Medicare Part D coverage · tramadol hydrochloride · RxCUI 2179635
tramadol hydrochloride 100 MG Oral Tablet
Per the CMS 2026 Part D formulary file, tramadol hydrochloride 100 MG Oral Tablet is covered by 159 Medicare Part D plans (3.1% of enrollable products), averaging Tier 1.9, with prior authorization required on 4.3% of covering formularies.
- 3.1%
- Plan coverage
- 159
- Plans covering
- T1.9
- Avg tier
- 4.3%
- Prior auth required
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 $91,670,187 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
- $91,670,187
- 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 |
Show the next 30 plans
| 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 |
Showing top 50 of 100 plans.
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 $91,670,187, covering 3,884,717 beneficiaries. The average spend per beneficiary was $23.60.
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
- methylprednisolone 8 MG Oral Tablet T1.9
- 24 HR diltiazem hydrochloride 300 MG Extended Release Oral Capsule [Tiadylt] T1.9
- 24 HR diltiazem hydrochloride 420 MG Extended Release Oral Capsule [Tiadylt] T1.9
- fluoxetine 10 MG Oral Tablet T1.9
- metaxalone 800 MG Oral Tablet T1.9
- cefuroxime 250 MG Oral Tablet T1.9
Similar prior-authorization rate
- insulin lispro 100 UNT/ML Injectable Solution [Humalog] 4.3% PA
- 1000 ML potassium chloride 0.02 MEQ/ML / sodium chloride 9 MG/ML Injection 4.3% PA
- estrogens, conjugated (USP) 0.3 MG Oral Tablet 4.3% PA
- 12 HR clonidine hydrochloride 0.1 MG Extended Release Oral Tablet 4.3% PA
- risperidone 37.5 MG Injection [Risperdal] 4.2% PA
- risperidone 12.5 MG Injection [Risperdal] 4.2% PA