aspirin 325 MG / butalbital 50 MG / caffeine 40 MG / codeine phosphate 30 MG Oral Capsule

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aspirin

RxCUI: 994237

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.
3.1%
Plan Coverage
156
Plans Covering
T2.4
Avg Tier
60.7%
Prior Auth Required

What the CMS Formulary Data Shows for aspirin 325 MG / butalbital 50 MG / caffeine 40 MG / codeine phosphate 30 MG Oral Capsule

Per the CMS 2026 Part D formulary file, aspirin 325 MG / butalbital 50 MG / caffeine 40 MG / codeine phosphate 30 MG Oral Capsule (RxNorm concept RXCUI 994237, generic name aspirin) appears on 28 distinct formulary files spanning 156 Medicare Part D plan offerings - 3.1% 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 2.4.

Real-world access to aspirin 325 MG / butalbital 50 MG / caffeine 40 MG / codeine phosphate 30 MG Oral Capsule depends on utilization management as much as tier placement: 60.7% of covering formularies require prior authorization. 0% require step therapy. 35.7% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 22,634 Part D beneficiaries filled aspirin 325 MG / butalbital 50 MG / caffeine 40 MG / codeine phosphate 30 MG Oral Capsule in 2023, with total plan-and-beneficiary spending of $31,146,709 and an average per-beneficiary annual cost of $1,376.10. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry aspirin 325 MG / butalbital 50 MG / caffeine 40 MG / codeine phosphate 30 MG Oral Capsule today.

Coverage Details

Formularies covering
28
Plans covering
156
Coverage rate
3.1%
Tier range
Tier 1 – Tier 4
Average tier
Tier 2, Generic

Restrictions

Prior authorization required
60.7% of formularies
Step therapy required
0% of formularies
Quantity limits
35.7% of formularies

2023 Medicare Spending

Beneficiaries
22,634
Total spending
$31,146,709
Avg per beneficiary
$1,376.10

Tier Distribution Across Plans

8 plans
Tier 1, Preferred Generic
34 plans
Tier 2, Generic
58 plans
Tier 3, Preferred Brand

Medicare Advantage Plans (MA-PD) Covering aspirin 325 MG / butalbital 50 MG / caffeine 40 MG / codeine phosphate 30 MG Oral Capsule

