tacrolimus 1 MG Oral Capsule [Prograf]
tacrolimus
RxCUI: 108513
What the CMS Formulary Data Shows for tacrolimus 1 MG Oral Capsule [Prograf]
Per the CMS 2026 Part D formulary file, tacrolimus 1 MG Oral Capsule [Prograf] (RxNorm concept RXCUI 108513, generic name tacrolimus) appears on 7 distinct formulary files spanning 104 Medicare Part D plan offerings - 2.1% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 3.1.
Real-world access to tacrolimus 1 MG Oral Capsule [Prograf] depends on utilization management as much as tier placement: 100% 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 204,385 Part D beneficiaries filled tacrolimus 1 MG Oral Capsule [Prograf] in 2023, with total plan-and-beneficiary spending of $103,329,148 and an average per-beneficiary annual cost of $505.56. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry tacrolimus 1 MG Oral Capsule [Prograf] today.
Coverage Details
- Formularies covering
- 7
- Plans covering
- 104
- Coverage rate
- 2.1%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 100% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 204,385
- Total spending
- $103,329,148
- Avg per beneficiary
- $505.56
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering tacrolimus 1 MG Oral Capsule [Prograf]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Hamaspik Medicare Choice (HMO D-SNP) | HAMASPIK, INC. | T1 | Yes | $0 | NY |
| CalOptima Health OneCare Complete (HMO D-SNP) | ORANGE COUNTY HEALTH AUTHORITY | T1 | Yes | $0 | CA |
| Hamaspik Medicare Select (HMO D-SNP) | HAMASPIK, INC. | T1 | Yes | $34.50 | NY |
| Medicare BlueEssential (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | Yes | $0 | NY |
| Medicare BlueActive (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | Yes | $0 | NY |
| Medicare BlueVital (PPO) | EXCELLUS HEALTH PLAN, INC. | T4 | Yes | $0 | NY |
| Univera SeniorChoice Basic (HMO) | EXCELLUS HEALTH PLAN, INC. | T4 | Yes | $0 | NY |
| Univera SeniorChoice Extra (HMO) | EXCELLUS HEALTH PLAN, INC. | T4 | Yes | $0 | NY |
| Medicare Blue Choice Core (HMO) | EXCELLUS HEALTH PLAN, INC. | T4 | Yes | $0 | NY |
| Univera Medicare Dual (HMO D-SNP) | EXCELLUS HEALTH PLAN COMMUNITY CARE LLC | T4 | Yes | $0 | NY |
| Medicare Blue Dual (HMO D-SNP) | EXCELLUS HEALTH PLAN COMMUNITY CARE LLC | T4 | Yes | $0 | NY |
| Óptimo Plus (PPO) | TRIPLE S ADVANTAGE, INC. | T4 | Yes | $0 | PR |
| Contigo Plus (HMO C-SNP) | TRIPLE S ADVANTAGE, INC. | T4 | Yes | $0 | PR |
| Brillante (HMO-POS) | TRIPLE S ADVANTAGE, INC. | T4 | Yes | $0 | PR |
| Enlace Plus (HMO) | TRIPLE S ADVANTAGE, INC. | T4 | Yes | $0 | PR |
| ContigoEnMente (HMO C-SNP) | TRIPLE S ADVANTAGE, INC. | T4 | Yes | $0 | PR |
| Ahorro Plus (HMO) | TRIPLE S ADVANTAGE, INC. | T4 | Yes | $0 | PR |
| CDPHP $0 Medicare Rx (HMO) | CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. | T4 | Yes | $0 | NY |
| SCAN Connections (HMO D-SNP) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Connections at Home (HMO D-SNP) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN NEVADA, INC. | T4 | Yes | $0 | NV |
| SCAN Balance (HMO C-SNP) | SCAN HEALTH PLAN NEVADA, INC. | T4 | Yes | $0 | NV |
| SCAN Strive (HMO C-SNP) | SCAN HEALTH PLAN NEVADA, INC. | T4 | Yes | $0 | NV |
| SCAN MyChoice (HMO) | SCAN HEALTH PLAN NEVADA, INC. | T4 | Yes | $0 | NV |
| SCAN Classic (HMO) | SCAN DESERT HEALTH PLAN, INC. | T4 | Yes | $0 | AZ |
| SCAN Balance (HMO C-SNP) | SCAN DESERT HEALTH PLAN, INC. | T4 | Yes | $0 | AZ |
| SCAN Embrace (HMO-POS I-SNP) | SCAN DESERT HEALTH PLAN, INC. | T4 | Yes | $0 | AZ |
| SCAN Strive (HMO C-SNP) | SCAN DESERT HEALTH PLAN, INC. | T4 | Yes | $0 | AZ |
| SCAN MyChoice (HMO) | SCAN DESERT HEALTH PLAN, INC. | T4 | Yes | $0 | AZ |
| SCAN Classic WA (HMO) | SCAN HEALTH PLAN (WA) | T4 | Yes | $0 | WA |
| SCAN MyChoice WA (HMO) | SCAN HEALTH PLAN (WA) | T4 | Yes | $0 | WA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN (NM) | T4 | Yes | $0 | NM |
| SCAN Balance (HMO C-SNP) | SCAN HEALTH PLAN (NM) | T4 | Yes | $0 | NM |
| SCAN Strive (HMO C-SNP) | SCAN HEALTH PLAN (NM) | T4 | Yes | $0 | NM |
| SCAN MyChoice (HMO) | SCAN HEALTH PLAN (NM) | T4 | Yes | $0 | NM |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Balance (HMO C-SNP) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Prime (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Balance (HMO C-SNP) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Balance (HMO C-SNP) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Alta (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
| SCAN Venture (HMO) | SCAN HEALTH PLAN | T4 | Yes | $0 | CA |
Frequently Asked Questions
Is tacrolimus 1 MG Oral Capsule [Prograf] covered by Medicare Part D?
Yes, tacrolimus 1 MG Oral Capsule [Prograf] is covered by 104 Medicare Part D plans (2.1% of all Part D formularies).
What tier is tacrolimus 1 MG Oral Capsule [Prograf] on Medicare Part D plans?
tacrolimus 1 MG Oral Capsule [Prograf] averages Tier 3.1 across Part D plans, ranging from Tier 1 to Tier 4.
Does tacrolimus 1 MG Oral Capsule [Prograf] require prior authorization?
100% of Part D formularies require prior authorization for tacrolimus 1 MG Oral Capsule [Prograf]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on tacrolimus 1 MG Oral Capsule [Prograf]?
In 2023, total Medicare Part D spending on tacrolimus 1 MG Oral Capsule [Prograf] was $103,329,148, covering 204,385 beneficiaries. The average spend per beneficiary was $505.56.
Read our methodology - how this data is sourced, computed, and verified.