lactulose 20000 MG Powder for Oral Solution [Kristalose]
lactulose
RxCUI: 1251196
What the CMS Formulary Data Shows for lactulose 20000 MG Powder for Oral Solution [Kristalose]
Per the CMS 2026 Part D formulary file, lactulose 20000 MG Powder for Oral Solution [Kristalose] (RxNorm concept RXCUI 1251196, generic name lactulose) appears on 11 distinct formulary files spanning 671 Medicare Part D plan offerings - 13.2% 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 3.7.
Real-world access to lactulose 20000 MG Powder for Oral Solution [Kristalose] depends on utilization management as much as tier placement: 63.6% 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 [Kristalose] 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 [Kristalose] today.
Coverage Details
- Formularies covering
- 11
- Plans covering
- 671
- Coverage rate
- 13.2%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 63.6% 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 [Kristalose]
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 |
| 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 |
| Aetna Medicare Signature (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T4 | Yes | $0 | NE |
| Aetna Medicare Signature (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T4 | Yes | $0 | KS, MO |
| Aetna Medicare Signature Extra (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T4 | Yes | $0 | KS |
| Aetna Medicare Signature (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T4 | Yes | $0 | KS, MO |
| Aetna Medicare Signature Plus (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T4 | Yes | $0 | AR |
| Aetna Medicare Signature (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T4 | Yes | $0 | KS |
| Aetna Medicare Advantra (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T4 | Yes | $0 | OH |
| Aetna Medicare Advantra Signature Giveback (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T4 | Yes | $0 | WV |
| Aetna Medicare Elite (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T4 | Yes | $0 | IA |
| Aetna Medicare Signature Extra (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T4 | Yes | $0 | NE |
| Aetna Medicare Advantra Signature (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T4 | Yes | $0 | WV |
| Aetna Medicare Elite (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T4 | Yes | $0 | IL, MO |
| Aetna Medicare Signature (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T4 | Yes | $0 | MO |
| Aetna Medicare Elite (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T4 | Yes | $0 | KS, MO |
| Aetna Medicare Elite (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T4 | Yes | $0 | AR |
| Aetna Medicare Dual (PPO D-SNP) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T4 | Yes | $0 | SD |
| Aetna Medicare Signature (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T4 | Yes | $0 | MO |
| Aetna Medicare Signature (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T4 | Yes | $0 | KS |
| Aetna Medicare Signature (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T4 | Yes | $0 | KS |
Frequently Asked Questions
Is lactulose 20000 MG Powder for Oral Solution [Kristalose] covered by Medicare Part D?
Yes, lactulose 20000 MG Powder for Oral Solution [Kristalose] is covered by 671 Medicare Part D plans (13.2% of all Part D formularies).
What tier is lactulose 20000 MG Powder for Oral Solution [Kristalose] on Medicare Part D plans?
lactulose 20000 MG Powder for Oral Solution [Kristalose] averages Tier 3.7 across Part D plans, ranging from Tier 1 to Tier 4.
Does lactulose 20000 MG Powder for Oral Solution [Kristalose] require prior authorization?
63.6% of Part D formularies require prior authorization for lactulose 20000 MG Powder for Oral Solution [Kristalose]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on lactulose 20000 MG Powder for Oral Solution [Kristalose]?
In 2023, total Medicare Part D spending on lactulose 20000 MG Powder for Oral Solution [Kristalose] 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.