nifedipine 20 MG Oral Capsule
nifedipine
RxCUI: 198033
What the CMS Formulary Data Shows for nifedipine 20 MG Oral Capsule
Per the CMS 2026 Part D formulary file, nifedipine 20 MG Oral Capsule (RxNorm concept RXCUI 198033, generic name nifedipine) appears on 60 distinct formulary files spanning 574 Medicare Part D plan offerings - 11.3% 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 1.7.
Real-world access to nifedipine 20 MG Oral Capsule depends on utilization management as much as tier placement: 23.3% 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 849,024 Part D beneficiaries filled nifedipine 20 MG Oral Capsule in 2023, with total plan-and-beneficiary spending of $146,639,465 and an average per-beneficiary annual cost of $172.72. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry nifedipine 20 MG Oral Capsule today.
Coverage Details
- Formularies covering
- 60
- Plans covering
- 574
- Coverage rate
- 11.3%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 23.3% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 849,024
- Total spending
- $146,639,465
- Avg per beneficiary
- $172.72
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering nifedipine 20 MG Oral Capsule
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T1 | No | $0 | UT |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T1 | No | $0 | NV |
| Select Health Medicare Dual (HMO D-SNP) | SELECTHEALTH, INC. | T1 | No | $0 | UT |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T1 | No | $0 | UT |
| Select Health Medicare + Kroger (HMO) | SELECTHEALTH, INC. | T1 | No | $0 | NV |
| Select Health Medicare + Kroger (HMO) | SELECTHEALTH, INC. | T1 | No | $0 | UT |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T1 | No | $0 | CO |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T1 | No | $0 | CO |
| Select Health Medicare + Kroger (HMO) | SELECTHEALTH, INC. | T1 | No | $0 | CO |
| Select Health Medicare Flex (HMO) | SELECTHEALTH, INC. | T1 | No | $0 | CO |
| Select Health Medicare + Kroger (HMO) | SELECTHEALTH, INC. | T1 | No | $0 | CO |
| Select Health Medicare Active (HMO) | SELECTHEALTH, INC. | T1 | No | $0 | CO |
| Select Health Medicare Dual (HMO D-SNP) | SELECTHEALTH, INC. | T1 | No | $0 | NV |
| Select Health Medicare Wellness (HMO) | SELECTHEALTH, INC. | T1 | No | $0 | NV |
| PruittHealth Premier D-SNP (HMO D-SNP) | PRUITTHEALTH PREMIER, INC. | T1 | No | $0 | GA |
| KeyCare Advantage Plus (HMO C-SNP) | ISNP VENTURES, LLC | T1 | No | $0 | MD |
| Premier Care (HMO-POS I-SNP) | LIFEWORKS ADVANTAGE, LLC | T1 | No | $0 | VA |
| Premier Care (HMO I-SNP) | ALIGN SENIOR CARE CALIFORNIA INC. | T1 | No | $0 | CA |
| Advantage Care (HMO) | ALIGN SENIOR CARE CALIFORNIA INC. | T1 | No | $0 | CA |
| Premier Care (HMO-POS I-SNP) | ALIGN SENIOR CARE MI, LLC | T1 | No | $0 | MI |
| Premier Care (HMO I-SNP) | ALIGN SENIOR CARE FLORIDA, INC. | T1 | No | $0 | FL |
| Perennial Advantage Freedom (HMO-POS) | PERENNIAL ADVANTAGE OF COLORADO, INC. | T1 | No | $0 | CO |
| Perennial Advantage Premier (HMO-POS I-SNP) | PERENNIAL ADVANTAGE OF COLORADO, INC. | T1 | No | $0 | CO |
| Perennial Advantage Freedom (HMO) | PERENNIAL ADVANTAGE OF COLORADO, INC. | T1 | No | $0 | PA |
| Perennial Advantage Premier (HMO I-SNP) | PERENNIAL ADVANTAGE OF COLORADO, INC. | T1 | No | $0 | PA |
| Perennial Advantage Freedom (HMO-POS) | PERENNIAL ADVANTAGE OF OHIO, INC. | T1 | No | $0 | OH |
| Perennial Advantage Premier (HMO-POS I-SNP) | PERENNIAL ADVANTAGE OF OHIO, INC. | T1 | No | $0 | OH |
| ProCare Advantage - Diabetes Care Management (HMO-POS C-SNP) | PROCARE ADVANTAGE, LLC | T1 | No | $0 | TX |
| PruittHealth Premier Advantage (HMO I-SNP) | PRUITTHEALTH PREMIER, INC. | T1 | No | $0 | GA |
| CareAdvantage (HMO D-SNP) | SAN MATEO HEALTH COMMISSION | T1 | No | $0 | CA |
| Hamaspik Medicare Choice (HMO D-SNP) | HAMASPIK, INC. | T1 | No | $0 | NY |
| SeniorCare Complete (HMO D-SNP) | SOUTH COUNTRY HEALTH ALLIANCE | T1 | Yes | $0 | MN |
| AbilityCare (HMO D-SNP) | SOUTH COUNTRY HEALTH ALLIANCE | T1 | Yes | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | ALAMEDA ALLIANCE FOR HEALTH | T1 | Yes | $0 | CA |
| Healthy Mississippi Premier Advantage (HMO-POS) | Healthy Mississippi, Inc. | T1 | No | $0 | MS |
| PHP (HMO C-SNP) | AIDS HEALTHCARE FOUNDATION | T1 | No | $0 | CA |
| VNS Health Total (HMO D-SNP) | VNS CHOICE | T1 | No | $0 | NY |
| 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 |
| CalOptima Health OneCare Complete (HMO D-SNP) | ORANGE COUNTY HEALTH AUTHORITY | T1 | No | $0 | CA |
| Senior Care (HMO I-SNP) | NHC ADVANTAGE, LLC | T1 | No | $0 | MO, NC, SC, TN |
| Leon MediExtra (HMO) | LEON HEALTH, INC. | T1 | No | $0 | FL |
| Leon MediDual (HMO D-SNP) | LEON HEALTH, INC. | T1 | No | $0 | FL |
| Leon MediMore (HMO) | LEON HEALTH, INC. | T1 | No | $0 | FL |
| Leon MediMax (HMO D-SNP) | LEON HEALTH, INC. | T1 | No | $0 | FL |
| 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 |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | GOLD KIDNEY OF FLORIDA INC | T1 | No | $4.80 | FL |
Frequently Asked Questions
Is nifedipine 20 MG Oral Capsule covered by Medicare Part D?
Yes, nifedipine 20 MG Oral Capsule is covered by 574 Medicare Part D plans (11.3% of all Part D formularies).
What tier is nifedipine 20 MG Oral Capsule on Medicare Part D plans?
nifedipine 20 MG Oral Capsule averages Tier 1.7 across Part D plans, ranging from Tier 1 to Tier 4.
Does nifedipine 20 MG Oral Capsule require prior authorization?
23.3% of Part D formularies require prior authorization for nifedipine 20 MG Oral Capsule. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on nifedipine 20 MG Oral Capsule?
In 2023, total Medicare Part D spending on nifedipine 20 MG Oral Capsule was $146,639,465, covering 849,024 beneficiaries. The average spend per beneficiary was $172.72.
Read our methodology - how this data is sourced, computed, and verified.