magnesium sulfate 225 MG / potassium chloride 188 MG / sodium sulfate 1479 MG Oral Tablet [Sutab]
magnesium sulfate
RxCUI: 2465556
What the CMS Formulary Data Shows for magnesium sulfate 225 MG / potassium chloride 188 MG / sodium sulfate 1479 MG Oral Tablet [Sutab]
Per the CMS 2026 Part D formulary file, magnesium sulfate 225 MG / potassium chloride 188 MG / sodium sulfate 1479 MG Oral Tablet [Sutab] (RxNorm concept RXCUI 2465556, generic name magnesium sulfate) appears on 135 distinct formulary files spanning 3,107 Medicare Part D plan offerings - 61.3% of enrollable Part D products, mid-range placement; shopping across contracts changes access. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 3.2.
Real-world access to magnesium sulfate 225 MG / potassium chloride 188 MG / sodium sulfate 1479 MG Oral Tablet [Sutab] 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 929 Part D beneficiaries filled magnesium sulfate 225 MG / potassium chloride 188 MG / sodium sulfate 1479 MG Oral Tablet [Sutab] in 2023, with total plan-and-beneficiary spending of $169,009 and an average per-beneficiary annual cost of $181.93. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry magnesium sulfate 225 MG / potassium chloride 188 MG / sodium sulfate 1479 MG Oral Tablet [Sutab] today.
Coverage Details
- Formularies covering
- 135
- Plans covering
- 3,107
- Coverage rate
- 61.3%
- Tier range
- Tier 1 – Tier 4
- 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
- 929
- Total spending
- $169,009
- Avg per beneficiary
- $181.93
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering magnesium sulfate 225 MG / potassium chloride 188 MG / sodium sulfate 1479 MG Oral Tablet [Sutab]
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 | T3 | No | No | $0 | - |
| AARP Medicare Rx Preferred from UHC (PDP) | UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY | T3 | No | No | $0 | - |
Medicare Advantage Plans (MA-PD) Covering magnesium sulfate 225 MG / potassium chloride 188 MG / sodium sulfate 1479 MG Oral Tablet [Sutab]
98 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| PruittHealth Premier D-SNP (HMO D-SNP) | PRUITTHEALTH PREMIER, INC. | T1 | No | $0 | GA |
| Simpra Advantage Dual Care (PPO D-SNP) | SIMPRA ADVANTAGE, INC. | T1 | No | $0 | AL |
| Gold Coast Health Plan Total Care Advantage (HMO D-SNP) | Ventura County Medi-Cal Managed Care Commission | T1 | No | $0 | CA |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | No | $0 | MN |
| Hamaspik Medicare Choice (HMO D-SNP) | HAMASPIK, INC. | T1 | No | $0 | NY |
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC | T1 | No | $0 | PA |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA | T1 | No | $0 | NC |
| Provider Partners Indiana Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF INDIANA | T1 | No | $0 | IN |
| Provider Partners Maryland Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN, INC. | T1 | No | $0 | MD |
| Provider Partners Missouri Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC. | T1 | No | $0 | MO |
| Senior Care (HMO I-SNP) | ALIGN SENIOR CARE FLORIDA, INC. | T1 | No | $4.80 | FL |
| ProCare Advantage (HMO-POS I-SNP) | PROCARE ADVANTAGE, LLC | T1 | No | $4.80 | TX |
| ProCare Advantage - Kidney Care (HMO-POS C-SNP) | PROCARE ADVANTAGE, LLC | T1 | No | $4.80 | TX |
| American Health Advantage of Florida (HMO I-SNP) | AMERICAN HEALTH PLAN OF FL, INC. | T1 | No | $4.80 | FL |
| SECUR Advantage (HMO I-SNP) | SECUR INC | T1 | No | $4.80 | FL |
| SECUR Enhanced (HMO I-SNP) | SECUR INC | T1 | No | $4.80 | FL |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | HCSC INSURANCE SERVICES COMPANY | T1 | No | $4.80 | TX |
| Provider Partners Texas Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF TEXAS, INC. | T1 | No | $4.80 | TX |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | GHS INSURANCE COMPANY | T1 | No | $5.00 | OK |
| Senior Care (HMO I-SNP) | ALIGN SENIOR CARE MI, LLC | T1 | No | $8.80 | MI |
| AgeRight Advantage Health Plan (HMO I-SNP) | MARQUIS ADVANTAGE, INC. | T1 | No | $10.50 | OR, WA |
| Senior Care (HMO I-SNP) | ALIGN SENIOR CARE CALIFORNIA INC. | T1 | No | $12.00 | CA |
