sulfacetamide sodium 0.1 MG/MG Ophthalmic Ointment

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sulfacetamide sodium

RxCUI: 1000673

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.
85%
Plan Coverage
4,309
Plans Covering
T2.3
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for sulfacetamide sodium 0.1 MG/MG Ophthalmic Ointment

Per the CMS 2026 Part D formulary file, sulfacetamide sodium 0.1 MG/MG Ophthalmic Ointment (RxNorm concept RXCUI 1000673, generic name sulfacetamide sodium) appears on 259 distinct formulary files spanning 4,309 Medicare Part D plan offerings - 85% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.3.

Real-world access to sulfacetamide sodium 0.1 MG/MG Ophthalmic Ointment depends on utilization management as much as tier placement: 0% 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 23,854 Part D beneficiaries filled sulfacetamide sodium 0.1 MG/MG Ophthalmic Ointment in 2023, with total plan-and-beneficiary spending of $2,124,262 and an average per-beneficiary annual cost of $89.05. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry sulfacetamide sodium 0.1 MG/MG Ophthalmic Ointment today.

Coverage Details

Formularies covering
259
Plans covering
4,309
Coverage rate
85%
Tier range
Tier 1 – Tier 4
Average tier
Tier 2, Generic

Restrictions

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

2023 Medicare Spending

Beneficiaries
23,854
Total spending
$2,124,262
Avg per beneficiary
$89.05

Tier Distribution Across Plans

100 plans
Tier 1, Preferred Generic

Medicare Advantage Plans (MA-PD) Covering sulfacetamide sodium 0.1 MG/MG Ophthalmic Ointment

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
HAP CareSource MI Coordinated Health (HMO D-SNP) HAP CARESOURCE T1 No $0 MI
Gold Coast Health Plan Total Care Advantage (HMO D-SNP) Ventura County Medi-Cal Managed Care Commission T1 No $0 CA
MCS Classicare RxMax (HMO) MCS ADVANTAGE, INC. T1 No $0 PR
MCS Classicare Platino Ideal (HMO D-SNP) MCS ADVANTAGE, INC. T1 No $0 PR
MCS Classicare Efectivo (HMO) MCS ADVANTAGE, INC. T1 No $0 PR
MCS Classicare Essential (HMO-POS) MCS ADVANTAGE, INC. T1 No $0 PR
MCS Classicare Platino Progreso (HMO D-SNP) MCS ADVANTAGE, INC. T1 No $0 PR
MCS Classicare Primero (HMO C-SNP) MCS ADVANTAGE, INC. T1 No $0 PR
MCS Classicare Firme (HMO) MCS ADVANTAGE, INC. T1 No $0 PR
MCS Classicare En Tu Hogar (HMO) MCS ADVANTAGE, INC. T1 No $0 PR
MCS Classicare Hero (HMO) MCS ADVANTAGE, INC. T1 No $0 PR
MCS Classicare Platino Total (HMO D-SNP) MCS ADVANTAGE, INC. T1 No $0 PR
MCS Classicare InteliCare (HMO) MCS ADVANTAGE, INC. T1 No $0 PR
MCS Classicare Platino Maximo (HMO D-SNP) MCS ADVANTAGE, INC. T1 No $0 PR
MCS Classicare Excede (HMO) MCS ADVANTAGE, INC. T1 No $0 PR
MCS Classicare Estrella (HMO) MCS ADVANTAGE, INC. T1 No $0 PR
MCS Classicare Platino Superior (HMO D-SNP) MCS ADVANTAGE, INC. T1 No $0 PR
MCS Classicare Platino 185 (HMO D-SNP) MCS ADVANTAGE, INC. T1 No $0 PR
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
SecureBlue (HMO D-SNP) HMO Minnesota T1 No $0 MN
NaviCare (HMO D-SNP) FALLON COMMUNITY HEALTH PLAN T1 No $0 MA
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
PHP (HMO C-SNP) AIDS HEALTHCARE FOUNDATION 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

Frequently Asked Questions

Is sulfacetamide sodium 0.1 MG/MG Ophthalmic Ointment covered by Medicare Part D?

Yes, sulfacetamide sodium 0.1 MG/MG Ophthalmic Ointment is covered by 4,309 Medicare Part D plans (85% of all Part D formularies).

What tier is sulfacetamide sodium 0.1 MG/MG Ophthalmic Ointment on Medicare Part D plans?

sulfacetamide sodium 0.1 MG/MG Ophthalmic Ointment averages Tier 2.3 across Part D plans, ranging from Tier 1 to Tier 4.

Does sulfacetamide sodium 0.1 MG/MG Ophthalmic Ointment require prior authorization?

0% of Part D formularies require prior authorization for sulfacetamide sodium 0.1 MG/MG Ophthalmic Ointment. Step therapy: 0%. Quantity limits: 0%.

How much does Medicare spend on sulfacetamide sodium 0.1 MG/MG Ophthalmic Ointment?

In 2023, total Medicare Part D spending on sulfacetamide sodium 0.1 MG/MG Ophthalmic Ointment was $2,124,262, covering 23,854 beneficiaries. The average spend per beneficiary was $89.05.

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