vancomycin 250 MG Oral Capsule [Vancocin]
vancomycin
RxCUI: 201849
What the CMS Formulary Data Shows for vancomycin 250 MG Oral Capsule [Vancocin]
Per the CMS 2026 Part D formulary file, vancomycin 250 MG Oral Capsule [Vancocin] (RxNorm concept RXCUI 201849, generic name vancomycin) appears on 1 distinct formulary file spanning 6 Medicare Part D plan offerings - 0.1% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 5 to Tier 5, with a cross-plan average of Tier 5.
Real-world access to vancomycin 250 MG Oral Capsule [Vancocin] depends on utilization management as much as tier placement: 0% 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 161,077 Part D beneficiaries filled vancomycin 250 MG Oral Capsule [Vancocin] in 2023, with total plan-and-beneficiary spending of $66,162,664 and an average per-beneficiary annual cost of $410.75. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry vancomycin 250 MG Oral Capsule [Vancocin] today.
Coverage Details
- Formularies covering
- 1
- Plans covering
- 6
- Coverage rate
- 0.1%
- Tier range
- Tier 5, Specialty
- Average tier
- Tier 5, Specialty
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 161,077
- Total spending
- $66,162,664
- Avg per beneficiary
- $410.75
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering vancomycin 250 MG Oral Capsule [Vancocin]
6 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Óptimo Plus (PPO) | TRIPLE S ADVANTAGE, INC. | T5 | No | $0 | PR |
| Contigo Plus (HMO C-SNP) | TRIPLE S ADVANTAGE, INC. | T5 | No | $0 | PR |
| Brillante (HMO-POS) | TRIPLE S ADVANTAGE, INC. | T5 | No | $0 | PR |
| Enlace Plus (HMO) | TRIPLE S ADVANTAGE, INC. | T5 | No | $0 | PR |
| ContigoEnMente (HMO C-SNP) | TRIPLE S ADVANTAGE, INC. | T5 | No | $0 | PR |
| Ahorro Plus (HMO) | TRIPLE S ADVANTAGE, INC. | T5 | No | $0 | PR |
Frequently Asked Questions
Is vancomycin 250 MG Oral Capsule [Vancocin] covered by Medicare Part D?
Yes, vancomycin 250 MG Oral Capsule [Vancocin] is covered by 6 Medicare Part D plans (0.1% of all Part D formularies).
What tier is vancomycin 250 MG Oral Capsule [Vancocin] on Medicare Part D plans?
vancomycin 250 MG Oral Capsule [Vancocin] averages Tier 5 across Part D plans, ranging from Tier 5 to Tier 5.
Does vancomycin 250 MG Oral Capsule [Vancocin] require prior authorization?
0% of Part D formularies require prior authorization for vancomycin 250 MG Oral Capsule [Vancocin]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on vancomycin 250 MG Oral Capsule [Vancocin]?
In 2023, total Medicare Part D spending on vancomycin 250 MG Oral Capsule [Vancocin] was $66,162,664, covering 161,077 beneficiaries. The average spend per beneficiary was $410.75.
Read our methodology - how this data is sourced, computed, and verified.