| Liberty Medicare Dual Plan (HMO D-SNP) | LIBERTY ADVANTAGE, LLC | T1 | No | $14.70 | NC |
| Provider Partners Illinois Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF ILLINOIS | T1 | No | $15.20 | IL |
| KeyCare Advantage (HMO I-SNP) | ISNP VENTURES, LLC | T1 | No | $23.20 | MD |
| American Health Advantage of Mississippi (HMO I-SNP) | AMERICAN HEALTH PLAN OF MS, INC. | T1 | No | $23.80 | MS |
| Senior Care (HMO I-SNP) | LIFEWORKS ADVANTAGE, LLC | T1 | No | $24.60 | VA |
| PruittHealth Premier (HMO I-SNP) | PRUITTHEALTH PREMIER, INC. | T1 | No | $25.40 | GA |
| Georgia Health Advantage (HMO I-SNP) | GEORGIA ASSURANCE, INC. | T1 | No | $25.40 | GA |
| Georgia Health Advantage Choice (HMO I-SNP) | GEORGIA ASSURANCE, INC. | T1 | No | $25.40 | GA |
| American Health Advantage of Tennessee (HMO I-SNP) | AMERICAN HEALTH PLAN, INC. | T1 | No | $27.70 | TN |
| Simpra Advantage Nursing Home Plan (PPO I-SNP) | SIMPRA ADVANTAGE, INC. | T1 | No | $27.70 | AL |
| American Health Advantage of Oklahoma (HMO I-SNP) | OKLAHOMA SUPERIOR SELECT, INC. | T1 | No | $28.20 | OK |
| NHC Advantage (HMO I-SNP) | NHC ADVANTAGE, LLC | T1 | No | $31.00 | MO, NC, SC, TN |
| Provider Partners Maryland Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN, INC. | T1 | No | $31.20 | MD |
| Provider Partners Maryland Essential Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN, INC. | T1 | No | $31.20 | MD |
| Perennial Advantage Strive (HMO I-SNP) | PERENNIAL ADVANTAGE OF OHIO, INC. | T1 | No | $31.40 | OH |
| Perennial Advantage Strive (HMO I-SNP) | PERENNIAL ADVANTAGE OF COLORADO, INC. | T1 | No | $32.70 | PA |
| American Health Advantage of Pennsylvania (HMO I-SNP) | AMERICAN HEALTH PLAN OF PENNSYLVANIA INC | T1 | No | $32.70 | PA |
| Provider Partners Pennsylvania Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC | T1 | No | $32.70 | PA |
| Provider Partners Pennsylvania Essential Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC | T1 | No | $32.70 | PA |
| Lagniappe Advantage (PPO I-SNP) | LAGNIAPPE ADVANTAGE INSURANCE COMPANY | T1 | No | $32.90 | LA |
| American Health Advantage of Louisiana (HMO I-SNP) | DIGNITY CARE CORPORATION | T1 | No | $32.90 | LA |
| Hamaspik Medicare Select (HMO D-SNP) | HAMASPIK, INC. | T1 | No | $34.50 | NY |
| Perennial Advantage Strive (HMO I-SNP) | PERENNIAL ADVANTAGE OF COLORADO, INC. | T1 | No | $35.20 | CO |
| PruittHealth Premier (HMO I-SNP) | PRUITTHEALTH PREMIER NORTH CAROLINA, LLC | T1 | No | $35.70 | SC |
| PruittHealth Premier (HMO I-SNP) | PRUITTHEALTH PREMIER NORTH CAROLINA, LLC | T1 | No | $36.20 | NC |
| Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | LIBERTY ADVANTAGE, LLC | T1 | No | $36.20 | NC |
Frequently Asked Questions
Is magnesium sulfate 225 MG / potassium chloride 188 MG / sodium sulfate 1479 MG Oral Tablet [Sutab] covered by Medicare Part D?
Yes, magnesium sulfate 225 MG / potassium chloride 188 MG / sodium sulfate 1479 MG Oral Tablet [Sutab] is covered by 3,107 Medicare Part D plans (61.3% of all Part D formularies).
What tier is magnesium sulfate 225 MG / potassium chloride 188 MG / sodium sulfate 1479 MG Oral Tablet [Sutab] on Medicare Part D plans?
magnesium sulfate 225 MG / potassium chloride 188 MG / sodium sulfate 1479 MG Oral Tablet [Sutab] averages Tier 3.2 across Part D plans, ranging from Tier 1 to Tier 4.
Does magnesium sulfate 225 MG / potassium chloride 188 MG / sodium sulfate 1479 MG Oral Tablet [Sutab] require prior authorization?
0% of Part D formularies require prior authorization for magnesium sulfate 225 MG / potassium chloride 188 MG / sodium sulfate 1479 MG Oral Tablet [Sutab]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on magnesium sulfate 225 MG / potassium chloride 188 MG / sodium sulfate 1479 MG Oral Tablet [Sutab]?
In 2023, total Medicare Part D spending on magnesium sulfate 225 MG / potassium chloride 188 MG / sodium sulfate 1479 MG Oral Tablet [Sutab] was $169,009, covering 929 beneficiaries. The average spend per beneficiary was $181.93.
Read our methodology - how this data is sourced, computed, and verified.