tramadol hydrochloride 100 MG Oral Tablet
tramadol hydrochloride
RxCUI: 2179635
What the CMS Formulary Data Shows for tramadol hydrochloride 100 MG Oral Tablet
Per the CMS 2026 Part D formulary file, tramadol hydrochloride 100 MG Oral Tablet (RxNorm concept RXCUI 2179635, generic name tramadol hydrochloride) appears on 23 distinct formulary files spanning 159 Medicare Part D plan offerings - 3.1% 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 1.9.
Real-world access to tramadol hydrochloride 100 MG Oral Tablet depends on utilization management as much as tier placement: 4.3% of covering formularies require prior authorization. 0% require step therapy. 82.6% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 3,884,717 Part D beneficiaries filled tramadol hydrochloride 100 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $91,679,129 and an average per-beneficiary annual cost of $23.60. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry tramadol hydrochloride 100 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 23
- Plans covering
- 159
- Coverage rate
- 3.1%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 4.3% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 82.6% of formularies
2023 Medicare Spending
- Beneficiaries
- 3,884,717
- Total spending
- $91,679,129
- Avg per beneficiary
- $23.60
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering tramadol hydrochloride 100 MG Oral Tablet
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| CareAdvantage (HMO D-SNP) | SAN MATEO HEALTH COMMISSION | T1 | No | $0 | CA |
| DrMax (HMO) | DOCTORS HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| DrExtraCare (HMO C-SNP) | DOCTORS HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| DrSelect (HMO) | DOCTORS HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| DrSelect-CFL (HMO) | DOCTORS HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| DrPlatinum-CFL (HMO D-SNP) | DOCTORS HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| DrTotalCare-CFL (HMO C-SNP) | DOCTORS HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| DrElite-SFL (HMO) | DOCTORS HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| 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 |
| CalOptima Health OneCare Complete (HMO D-SNP) | ORANGE COUNTY HEALTH AUTHORITY | T1 | No | $0 | CA |
| Mass General Brigham SCO (HMO D-SNP) | MASS GENERAL BRIGHAM HEALTH PLAN, INC | T1 | No | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | MASS GENERAL BRIGHAM HEALTH PLAN, INC | T1 | No | $0 | MA |
| DrFlex (HMO D-SNP) | DOCTORS HEALTHCARE PLANS, INC. | T1 | No | $1.10 | FL |
| DrPlus (HMO D-SNP) | DOCTORS HEALTHCARE PLANS, INC. | T1 | No | $4.80 | FL |
| Texas Independence Health Plan, Inc. (HMO I-SNP) | TEXAS INDEPENDENCE HEALTH PLAN, INC. | T1 | No | $4.80 | TX |
| Texas Independence Community Plan (HMO I-SNP) | TEXAS INDEPENDENCE HEALTH PLAN, INC. | T1 | No | $4.80 | TX |
| Tribute Select (HMO-POS I-SNP) | ARKANSAS SUPERIOR SELECT, INC. | T1 | No | $8.90 | AR |
| Valor Health Plan (HMO I-SNP) | TSG GUARD, INC. | T1 | No | $31.40 | OH |
| WV Senior Advantage (HMO I-SNP) | WEST VIRGINIA SENIOR ADVANTAGE, INC. | T1 | No | $32.70 | WV |
| Abilis Health (HMO I-SNP) | SIGNATURE ADVANTAGE, LLC | T1 | No | $35.90 | KY, TN |
| CommuniCare Advantage ISNP (HMO I-SNP) | OH CHS SNP INC. | T1 | No | $38.40 | IN, MD, OH |
| Presbyterian Senior Care Plan 2 with Rx (HMO) | PRESBYTERIAN HEALTH PLAN | T2 | No | $0 | NM |
| Presbyterian Dual Plus (HMO D-SNP) | PRESBYTERIAN HEALTH PLAN | T2 | No | $0 | NM |
| Presbyterian Senior Care Extra Health Plan with Rx (HMO) | PRESBYTERIAN HEALTH PLAN | T2 | No | $0 | NM |
| Mass General Brigham Advantage (PPO) | Mass General Brigham Health Plan, Inc. | T2 | No | $0 | MA |
| SCAN Connections (HMO D-SNP) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Connections at Home (HMO D-SNP) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN NEVADA, INC. | T2 | No | $0 | NV |
| SCAN Balance (HMO C-SNP) | SCAN HEALTH PLAN NEVADA, INC. | T2 | No | $0 | NV |
| SCAN Strive (HMO C-SNP) | SCAN HEALTH PLAN NEVADA, INC. | T2 | No | $0 | NV |
| SCAN MyChoice (HMO) | SCAN HEALTH PLAN NEVADA, INC. | T2 | No | $0 | NV |
| SCAN Classic (HMO) | SCAN DESERT HEALTH PLAN, INC. | T2 | No | $0 | AZ |
| SCAN Balance (HMO C-SNP) | SCAN DESERT HEALTH PLAN, INC. | T2 | No | $0 | AZ |
| SCAN Embrace (HMO-POS I-SNP) | SCAN DESERT HEALTH PLAN, INC. | T2 | No | $0 | AZ |
| SCAN Strive (HMO C-SNP) | SCAN DESERT HEALTH PLAN, INC. | T2 | No | $0 | AZ |
| SCAN MyChoice (HMO) | SCAN DESERT HEALTH PLAN, INC. | T2 | No | $0 | AZ |
| SCAN Classic WA (HMO) | SCAN HEALTH PLAN (WA) | T2 | No | $0 | WA |
| SCAN MyChoice WA (HMO) | SCAN HEALTH PLAN (WA) | T2 | No | $0 | WA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN (NM) | T2 | No | $0 | NM |
| SCAN Balance (HMO C-SNP) | SCAN HEALTH PLAN (NM) | T2 | No | $0 | NM |
| SCAN Strive (HMO C-SNP) | SCAN HEALTH PLAN (NM) | T2 | No | $0 | NM |
| SCAN MyChoice (HMO) | SCAN HEALTH PLAN (NM) | T2 | No | $0 | NM |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
Frequently Asked Questions
Is tramadol hydrochloride 100 MG Oral Tablet covered by Medicare Part D?
Yes, tramadol hydrochloride 100 MG Oral Tablet is covered by 159 Medicare Part D plans (3.1% of all Part D formularies).
What tier is tramadol hydrochloride 100 MG Oral Tablet on Medicare Part D plans?
tramadol hydrochloride 100 MG Oral Tablet averages Tier 1.9 across Part D plans, ranging from Tier 1 to Tier 4.
Does tramadol hydrochloride 100 MG Oral Tablet require prior authorization?
4.3% of Part D formularies require prior authorization for tramadol hydrochloride 100 MG Oral Tablet. Step therapy: 0%. Quantity limits: 82.6%.
How much does Medicare spend on tramadol hydrochloride 100 MG Oral Tablet?
In 2023, total Medicare Part D spending on tramadol hydrochloride 100 MG Oral Tablet was $91,679,129, covering 3,884,717 beneficiaries. The average spend per beneficiary was $23.60.
Read our methodology - how this data is sourced, computed, and verified.