Medicare Part D coverage · acetaminophen · RxCUI 238154
acetaminophen 325 MG / butalbital 50 MG / caffeine 40 MG Oral Tablet
Per the CMS 2026 Part D formulary file, acetaminophen 325 MG / butalbital 50 MG / caffeine 40 MG Oral Tablet is covered by 2,736 Medicare Part D plans (54.2% of enrollable products), averaging Tier 2.3, with prior authorization required on 35.9% of covering formularies.
- 54.2%
- Plan coverage
- 2,736
- Plans covering
- T2.3
- Avg tier
- 35.9%
- Prior auth required
What the CMS Formulary Data Shows for acetaminophen 325 MG / butalbital 50 MG / caffeine 40 MG Oral Tablet
Per the CMS 2026 Part D formulary file, acetaminophen 325 MG / butalbital 50 MG / caffeine 40 MG Oral Tablet (RxNorm concept RXCUI 238154, generic name acetaminophen) appears on 167 distinct formulary files spanning 2,736 Medicare Part D plan offerings - 54.2% of enrollable Part D products, mid-range placement; shopping across contracts changes access. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.3.
Real-world access to acetaminophen 325 MG / butalbital 50 MG / caffeine 40 MG Oral Tablet depends on utilization management as much as tier placement: 35.9% of covering formularies require prior authorization. 0% require step therapy. 76% 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 / caffeine 40 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 / caffeine 40 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 167
- Plans covering
- 2,736
- Coverage rate
- 54.2%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 35.9% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 76% of formularies
2023 Medicare Spending
- Beneficiaries
- 156
- Total spending
- $48,943
- Avg per beneficiary
- $313.74
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering acetaminophen 325 MG / butalbital 50 MG / caffeine 40 MG Oral Tablet
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Sentara Community Complete Select (HMO D-SNP) | Sentara Health Plans | T1 | No | $0 | VA |
| Sentara Community Complete (HMO D-SNP) | Sentara Health Plans | T1 | No | $0 | VA |
| DrMax (HMO) | Doctors Healthcare Plans, Inc. | T1 | No | $0 | FL |
| DrExtraCare (HMO C-SNP) | Doctors Healthcare Plans, Inc. | T1 | No | $0 | FL |
| DrSelect (HMO) | Doctors Healthcare Plans, Inc. | T1 | No | $0 | FL |
| DrSelect-CFL (HMO) | Doctors Healthcare Plans, Inc. | T1 | No | $0 | FL |
| DrPlatinum-CFL (HMO D-SNP) | Doctors Healthcare Plans, Inc. | T1 | No | $0 | FL |
| DrTotalCare-CFL (HMO C-SNP) | Doctors Healthcare Plans, Inc. | T1 | No | $0 | FL |
| DrElite-SFL (HMO) | Doctors Healthcare Plans, Inc. | T1 | No | $0 | FL |
| 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 |
| Horizon NJ TotalCare (HMO D-SNP) | Horizon Healthcare OF NEW Jersey, Inc. | T1 | No | $0 | NJ |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | No | $0 | MN |
| 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 |
| PHP (HMO C-snp) | Aids Healthcare Foundation | T1 | Yes | $0 | CA |
| Astiva Health Savings Plan (HMO) | Astiva Health, Inc. | T1 | Yes | $0 | CA |
Show the next 30 plans
| Astiva Health C-SNP Deluxe (HMO C-SNP) | Astiva Health, Inc. | T1 | Yes | $0 | CA |
| Astiva Health Savings Plan - NorCal (HMO) | Astiva Health, Inc. | T1 | Yes | $0 | CA |
| Astiva Health Premier Plan - NorCal (HMO) | Astiva Health, Inc. | T1 | Yes | $0 | CA |
| Astiva Health Premier Plan (HMO) | Astiva Health, Inc. | T1 | Yes | $0 | CA |
| ATRIO Prime Rx (HMO) | Atrio Health Plans | T1 | Yes | $0 | OR |
| ATRIO Choice Rx (PPO) | Atrio Health Plans | T1 | Yes | $0 | OR |
| ATRIO Choice Rx (PPO) | Atrio Health Plans | T1 | Yes | $0 | OR |
| ATRIO Prime Rx (PPO) | Atrio Health Plans | T1 | Yes | $0 | OR |
