levobunolol hydrochloride 5 MG/ML Ophthalmic Solution

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levobunolol hydrochloride

RxCUI: 1150836

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
T1.6
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for levobunolol hydrochloride 5 MG/ML Ophthalmic Solution

Per the CMS 2026 Part D formulary file, levobunolol hydrochloride 5 MG/ML Ophthalmic Solution (RxNorm concept RXCUI 1150836, generic name levobunolol hydrochloride) 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 1.6.

Real-world access to levobunolol hydrochloride 5 MG/ML Ophthalmic Solution depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 0.6% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 13,542 Part D beneficiaries filled levobunolol hydrochloride 5 MG/ML Ophthalmic Solution in 2023, with total plan-and-beneficiary spending of $1,515,148 and an average per-beneficiary annual cost of $111.89. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry levobunolol hydrochloride 5 MG/ML Ophthalmic Solution 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
0.6% of formularies

2023 Medicare Spending

Beneficiaries
13,542
Total spending
$1,515,148
Avg per beneficiary
$111.89

Tier Distribution Across Plans

100 plans
Tier 1, Preferred Generic

Standalone Drug Plans (PDP) Covering levobunolol hydrochloride 5 MG/ML Ophthalmic Solution

2 standalone prescription drug plans include this drug.

Plan Insurer Tier PA ST Premium States
AARP Medicare Rx Preferred from UHC (PDP) UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY T1 No No $0 -
AARP Medicare Rx Preferred from UHC (PDP) UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY T1 No No $0 -

Medicare Advantage Plans (MA-PD) Covering levobunolol hydrochloride 5 MG/ML Ophthalmic Solution

