lactulose 20000 MG Powder for Oral Solution
lactulose
RxCUI: 1251194
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 - 13.6% 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
- 13.6%
- 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
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 |
| 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 |
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 (13.6% 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.
Read our methodology - how this data is sourced, computed, and verified.