acetaminophen 325 MG / butalbital 50 MG Oral Tablet

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acetaminophen

RxCUI: 197426

Important: Drug coverage and costs vary by plan and location. Verify coverage directly with your Medicare plan before filling a prescription. This is informational data only and should not replace advice from your healthcare provider or pharmacist.
5%
Plan Coverage
253
Plans Covering
T2.5
Avg Tier
64.5%
Prior Auth Required

What the CMS Formulary Data Shows for acetaminophen 325 MG / butalbital 50 MG Oral Tablet

Per the CMS 2026 Part D formulary file, acetaminophen 325 MG / butalbital 50 MG Oral Tablet (RxNorm concept RXCUI 197426, generic name acetaminophen) appears on 31 distinct formulary files spanning 253 Medicare Part D plan offerings - 5% 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 2.5.

Real-world access to acetaminophen 325 MG / butalbital 50 MG Oral Tablet depends on utilization management as much as tier placement: 64.5% of covering formularies require prior authorization. 0% require step therapy. 41.9% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 156 Part D beneficiaries filled acetaminophen 325 MG / butalbital 50 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $48,943 and an average per-beneficiary annual cost of $313.74. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry acetaminophen 325 MG / butalbital 50 MG Oral Tablet today.

Coverage Details

Formularies covering
31
Plans covering
253
Coverage rate
5%
Tier range
Tier 1 – Tier 4
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
64.5% of formularies
Step therapy required
0% of formularies
Quantity limits
41.9% of formularies

2023 Medicare Spending

Beneficiaries
156
Total spending
$48,943
Avg per beneficiary
$313.74

Tier Distribution Across Plans

16 plans
Tier 1, Preferred Generic
84 plans
Tier 2, Generic

Medicare Advantage Plans (MA-PD) Covering acetaminophen 325 MG / butalbital 50 MG Oral Tablet