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

Plan Insurer Tier PA Premium States
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
VNS Health Total (HMO D-SNP) VNS CHOICE T1 No $0 NY
Gold Dialysis & Kidney Complete (HMO-POS C-SNP) GOLD KIDNEY OF FLORIDA INC T1 No $4.80 FL
Gold Dialysis & Kidney Complete (HMO-POS C-SNP) GOLD KIDNEY OF ARIZONA T1 No $17.00 AZ
VNS Health EasyCare Plus (HMO D-SNP) VNS CHOICE T1 No $51.60 NY
DrMax (HMO) DOCTORS HEALTHCARE PLANS, INC. T2 No $0 FL
DrExtraCare (HMO C-SNP) DOCTORS HEALTHCARE PLANS, INC. T2 No $0 FL
DrSelect (HMO) DOCTORS HEALTHCARE PLANS, INC. T2 No $0 FL
DrSelect-CFL (HMO) DOCTORS HEALTHCARE PLANS, INC. T2 No $0 FL
DrPlatinum-CFL (HMO D-SNP) DOCTORS HEALTHCARE PLANS, INC. T2 No $0 FL
DrTotalCare-CFL (HMO C-SNP) DOCTORS HEALTHCARE PLANS, INC. T2 No $0 FL
DrElite-SFL (HMO) DOCTORS HEALTHCARE PLANS, INC. T2 No $0 FL
Troy Medicare (HMO) TROY HEALTH, INC. T2 Yes $0 NC
Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) TROY HEALTH, INC. T2 Yes $0 NC
Contra Costa Health Care Plus (HMO D-SNP) CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH T2 Yes $0 CA
Keystone First VIP Choice (HMO D-SNP) VISTA HEALTH PLAN, INC. T2 Yes $0 PA
AmeriHealth Caritas VIP Care (HMO D-SNP) VISTA HEALTH PLAN, INC. T2 Yes $0 PA
First Choice VIP Care (HMO D-SNP) SELECT HEALTH OF SOUTH CAROLINA, INC. T2 Yes $0 SC
AmeriHealth Caritas VIP Care (HMO D-SNP) AmeriHealth Caritas VIP Next, Inc. T2 Yes $0 DE
AmeriHealth Caritas VIP Care Choice (HMO D-SNP) AmeriHealth Caritas VIP Next, Inc. T2 Yes $0 DE
AmeriHealth Caritas VIP Care (HMO D-SNP) AMERIHEALTH CARITAS FLORIDA INC T2 Yes $0 FL
AmeriHealth Caritas VIP Care (HMO D-SNP) AMERIHEALTH CARITAS LOUISIANA, INC. T2 Yes $0 LA
AmeriHealth Caritas VIP Care (HMO D-SNP) AMERIHEALTH CARITAS NORTH CAROLINA, INC. T2 Yes $0 NC
AmeriHealth Caritas VIP Care (HMO D-SNP) AMERIHEALTH MICHIGAN, INC. T2 Yes $0 MI
Healthy Mississippi Premier Advantage (HMO-POS) Healthy Mississippi, Inc. T2 No $0 MS
Gold Heart & Diabetes (HMO-POS C-SNP) GOLD KIDNEY OF FLORIDA INC T2 No $0 FL
Gold Heart & Diabetes Complete (HMO-POS C-SNP) GOLD KIDNEY OF FLORIDA INC T2 No $0 FL
Gold Dialysis & Kidney (HMO-POS C-SNP) GOLD KIDNEY OF FLORIDA INC T2 No $0 FL
Gold Health (HMO-POS C-SNP) GOLD KIDNEY OF FLORIDA INC T2 No $0 FL
Gold Dialysis & Kidney (HMO-POS C-SNP) GOLD KIDNEY OF FLORIDA INC T2 No $0 FL
Gold Heart & Diabetes (HMO-POS C-SNP) GOLD KIDNEY OF ARIZONA T2 No $0 AZ
Gold Dialysis & Kidney (HMO-POS C-SNP) GOLD KIDNEY OF ARIZONA T2 No $0 AZ
Gold Heart & Diabetes (HMO-POS C-SNP) GOLD KIDNEY OF ARIZONA T2 No $0 AZ
Gold Dialysis & Kidney (HMO-POS C-SNP) GOLD KIDNEY OF ARIZONA T2 No $0 AZ
VillageCareMAX Medicare Health Advantage Plan (HMO D-SNP) VILLAGE SENIOR SERVICES CORPORATION T2 Yes $0 NY
VillageCareMAX Medicare Total Advantage Plan (HMO D-SNP) VILLAGE SENIOR SERVICES CORPORATION T2 Yes $0 NY
CareOregon Advantage Plus (HMO D-SNP) HEALTH PLAN OF CAREOREGON, INC. T2 No $0 OR
DrFlex (HMO D-SNP) DOCTORS HEALTHCARE PLANS, INC. T2 No $1.10 FL
DrPlus (HMO D-SNP) DOCTORS HEALTHCARE PLANS, INC. T2 No $4.80 FL
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T3 No $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T3 No $0 NV
Select Health Medicare Dual (HMO D-SNP) SELECTHEALTH, INC. T3 No $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T3 No $0 UT
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T3 No $0 NV
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T3 No $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T3 No $0 CO
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T3 No $0 CO

Frequently Asked Questions

Is aspirin 325 MG / butalbital 50 MG / caffeine 40 MG / codeine phosphate 30 MG Oral Capsule covered by Medicare Part D?

Yes, aspirin 325 MG / butalbital 50 MG / caffeine 40 MG / codeine phosphate 30 MG Oral Capsule is covered by 156 Medicare Part D plans (3.1% of all Part D formularies).

What tier is aspirin 325 MG / butalbital 50 MG / caffeine 40 MG / codeine phosphate 30 MG Oral Capsule on Medicare Part D plans?

aspirin 325 MG / butalbital 50 MG / caffeine 40 MG / codeine phosphate 30 MG Oral Capsule averages Tier 2.4 across Part D plans, ranging from Tier 1 to Tier 4.

Does aspirin 325 MG / butalbital 50 MG / caffeine 40 MG / codeine phosphate 30 MG Oral Capsule require prior authorization?

60.7% of Part D formularies require prior authorization for aspirin 325 MG / butalbital 50 MG / caffeine 40 MG / codeine phosphate 30 MG Oral Capsule. Step therapy: 0%. Quantity limits: 35.7%.

How much does Medicare spend on aspirin 325 MG / butalbital 50 MG / caffeine 40 MG / codeine phosphate 30 MG Oral Capsule?

In 2023, total Medicare Part D spending on aspirin 325 MG / butalbital 50 MG / caffeine 40 MG / codeine phosphate 30 MG Oral Capsule was $31,146,709, covering 22,634 beneficiaries. The average spend per beneficiary was $1,376.10.

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