nitrofurantoin 5 MG/ML Oral Suspension
nitrofurantoin
RxCUI: 311989
What the CMS Formulary Data Shows for nitrofurantoin 5 MG/ML Oral Suspension
Per the CMS 2026 Part D formulary file, nitrofurantoin 5 MG/ML Oral Suspension (RxNorm concept RXCUI 311989, generic name nitrofurantoin) appears on 25 distinct formulary files spanning 267 Medicare Part D plan offerings - 5.3% 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 2.6.
Real-world access to nitrofurantoin 5 MG/ML Oral Suspension depends on utilization management as much as tier placement: 8% of covering formularies require prior authorization. 0% require step therapy. 24% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 1,444 Part D beneficiaries filled nitrofurantoin 5 MG/ML Oral Suspension in 2023, with total plan-and-beneficiary spending of $8,114,037 and an average per-beneficiary annual cost of $5,619.14. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry nitrofurantoin 5 MG/ML Oral Suspension today.
Coverage Details
- Formularies covering
- 25
- Plans covering
- 267
- Coverage rate
- 5.3%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 8% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 24% of formularies
2023 Medicare Spending
- Beneficiaries
- 1,444
- Total spending
- $8,114,037
- Avg per beneficiary
- $5,619.14
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering nitrofurantoin 5 MG/ML Oral Suspension
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 |
| 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 |
| 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 |
| 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 |
| Tribute Select (HMO-POS I-SNP) | ARKANSAS SUPERIOR SELECT, INC. | T1 | No | $8.90 | AR |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | No | $13.10 | PA |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | No | $17.60 | PA |
| Highmark Health Options Duals Select (HMO D-SNP) | HIGHMARK BCBSD, INC. | T1 | No | $31.20 | DE |
| Valor Health Plan (HMO I-SNP) | TSG GUARD, INC. | T1 | No | $31.40 | OH |
| WV Senior Advantage (HMO I-SNP) | WEST VIRGINIA SENIOR ADVANTAGE, INC. | T1 | No | $32.70 | WV |
| 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 |
| HAP Medicare Explore (PPO) | ALLIANCE HEALTH AND LIFE INSURANCE COMPANY | T2 | No | $0 | MI |
| HAP Medicare Prime (PPO) | ALLIANCE HEALTH AND LIFE INSURANCE COMPANY | T2 | No | $0 | MI |
| HAP Medicare Connect (HMO) | HEALTH ALLIANCE PLAN OF MICHIGAN | T2 | No | $0 | MI |
| HAP Medicare Complete Duals (HMO D-SNP) | HEALTH ALLIANCE PLAN OF MICHIGAN | T2 | No | $0 | MI |
| HAP Medicare Superior (HMO) | HEALTH ALLIANCE PLAN OF MICHIGAN | T2 | No | $0 | MI |
| Henry Ford Select (HMO) | HEALTH ALLIANCE PLAN OF MICHIGAN | T2 | No | $0 | MI |
| MCS Classicare RxMax (HMO) | MCS ADVANTAGE, INC. | T2 | No | $0 | PR |
| MCS Classicare Platino Ideal (HMO D-SNP) | MCS ADVANTAGE, INC. | T2 | No | $0 | PR |
| MCS Classicare Efectivo (HMO) | MCS ADVANTAGE, INC. | T2 | No | $0 | PR |
| MCS Classicare Essential (HMO-POS) | MCS ADVANTAGE, INC. | T2 | No | $0 | PR |
| MCS Classicare Platino Progreso (HMO D-SNP) | MCS ADVANTAGE, INC. | T2 | No | $0 | PR |
| MCS Classicare Primero (HMO C-SNP) | MCS ADVANTAGE, INC. | T2 | No | $0 | PR |
| MCS Classicare Firme (HMO) | MCS ADVANTAGE, INC. | T2 | No | $0 | PR |
| MCS Classicare En Tu Hogar (HMO) | MCS ADVANTAGE, INC. | T2 | No | $0 | PR |
| MCS Classicare Hero (HMO) | MCS ADVANTAGE, INC. | T2 | No | $0 | PR |
| MCS Classicare Platino Total (HMO D-SNP) | MCS ADVANTAGE, INC. | T2 | No | $0 | PR |
| MCS Classicare InteliCare (HMO) | MCS ADVANTAGE, INC. | T2 | No | $0 | PR |
| MCS Classicare Platino Maximo (HMO D-SNP) | MCS ADVANTAGE, INC. | T2 | No | $0 | PR |
| MCS Classicare Excede (HMO) | MCS ADVANTAGE, INC. | T2 | No | $0 | PR |
| MCS Classicare Estrella (HMO) | MCS ADVANTAGE, INC. | T2 | No | $0 | PR |
| MCS Classicare Platino Superior (HMO D-SNP) | MCS ADVANTAGE, INC. | T2 | No | $0 | PR |
| MCS Classicare Platino 185 (HMO D-SNP) | MCS ADVANTAGE, INC. | T2 | No | $0 | PR |
| Healthy Mississippi Premier Advantage (HMO-POS) | Healthy Mississippi, Inc. | T2 | Yes | $0 | MS |
| HAP Member Assist (PPO) | ALLIANCE HEALTH AND LIFE INSURANCE COMPANY | T2 | No | $8.80 | MI |
| HAP Medicare Complete Assist (PPO D-SNP) | ALLIANCE HEALTH AND LIFE INSURANCE COMPANY | T2 | No | $8.80 | MI |
| HAP Medicare Diabetes and Heart (HMO C-SNP) | HEALTH ALLIANCE PLAN OF MICHIGAN | T2 | No | $8.80 | MI |
| HAP Senior Plus Henry Ford Tiered Access (HMO) | HEALTH ALLIANCE PLAN OF MICHIGAN | T2 | No | $11.30 | MI |
| HAP Senior Plus (HMO-POS) | HEALTH ALLIANCE PLAN OF MICHIGAN | T2 | No | $13.50 | MI |
| HAP Senior Plus (PPO) | ALLIANCE HEALTH AND LIFE INSURANCE COMPANY | T2 | No | $42.60 | MI |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T3 | Yes | $0 | UT |
Frequently Asked Questions
Is nitrofurantoin 5 MG/ML Oral Suspension covered by Medicare Part D?
Yes, nitrofurantoin 5 MG/ML Oral Suspension is covered by 267 Medicare Part D plans (5.3% of all Part D formularies).
What tier is nitrofurantoin 5 MG/ML Oral Suspension on Medicare Part D plans?
nitrofurantoin 5 MG/ML Oral Suspension averages Tier 2.6 across Part D plans, ranging from Tier 1 to Tier 5.
Does nitrofurantoin 5 MG/ML Oral Suspension require prior authorization?
8% of Part D formularies require prior authorization for nitrofurantoin 5 MG/ML Oral Suspension. Step therapy: 0%. Quantity limits: 24%.
How much does Medicare spend on nitrofurantoin 5 MG/ML Oral Suspension?
In 2023, total Medicare Part D spending on nitrofurantoin 5 MG/ML Oral Suspension was $8,114,037, covering 1,444 beneficiaries. The average spend per beneficiary was $5,619.14.
Read our methodology - how this data is sourced, computed, and verified.