mycophenolic acid 360 MG Delayed Release Oral Tablet [Myfortic]
mycophenolic acid
RxCUI: 616449
What the CMS Formulary Data Shows for mycophenolic acid 360 MG Delayed Release Oral Tablet [Myfortic]
Per the CMS 2026 Part D formulary file, mycophenolic acid 360 MG Delayed Release Oral Tablet [Myfortic] (RxNorm concept RXCUI 616449, generic name mycophenolic acid) appears on 6 distinct formulary files spanning 102 Medicare Part D plan offerings - 2% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 3.7.
Real-world access to mycophenolic acid 360 MG Delayed Release Oral Tablet [Myfortic] depends on utilization management as much as tier placement: 100% 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 215 Part D beneficiaries filled mycophenolic acid 360 MG Delayed Release Oral Tablet [Myfortic] in 2023, with total plan-and-beneficiary spending of $1,330,716 and an average per-beneficiary annual cost of $6,189.38. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry mycophenolic acid 360 MG Delayed Release Oral Tablet [Myfortic] today.
Coverage Details
- Formularies covering
- 6
- Plans covering
- 102
- Coverage rate
- 2%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 100% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 215
- Total spending
- $1,330,716
- Avg per beneficiary
- $6,189.38
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering mycophenolic acid 360 MG Delayed Release Oral Tablet [Myfortic]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| CalOptima Health OneCare Complete (HMO D-SNP) | ORANGE COUNTY HEALTH AUTHORITY | T1 | Yes | $0 | CA |
| Medicare BlueEssential (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | Yes | $0 | NY |
| Medicare BlueActive (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | Yes | $0 | NY |
| Medicare BlueVital (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | Yes | $0 | NY |
| Univera SeniorChoice Basic (HMO) | EXCELLUS HEALTH PLAN, INC. | T4 | Yes | $0 | NY |
| Univera SeniorChoice Extra (HMO) | EXCELLUS HEALTH PLAN, INC. | T4 | Yes | $0 | NY |
| Medicare Blue Choice Core (HMO) | EXCELLUS HEALTH PLAN, INC. | T4 | Yes | $0 | NY |
| Univera Medicare Dual (HMO D-SNP) | EXCELLUS HEALTH PLAN COMMUNITY CARE LLC | T4 | Yes | $0 | NY |
| Medicare Blue Dual (HMO D-SNP) | EXCELLUS HEALTH PLAN COMMUNITY CARE LLC | T4 | Yes | $0 | NY |
| CDPHP $0 Medicare Rx (HMO) | CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. | T4 | Yes | $0 | NY |
| SCAN Connections (HMO D-SNP) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Connections at Home (HMO D-SNP) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN NEVADA, INC. | T4 | Yes | $0 | NV |
| SCAN Balance (HMO C-SNP) | SCAN HEALTH PLAN NEVADA, INC. | T4 | Yes | $0 | NV |
| SCAN Strive (HMO C-SNP) | SCAN HEALTH PLAN NEVADA, INC. | T4 | Yes | $0 | NV |
| SCAN MyChoice (HMO) | SCAN HEALTH PLAN NEVADA, INC. | T4 | Yes | $0 | NV |
| SCAN Classic (HMO) | SCAN DESERT HEALTH PLAN, INC. | T4 | Yes | $0 | AZ |
| SCAN Balance (HMO C-SNP) | SCAN DESERT HEALTH PLAN, INC. | T4 | Yes | $0 | AZ |
| SCAN Embrace (HMO-POS I-SNP) | SCAN DESERT HEALTH PLAN, INC. | T4 | Yes | $0 | AZ |
| SCAN Strive (HMO C-SNP) | SCAN DESERT HEALTH PLAN, INC. | T4 | Yes | $0 | AZ |
| SCAN MyChoice (HMO) | SCAN DESERT HEALTH PLAN, INC. | T4 | Yes | $0 | AZ |
| SCAN Classic WA (HMO) | SCAN HEALTH PLAN (WA) | T4 | Yes | $0 | WA |
| SCAN MyChoice WA (HMO) | SCAN HEALTH PLAN (WA) | T4 | Yes | $0 | WA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN (NM) | T4 | Yes | $0 | NM |
| SCAN Balance (HMO C-SNP) | SCAN HEALTH PLAN (NM) | T4 | Yes | $0 | NM |
| SCAN Strive (HMO C-SNP) | SCAN HEALTH PLAN (NM) | T4 | Yes | $0 | NM |
| SCAN MyChoice (HMO) | SCAN HEALTH PLAN (NM) | T4 | Yes | $0 | NM |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Balance (HMO C-SNP) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Prime (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Balance (HMO C-SNP) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Balance (HMO C-SNP) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Alta (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Venture (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Venture (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Embrace (HMO I-SNP) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Embrace (HMO I-SNP) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Embrace (HMO-POS I-SNP) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Affirm partnered with Included LGBTQ+ Health (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Affirm partnered with Included LGBTQ+ Health (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Strive (HMO C-SNP) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Strive (HMO C-SNP) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
Frequently Asked Questions
Is mycophenolic acid 360 MG Delayed Release Oral Tablet [Myfortic] covered by Medicare Part D?
Yes, mycophenolic acid 360 MG Delayed Release Oral Tablet [Myfortic] is covered by 102 Medicare Part D plans (2% of all Part D formularies).
What tier is mycophenolic acid 360 MG Delayed Release Oral Tablet [Myfortic] on Medicare Part D plans?
mycophenolic acid 360 MG Delayed Release Oral Tablet [Myfortic] averages Tier 3.7 across Part D plans, ranging from Tier 1 to Tier 5.
Does mycophenolic acid 360 MG Delayed Release Oral Tablet [Myfortic] require prior authorization?
100% of Part D formularies require prior authorization for mycophenolic acid 360 MG Delayed Release Oral Tablet [Myfortic]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on mycophenolic acid 360 MG Delayed Release Oral Tablet [Myfortic]?
In 2023, total Medicare Part D spending on mycophenolic acid 360 MG Delayed Release Oral Tablet [Myfortic] was $1,330,716, covering 215 beneficiaries. The average spend per beneficiary was $6,189.38.
Read our methodology - how this data is sourced, computed, and verified.