loteprednol etabonate 5 MG/ML Ophthalmic Suspension [Lotemax]
loteprednol etabonate
RxCUI: 213263
What the CMS Formulary Data Shows for loteprednol etabonate 5 MG/ML Ophthalmic Suspension [Lotemax]
Per the CMS 2026 Part D formulary file, loteprednol etabonate 5 MG/ML Ophthalmic Suspension [Lotemax] (RxNorm concept RXCUI 213263, generic name loteprednol etabonate) appears on 4 distinct formulary files spanning 775 Medicare Part D plan offerings - 15.3% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 4 to Tier 4, with a cross-plan average of Tier 4.
Real-world access to loteprednol etabonate 5 MG/ML Ophthalmic Suspension [Lotemax] 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 5 MG/ML Ophthalmic Suspension [Lotemax] 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 5 MG/ML Ophthalmic Suspension [Lotemax] today.
Coverage Details
- Formularies covering
- 4
- Plans covering
- 775
- Coverage rate
- 15.3%
- Tier range
- Tier 4, Non-Preferred
- Average tier
- Tier 4, Non-Preferred
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
Standalone Drug Plans (PDP) Covering loteprednol etabonate 5 MG/ML Ophthalmic Suspension [Lotemax]
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 | T4 | No | No | $0 | - |
| AARP Medicare Rx Preferred from UHC (PDP) | UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY | T4 | No | No | $0 | - |
Medicare Advantage Plans (MA-PD) Covering loteprednol etabonate 5 MG/ML Ophthalmic Suspension [Lotemax]
98 Medicare Advantage plans with Part D drug coverage include this drug.
Frequently Asked Questions
Is loteprednol etabonate 5 MG/ML Ophthalmic Suspension [Lotemax] covered by Medicare Part D?
Yes, loteprednol etabonate 5 MG/ML Ophthalmic Suspension [Lotemax] is covered by 775 Medicare Part D plans (15.3% of all Part D formularies).
What tier is loteprednol etabonate 5 MG/ML Ophthalmic Suspension [Lotemax] on Medicare Part D plans?
loteprednol etabonate 5 MG/ML Ophthalmic Suspension [Lotemax] averages Tier 4 across Part D plans, ranging from Tier 4 to Tier 4.
Does loteprednol etabonate 5 MG/ML Ophthalmic Suspension [Lotemax] require prior authorization?
0% of Part D formularies require prior authorization for loteprednol etabonate 5 MG/ML Ophthalmic Suspension [Lotemax]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on loteprednol etabonate 5 MG/ML Ophthalmic Suspension [Lotemax]?
In 2023, total Medicare Part D spending on loteprednol etabonate 5 MG/ML Ophthalmic Suspension [Lotemax] was $33,190,775, covering 91,483 beneficiaries. The average spend per beneficiary was $362.81.
Read our methodology - how this data is sourced, computed, and verified.