Medicare Part D coverage · lactulose · RxCUI 1251194

lactulose 20000 MG Powder for Oral Solution

Per the CMS 2026 Part D formulary file, lactulose 20000 MG Powder for Oral Solution is covered by 690 Medicare Part D plans (13.7% of enrollable products), averaging Tier 3.4, with prior authorization required on 50% of covering formularies.

13.7%
Plan coverage
690
Plans covering
T3.4
Avg tier
50%
Prior auth required

Verify with CMS →

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.

What the CMS Formulary Data Shows for lactulose 20000 MG Powder for Oral Solution

Per the CMS 2026 Part D formulary file, lactulose 20000 MG Powder for Oral Solution (RxNorm concept RXCUI 1251194, generic name lactulose) appears on 14 distinct formulary files spanning 690 Medicare Part D plan offerings - 13.7% 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 3.4.

Real-world access to lactulose 20000 MG Powder for Oral Solution depends on utilization management as much as tier placement: 50% 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 526,962 Part D beneficiaries filled lactulose 20000 MG Powder for Oral Solution in 2023, with total plan-and-beneficiary spending of $72,482,220 and an average per-beneficiary annual cost of $137.55. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry lactulose 20000 MG Powder for Oral Solution today.

Coverage Details

Formularies covering
14
Plans covering
690
Coverage rate
13.7%
Tier range
Tier 1 – Tier 4
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
50% of formularies
Step therapy required
0% of formularies
Quantity limits
0% of formularies

2023 Medicare Spending

Beneficiaries
526,962
Total spending
$72,482,220
Avg per beneficiary
$137.55

Tier Distribution Across Plans

1 plans
Tier 1, Preferred Generic
19 plans
Tier 2, Generic
80 plans
Tier 4, Non-Preferred

Medicare Advantage Plans (MA-PD) Covering lactulose 20000 MG Powder for Oral Solution

