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

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aspirin

RxCUI: 994239

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.
2.5%
Plan Coverage
129
Plans Covering
T2.7
Avg Tier
33.3%
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 [Ascomp]

Per the CMS 2026 Part D formulary file, aspirin 325 MG / butalbital 50 MG / caffeine 40 MG / codeine phosphate 30 MG Oral Capsule [Ascomp] (RxNorm concept RXCUI 994239, generic name aspirin) appears on 15 distinct formulary files spanning 129 Medicare Part D plan offerings - 2.5% 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 2.7.

Real-world access to aspirin 325 MG / butalbital 50 MG / caffeine 40 MG / codeine phosphate 30 MG Oral Capsule [Ascomp] depends on utilization management as much as tier placement: 33.3% of covering formularies require prior authorization. 0% require step therapy. 60% 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 [Ascomp] 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 [Ascomp] today.

Coverage Details

Formularies covering
15
Plans covering
129
Coverage rate
2.5%
Tier range
Tier 1 – Tier 4
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
33.3% of formularies
Step therapy required
0% of formularies
Quantity limits
60% of formularies

2023 Medicare Spending

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

Tier Distribution Across Plans

5 plans
Tier 1, Preferred Generic
13 plans
Tier 2, Generic
81 plans
Tier 3, Preferred Brand
1 plans
Tier 4, Non-Preferred

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

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

Plan Insurer Tier PA Premium States
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
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
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
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T3 No $0 CO
Select Health Medicare Flex (HMO) SELECTHEALTH, INC. T3 No $0 CO
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T3 No $0 CO
Select Health Medicare Active (HMO) SELECTHEALTH, INC. T3 No $0 CO
Select Health Medicare Dual (HMO D-SNP) SELECTHEALTH, INC. T3 No $0 NV
Select Health Medicare Wellness (HMO) SELECTHEALTH, INC. T3 No $0 NV
Alignment Health the ONE + Walgreens (HMO) ALIGNMENT HEALTH PLAN OF ARIZONA, INC. T3 No $0 AZ
Alignment Health the ONE + Walgreens (HMO) ALIGNMENT HEALTH PLAN OF ARIZONA, INC. T3 No $0 AZ
Alignment Health Heart & Diabetes (HMO C-SNP) ALIGNMENT HEALTH PLAN OF ARIZONA, INC. T3 No $0 AZ
Alignment Health smartHMO (HMO) ALIGNMENT HEALTH PLAN OF ARIZONA, INC. T3 No $0 AZ
Alignment Health My Choice (HMO) ALIGNMENT HEALTH PLAN T3 No $0 CA
Alignment Health Platinum + Instacart (HMO) ALIGNMENT HEALTH PLAN T3 No $0 CA
Alignment Health Heart & Diabetes (HMO C-SNP) ALIGNMENT HEALTH PLAN T3 No $0 CA
Alignment Health AllCare Preferred (HMO) ALIGNMENT HEALTH PLAN T3 No $0 CA
Alignment Health smartHMO (HMO) ALIGNMENT HEALTH PLAN T3 No $0 CA
Alignment Health Platinum + Instacart (HMO-POS) ALIGNMENT HEALTH PLAN T3 No $0 CA
Alignment Health My Choice (HMO) ALIGNMENT HEALTH PLAN T3 No $0 CA
Alignment Health Harmony (HMO) ALIGNMENT HEALTH PLAN T3 No $0 CA
Alignment Health Balance (HMO C-SNP) ALIGNMENT HEALTH PLAN T3 No $0 CA
Alignment Health the ONE (HMO) ALIGNMENT HEALTH PLAN T3 No $0 CA
Alignment Health the ONE + Walgreens (HMO) ALIGNMENT HEALTH PLAN T3 No $0 CA
Alignment Health smartHMO (HMO) ALIGNMENT HEALTH PLAN T3 No $0 CA
Alignment Health smartHMO (HMO) ALIGNMENT HEALTH PLAN T3 No $0 CA
Alignment Health CommUnity (HMO) ALIGNMENT HEALTH PLAN T3 No $0 CA

Frequently Asked Questions

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

Yes, aspirin 325 MG / butalbital 50 MG / caffeine 40 MG / codeine phosphate 30 MG Oral Capsule [Ascomp] is covered by 129 Medicare Part D plans (2.5% of all Part D formularies).

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

aspirin 325 MG / butalbital 50 MG / caffeine 40 MG / codeine phosphate 30 MG Oral Capsule [Ascomp] averages Tier 2.7 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 [Ascomp] require prior authorization?

33.3% of Part D formularies require prior authorization for aspirin 325 MG / butalbital 50 MG / caffeine 40 MG / codeine phosphate 30 MG Oral Capsule [Ascomp]. Step therapy: 0%. Quantity limits: 60%.

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

In 2023, total Medicare Part D spending on aspirin 325 MG / butalbital 50 MG / caffeine 40 MG / codeine phosphate 30 MG Oral Capsule [Ascomp] 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