Medicare Part D coverage · sodium zirconium cyclosilicate · RxCUI 2047639
sodium zirconium cyclosilicate 5000 MG Powder for Oral Suspension [Lokelma]
Per the CMS 2026 Part D formulary file, sodium zirconium cyclosilicate 5000 MG Powder for Oral Suspension [Lokelma] is covered by 4,900 Medicare Part D plans (97% of enrollable products), averaging Tier 2.7, with prior authorization required on 11.6% of covering formularies.
- 97%
- Plan coverage
- 4,900
- Plans covering
- T2.7
- Avg tier
- 11.6%
- Prior auth required
What the CMS Formulary Data Shows for sodium zirconium cyclosilicate 5000 MG Powder for Oral Suspension [Lokelma]
Per the CMS 2026 Part D formulary file, sodium zirconium cyclosilicate 5000 MG Powder for Oral Suspension [Lokelma] (RxNorm concept RXCUI 2047639, generic name sodium zirconium cyclosilicate) appears on 319 distinct formulary files spanning 4,900 Medicare Part D plan offerings - 97% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.7.
Real-world access to sodium zirconium cyclosilicate 5000 MG Powder for Oral Suspension [Lokelma] depends on utilization management as much as tier placement: 11.6% of covering formularies require prior authorization. 0% require step therapy. 33.2% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 94,774 Part D beneficiaries filled sodium zirconium cyclosilicate 5000 MG Powder for Oral Suspension [Lokelma] in 2023, with total plan-and-beneficiary spending of $205,055,771 and an average per-beneficiary annual cost of $2,163.63. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry sodium zirconium cyclosilicate 5000 MG Powder for Oral Suspension [Lokelma] today.
Coverage Details
- Formularies covering
- 319
- Plans covering
- 4,900
- Coverage rate
- 97%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 11.6% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 33.2% of formularies
2023 Medicare Spending
- Beneficiaries
- 94,774
- Total spending
- $205,055,771
- Avg per beneficiary
- $2,163.63
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering sodium zirconium cyclosilicate 5000 MG Powder for Oral Suspension [Lokelma]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Sentara Community Complete Select (HMO D-SNP) | Sentara Health Plans | T1 | No | $0 | VA |
| Sentara Community Complete (HMO D-SNP) | Sentara Health Plans | T1 | No | $0 | VA |
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) | Hpmp OF Florida, Inc. | T1 | No | $0 | FL |
| ElderServe MAP (HMO D-SNP) | Elderserve Health, Inc. | T1 | No | $0 | NY |
| Cooperative Advantage (HMO D-SNP) | Group Health Cooperative OF EAU Claire | T1 | No | $0 | WI |
| Longevity Health Plan (PPO I-SNP) | Longevity Health Plan OF NEW Jersey Insurance Comp | T1 | No | $0 | NJ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Elderplan Plus Long-Term Care (HMO-POS D-SNP) | Elderplan, Inc. | T1 | No | $0 | NY |
| Health Choice Pathway (HMO D-SNP) | Health Choice Arizona, Inc. | T1 | No | $0 | AZ |
| Healthfirst CompleteCare (HMO D-SNP) | Healthfirst Health Plan, Inc. | T1 | No | $0 | NY |
| IMCare Classic (HMO D-SNP) | Itasca Medical Care | T1 | No | $0 | MN |
| Johns Hopkins Advantage MD D-SNP (HMO D-SNP) | Hopkins Health Advantage, Inc. | T1 | No | $0 | MD |
| MetroPlus UltraCare (HMO D-SNP) | Metroplus Health Plan, Inc. | T1 | No | $0 | NY |
| Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) | Upper Peninsula Health Plan, LLC | T1 | No | $0 | MI |
| CareSource Dual Advantage (HMO D-SNP) | Caresource Georgia Co. | T1 | No | $0 | GA |
| Senior Whole Health SCO (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| Senior Whole Health SCO NHC (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| Molina One Care (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
Show the next 30 plans
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP Caresource | T1 | No | $0 | MI |
| PruittHealth Premier D-SNP (HMO D-SNP) | Pruitthealth Premier, Inc. | T1 | Yes | $0 | GA |
| Simpra Advantage Dual Care (PPO D-SNP) | Simpra Advantage, Inc. | T1 | Yes | $0 | AL |
| Gold Coast Health Plan Total Care Advantage (HMO D-SNP) | Ventura County Medi-Cal Managed Care Commission | T1 | No | $0 | CA |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| Horizon NJ TotalCare (HMO D-SNP) | Horizon Healthcare OF NEW Jersey, Inc. | T1 | No | $0 | NJ |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | No | $0 | MN |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $0 | NY |
