nitrofurantoin, macrocrystals 25 MG Oral Capsule [Macrodantin]

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nitrofurantoin, macrocrystals

RxCUI: 207791

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.
0.1%
Plan Coverage
6
Plans Covering
T4
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for nitrofurantoin, macrocrystals 25 MG Oral Capsule [Macrodantin]

Per the CMS 2026 Part D formulary file, nitrofurantoin, macrocrystals 25 MG Oral Capsule [Macrodantin] (RxNorm concept RXCUI 207791, generic name nitrofurantoin, macrocrystals) appears on 1 distinct formulary file spanning 6 Medicare Part D plan offerings - 0.1% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 4 to Tier 4, with a cross-plan average of Tier 4.

Real-world access to nitrofurantoin, macrocrystals 25 MG Oral Capsule [Macrodantin] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 100% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 2,638,012 Part D beneficiaries filled nitrofurantoin, macrocrystals 25 MG Oral Capsule [Macrodantin] in 2023, with total plan-and-beneficiary spending of $76,395,047 and an average per-beneficiary annual cost of $28.96. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry nitrofurantoin, macrocrystals 25 MG Oral Capsule [Macrodantin] today.

Coverage Details

Formularies covering
1
Plans covering
6
Coverage rate
0.1%
Tier range
Tier 4, Non-Preferred
Average tier
Tier 4, Non-Preferred

Restrictions

Prior authorization required
0% of formularies
Step therapy required
0% of formularies
Quantity limits
100% of formularies

2023 Medicare Spending

Beneficiaries
2,638,012
Total spending
$76,395,047
Avg per beneficiary
$28.96

Tier Distribution Across Plans

6 plans
Tier 4, Non-Preferred

Medicare Advantage Plans (MA-PD) Covering nitrofurantoin, macrocrystals 25 MG Oral Capsule [Macrodantin]

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

Plan Insurer Tier PA Premium States
Óptimo Plus (PPO) TRIPLE S ADVANTAGE, INC. T4 No $0 PR
Contigo Plus (HMO C-SNP) TRIPLE S ADVANTAGE, INC. T4 No $0 PR
Brillante (HMO-POS) TRIPLE S ADVANTAGE, INC. T4 No $0 PR
Enlace Plus (HMO) TRIPLE S ADVANTAGE, INC. T4 No $0 PR
ContigoEnMente (HMO C-SNP) TRIPLE S ADVANTAGE, INC. T4 No $0 PR
Ahorro Plus (HMO) TRIPLE S ADVANTAGE, INC. T4 No $0 PR

Frequently Asked Questions

Is nitrofurantoin, macrocrystals 25 MG Oral Capsule [Macrodantin] covered by Medicare Part D?

Yes, nitrofurantoin, macrocrystals 25 MG Oral Capsule [Macrodantin] is covered by 6 Medicare Part D plans (0.1% of all Part D formularies).

What tier is nitrofurantoin, macrocrystals 25 MG Oral Capsule [Macrodantin] on Medicare Part D plans?

nitrofurantoin, macrocrystals 25 MG Oral Capsule [Macrodantin] averages Tier 4 across Part D plans, ranging from Tier 4 to Tier 4.

Does nitrofurantoin, macrocrystals 25 MG Oral Capsule [Macrodantin] require prior authorization?

0% of Part D formularies require prior authorization for nitrofurantoin, macrocrystals 25 MG Oral Capsule [Macrodantin]. Step therapy: 0%. Quantity limits: 100%.

How much does Medicare spend on nitrofurantoin, macrocrystals 25 MG Oral Capsule [Macrodantin]?

In 2023, total Medicare Part D spending on nitrofurantoin, macrocrystals 25 MG Oral Capsule [Macrodantin] was $76,395,047, covering 2,638,012 beneficiaries. The average spend per beneficiary was $28.96.

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