omeprazole 10 MG Delayed Release Oral Capsule
omeprazole
RxCUI: 199119
What the CMS Formulary Data Shows for omeprazole 10 MG Delayed Release Oral Capsule
Per the CMS 2026 Part D formulary file, omeprazole 10 MG Delayed Release Oral Capsule (RxNorm concept RXCUI 199119, generic name omeprazole) 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 6, with a cross-plan average of Tier 1.2.
Real-world access to omeprazole 10 MG Delayed Release Oral Capsule depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 44.5% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 7,298,218 Part D beneficiaries filled omeprazole 10 MG Delayed Release Oral Capsule in 2023, with total plan-and-beneficiary spending of $422,372,715 and an average per-beneficiary annual cost of $57.87. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry omeprazole 10 MG Delayed Release Oral Capsule today.
Coverage Details
- Formularies covering
- 330
- Plans covering
- 5,067
- Coverage rate
- 100%
- Tier range
- Tier 1 – Tier 6
- Average tier
- Tier 1, Preferred Generic
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 44.5% of formularies
2023 Medicare Spending
- Beneficiaries
- 7,298,218
- Total spending
- $422,372,715
- Avg per beneficiary
- $57.87
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering omeprazole 10 MG Delayed Release Oral Capsule
2 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP) | UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY | T1 | No | No | $0 | - |
| AARP Medicare Rx Preferred from UHC (PDP) | UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY | T1 | No | No | $0 | - |
Medicare Advantage Plans (MA-PD) Covering omeprazole 10 MG Delayed Release Oral Capsule
98 Medicare Advantage plans with Part D drug coverage include this drug.
Frequently Asked Questions
Is omeprazole 10 MG Delayed Release Oral Capsule covered by Medicare Part D?
Yes, omeprazole 10 MG Delayed Release Oral Capsule is covered by 5,067 Medicare Part D plans (100% of all Part D formularies).
What tier is omeprazole 10 MG Delayed Release Oral Capsule on Medicare Part D plans?
omeprazole 10 MG Delayed Release Oral Capsule averages Tier 1.2 across Part D plans, ranging from Tier 1 to Tier 6.
Does omeprazole 10 MG Delayed Release Oral Capsule require prior authorization?
0% of Part D formularies require prior authorization for omeprazole 10 MG Delayed Release Oral Capsule. Step therapy: 0%. Quantity limits: 44.5%.
How much does Medicare spend on omeprazole 10 MG Delayed Release Oral Capsule?
In 2023, total Medicare Part D spending on omeprazole 10 MG Delayed Release Oral Capsule was $422,372,715, covering 7,298,218 beneficiaries. The average spend per beneficiary was $57.87.
Read our methodology - how this data is sourced, computed, and verified.