| SeniorCare Complete (HMO D-SNP) | South Country Health Alliance | T1 | No | $0 | MN |
| AbilityCare (HMO D-SNP) | South Country Health Alliance | T1 | No | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | Alameda Alliance FOR Health | T1 | No | $0 | CA |
| CCA One Care (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | No | $0 | MA |
| CCA Senior Care Options (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | No | $0 | MA |
| Elevate Medicare Choice (HMO D-SNP) | Denver Health Medical Plan, Inc. | T1 | No | $0 | CO |
| AllCare Advantage Redwood Rx (HMO D-SNP) | Allcare Health Plan, Inc. | T1 | No | $0 | OR |
| PrimeWest Senior Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | No | $0 | MN |
| Prime Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | No | $0 | MN |
| Alterwood Advantage Dual Secure (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | No | $0 | MD |
| Nascentia Dual Advantage (HMO D-SNP) | Visiting Nurse Association OF Central NEW York | T1 | No | $0 | NY |
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | No | $0 | PA |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | Provider Partners Health Plan OF North Carolina | T1 | No | $0 | NC |
| Provider Partners Indiana Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Indiana | T1 | No | $0 | IN |
| Provider Partners Missouri Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Missouri, Inc. | T1 | No | $0 | MO |
| 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 |
| Community Care's Partnership Program (HMO D-SNP) | Community Care Health Plan, Inc. | T1 | No | $0 | WI |
| Platino Blindao (HMO D-SNP) | Triple S Advantage, Inc. | T1 | Yes | $0 | PR |
| Platino Enlace (HMO D-SNP) | Triple S Advantage, Inc. | T1 | Yes | $0 | PR |
| Platino Advance (HMO D-snp) | Triple S Advantage, Inc. | T1 | Yes | $0 | PR |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is sodium zirconium cyclosilicate 5000 MG Powder for Oral Suspension [Lokelma] covered by Medicare Part D?
Yes, sodium zirconium cyclosilicate 5000 MG Powder for Oral Suspension [Lokelma] is covered by 4,900 Medicare Part D plans (97% of all Part D formularies).
What tier is sodium zirconium cyclosilicate 5000 MG Powder for Oral Suspension [Lokelma] on Medicare Part D plans?
sodium zirconium cyclosilicate 5000 MG Powder for Oral Suspension [Lokelma] averages Tier 2.7 across Part D plans, ranging from Tier 1 to Tier 4.
Does sodium zirconium cyclosilicate 5000 MG Powder for Oral Suspension [Lokelma] require prior authorization?
11.6% of Part D formularies require prior authorization for sodium zirconium cyclosilicate 5000 MG Powder for Oral Suspension [Lokelma]. Step therapy: 0%. Quantity limits: 33.2%.
How much does Medicare spend on sodium zirconium cyclosilicate 5000 MG Powder for Oral Suspension [Lokelma]?
In 2023, total Medicare Part D spending on sodium zirconium cyclosilicate 5000 MG Powder for Oral Suspension [Lokelma] was $205,055,771, covering 94,774 beneficiaries. The average spend per beneficiary was $2,163.63.
Read our methodology - how this data is sourced, computed, and verified.
Nationwide similar Part D drugs
Data-derived peers across the CMS Part D formulary extract: nearest average tier placement and nearest prior-authorization rate. Not therapeutic alternatives or same-generic strengths.
Closest average formulary tier
- abacavir 300 MG Oral Tablet T2.7
- escitalopram 1 MG/ML Oral Solution T2.7
- riluzole 50 MG Oral Tablet T2.7
- 168 HR clonidine 0.00417 MG/HR Transdermal System T2.7
- 1000 ML glucose 50 MG/ML / potassium chloride 0.02 MEQ/ML / sodium chloride 2.25 MG/ML Injection T2.7
- 3 ML insulin glargine 100 UNT/ML / lixisenatide 0.033 MG/ML Pen Injector [Soliqua] T2.7
Similar prior-authorization rate
- 100 ML gentamicin 1 MG/ML Injection 11.6% PA
- 1.6 ML aripiprazole lauroxil 276 MG/ML Prefilled Syringe [Aristada] 11.5% PA
- 2.4 ML aripiprazole lauroxil 276 MG/ML Prefilled Syringe [Aristada] 11.5% PA
- 3.2 ML aripiprazole lauroxil 276 MG/ML Prefilled Syringe [Aristada] 11.5% PA
- 3.9 ML aripiprazole lauroxil 273 MG/ML Prefilled Syringe [Aristada] 11.5% PA
- 2.4 ML aripiprazole lauroxil 281.3 MG/ML Prefilled Syringe [Aristada] 11.5% PA