicare Advantage (HMO-POS) WELLPOINT WEST VIRGINIA , INC. T1 No $0 WV
Anthem Medicare Advantage 3 (HMO-POS) HealthKeepers, Inc. T1 No $0 VA
Anthem Medicare Advantage 3 (HMO-POS) HealthKeepers, Inc. T1 No $0 VA
Anthem Medicare Advantage 3 (HMO-POS) HealthKeepers, Inc. T1 No $0 VA
Wellpoint Medicare Advantage 2 (HMO-POS) WELLPOINT TENNESSEE, INC. T1 No $0 TN
Wellpoint Medicare Advantage 2 (HMO-POS) WELLPOINT TENNESSEE, INC. T1 No $0 TN
Wellpoint Medicare Advantage 2 (HMO-POS) WELLPOINT TENNESSEE, INC. T1 No $0 TN
Wellpoint Medicare Advantage 2 (HMO-POS) WELLPOINT TENNESSEE, INC. T1 No $0 TN
Freedom VIP Care (HMO C-SNP) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom VIP Savings (HMO C-SNP) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom VIP Savings (HMO C-SNP) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom VIP Rewards (HMO C-SNP) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom VIP Rewards (HMO C-SNP) FREEDOM HEALTH, INC. T1 No $0 FL
Optimum Diamond Rewards (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Diamond Savings (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Diamond Rewards (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Diamond (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Freedom Medi-Medi Partial (HMO D-SNP) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Medi-Medi Full (HMO D-SNP) FREEDOM HEALTH, INC. T1 No $0 FL
Optimum Emerald Partial (HMO D-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Emerald Full (HMO D-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Freedom Medicare Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Medicare Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom VIP Savings COPD (HMO C-SNP) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom VIP Savings COPD (HMO C-SNP) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Máximo (HMO-POS) FREEDOM HEALTH, INC. T1 No $0 FL
Freedom Máximo (HMO-POS) FREEDOM HEALTH, INC. T1 No $0 FL
Optimum Gold Rewards Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Platinum Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Gold Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Gold Rewards Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Gold Rewards Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Diamond Rewards COPD (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Diamond Savings COPD (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Gold Plus Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
Optimum Diamond Rewards COPD (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 No $0 FL
HealthSun HealthAdvantage Plan (HMO) HEALTHSUN HEALTH PLANS, INC. T1 No $0 FL

Frequently Asked Questions

Is ketoconazole 20 MG/ML Medicated Shampoo covered by Medicare Part D?

Yes, ketoconazole 20 MG/ML Medicated Shampoo is covered by 5,067 Medicare Part D plans (100% of all Part D formularies).

What tier is ketoconazole 20 MG/ML Medicated Shampoo on Medicare Part D plans?

ketoconazole 20 MG/ML Medicated Shampoo averages Tier 1.7 across Part D plans, ranging from Tier 1 to Tier 4.

Does ketoconazole 20 MG/ML Medicated Shampoo require prior authorization?

0% of Part D formularies require prior authorization for ketoconazole 20 MG/ML Medicated Shampoo. Step therapy: 0%. Quantity limits: 63%.

How much does Medicare spend on ketoconazole 20 MG/ML Medicated Shampoo?

In 2023, total Medicare Part D spending on ketoconazole 20 MG/ML Medicated Shampoo was $96,053,241, covering 1,750,875 beneficiaries. The average spend per beneficiary was $54.86.

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