nortriptyline 10 MG Oral Capsule
nortriptyline
RxCUI: 198045
What the CMS Formulary Data Shows for nortriptyline 10 MG Oral Capsule
Per the CMS 2026 Part D formulary file, nortriptyline 10 MG Oral Capsule (RxNorm concept RXCUI 198045, generic name nortriptyline) appears on 330 distinct formulary files spanning 5,067 Medicare Part D plan offerings - 100% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 1.7.
Real-world access to nortriptyline 10 MG Oral Capsule depends on utilization management as much as tier placement: 2.4% 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 302,986 Part D beneficiaries filled nortriptyline 10 MG Oral Capsule in 2023, with total plan-and-beneficiary spending of $23,070,730 and an average per-beneficiary annual cost of $76.14. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry nortriptyline 10 MG Oral Capsule today.
Coverage Details
- Formularies covering
- 330
- Plans covering
- 5,067
- Coverage rate
- 100%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 2.4% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 302,986
- Total spending
- $23,070,730
- Avg per beneficiary
- $76.14
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering nortriptyline 10 MG Oral Capsule
5 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| Anthem Full Dual Advantage (PPO D-SNP) | ANTHEM HEALTH PLANS, INC. | T1 | No | No | $0 | CT |
| Anthem Dual Advantage (PPO D-SNP) | ANTHEM HEALTH PLANS, INC. | T1 | No | No | $0 | CT |
| Anthem Kidney Care (HMO-POS C-SNP) | ANTHEM HEALTH PLANS, INC. | T1 | No | No | $0 | CT |
| Anthem Full Dual Advantage Select (HMO D-SNP) | ANTHEM HEALTH PLANS, INC. | T1 | No | No | $0 | CT |
| Anthem Dual Advantage (HMO D-SNP) | ANTHEM HEALTH PLANS, INC. | T1 | No | No | $0 | CT |
Medicare Advantage Plans (MA-PD) Covering nortriptyline 10 MG Oral Capsule
95 Medicare Advantage plans with Part D drug coverage include this drug.
Frequently Asked Questions
Is nortriptyline 10 MG Oral Capsule covered by Medicare Part D?
Yes, nortriptyline 10 MG Oral Capsule is covered by 5,067 Medicare Part D plans (100% of all Part D formularies).
What tier is nortriptyline 10 MG Oral Capsule on Medicare Part D plans?
nortriptyline 10 MG Oral Capsule averages Tier 1.7 across Part D plans, ranging from Tier 1 to Tier 4.
Does nortriptyline 10 MG Oral Capsule require prior authorization?
2.4% of Part D formularies require prior authorization for nortriptyline 10 MG Oral Capsule. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on nortriptyline 10 MG Oral Capsule?
In 2023, total Medicare Part D spending on nortriptyline 10 MG Oral Capsule was $23,070,730, covering 302,986 beneficiaries. The average spend per beneficiary was $76.14.
Read our methodology - how this data is sourced, computed, and verified.