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

Plan Insurer Tier PA Premium States
UHC Dual Complete IA-S001 (HMO-POS D-SNP) UNITEDHEALTHCARE OF WISCONSIN, INC. T1 No $0 IA
UHC Dual Complete MO-S001 (HMO-POS D-SNP) UNITEDHEALTHCARE OF WISCONSIN, INC. T1 No $0 MO
UHC Dual Complete NE-S001 (HMO-POS D-SNP) UNITEDHEALTHCARE OF WISCONSIN, INC. T1 No $0 NE
UHC Dual Complete KS-S001 (HMO-POS D-SNP) UNITEDHEALTHCARE OF WISCONSIN, INC. T1 No $0 KS
UHC Dual Complete MO-S3 (HMO-POS D-SNP) UNITEDHEALTHCARE OF WISCONSIN, INC. T1 No $0 MO
UHC Dual Complete KS-Q1 (HMO-POS D-SNP) UNITEDHEALTHCARE OF WISCONSIN, INC. T1 No $0 KS
UHC Dual Complete TN-S001 (HMO-POS D-SNP) UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. T1 No $0 TN
UHC Dual Complete TN-Y001 (HMO-POS D-SNP) UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. T1 No $0 TN
UHC Dual Complete TN-Y2 (HMO-POS D-SNP) UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. T1 No $0 TN
AARP Medicare Advantage from UHC MI-0001 (PPO) UNITEDHEALTHCARE INSURANCE COMPANY T1 No $0 MI
UHC Dual Complete NM-Y1 (PPO D-SNP) UNITEDHEALTHCARE INSURANCE COMPANY T1 No $0 NM
UHC Dual Complete NM-S1 (PPO D-SNP) UNITEDHEALTHCARE INSURANCE COMPANY T1 No $0 NM
UHC Dual Complete NM-V1 (PPO D-SNP) UNITEDHEALTHCARE INSURANCE COMPANY T1 No $0 NM
UHC Dual Complete AZ-S001 (HMO-POS D-SNP) ARIZONA PHYSICIANS IPA, INC. T1 No $0 AZ
UHC Dual Complete AZ-Y001 (HMO-POS D-SNP) ARIZONA PHYSICIANS IPA, INC. T1 No $0 AZ
UHC Dual Complete VA-Y4 (PPO D-SNP) CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. T1 No $0 VA
AARP Medicare Advantage from UHC AL-0001 (HMO-POS) UNITEDHEALTHCARE OF THE MIDLANDS, INC. T1 No $0 AL
AARP Medicare Advantage from UHC CA-0002 (HMO-POS) UHC OF CALIFORNIA T1 No $0 CA
UHC Sharp Medicare Advantage CA-001P (HMO-POS) UHC OF CALIFORNIA T1 No $0 CA
AARP Medicare Advantage from UHC CA-003P (HMO-POS) UHC OF CALIFORNIA T1 No $0 CA
AARP Medicare Advantage from UHC CA-0012 (HMO-POS) UHC OF CALIFORNIA T1 No $0 CA
AARP Medicare Advantage from UHC CA-004P (HMO-POS) UHC OF CALIFORNIA T1 No $0 CA
AARP Medicare Advantage from UHC CA-005P (HMO-POS) UHC OF CALIFORNIA T1 No $0 CA
AARP Medicare Advantage from UHC CA-006P (HMO-POS) UHC OF CALIFORNIA T1 No $0 CA
AARP Medicare Advantage from UHC CA-10 (HMO-POS) UHC OF CALIFORNIA T1 No $0 CA
UHC Sharp Medicare Advantage ValueRx CA-12P (HMO-POS) UHC OF CALIFORNIA T1 No $0 CA
AARP Medicare Advantage from UHC CA-021P (HMO-POS) UHC OF CALIFORNIA T1 No $0 CA
AARP Medicare Advantage from UHC CA-022P (HMO-POS) UHC OF CALIFORNIA T1 No $0 CA
AARP Medicare Advantage from UHC CA-023P (HMO-POS) UHC OF CALIFORNIA T1 No $0 CA
AARP Medicare Advantage from UHC CA-026P (HMO-POS) UHC OF CALIFORNIA T1 No $0 CA
AARP Medicare Advantage Giveback from UHC CA-19 (HMO-POS) UHC OF CALIFORNIA T1 No $0 CA
AARP Medicare Advantage Giveback from UHC CA-20 (HMO-POS) UHC OF CALIFORNIA T1 No $0 CA
AARP Medicare Advantage Giveback from UHC CA-21 (HMO-POS) UHC OF CALIFORNIA T1 No $0 CA
AARP Medicare Advantage Essentials from UHC CO-2 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T1 No $0 CO
AARP Medicare Advantage Essentials from UHC AZ-1 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T1 No $0 AZ
AARP Medicare Advantage Essentials from UHC AZ-2 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T1 No $0 AZ
AARP Medicare Advantage from UHC AZ-002P (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T1 No $0 AZ
AARP Medicare Advantage from UHC NV-0001 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T1 No $0 NV
AARP Medicare Advantage from UHC NV-0002 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T1 No $0 NV
UHC Medicare Advantage NV-001P (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T1 No $0 NV
AARP Medicare Advantage Essentials from UHC CO-4 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T1 No $0 CO
AARP Medicare Advantage Essentials ValueRx NV-5 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T1 No $0 NV
AARP Medicare Advantage from UHC NV-0006 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T1 No $0 NV
AARP Medicare Advantage Extras from UHC AZ-4 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T1 No $0 AZ
AARP Medicare Advantage Extras from UHC AZ-5 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T1 No $0 AZ
AARP Medicare Advantage Extras from UHC CO-5 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T1 No $0 CO
AARP Medicare Advantage Essentials from UHC TX-21 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T1 No $0 TX
AARP Medicare Advantage Essentials from UHC TX-22 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T1 No $0 TX
UHC Dual Complete TX-D004 (HMO-POS D-SNP) UnitedHealthcare Benefits of Texas, Inc. T1 No $0 TX
AARP Medicare Advantage from UHC TX-23 (HMO-POS) UnitedHealthcare Benefits of Texas, Inc. T1 No $0 TX

Frequently Asked Questions

Is levobunolol hydrochloride 5 MG/ML Ophthalmic Solution covered by Medicare Part D?

Yes, levobunolol hydrochloride 5 MG/ML Ophthalmic Solution is covered by 5,067 Medicare Part D plans (100% of all Part D formularies).

What tier is levobunolol hydrochloride 5 MG/ML Ophthalmic Solution on Medicare Part D plans?

levobunolol hydrochloride 5 MG/ML Ophthalmic Solution averages Tier 1.6 across Part D plans, ranging from Tier 1 to Tier 4.

Does levobunolol hydrochloride 5 MG/ML Ophthalmic Solution require prior authorization?

0% of Part D formularies require prior authorization for levobunolol hydrochloride 5 MG/ML Ophthalmic Solution. Step therapy: 0%. Quantity limits: 0.6%.

How much does Medicare spend on levobunolol hydrochloride 5 MG/ML Ophthalmic Solution?

In 2023, total Medicare Part D spending on levobunolol hydrochloride 5 MG/ML Ophthalmic Solution was $1,515,148, covering 13,542 beneficiaries. The average spend per beneficiary was $111.89.

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