Medicare Part D coverage · metronidazole · RxCUI 199055
metronidazole 375 MG Oral Capsule
Per the CMS 2026 Part D formulary file, metronidazole 375 MG Oral Capsule is covered by 1,184 Medicare Part D plans (23.4% of enrollable products), averaging Tier 2.4, with prior authorization required on 0% of covering formularies.
- 23.4%
- Plan coverage
- 1,184
- Plans covering
- T2.4
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for metronidazole 375 MG Oral Capsule
Per the CMS 2026 Part D formulary file, metronidazole 375 MG Oral Capsule (RxNorm concept RXCUI 199055, generic name metronidazole) appears on 60 distinct formulary files spanning 1,184 Medicare Part D plan offerings - 23.4% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.4.
Real-world access to metronidazole 375 MG Oral Capsule 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 1,528,785 Part D beneficiaries filled metronidazole 375 MG Oral Capsule in 2023, with total plan-and-beneficiary spending of $70,489,119 and an average per-beneficiary annual cost of $46.11. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry metronidazole 375 MG Oral Capsule today.
Coverage Details
- Formularies covering
- 60
- Plans covering
- 1,184
- Coverage rate
- 23.4%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 1,528,785
- Total spending
- $70,489,119
- Avg per beneficiary
- $46.11
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering metronidazole 375 MG Oral Capsule
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| CareAdvantage (HMO D-SNP) | SAN Mateo Health Commission | T1 | No | $0 | CA |
| 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 |
| SeniorCare Complete (HMO D-SNP) | South Country Health Alliance | T1 | No | $0 | MN |
| AbilityCare (HMO D-SNP) | South Country Health Alliance | T1 | No | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | Alameda Alliance FOR Health | T1 | No | $0 | CA |
| Abilis Health Community (HMO I-SNP) | Signature Advantage, LLC | T1 | No | $0 | KY, TN |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) | Arkansas Superior Select, Inc. | T1 | No | $0 | AR |
| Community Care's Partnership Program (HMO D-SNP) | Community Care Health Plan, Inc. | T1 | No | $0 | WI |
| Mass General Brigham SCO (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Hcsc Insurance Services Company | T1 | No | $4.80 | TX |
| Texas Independence Health Plan, Inc. (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | No | $4.80 | TX |
| Texas Independence Community Plan (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | No | $4.80 | TX |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | GHS Insurance Company | T1 | No | $5.00 | OK |
| Tribute Select (HMO-POS I-SNP) | Arkansas Superior Select, Inc. | T1 | No | $8.90 | AR |
| Valor Health Plan (HMO I-SNP) | TSG Guard, Inc. | T1 | No | $31.40 | OH |
Show the next 30 plans
| WV Senior Advantage (HMO I-SNP) | West Virginia Senior Advantage, Inc. | T1 | No | $32.70 | WV |
| Hamaspik Medicare Select (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $34.50 | NY |
| Abilis Health (HMO I-SNP) | Signature Advantage, LLC | T1 | No | $35.90 | KY, TN |
| CommuniCare Advantage ISNP (HMO I-SNP) | OH CHS SNP Inc. | T1 | No | $38.40 | IN, MD, OH |
| Aetna Medicare Signature (HMO) | Aetna Health OF California Inc. | T2 | No | $0 | CA |
| Aetna Medicare Signature (HMO) | Aetna Health OF California Inc. | T2 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO-POS) | Aetna Health OF California Inc. | T2 | No | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T2 | No | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T2 | No | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T2 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T2 | No | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T2 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T2 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T2 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T2 | No | $0 | CA |
| Aetna Medicare Signature Care (HMO-POS) | Aetna Health OF Ohio Inc. | T2 | No | $0 | OH |
| Aetna Medicare Signature Extra (HMO-POS) | Aetna Health OF Ohio Inc. | T2 | No | $0 | OH |
| Aetna Medicare Signature Care (HMO-POS) | Aetna Health OF Ohio Inc. | T2 | No | $0 | OH |
| Aetna Medicare Signature Extra (HMO-POS) | Aetna Health OF Ohio Inc. | T2 | No | $0 | KY |
| Aetna Medicare Signature (HMO-POS) | Aetna Health OF Ohio Inc. | T2 | No | $0 | KY |
| Aetna Medicare Signature (HMO-POS) | Aetna Health OF Ohio Inc. | T2 | No | $0 | KY |
| Aetna Medicare HIDE (HMO D-SNP) | Aetna Health OF Ohio Inc. | T2 | No | $0 | KY |
| Aetna Medicare Dual Care (HMO D-SNP) | Aetna Health OF Ohio Inc. | T2 | No | $0 | OH |
| Aetna Medicare Signature Care (HMO-POS) | Aetna Health OF Ohio Inc. | T2 | No | $0 | OH |
| Aetna Medicare Signature (HMO-POS) | Aetna Health OF Ohio Inc. | T2 | No | $0 | OH |
| Aetna Medicare Signature (HMO-POS) | Aetna Health OF Ohio Inc. | T2 | No | $0 | KY |
| Aetna Medicare Partial Dual (HMO D-SNP) | Aetna Health OF Ohio Inc. | T2 | No | $0 | KY |
| Aetna Medicare Partial Dual (HMO D-SNP) | Aetna Health OF Ohio Inc. | T2 | No | $0 | OH |
| Aetna Medicare Signature (HMO) | Aetna Health Inc. (GA) | T2 | No | $0 | GA |
| Aetna Medicare Signature (HMO-POS) | Coventry Health Care OF Illinois, Inc. | T2 | No | $0 | WI |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is metronidazole 375 MG Oral Capsule covered by Medicare Part D?
Yes, metronidazole 375 MG Oral Capsule is covered by 1,184 Medicare Part D plans (23.4% of all Part D formularies).
What tier is metronidazole 375 MG Oral Capsule on Medicare Part D plans?
metronidazole 375 MG Oral Capsule averages Tier 2.4 across Part D plans, ranging from Tier 1 to Tier 4.
Does metronidazole 375 MG Oral Capsule require prior authorization?
0% of Part D formularies require prior authorization for metronidazole 375 MG Oral Capsule. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on metronidazole 375 MG Oral Capsule?
In 2023, total Medicare Part D spending on metronidazole 375 MG Oral Capsule was $70,489,119, covering 1,528,785 beneficiaries. The average spend per beneficiary was $46.11.
Read our methodology - how this data is sourced, computed, and verified.
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.
Closest average formulary tier
- 10 ML furosemide 10 MG/ML Injection T2.4
- disulfiram 250 MG Oral Tablet T2.4
- hydrocortisone 10 MG/ML / neomycin 3.5 MG/ML / polymyxin B 10000 UNT/ML Otic Solution T2.4
- hydrochlorothiazide 12.5 MG / valsartan 320 MG Oral Tablet T2.4
- 168 HR ethinyl estradiol 0.00146 MG/HR / norelgestromin 0.00625 MG/HR Transdermal System [Xulane] T2.4
- dexmethylphenidate hydrochloride 5 MG Oral Tablet T2.4
Similar prior-authorization rate
- 24 HR minocycline 40 MG Extended Release Oral Capsule [Emrosi] 0% PA
- buspirone hydrochloride 10 MG Oral Capsule [Bucapsol] 0% PA
- diflunisal 375 MG Oral Tablet [Dolobid] 0% PA
- hydrocortisone 1 MG/ML Oral Solution [Khindivi] 0% PA
- indomethacin 50 MG Rectal Suppository [Indocin] 0% PA
- sarecycline 100 MG Oral Tablet [Seysara] 0% PA