100 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
CalOptima Health OneCare Complete (HMO D-SNP) Orange County Health Authority T1 Yes $0 CA
Select Health Medicare Essential (HMO) Selecthealth, Inc. T2 No $0 UT
Select Health Medicare Essential (HMO) Selecthealth, Inc. T2 No $0 NV
Select Health Medicare Dual (HMO D-SNP) Selecthealth, Inc. T2 No $0 UT
Select Health Medicare Essential (HMO) Selecthealth, Inc. T2 No $0 UT
Select Health Medicare + Kroger (HMO) Selecthealth, Inc. T2 No $0 NV
Select Health Medicare + Kroger (HMO) Selecthealth, Inc. T2 No $0 UT
Select Health Medicare Essential (HMO) Selecthealth, Inc. T2 No $0 CO
Select Health Medicare Essential (HMO) Selecthealth, Inc. T2 No $0 CO
Select Health Medicare + Kroger (HMO) Selecthealth, Inc. T2 No $0 CO
Select Health Medicare Flex (HMO) Selecthealth, Inc. T2 No $0 CO
Select Health Medicare + Kroger (HMO) Selecthealth, Inc. T2 No $0 CO
Select Health Medicare Active (HMO) Selecthealth, Inc. T2 No $0 CO
Select Health Medicare Dual (HMO D-SNP) Selecthealth, Inc. T2 No $0 NV
Select Health Medicare Wellness (HMO) Selecthealth, Inc. T2 No $0 NV
Health New England Medicare Compass (PPO) Health NEW England, Inc. T2 No $0 MA
Health New England Medicare Value (HMO) Health NEW England, Inc. T2 No $0 MA
Healthy Mississippi Premier Advantage (HMO-POS) Healthy Mississippi, Inc. T2 No $0 MS
Health New England Medicare Premium (HMO) Health NEW England, Inc. T2 No $15.80 MA
Health New England Medicare Plus (HMO) Health NEW England, Inc. T2 No $58.40 MA
Show the next 30 plans
Aetna Medicare Signature (HMO) Aetna Health OF California Inc. T4 Yes $0 CA
Aetna Medicare Signature (HMO) Aetna Health OF California Inc. T4 Yes $0 CA
Aetna Medicare Signature Extra (HMO-POS) Aetna Health OF California Inc. T4 Yes $0 CA
Aetna Medicare Prime (HMO-POS) Aetna Health OF California Inc. T4 Yes $0 CA
Aetna Medicare Prime (HMO-POS) Aetna Health OF California Inc. T4 Yes $0 CA
Aetna Medicare Prime (HMO-POS) Aetna Health OF California Inc. T4 Yes $0 CA
Aetna Medicare Signature Extra (HMO) Aetna Health OF California Inc. T4 Yes $0 CA
Aetna Medicare Prime (HMO-POS) Aetna Health OF California Inc. T4 Yes $0 CA
Aetna Medicare Signature Extra (HMO) Aetna Health OF California Inc. T4 Yes $0 CA
Aetna Medicare Signature Extra (HMO) Aetna Health OF California Inc. T4 Yes $0 CA
Aetna Medicare Signature Extra (HMO) Aetna Health OF California Inc. T4 Yes $0 CA
Aetna Medicare Signature Care (HMO-POS) Aetna Health OF Ohio Inc. T4 Yes $0 OH
Aetna Medicare Signature Extra (HMO-POS) Aetna Health OF Ohio Inc. T4 Yes $0 OH
Aetna Medicare Signature Care (HMO-POS) Aetna Health OF Ohio Inc. T4 Yes $0 OH
Aetna Medicare Signature Extra (HMO-POS) Aetna Health OF Ohio Inc. T4 Yes $0 KY
Aetna Medicare Signature (HMO-POS) Aetna Health OF Ohio Inc. T4 Yes $0 KY
Aetna Medicare Signature (HMO-POS) Aetna Health OF Ohio Inc. T4 Yes $0 KY
Aetna Medicare HIDE (HMO D-SNP) Aetna Health OF Ohio Inc. T4 Yes $0 KY
Aetna Medicare Dual Care (HMO D-SNP) Aetna Health OF Ohio Inc. T4 Yes $0 OH
Aetna Medicare Signature Care (HMO-POS) Aetna Health OF Ohio Inc. T4 Yes $0 OH
Aetna Medicare Signature (HMO-POS) Aetna Health OF Ohio Inc. T4 Yes $0 OH
Aetna Medicare Signature (HMO-POS) Aetna Health OF Ohio Inc. T4 Yes $0 KY
Aetna Medicare Partial Dual (HMO D-SNP) Aetna Health OF Ohio Inc. T4 Yes $0 KY
Aetna Medicare Partial Dual (HMO D-SNP) Aetna Health OF Ohio Inc. T4 Yes $0 OH
Aetna Medicare Signature (HMO) Aetna Health Inc. (GA) T4 Yes $0 GA
Aetna Medicare Signature (HMO-POS) Coventry Health Care OF Illinois, Inc. T4 Yes $0 WI
Aetna Medicare Signature (HMO-POS) Coventry Health Care OF Illinois, Inc. T4 Yes $0 IL
Aetna Medicare Prime Chronic Care (HMO C-SNP) Coventry Health Care OF Illinois, Inc. T4 Yes $0 IL
Aetna Medicare Signature Extra (HMO-POS) Coventry Health Care OF Illinois, Inc. T4 Yes $0 IL
Aetna Medicare Signature (PPO) Coventry Health AND Life Insurance Company T4 Yes $0 IA

Showing top 50 of 100 plans.

Frequently Asked Questions

Is lactulose 20000 MG Powder for Oral Solution covered by Medicare Part D?

Yes, lactulose 20000 MG Powder for Oral Solution is covered by 690 Medicare Part D plans (13.7% of all Part D formularies).

What tier is lactulose 20000 MG Powder for Oral Solution on Medicare Part D plans?

lactulose 20000 MG Powder for Oral Solution averages Tier 3.4 across Part D plans, ranging from Tier 1 to Tier 4.

Does lactulose 20000 MG Powder for Oral Solution require prior authorization?

50% of Part D formularies require prior authorization for lactulose 20000 MG Powder for Oral Solution. Step therapy: 0%. Quantity limits: 0%.

How much does Medicare spend on lactulose 20000 MG Powder for Oral Solution?

In 2023, total Medicare Part D spending on lactulose 20000 MG Powder for Oral Solution was $72,482,220, covering 526,962 beneficiaries. The average spend per beneficiary was $137.55.

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.

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