Medicare Part D coverage · levorphanol tartrate · RxCUI 2058845
levorphanol tartrate 3 MG Oral Tablet
Per the CMS 2026 Part D formulary file, levorphanol tartrate 3 MG Oral Tablet is covered by 124 Medicare Part D plans (2.5% of enrollable products), averaging Tier 3, with prior authorization required on 12.5% of covering formularies.
- 2.5%
- Plan coverage
- 124
- Plans covering
- T3
- Avg tier
- 12.5%
- Prior auth required
What the CMS Formulary Data Shows for levorphanol tartrate 3 MG Oral Tablet
Per the CMS 2026 Part D formulary file, levorphanol tartrate 3 MG Oral Tablet (RxNorm concept RXCUI 2058845, generic name levorphanol tartrate) appears on 8 distinct formulary files spanning 124 Medicare Part D plan offerings - 2.5% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 3.
Real-world access to levorphanol tartrate 3 MG Oral Tablet depends on utilization management as much as tier placement: 12.5% of covering formularies require prior authorization. 0% require step therapy. 75% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 657 Part D beneficiaries filled levorphanol tartrate 3 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $17,511,497 and an average per-beneficiary annual cost of $26,653.72. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry levorphanol tartrate 3 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 8
- Plans covering
- 124
- Coverage rate
- 2.5%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 12.5% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 75% of formularies
2023 Medicare Spending
- Beneficiaries
- 657
- Total spending
- $17,511,497
- Avg per beneficiary
- $26,653.72
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering levorphanol tartrate 3 MG Oral Tablet
100 Medicare Advantage plans with Part D drug coverage include this drug.
Show the next 30 plans
Showing top 50 of 100 plans.
Frequently Asked Questions
Is levorphanol tartrate 3 MG Oral Tablet covered by Medicare Part D?
Yes, levorphanol tartrate 3 MG Oral Tablet is covered by 124 Medicare Part D plans (2.5% of all Part D formularies).
What tier is levorphanol tartrate 3 MG Oral Tablet on Medicare Part D plans?
levorphanol tartrate 3 MG Oral Tablet averages Tier 3 across Part D plans, ranging from Tier 1 to Tier 5.
Does levorphanol tartrate 3 MG Oral Tablet require prior authorization?
12.5% of Part D formularies require prior authorization for levorphanol tartrate 3 MG Oral Tablet. Step therapy: 0%. Quantity limits: 75%.
How much does Medicare spend on levorphanol tartrate 3 MG Oral Tablet?
In 2023, total Medicare Part D spending on levorphanol tartrate 3 MG Oral Tablet was $17,511,497, covering 657 beneficiaries. The average spend per beneficiary was $26,653.72.
Read our methodology - how this data is sourced, computed, and verified.
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