loteprednol etabonate 2 MG/ML Ophthalmic Suspension [Alrex]

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loteprednol etabonate

RxCUI: 213262

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.
0.2%
Plan Coverage
10
Plans Covering
T3
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for loteprednol etabonate 2 MG/ML Ophthalmic Suspension [Alrex]

Per the CMS 2026 Part D formulary file, loteprednol etabonate 2 MG/ML Ophthalmic Suspension [Alrex] (RxNorm concept RXCUI 213262, generic name loteprednol etabonate) appears on 1 distinct formulary file spanning 10 Medicare Part D plan offerings - 0.2% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 3 to Tier 3, with a cross-plan average of Tier 3.

Real-world access to loteprednol etabonate 2 MG/ML Ophthalmic Suspension [Alrex] depends on utilization management as much as tier placement: 0% 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 91,483 Part D beneficiaries filled loteprednol etabonate 2 MG/ML Ophthalmic Suspension [Alrex] in 2023, with total plan-and-beneficiary spending of $33,190,775 and an average per-beneficiary annual cost of $362.81. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry loteprednol etabonate 2 MG/ML Ophthalmic Suspension [Alrex] today.

Coverage Details

Formularies covering
1
Plans covering
10
Coverage rate
0.2%
Tier range
Tier 3, Preferred Brand
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
0% of formularies
Step therapy required
0% of formularies
Quantity limits
0% of formularies

2023 Medicare Spending

Beneficiaries
91,483
Total spending
$33,190,775
Avg per beneficiary
$362.81

Tier Distribution Across Plans

10 plans
Tier 3, Preferred Brand

Medicare Advantage Plans (MA-PD) Covering loteprednol etabonate 2 MG/ML Ophthalmic Suspension [Alrex]

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

Plan Insurer Tier PA Premium States
Health First Rewards H1099-014 (HMO) HEALTH FIRST HEALTH PLANS T3 No $0 FL
Health First SunSaver H1099-016 (HMO) HEALTH FIRST HEALTH PLANS T3 No $0 FL
Health First Complete Care H1099-023 (HMO) HEALTH FIRST HEALTH PLANS T3 No $0 FL
Health First Emerald Plus H1099-024 (HMO) HEALTH FIRST HEALTH PLANS T3 No $0 FL
Health First Premier Access H1099-025 (HMO-POS) HEALTH FIRST HEALTH PLANS T3 No $0 FL
Health First Emerald Plus H1099-026 (HMO) HEALTH FIRST HEALTH PLANS T3 No $0 FL
Health First Premier Access H1099-027 (HMO-POS) HEALTH FIRST HEALTH PLANS T3 No $0 FL
Health First Emerald Plus H1099-028 (HMO) HEALTH FIRST HEALTH PLANS T3 No $0 FL
Health First Value H1099-006 (HMO) HEALTH FIRST HEALTH PLANS T3 No $15.00 FL
Health First Classic H1099-001 (HMO-POS) HEALTH FIRST HEALTH PLANS T3 No $49.40 FL

Frequently Asked Questions

Is loteprednol etabonate 2 MG/ML Ophthalmic Suspension [Alrex] covered by Medicare Part D?

Yes, loteprednol etabonate 2 MG/ML Ophthalmic Suspension [Alrex] is covered by 10 Medicare Part D plans (0.2% of all Part D formularies).

What tier is loteprednol etabonate 2 MG/ML Ophthalmic Suspension [Alrex] on Medicare Part D plans?

loteprednol etabonate 2 MG/ML Ophthalmic Suspension [Alrex] averages Tier 3 across Part D plans, ranging from Tier 3 to Tier 3.

Does loteprednol etabonate 2 MG/ML Ophthalmic Suspension [Alrex] require prior authorization?

0% of Part D formularies require prior authorization for loteprednol etabonate 2 MG/ML Ophthalmic Suspension [Alrex]. Step therapy: 0%. Quantity limits: 0%.

How much does Medicare spend on loteprednol etabonate 2 MG/ML Ophthalmic Suspension [Alrex]?

In 2023, total Medicare Part D spending on loteprednol etabonate 2 MG/ML Ophthalmic Suspension [Alrex] was $33,190,775, covering 91,483 beneficiaries. The average spend per beneficiary was $362.81.

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