acetaminophen 325 MG / butalbital 50 MG / caffeine 40 MG Oral Tablet
acetaminophen
RxCUI: 238154
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
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.
Read our methodology - how this data is sourced, computed, and verified.