metronidazole 7.5 MG/ML Topical Lotion

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metronidazole

RxCUI: 242736

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.
91.4%
Plan Coverage
4,631
Plans Covering
T3.1
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for metronidazole 7.5 MG/ML Topical Lotion

Per the CMS 2026 Part D formulary file, metronidazole 7.5 MG/ML Topical Lotion (RxNorm concept RXCUI 242736, generic name metronidazole) appears on 225 distinct formulary files spanning 4,631 Medicare Part D plan offerings - 91.4% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 3.1.

Real-world access to metronidazole 7.5 MG/ML Topical Lotion depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 29.8% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 1,528,785 Part D beneficiaries filled metronidazole 7.5 MG/ML Topical Lotion 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 7.5 MG/ML Topical Lotion today.

Coverage Details

Formularies covering
225
Plans covering
4,631
Coverage rate
91.4%
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
29.8% of formularies

2023 Medicare Spending

Beneficiaries
1,528,785
Total spending
$70,489,119
Avg per beneficiary
$46.11

Tier Distribution Across Plans

78 plans
Tier 1, Preferred Generic
22 plans
Tier 2, Generic

Medicare Advantage Plans (MA-PD) Covering metronidazole 7.5 MG/ML Topical Lotion

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

Plan Insurer Tier PA Premium States
Sentara Community Complete Select (HMO D-SNP) SENTARA HEALTH PLANS T1 No $0 VA
Sentara Community Complete (HMO D-SNP) SENTARA HEALTH PLANS T1 No $0 VA
Florida Complete Care-Duals VIP (HMO-POS D-SNP) HPMP OF FLORIDA, INC. T1 No $0 FL
ElderServe MAP (HMO D-SNP) ELDERSERVE HEALTH, INC. T1 No $0 NY
Cooperative Advantage (HMO D-SNP) GROUP HEALTH COOPERATIVE OF EAU CLAIRE T1 No $0 WI
Longevity Health Plan (PPO I-SNP) LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP T1 No $0 NJ
Mercy Care Advantage (HMO D-SNP) MERCY CARE T1 No $0 AZ
Mercy Care Advantage (HMO D-SNP) MERCY CARE T1 No $0 AZ
Mercy Care Advantage (HMO D-SNP) MERCY CARE T1 No $0 AZ
Elderplan Plus Long-Term Care (HMO-POS D-SNP) ELDERPLAN, INC. T1 No $0 NY
Health Choice Pathway (HMO D-SNP) HEALTH CHOICE ARIZONA, INC. T1 No $0 AZ
Healthfirst CompleteCare (HMO D-SNP) HEALTHFIRST HEALTH PLAN, INC. T1 No $0 NY
IMCare Classic (HMO D-SNP) ITASCA MEDICAL CARE T1 No $0 MN
Johns Hopkins Advantage MD D-SNP (HMO D-SNP) HOPKINS HEALTH ADVANTAGE, INC. T1 No $0 MD
MetroPlus UltraCare (HMO D-SNP) METROPLUS HEALTH PLAN, INC. T1 No $0 NY
Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) UPPER PENINSULA HEALTH PLAN, LLC T1 No $0 MI
CareSource Dual Advantage (HMO D-SNP) CARESOURCE GEORGIA CO. T1 No $0 GA
Senior Whole Health SCO (HMO D-SNP) SENIOR WHOLE HEALTH, LLC T1 No $0 MA
Senior Whole Health SCO NHC (HMO D-SNP) SENIOR WHOLE HEALTH, LLC T1 No $0 MA
Molina One Care (HMO D-SNP) SENIOR WHOLE HEALTH, LLC T1 No $0 MA
HAP CareSource MI Coordinated Health (HMO D-SNP) HAP CARESOURCE T1 No $0 MI
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
Horizon NJ TotalCare (HMO D-SNP) HORIZON HEALTHCARE OF NEW JERSEY, INC. T1 No $0 NJ
SecureBlue (HMO D-SNP) HMO Minnesota T1 No $0 MN
NaviCare (HMO D-SNP) FALLON COMMUNITY HEALTH PLAN T1 No $0 MA
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
PHP (HMO C-SNP) AIDS HEALTHCARE FOUNDATION T1 No $0 CA
CCA One Care (HMO D-SNP) COMMONWEALTH CARE ALLIANCE, INC. T1 No $0 MA
CCA Senior Care Options (HMO D-SNP) COMMONWEALTH CARE ALLIANCE, INC. T1 No $0 MA
VNS Health Total (HMO D-SNP) VNS CHOICE T1 No $0 NY
Community Care's Partnership Program (HMO D-SNP) COMMUNITY CARE HEALTH PLAN, INC. T1 No $0 WI
CalOptima Health OneCare Complete (HMO D-SNP) ORANGE COUNTY HEALTH AUTHORITY T1 No $0 CA
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
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 No $0 PA
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 No $0 PA
Highmark Health Options Duals (HMO D-SNP) HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC. T1 No $0 WV
Highmark Health Options Duals (HMO D-SNP) HIGHMARK BCBSD, INC. T1 No $0 DE
Tufts Health One Care (HMO D-SNP) TUFTS HEALTH PUBLIC PLANS, INC. T1 No $0 MA
Tufts Health One Care CW (HMO D-SNP) TUFTS HEALTH PUBLIC PLANS, INC. T1 No $0 MA
Tufts Health Plan Senior Care Options (HMO D-SNP) TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION T1 No $0 MA
Tufts Health Plan Senior Care Options CW (HMO D-SNP) TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION T1 No $0 MA
CareOregon Advantage Plus (HMO D-SNP) HEALTH PLAN OF CAREOREGON, INC. T1 No $0 OR
Leon MediExtra (HMO) LEON HEALTH, INC. T1 No $0 FL

Frequently Asked Questions

Is metronidazole 7.5 MG/ML Topical Lotion covered by Medicare Part D?

Yes, metronidazole 7.5 MG/ML Topical Lotion is covered by 4,631 Medicare Part D plans (91.4% of all Part D formularies).

What tier is metronidazole 7.5 MG/ML Topical Lotion on Medicare Part D plans?

metronidazole 7.5 MG/ML Topical Lotion averages Tier 3.1 across Part D plans, ranging from Tier 1 to Tier 4.

Does metronidazole 7.5 MG/ML Topical Lotion require prior authorization?

0% of Part D formularies require prior authorization for metronidazole 7.5 MG/ML Topical Lotion. Step therapy: 0%. Quantity limits: 29.8%.

How much does Medicare spend on metronidazole 7.5 MG/ML Topical Lotion?

In 2023, total Medicare Part D spending on metronidazole 7.5 MG/ML Topical Lotion was $70,489,119, covering 1,528,785 beneficiaries. The average spend per beneficiary was $46.11.

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