Medicare Part D coverage · tacrolimus · RxCUI 108514
tacrolimus 5 MG Oral Capsule [Prograf]
Per the CMS 2026 Part D formulary file, tacrolimus 5 MG Oral Capsule [Prograf] is covered by 104 Medicare Part D plans (2.1% of enrollable products), averaging Tier 3.7, with prior authorization required on 100% of covering formularies.
- 2.1%
- Plan coverage
- 104
- Plans covering
- T3.7
- Avg tier
- 100%
- Prior auth required
What the CMS Formulary Data Shows for tacrolimus 5 MG Oral Capsule [Prograf]
Per the CMS 2026 Part D formulary file, tacrolimus 5 MG Oral Capsule [Prograf] (RxNorm concept RXCUI 108514, 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 5, with a cross-plan average of Tier 3.7.
Real-world access to tacrolimus 5 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 5 MG Oral Capsule [Prograf] in 2023, with total plan-and-beneficiary spending of $103,294,080 and an average per-beneficiary annual cost of $505.39. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry tacrolimus 5 MG Oral Capsule [Prograf] today.
Coverage Details
- Formularies covering
- 7
- Plans covering
- 104
- Coverage rate
- 2.1%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
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
- $103,294,080
- Avg per beneficiary
- $505.39
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering tacrolimus 5 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 |
| 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 |
Show the next 30 plans
| 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 |
| SCAN Venture (HMO) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Embrace (HMO I-SNP) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Embrace (HMO I-SNP) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Embrace (HMO-POS I-SNP) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Affirm partnered with Included LGBTQ+ Health (HMO) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Affirm partnered with Included LGBTQ+ Health (HMO) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Strive (HMO C-SNP) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Strive (HMO C-SNP) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Inspired by women for women (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 Balance (HMO C-SNP) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Balance (HMO C-SNP) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Balance (HMO C-SNP) | Scan Health Plan | T4 | Yes | $0 | CA |
| SCAN Affirm partnered with Included LGBTQ+ Health (HMO) | Scan Health Plan | T4 | Yes | $0 | CA |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is tacrolimus 5 MG Oral Capsule [Prograf] covered by Medicare Part D?
Yes, tacrolimus 5 MG Oral Capsule [Prograf] is covered by 104 Medicare Part D plans (2.1% of all Part D formularies).
What tier is tacrolimus 5 MG Oral Capsule [Prograf] on Medicare Part D plans?
tacrolimus 5 MG Oral Capsule [Prograf] averages Tier 3.7 across Part D plans, ranging from Tier 1 to Tier 5.
Does tacrolimus 5 MG Oral Capsule [Prograf] require prior authorization?
100% of Part D formularies require prior authorization for tacrolimus 5 MG Oral Capsule [Prograf]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on tacrolimus 5 MG Oral Capsule [Prograf]?
In 2023, total Medicare Part D spending on tacrolimus 5 MG Oral Capsule [Prograf] was $103,294,080, covering 204,385 beneficiaries. The average spend per beneficiary was $505.39.
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
- zonisamide 20 MG/ML Oral Suspension [Zonisade] T3.7
- lisdexamfetamine dimesylate 40 MG Chewable Tablet T3.7
- mometasone furoate 0.025 MG/ACTUAT / olopatadine hydrochloride 0.665 MG/ACTUAT Metered Dose Nasal Spray [Ryaltris] T3.7
- roflumilast 3 MG/ML Topical Foam [Zoryve] T3.7
- droxidopa 200 MG Oral Capsule T3.7
- lactulose 10000 MG Powder for Oral Solution [Kristalose] T3.7
Similar prior-authorization rate
- azathioprine 50 MG Oral Tablet 100% PA
- 0.5 ML hepatitis B surface antigen vaccine 0.04 MG/ML Prefilled Syringe [Heplisav-B] 100% PA
- 0.5 ML hepatitis B surface antigen vaccine 0.02 MG/ML Prefilled Syringe [Engerix-B] 100% PA
- 1 ML hepatitis B surface antigen vaccine 0.02 MG/ML Prefilled Syringe [Engerix-B] 100% PA
- sotagliflozin 200 MG Oral Tablet [Inpefa] 100% PA
- mycophenolate mofetil 250 MG Oral Capsule 100% PA