8 HR carbidopa 23.75 MG / levodopa 95 MG Extended Release Oral Capsule [Rytary]
carbidopa
RxCUI: 1600774
What the CMS Formulary Data Shows for 8 HR carbidopa 23.75 MG / levodopa 95 MG Extended Release Oral Capsule [Rytary]
Per the CMS 2026 Part D formulary file, 8 HR carbidopa 23.75 MG / levodopa 95 MG Extended Release Oral Capsule [Rytary] (RxNorm concept RXCUI 1600774, generic name carbidopa) appears on 58 distinct formulary files spanning 625 Medicare Part D plan offerings - 12.3% 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 3.6.
Real-world access to 8 HR carbidopa 23.75 MG / levodopa 95 MG Extended Release Oral Capsule [Rytary] depends on utilization management as much as tier placement: 1.7% of covering formularies require prior authorization. 55.2% require step therapy. 5.2% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 32,157 Part D beneficiaries filled 8 HR carbidopa 23.75 MG / levodopa 95 MG Extended Release Oral Capsule [Rytary] in 2023, with total plan-and-beneficiary spending of $266,869,488 and an average per-beneficiary annual cost of $8,298.95. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 8 HR carbidopa 23.75 MG / levodopa 95 MG Extended Release Oral Capsule [Rytary] today.
Coverage Details
- Formularies covering
- 58
- Plans covering
- 625
- Coverage rate
- 12.3%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 1.7% of formularies
- Step therapy required
- 55.2% of formularies
- Quantity limits
- 5.2% of formularies
2023 Medicare Spending
- Beneficiaries
- 32,157
- Total spending
- $266,869,488
- Avg per beneficiary
- $8,298.95
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering 8 HR carbidopa 23.75 MG / levodopa 95 MG Extended Release Oral Capsule [Rytary]
11 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| Blue Rx PDP Complete (PDP) | HM HEALTH INSURANCE COMPANY | T3 | No | Yes | $164.80 | - |
| Blue Rx PDP Plus (PDP) | HM HEALTH INSURANCE COMPANY | T3 | No | Yes | $193.20 | - |
| HealthSpring Assurance Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T4 | No | Yes | $0 | - |
| HealthSpring Assurance Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T4 | No | Yes | $0 | - |
| HealthSpring Assurance Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T4 | No | Yes | $0 | - |
| HealthSpring Assurance Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T4 | No | Yes | $0 | - |
| HealthSpring Assurance Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T4 | No | Yes | $0 | - |
| HealthSpring Assurance Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T4 | No | Yes | $0 | - |
| HealthSpring Assurance Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T4 | No | Yes | $0 | - |
| HealthSpring Assurance Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T4 | No | Yes | $0 | - |
| HealthSpring Assurance Rx (PDP) | MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY | T4 | No | Yes | $0 | - |
Medicare Advantage Plans (MA-PD) Covering 8 HR carbidopa 23.75 MG / levodopa 95 MG Extended Release Oral Capsule [Rytary]
89 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Gold Coast Health Plan Total Care Advantage (HMO D-SNP) | Ventura County Medi-Cal Managed Care Commission | T1 | No | $0 | CA |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | No | $0 | MN |
| NaviCare (HMO D-SNP) | FALLON COMMUNITY HEALTH PLAN | T1 | No | $0 | MA |
| Hamaspik Medicare Choice (HMO D-SNP) | HAMASPIK, INC. | T1 | No | $0 | NY |
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC | T1 | No | $0 | PA |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA | T1 | No | $0 | NC |
| Provider Partners Indiana Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF INDIANA | T1 | No | $0 | IN |
| Provider Partners Maryland Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN, INC. | T1 | No | $0 | MD |
| Provider Partners Missouri Community Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC. | T1 | No | $0 | MO |
| Platino Blindao (HMO D-SNP) | TRIPLE S ADVANTAGE, INC. | T1 | No | $0 | PR |
| Platino Enlace (HMO D-SNP) | TRIPLE S ADVANTAGE, INC. | T1 | No | $0 | PR |
| PLATINO ADVANCE (HMO D-SNP) | TRIPLE S ADVANTAGE, INC. | T1 | No | $0 | PR |
| PLATINO PLUS (HMO D-SNP) | TRIPLE S ADVANTAGE, INC. | T1 | No | $0 | PR |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | HCSC INSURANCE SERVICES COMPANY | T1 | No | $4.80 | TX |
| Provider Partners Texas Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF TEXAS, INC. | T1 | No | $4.80 | TX |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | GHS INSURANCE COMPANY | T1 | No | $5.00 | OK |
