12 HR carbamazepine 200 MG Extended Release Oral Capsule [Carbatrol]
carbamazepine
RxCUI: 308977
What the CMS Formulary Data Shows for 12 HR carbamazepine 200 MG Extended Release Oral Capsule [Carbatrol]
Per the CMS 2026 Part D formulary file, 12 HR carbamazepine 200 MG Extended Release Oral Capsule [Carbatrol] (RxNorm concept RXCUI 308977, generic name carbamazepine) appears on 3 distinct formulary files spanning 117 Medicare Part D plan offerings - 2.3% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 2, with a cross-plan average of Tier 1.7.
Real-world access to 12 HR carbamazepine 200 MG Extended Release Oral Capsule [Carbatrol] 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 1,707 Part D beneficiaries filled 12 HR carbamazepine 200 MG Extended Release Oral Capsule [Carbatrol] in 2023, with total plan-and-beneficiary spending of $3,558,086 and an average per-beneficiary annual cost of $2,084.41. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 12 HR carbamazepine 200 MG Extended Release Oral Capsule [Carbatrol] today.
Coverage Details
- Formularies covering
- 3
- Plans covering
- 117
- Coverage rate
- 2.3%
- Tier range
- Tier 1 – Tier 2
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 1,707
- Total spending
- $3,558,086
- Avg per beneficiary
- $2,084.41
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 12 HR carbamazepine 200 MG Extended Release Oral Capsule [Carbatrol]
100 Medicare Advantage plans with Part D drug coverage include this drug.
Frequently Asked Questions
Is 12 HR carbamazepine 200 MG Extended Release Oral Capsule [Carbatrol] covered by Medicare Part D?
Yes, 12 HR carbamazepine 200 MG Extended Release Oral Capsule [Carbatrol] is covered by 117 Medicare Part D plans (2.3% of all Part D formularies).
What tier is 12 HR carbamazepine 200 MG Extended Release Oral Capsule [Carbatrol] on Medicare Part D plans?
12 HR carbamazepine 200 MG Extended Release Oral Capsule [Carbatrol] averages Tier 1.7 across Part D plans, ranging from Tier 1 to Tier 2.
Does 12 HR carbamazepine 200 MG Extended Release Oral Capsule [Carbatrol] require prior authorization?
0% of Part D formularies require prior authorization for 12 HR carbamazepine 200 MG Extended Release Oral Capsule [Carbatrol]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on 12 HR carbamazepine 200 MG Extended Release Oral Capsule [Carbatrol]?
In 2023, total Medicare Part D spending on 12 HR carbamazepine 200 MG Extended Release Oral Capsule [Carbatrol] was $3,558,086, covering 1,707 beneficiaries. The average spend per beneficiary was $2,084.41.
Read our methodology - how this data is sourced, computed, and verified.