mupirocin 20 MG/ML Topical Cream

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mupirocin

RxCUI: 311877

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.
45.3%
Plan Coverage
2,297
Plans Covering
T3
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for mupirocin 20 MG/ML Topical Cream

Per the CMS 2026 Part D formulary file, mupirocin 20 MG/ML Topical Cream (RxNorm concept RXCUI 311877, generic name mupirocin) appears on 71 distinct formulary files spanning 2,297 Medicare Part D plan offerings - 45.3% 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 3.

Real-world access to mupirocin 20 MG/ML Topical Cream depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 40.8% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 2,467,308 Part D beneficiaries filled mupirocin 20 MG/ML Topical Cream in 2023, with total plan-and-beneficiary spending of $33,820,823 and an average per-beneficiary annual cost of $13.71. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry mupirocin 20 MG/ML Topical Cream today.

Coverage Details

Formularies covering
71
Plans covering
2,297
Coverage rate
45.3%
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
40.8% of formularies

2023 Medicare Spending

Beneficiaries
2,467,308
Total spending
$33,820,823
Avg per beneficiary
$13.71

Tier Distribution Across Plans

46 plans
Tier 1, Preferred Generic
54 plans
Tier 2, Generic

Medicare Advantage Plans (MA-PD) Covering mupirocin 20 MG/ML Topical Cream

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
MCS Classicare RxMax (HMO) MCS ADVANTAGE, INC. T1 No $0 PR
MCS Classicare Platino Ideal (HMO D-SNP) MCS ADVANTAGE, INC. T1 No $0 PR
MCS Classicare Efectivo (HMO) MCS ADVANTAGE, INC. T1 No $0 PR
MCS Classicare Essential (HMO-POS) MCS ADVANTAGE, INC. T1 No $0 PR
MCS Classicare Platino Progreso (HMO D-SNP) MCS ADVANTAGE, INC. T1 No $0 PR
MCS Classicare Primero (HMO C-SNP) MCS ADVANTAGE, INC. T1 No $0 PR
MCS Classicare Firme (HMO) MCS ADVANTAGE, INC. T1 No $0 PR
MCS Classicare En Tu Hogar (HMO) MCS ADVANTAGE, INC. T1 No $0 PR
MCS Classicare Hero (HMO) MCS ADVANTAGE, INC. T1 No $0 PR
MCS Classicare Platino Total (HMO D-SNP) MCS ADVANTAGE, INC. T1 No $0 PR
MCS Classicare InteliCare (HMO) MCS ADVANTAGE, INC. T1 No $0 PR
MCS Classicare Platino Maximo (HMO D-SNP) MCS ADVANTAGE, INC. T1 No $0 PR
MCS Classicare Excede (HMO) MCS ADVANTAGE, INC. T1 No $0 PR
MCS Classicare Estrella (HMO) MCS ADVANTAGE, INC. T1 No $0 PR
MCS Classicare Platino Superior (HMO D-SNP) MCS ADVANTAGE, INC. T1 No $0 PR
MCS Classicare Platino 185 (HMO D-SNP) MCS ADVANTAGE, INC. T1 No $0 PR
NaviCare (HMO D-SNP) FALLON COMMUNITY HEALTH PLAN T1 No $0 MA
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
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
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
Provider Partners Texas Advantage Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF TEXAS, INC. T1 No $4.80 TX
Provider Partners Illinois Advantage Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF ILLINOIS T1 No $15.20 IL
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
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
Hamaspik Medicare Select (HMO D-SNP) HAMASPIK, INC. T1 No $34.50 NY
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
Provider Partners Indiana Advantage Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF INDIANA T1 No $38.40 IN
Provider Partners Indiana Essential Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF INDIANA T1 No $38.40 IN
Provider Partners Kentucky Advantage Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY T1 No $38.40 KY
Provider Partners Missouri Advantage Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC. T1 No $43.00 MO
Provider Partners Missouri Essential Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC. T1 No $43.00 MO
HealthSun HealthAdvantage Plan (HMO) HEALTHSUN HEALTH PLANS, INC. T2 No $0 FL
HealthSun MediMax (HMO) HEALTHSUN HEALTH PLANS, INC. T2 No $0 FL
HealthSun HealthAdvantage Plan (HMO) HEALTHSUN HEALTH PLANS, INC. T2 No $0 FL
HealthSun HealthAdvantage Plan (HMO) HEALTHSUN HEALTH PLANS, INC. T2 No $0 FL

Frequently Asked Questions

Is mupirocin 20 MG/ML Topical Cream covered by Medicare Part D?

Yes, mupirocin 20 MG/ML Topical Cream is covered by 2,297 Medicare Part D plans (45.3% of all Part D formularies).

What tier is mupirocin 20 MG/ML Topical Cream on Medicare Part D plans?

mupirocin 20 MG/ML Topical Cream averages Tier 3 across Part D plans, ranging from Tier 1 to Tier 4.

Does mupirocin 20 MG/ML Topical Cream require prior authorization?

0% of Part D formularies require prior authorization for mupirocin 20 MG/ML Topical Cream. Step therapy: 0%. Quantity limits: 40.8%.

How much does Medicare spend on mupirocin 20 MG/ML Topical Cream?

In 2023, total Medicare Part D spending on mupirocin 20 MG/ML Topical Cream was $33,820,823, covering 2,467,308 beneficiaries. The average spend per beneficiary was $13.71.

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