aspirin 325 MG / butalbital 50 MG / caffeine 40 MG / codeine phosphate 30 MG Oral Capsule
aspirin
RxCUI: 994237
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
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.
Read our methodology - how this data is sourced, computed, and verified.