| Provider Partners Illinois Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF ILLINOIS | T1 | No | $15.20 | IL |
| Provider Partners Maryland Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN, INC. | T1 | No | $31.20 | MD |
| Provider Partners Maryland Essential Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN, INC. | T1 | No | $31.20 | MD |
| Provider Partners Pennsylvania Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC | T1 | No | $32.70 | PA |
| Provider Partners Pennsylvania Essential Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC | T1 | No | $32.70 | PA |
| Hamaspik Medicare Select (HMO D-SNP) | HAMASPIK, INC. | T1 | No | $34.50 | NY |
| Provider Partners North Carolina Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA | T1 | No | $36.20 | NC |
| Provider Partners North Carolina Essential Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA | T1 | No | $36.20 | NC |
| Provider Partners Indiana Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF INDIANA | T1 | No | $38.40 | IN |
| Provider Partners Indiana Essential Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF INDIANA | T1 | No | $38.40 | IN |
| Provider Partners Kentucky Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY | T1 | No | $38.40 | KY |
| Provider Partners Missouri Advantage Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC. | T1 | No | $43.00 | MO |
| Provider Partners Missouri Essential Plan (HMO I-SNP) | PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC. | T1 | No | $43.00 | MO |
| Leon MediExtra (HMO) | LEON HEALTH, INC. | T2 | No | $0 | FL |
| Leon MediDual (HMO D-SNP) | LEON HEALTH, INC. | T2 | No | $0 | FL |
| Leon MediMore (HMO) | LEON HEALTH, INC. | T2 | No | $0 | FL |
| Leon MediMax (HMO D-SNP) | LEON HEALTH, INC. | T2 | No | $0 | FL |
| Community Blue Medicare HMO Signature (HMO) | Highmark Western and Northeastern New York Inc. | T3 | No | $0 | NY |
| Community Blue Medicare HMO Merit (HMO) | Highmark Western and Northeastern New York Inc. | T3 | No | $0 | NY |
| Community Blue Medicare PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T3 | No | $0 | PA |
| Complete Blue PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T3 | No | $0 | PA |
| Community Blue Medicare Plus PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T3 | No | $0 | PA |
| Complete Blue PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T3 | No | $0 | PA |
| Complete Blue PPO Merit (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T3 | No | $0 | PA |
| Complete Blue PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T3 | No | $0 | PA |
| Complete Blue PPO Distinct (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T3 | No | $0 | PA |
| Community Blue Medicare Plus PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T3 | No | $0 | PA |
| Complete Blue Plus PPO Merit (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T3 | No | $0 | PA |
| Community Blue Medicare PPO Signature (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T3 | No | $0 | PA |
| Complete Blue PPO Merit (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T3 | No | $0 | PA |
| Community Blue Medicare HMO Signature (HMO) | HIGHMARK CHOICE COMPANY | T3 | No | $0 | PA |
| Security Blue HMO-POS ValueRx (HMO-POS) | HIGHMARK CHOICE COMPANY | T3 | No | $0 | PA |
Frequently Asked Questions
Is 8 HR carbidopa 23.75 MG / levodopa 95 MG Extended Release Oral Capsule [Rytary] covered by Medicare Part D?
Yes, 8 HR carbidopa 23.75 MG / levodopa 95 MG Extended Release Oral Capsule [Rytary] is covered by 625 Medicare Part D plans (12.3% of all Part D formularies).
What tier is 8 HR carbidopa 23.75 MG / levodopa 95 MG Extended Release Oral Capsule [Rytary] on Medicare Part D plans?
8 HR carbidopa 23.75 MG / levodopa 95 MG Extended Release Oral Capsule [Rytary] averages Tier 3.6 across Part D plans, ranging from Tier 1 to Tier 4.
Does 8 HR carbidopa 23.75 MG / levodopa 95 MG Extended Release Oral Capsule [Rytary] require prior authorization?
1.7% of Part D formularies require prior authorization for 8 HR carbidopa 23.75 MG / levodopa 95 MG Extended Release Oral Capsule [Rytary]. Step therapy: 55.2%. Quantity limits: 5.2%.
How much does Medicare spend on 8 HR carbidopa 23.75 MG / levodopa 95 MG Extended Release Oral Capsule [Rytary]?
In 2023, total Medicare Part D spending on 8 HR carbidopa 23.75 MG / levodopa 95 MG Extended Release Oral Capsule [Rytary] was $266,869,488, covering 32,157 beneficiaries. The average spend per beneficiary was $8,298.95.
Read our methodology - how this data is sourced, computed, and verified.