acetaminophen 325 MG / butalbital 50 MG / caffeine 40 MG Oral Tablet

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acetaminophen

RxCUI: 238154

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.
54.3%
Plan Coverage
2,749
Plans Covering
T2.3
Avg Tier
35.7%
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 168 distinct formulary files spanning 2,749 Medicare Part D plan offerings - 54.3% 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: 35.7% of covering formularies require prior authorization. 0% require step therapy. 75.6% 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
168
Plans covering
2,749
Coverage rate
54.3%
Tier range
Tier 1 – Tier 4
Average tier
Tier 2, Generic

Restrictions

Prior authorization required
35.7% of formularies
Step therapy required
0% of formularies
Quantity limits
75.6% of formularies

2023 Medicare Spending

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

Tier Distribution Across Plans

100 plans
Tier 1, Preferred Generic

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
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

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 2,749 Medicare Part D plans (54.3% 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?

35.7% of Part D formularies require prior authorization for acetaminophen 325 MG / butalbital 50 MG / caffeine 40 MG Oral Tablet. Step therapy: 0%. Quantity limits: 75.6%.

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.

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