ursodiol 200 MG Oral Capsule
ursodiol
RxCUI: 412174
What the CMS Formulary Data Shows for ursodiol 200 MG Oral Capsule
Per the CMS 2026 Part D formulary file, ursodiol 200 MG Oral Capsule (RxNorm concept RXCUI 412174, generic name ursodiol) appears on 52 distinct formulary files spanning 146 Medicare Part D plan offerings - 2.9% 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 3.9.
Real-world access to ursodiol 200 MG Oral Capsule depends on utilization management as much as tier placement: 5.8% of covering formularies require prior authorization. 0% require step therapy. 5.8% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 102,032 Part D beneficiaries filled ursodiol 200 MG Oral Capsule in 2023, with total plan-and-beneficiary spending of $97,745,976 and an average per-beneficiary annual cost of $957.99. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry ursodiol 200 MG Oral Capsule today.
Coverage Details
- Formularies covering
- 52
- Plans covering
- 146
- Coverage rate
- 2.9%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 5.8% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 5.8% of formularies
2023 Medicare Spending
- Beneficiaries
- 102,032
- Total spending
- $97,745,976
- Avg per beneficiary
- $957.99
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering ursodiol 200 MG Oral Capsule
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Elevate Medicare Choice (HMO D-SNP) | DENVER HEALTH MEDICAL PLAN, INC. | T1 | No | $0 | CO |
| AllCare Advantage Redwood Rx (HMO D-SNP) | ALLCARE HEALTH PLAN, INC. | T1 | No | $0 | OR |
| PrimeWest Senior Health Complete (HMO D-SNP) | PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE | T1 | No | $0 | MN |
| Prime Health Complete (HMO D-SNP) | PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE | T1 | No | $0 | MN |
| Alterwood Advantage Dual Secure (HMO D-SNP) | ALTERWOOD ADVANTAGE, INC. | T1 | No | $0 | MD |
| Nascentia Dual Advantage (HMO D-SNP) | VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK | T1 | No | $0 | NY |
| 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 |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | GOLD KIDNEY OF FLORIDA 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 |
| ATRIO Special Needs Plan (HMO D-SNP) | ATRIO HEALTH PLANS | T1 | No | $10.50 | OR |
| ATRIO Special Needs Plan (HMO D-SNP) | ATRIO HEALTH PLANS | T1 | No | $10.50 | OR |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | GOLD KIDNEY OF ARIZONA | T1 | No | $17.00 | AZ |
| Alterwood Advantage Dual Value (HMO D-SNP) | ALTERWOOD ADVANTAGE, INC. | T1 | No | $31.20 | MD |
| 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 |
| Nascentia Skilled Nursing Facility (HMO I-SNP) | VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK | T1 | No | $58.80 | NY |
| PHP (HMO C-SNP) | AIDS HEALTHCARE FOUNDATION | T4 | No | $0 | CA |
| VNS Health Total (HMO D-SNP) | VNS CHOICE | T4 | No | $0 | NY |
| VNS Health EasyCare Plus (HMO D-SNP) | VNS CHOICE | T4 | No | $51.60 | NY |
| Medicare BlueEssential (PPO) | EXCELLUS HEALTH PLAN, INC. | T5 | Yes | $0 | NY |
| Medicare BlueActive (PPO) | EXCELLUS HEALTH PLAN, INC. | T5 | Yes | $0 | NY |
| Medicare BlueVital (PPO) | EXCELLUS HEALTH PLAN, INC. | T5 | Yes | $0 | NY |
| Univera SeniorChoice Basic (HMO) | EXCELLUS HEALTH PLAN, INC. | T5 | Yes | $0 | NY |
| Univera SeniorChoice Extra (HMO) | EXCELLUS HEALTH PLAN, INC. | T5 | Yes | $0 | NY |
| Medicare Blue Choice Core (HMO) | EXCELLUS HEALTH PLAN, INC. | T5 | Yes | $0 | NY |
| Univera Medicare Dual (HMO D-SNP) | EXCELLUS HEALTH PLAN COMMUNITY CARE LLC | T5 | Yes | $0 | NY |
| Medicare Blue Dual (HMO D-SNP) | EXCELLUS HEALTH PLAN COMMUNITY CARE LLC | T5 | Yes | $0 | NY |
| CenCal CareConnect (HMO D-SNP) | SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA | T5 | No | $0 | CA |
| SummaCare Medicare Topaz (HMO) | SUMMACARE INC. | T5 | No | $0 | OH |
| SummaCare Medicare Quartz (HMO) | SUMMACARE INC. | T5 | No | $0 | OH |
| IEHP DualChoice (HMO D-SNP) | Inland Empire Health Plan | T5 | No | $0 | CA |
| Astiva Health Savings Plan (HMO) | ASTIVA HEALTH, INC. | T5 | No | $0 | CA |
| Astiva Health C-SNP Deluxe (HMO C-SNP) | ASTIVA HEALTH, INC. | T5 | No | $0 | CA |
| Astiva Health Savings Plan - NorCal (HMO) | ASTIVA HEALTH, INC. | T5 | No | $0 | CA |
| Astiva Health Premier Plan - NorCal (HMO) | ASTIVA HEALTH, INC. | T5 | No | $0 | CA |
| Astiva Health Premier Plan (HMO) | ASTIVA HEALTH, INC. | T5 | No | $0 | CA |
| ATRIO Prime Rx (HMO) | ATRIO HEALTH PLANS | T5 | No | $0 | OR |
| ATRIO Choice Rx (PPO) | ATRIO HEALTH PLANS | T5 | No | $0 | OR |
| ATRIO Choice Rx (PPO) | ATRIO HEALTH PLANS | T5 | No | $0 | OR |
| ATRIO Prime Rx (PPO) | ATRIO HEALTH PLANS | T5 | No | $0 | OR |
| ATRIO Prime Rx (PPO) | ATRIO HEALTH PLANS | T5 | No | $0 | OR |
| ATRIO Prime Rx (PPO) | ATRIO HEALTH PLANS | T5 | No | $0 | OR |
| ATRIO Choice Rx (PPO) | ATRIO HEALTH PLANS | T5 | No | $0 | OR |
| ATRIO Choice Rx (PPO) | ATRIO HEALTH PLANS | T5 | No | $0 | OR |
Frequently Asked Questions
Is ursodiol 200 MG Oral Capsule covered by Medicare Part D?
Yes, ursodiol 200 MG Oral Capsule is covered by 146 Medicare Part D plans (2.9% of all Part D formularies).
What tier is ursodiol 200 MG Oral Capsule on Medicare Part D plans?
ursodiol 200 MG Oral Capsule averages Tier 3.9 across Part D plans, ranging from Tier 1 to Tier 5.
Does ursodiol 200 MG Oral Capsule require prior authorization?
5.8% of Part D formularies require prior authorization for ursodiol 200 MG Oral Capsule. Step therapy: 0%. Quantity limits: 5.8%.
How much does Medicare spend on ursodiol 200 MG Oral Capsule?
In 2023, total Medicare Part D spending on ursodiol 200 MG Oral Capsule was $97,745,976, covering 102,032 beneficiaries. The average spend per beneficiary was $957.99.
Read our methodology - how this data is sourced, computed, and verified.