Medicare Part D coverage · lactulose · RxCUI 1251192
lactulose 10000 MG Powder for Oral Solution [Kristalose]
Per the CMS 2026 Part D formulary file, lactulose 10000 MG Powder for Oral Solution [Kristalose] is covered by 667 Medicare Part D plans (13.2% of enrollable products), averaging Tier 3.7, with prior authorization required on 70% of covering formularies.
- 13.2%
- Plan coverage
- 667
- Plans covering
- T3.7
- Avg tier
- 70%
- Prior auth required
What the CMS Formulary Data Shows for lactulose 10000 MG Powder for Oral Solution [Kristalose]
Per the CMS 2026 Part D formulary file, lactulose 10000 MG Powder for Oral Solution [Kristalose] (RxNorm concept RXCUI 1251192, generic name lactulose) appears on 10 distinct formulary files spanning 667 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 10000 MG Powder for Oral Solution [Kristalose] depends on utilization management as much as tier placement: 70% 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 10000 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 10000 MG Powder for Oral Solution [Kristalose] today.
Coverage Details
- Formularies covering
- 10
- Plans covering
- 667
- Coverage rate
- 13.2%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 70% 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 10000 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 |
Show the next 30 plans
| 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 |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is lactulose 10000 MG Powder for Oral Solution [Kristalose] covered by Medicare Part D?
Yes, lactulose 10000 MG Powder for Oral Solution [Kristalose] is covered by 667 Medicare Part D plans (13.2% of all Part D formularies).
What tier is lactulose 10000 MG Powder for Oral Solution [Kristalose] on Medicare Part D plans?
lactulose 10000 MG Powder for Oral Solution [Kristalose] averages Tier 3.7 across Part D plans, ranging from Tier 1 to Tier 4.
Does lactulose 10000 MG Powder for Oral Solution [Kristalose] require prior authorization?
70% of Part D formularies require prior authorization for lactulose 10000 MG Powder for Oral Solution [Kristalose]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on lactulose 10000 MG Powder for Oral Solution [Kristalose]?
In 2023, total Medicare Part D spending on lactulose 10000 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.
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.
Closest average formulary tier
- droxidopa 200 MG Oral Capsule T3.7
- ciprofloxacin 100 MG/ML Oral Suspension [Cipro] T3.7
- zonisamide 20 MG/ML Oral Suspension [Zonisade] T3.7
- lisdexamfetamine dimesylate 40 MG Chewable Tablet T3.7
- mometasone furoate 0.025 MG/ACTUAT / olopatadine hydrochloride 0.665 MG/ACTUAT Metered Dose Nasal Spray [Ryaltris] T3.7
- roflumilast 3 MG/ML Topical Foam [Zoryve] T3.7
Similar prior-authorization rate
- Twice-Daily deferiprone 1000 MG Oral Tablet [Ferriprox] 70% PA
- megestrol acetate 125 MG/ML Oral Suspension 69.9% PA
- 0.5 ML interferon beta-1a 0.088 MG/ML Auto-Injector [Rebif] 70.2% PA
- {6 (0.2 ML interferon beta-1a 0.044 MG/ML Auto-Injector [Rebif]) / 6 (0.5 ML interferon beta-1a 0.044 MG/ML Auto-Injector [Rebif]) } Pack [Rebif Rebidose] 70.2% PA
- aripiprazole 2 MG Oral Film [Opipza] 69.8% PA
- diclofenac sodium 0.03 MG/MG Topical Gel 70.3% PA