tramadol hydrochloride 25 MG Oral Tablet
tramadol hydrochloride
RxCUI: 2670390
What the CMS Formulary Data Shows for tramadol hydrochloride 25 MG Oral Tablet
Per the CMS 2026 Part D formulary file, tramadol hydrochloride 25 MG Oral Tablet (RxNorm concept RXCUI 2670390, generic name tramadol hydrochloride) appears on 12 distinct formulary files spanning 29 Medicare Part D plan offerings - 0.6% 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 1.8.
Real-world access to tramadol hydrochloride 25 MG Oral Tablet depends on utilization management as much as tier placement: 8.3% of covering formularies require prior authorization. 0% require step therapy. 91.7% 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 25 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 25 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 12
- Plans covering
- 29
- Coverage rate
- 0.6%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 8.3% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 91.7% of formularies
2023 Medicare Spending
- Beneficiaries
- 3,884,717
- Total spending
- $91,679,129
- Avg per beneficiary
- $23.60
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering tramadol hydrochloride 25 MG Oral Tablet
2 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| Blue Rx PDP Complete (PDP) | HM HEALTH INSURANCE COMPANY | T4 | Yes | No | $164.80 | - |
| Blue Rx PDP Plus (PDP) | HM HEALTH INSURANCE COMPANY | T4 | Yes | No | $193.20 | - |
Medicare Advantage Plans (MA-PD) Covering tramadol hydrochloride 25 MG Oral Tablet
27 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| 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 |
| 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 |
| 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 |
| Health New England Medicare Compass (PPO) | HEALTH NEW ENGLAND, INC. | T3 | No | $0 | MA |
| Health New England Medicare Value (HMO) | HEALTH NEW ENGLAND, INC. | T3 | No | $0 | MA |
| Mass General Brigham Advantage (PPO) | Mass General Brigham Health Plan, Inc. | T3 | No | $0 | MA |
| Health New England Medicare Premium (HMO) | HEALTH NEW ENGLAND, INC. | T3 | No | $15.80 | MA |
| Health New England Medicare Plus (HMO) | HEALTH NEW ENGLAND, INC. | T3 | No | $58.40 | MA |
| Mass General Brigham Advantage Secure (HMO-POS) | Mass General Brigham Health Plan, Inc. | T3 | No | $62.00 | MA |
| Mass General Brigham Advantage Premier (PPO) | Mass General Brigham Health Plan, Inc. | T3 | No | $79.70 | MA |
| Mass General Brigham Advantage Signature (PPO) | Mass General Brigham Health Plan, Inc. | T3 | No | $147.20 | MA |
| Security Blue HMO-POS Standard (HMO-POS) | HIGHMARK CHOICE COMPANY | T4 | Yes | $51.80 | PA |
| Freedom Blue PPO Select (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T4 | Yes | $95.70 | PA |
| Security Blue HMO-POS Deluxe (HMO-POS) | HIGHMARK CHOICE COMPANY | T4 | Yes | $95.90 | PA |
| Freedom Blue PPO Standard (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T4 | Yes | $98.20 | PA |
| Freedom Blue PPO Select (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T4 | Yes | $115.70 | PA |
| Freedom Blue PPO Deluxe (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T4 | Yes | $122.40 | PA |
| Freedom Blue PPO Classic (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T4 | Yes | $140.90 | PA |
| Freedom Blue PPO Classic (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T4 | Yes | $145.40 | PA |
Frequently Asked Questions
Is tramadol hydrochloride 25 MG Oral Tablet covered by Medicare Part D?
Yes, tramadol hydrochloride 25 MG Oral Tablet is covered by 29 Medicare Part D plans (0.6% of all Part D formularies).
What tier is tramadol hydrochloride 25 MG Oral Tablet on Medicare Part D plans?
tramadol hydrochloride 25 MG Oral Tablet averages Tier 1.8 across Part D plans, ranging from Tier 1 to Tier 4.
Does tramadol hydrochloride 25 MG Oral Tablet require prior authorization?
8.3% of Part D formularies require prior authorization for tramadol hydrochloride 25 MG Oral Tablet. Step therapy: 0%. Quantity limits: 91.7%.
How much does Medicare spend on tramadol hydrochloride 25 MG Oral Tablet?
In 2023, total Medicare Part D spending on tramadol hydrochloride 25 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.