| ATRIO Prime Rx (PPO) | Atrio Health Plans | T1 | Yes | $0 | OR |
| ATRIO Prime Rx (PPO) | Atrio Health Plans | T1 | Yes | $0 | OR |
| ATRIO Choice Rx (PPO) | Atrio Health Plans | T1 | Yes | $0 | OR |
| ATRIO Choice Rx (PPO) | Atrio Health Plans | T1 | Yes | $0 | OR |
| ATRIO Support Rx (PPO C-SNP) | Atrio Health Plans | T1 | Yes | $0 | OR |
| TotalCare (HMO D-SNP) | Santa Cruz Monterey Merced SAN Benito Mariposa Managed Medic | T1 | Yes | $0 | CA |
| Elevate Medicare Choice (HMO D-SNP) | Denver Health Medical Plan, Inc. | T1 | No | $0 | CO |
| McLaren Medicare Inspire (HMO) | Mclaren Health Plan, Inc. | T1 | Yes | $0 | MI |
| McLaren Medicare Inspire Select (HMO) | Mclaren Health Plan, Inc. | T1 | Yes | $0 | MI |
| AllCare Advantage Redwood Rx (HMO D-SNP) | Allcare Health Plan, Inc. | T1 | Yes | $0 | OR |
| PrimeWest Senior Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | Yes | $0 | MN |
| Prime Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | Yes | $0 | MN |
| DualConnect (HMO D-SNP) | Santa Clara County Health Authority | T1 | Yes | $0 | CA |
| VNS Health Total (HMO D-SNP) | VNS Choice | T1 | No | $0 | NY |
| Alterwood Advantage Dual Secure (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | No | $0 | MD |
| CommuniCare Advantage CSNP (HMO C-SNP) | OH CHS SNP Inc. | T1 | No | $0 | MD, OH |
| Generations Classic Rewards (HMO) | Globalhealth, Inc. | T1 | Yes | $0 | OK |
| Generations Classic Plus (HMO) | Globalhealth, Inc. | T1 | Yes | $0 | OK |
| Generations Chronic Care (HMO C-SNP) | Globalhealth, Inc. | T1 | Yes | $0 | OK |
| Generations Chronic Care Savings (HMO C-SNP) | Globalhealth, Inc. | T1 | Yes | $0 | OK |
| Generations Dual Support (HMO D-SNP) | Globalhealth, Inc. | T1 | Yes | $0 | OK |
| Generations Dual Premier (HMO D-SNP) | Globalhealth, Inc. | T1 | Yes | $0 | OK |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is acetaminophen 325 MG / butalbital 50 MG / caffeine 40 MG Oral Tablet covered by Medicare Part D?
Yes, acetaminophen 325 MG / butalbital 50 MG / caffeine 40 MG Oral Tablet is covered by 2,736 Medicare Part D plans (54.2% of all Part D formularies).
What tier is acetaminophen 325 MG / butalbital 50 MG / caffeine 40 MG Oral Tablet on Medicare Part D plans?
acetaminophen 325 MG / butalbital 50 MG / caffeine 40 MG Oral Tablet averages Tier 2.3 across Part D plans, ranging from Tier 1 to Tier 4.
Does acetaminophen 325 MG / butalbital 50 MG / caffeine 40 MG Oral Tablet require prior authorization?
35.9% of Part D formularies require prior authorization for acetaminophen 325 MG / butalbital 50 MG / caffeine 40 MG Oral Tablet. Step therapy: 0%. Quantity limits: 76%.
How much does Medicare spend on acetaminophen 325 MG / butalbital 50 MG / caffeine 40 MG Oral Tablet?
In 2023, total Medicare Part D spending on acetaminophen 325 MG / butalbital 50 MG / caffeine 40 MG Oral Tablet was $48,943, covering 156 beneficiaries. The average spend per beneficiary was $313.74.
Read our methodology - how this data is sourced, computed, and verified.
Nationwide similar Part D drugs
Data-derived peers across the CMS Part D formulary extract: nearest average tier placement and nearest prior-authorization rate. Not therapeutic alternatives or same-generic strengths.
Closest average formulary tier
Similar prior-authorization rate
- isotretinoin 30 MG Oral Capsule [Zenatane] 35.9% PA
- isotretinoin 10 MG Oral Capsule [Zenatane] 35.9% PA
- Sprinkle duloxetine 40 MG Delayed Release Oral Capsule [Drizalma] 36.1% PA
- 12 HR orphenadrine citrate 100 MG Extended Release Oral Tablet 36.2% PA
- Sprinkle duloxetine 20 MG Delayed Release Oral Capsule [Drizalma] 36.3% PA
- promethazine hydrochloride 25 MG Rectal Suppository [Promethegan] 35.4% PA