100 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
Hamaspik Medicare Choice (HMO D-SNP) HAMASPIK, INC. T1 No $0 NY
SeniorCare Complete (HMO D-SNP) SOUTH COUNTRY HEALTH ALLIANCE T1 Yes $0 MN
AbilityCare (HMO D-SNP) SOUTH COUNTRY HEALTH ALLIANCE T1 Yes $0 MN
Alameda Alliance Wellness (HMO D-SNP) ALAMEDA ALLIANCE FOR HEALTH T1 Yes $0 CA
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 Yes $0 PA
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 Yes $0 PA
Highmark Health Options Duals (HMO D-SNP) HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC. T1 Yes $0 WV
Highmark Health Options Duals (HMO D-SNP) HIGHMARK BCBSD, INC. T1 Yes $0 DE
Leon MediExtra (HMO) LEON HEALTH, INC. T1 No $0 FL
Leon MediDual (HMO D-SNP) LEON HEALTH, INC. T1 No $0 FL
Leon MediMore (HMO) LEON HEALTH, INC. T1 No $0 FL
Leon MediMax (HMO D-SNP) LEON HEALTH, INC. T1 No $0 FL
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 Yes $13.10 PA
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) GATEWAY HEALTH PLAN, INC. T1 Yes $17.60 PA
Highmark Health Options Duals Select (HMO D-SNP) HIGHMARK BCBSD, INC. T1 Yes $31.20 DE
Hamaspik Medicare Select (HMO D-SNP) HAMASPIK, INC. T1 No $34.50 NY
HealthSun HealthAdvantage Plan (HMO) HEALTHSUN HEALTH PLANS, INC. T2 Yes $0 FL
HealthSun MediMax (HMO) HEALTHSUN HEALTH PLANS, INC. T2 Yes $0 FL
HealthSun HealthAdvantage Plan (HMO) HEALTHSUN HEALTH PLANS, INC. T2 Yes $0 FL
HealthSun HealthAdvantage Plan (HMO) HEALTHSUN HEALTH PLANS, INC. T2 Yes $0 FL
HealthSun MediSun Plus (HMO D-SNP) HEALTHSUN HEALTH PLANS, INC. T2 Yes $0 FL
HealthSun HealthAdvantage Plus (HMO) HEALTHSUN HEALTH PLANS, INC. T2 Yes $0 FL
HealthSun HealthAdvantage Plus (HMO) HEALTHSUN HEALTH PLANS, INC. T2 Yes $0 FL
HealthSun MediSun Extra (HMO D-SNP) HEALTHSUN HEALTH PLANS, INC. T2 Yes $0 FL
HealthSun HealthAdvantage Plus (HMO) HEALTHSUN HEALTH PLANS, INC. T2 Yes $0 FL
HealthSun VitalCare (HMO C-SNP) HEALTHSUN HEALTH PLANS, INC. T2 Yes $0 FL
HealthSun VitalCare (HMO C-SNP) HEALTHSUN HEALTH PLANS, INC. T2 Yes $0 FL
HealthSun MediSun Full Dual Plus (HMO D-SNP) HEALTHSUN HEALTH PLANS, INC. T2 Yes $0 FL
HealthSun MediSun Full Dual Extra (HMO D-SNP) HEALTHSUN HEALTH PLANS, INC. T2 Yes $0 FL
Simply Complete (HMO D-SNP) SIMPLY HEALTHCARE PLANS, INC. T2 Yes $0 FL
Simply More (HMO) SIMPLY HEALTHCARE PLANS, INC. T2 Yes $0 FL
Simply Complete (HMO D-SNP) SIMPLY HEALTHCARE PLANS, INC. T2 Yes $0 FL
Simply Level (HMO C-SNP) SIMPLY HEALTHCARE PLANS, INC. T2 Yes $0 FL
Simply Level (HMO C-SNP) SIMPLY HEALTHCARE PLANS, INC. T2 Yes $0 FL
Simply More (HMO) SIMPLY HEALTHCARE PLANS, INC. T2 Yes $0 FL
Simply Level (HMO C-SNP) SIMPLY HEALTHCARE PLANS, INC. T2 Yes $0 FL
Simply More (HMO) SIMPLY HEALTHCARE PLANS, INC. T2 Yes $0 FL
Simply Level (HMO C-SNP) SIMPLY HEALTHCARE PLANS, INC. T2 Yes $0 FL
Simply Complete (HMO D-SNP) SIMPLY HEALTHCARE PLANS, INC. T2 Yes $0 FL
Simply More (HMO) SIMPLY HEALTHCARE PLANS, INC. T2 Yes $0 FL
Simply More (HMO) SIMPLY HEALTHCARE PLANS, INC. T2 Yes $0 FL
Simply Level (HMO C-SNP) SIMPLY HEALTHCARE PLANS, INC. T2 Yes $0 FL
Simply Complete (HMO D-SNP) SIMPLY HEALTHCARE PLANS, INC. T2 Yes $0 FL
Simply More (HMO) SIMPLY HEALTHCARE PLANS, INC. T2 Yes $0 FL
Simply Extra (HMO) SIMPLY HEALTHCARE PLANS, INC. T2 Yes $0 FL
Simply Extra Platinum (HMO) SIMPLY HEALTHCARE PLANS, INC. T2 Yes $0 FL
Simply More Platinum (HMO) SIMPLY HEALTHCARE PLANS, INC. T2 Yes $0 FL
Simply Complete Platinum (HMO D-SNP) SIMPLY HEALTHCARE PLANS, INC. T2 Yes $0 FL
Simply Level Platinum (HMO C-SNP) SIMPLY HEALTHCARE PLANS, INC. T2 Yes $0 FL
Simply Extra Platinum (HMO) SIMPLY HEALTHCARE PLANS, INC. T2 Yes $0 FL

Frequently Asked Questions

Is acetaminophen 325 MG / butalbital 50 MG Oral Tablet covered by Medicare Part D?

Yes, acetaminophen 325 MG / butalbital 50 MG Oral Tablet is covered by 253 Medicare Part D plans (5% of all Part D formularies).

What tier is acetaminophen 325 MG / butalbital 50 MG Oral Tablet on Medicare Part D plans?

acetaminophen 325 MG / butalbital 50 MG Oral Tablet averages Tier 2.5 across Part D plans, ranging from Tier 1 to Tier 4.

Does acetaminophen 325 MG / butalbital 50 MG Oral Tablet require prior authorization?

64.5% of Part D formularies require prior authorization for acetaminophen 325 MG / butalbital 50 MG Oral Tablet. Step therapy: 0%. Quantity limits: 41.9%.

How much does Medicare spend on acetaminophen 325 MG / butalbital 50 MG Oral Tablet?

In 2023, total Medicare Part D spending on acetaminophen 325 MG / butalbital 50 MG Oral Tablet was $48,943, covering 156 beneficiaries. The average spend per beneficiary was $313.74.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial