Medicare Part D coverage · magnesium sulfate · RxCUI 2465556

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] is covered by 3,093 Medicare Part D plans (61.2% of enrollable products), averaging Tier 3.2, with prior authorization required on 0% of covering formularies.

61.2%
Plan coverage
3,093
Plans covering
T3.2
Avg tier
0%
Prior auth required

Verify with CMS →

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.

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 134 distinct formulary files spanning 3,093 Medicare Part D plan offerings - 61.2% 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 $169,024 and an average per-beneficiary annual cost of $181.94. 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
134
Plans covering
3,093
Coverage rate
61.2%
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
$169,024
Avg per beneficiary
$181.94

Tier Distribution Across Plans

63 plans
Tier 1, Preferred Generic
5 plans
Tier 2, Generic
32 plans
Tier 3, Preferred Brand

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 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
Show the next 30 plans
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
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
Provider Partners North Carolina Advantage Plan (HMO I-SNP) Provider Partners Health Plan OF North Carolina T1 No $36.20 NC
Provider Partners North Carolina Essential Plan (HMO I-SNP) Provider Partners Health Plan OF North Carolina T1 No $36.20 NC
American Health Advantage of Utah (HMO I-SNP) American Health Plan OF UT, Inc. T1 No $37.60 UT

Showing top 50 of 98 plans.

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 3,093 Medicare Part D plans (61.2% 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 $169,024, covering 929 beneficiaries. The average spend per beneficiary was $181.94.

Nationwide similar Part D drugs

Data-derived peers across the CMS Part D formulary extract: nearest average tier placement and nearest prior-authorization rate. Not therapeutic alternatives or same-generic strengths.

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