carbamazepine 200 MG Oral Tablet
carbamazepine
RxCUI: 308979
What the CMS Formulary Data Shows for carbamazepine 200 MG Oral Tablet
Per the CMS 2026 Part D formulary file, carbamazepine 200 MG Oral Tablet (RxNorm concept RXCUI 308979, generic name carbamazepine) appears on 330 distinct formulary files spanning 5,067 Medicare Part D plan offerings - 100% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.1.
Real-world access to carbamazepine 200 MG Oral Tablet depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 0.6% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 135,324 Part D beneficiaries filled carbamazepine 200 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $52,182,713 and an average per-beneficiary annual cost of $385.61. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry carbamazepine 200 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 330
- Plans covering
- 5,067
- Coverage rate
- 100%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0.6% of formularies
2023 Medicare Spending
- Beneficiaries
- 135,324
- Total spending
- $52,182,713
- Avg per beneficiary
- $385.61
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering carbamazepine 200 MG Oral Tablet
5 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| Anthem Full Dual Advantage (PPO D-SNP) | ANTHEM HEALTH PLANS, INC. | T1 | No | No | $0 | CT |
| Anthem Dual Advantage (PPO D-SNP) | ANTHEM HEALTH PLANS, INC. | T1 | No | No | $0 | CT |
| Anthem Kidney Care (HMO-POS C-SNP) | ANTHEM HEALTH PLANS, INC. | T1 | No | No | $0 | CT |
| Anthem Full Dual Advantage Select (HMO D-SNP) | ANTHEM HEALTH PLANS, INC. | T1 | No | No | $0 | CT |
| Anthem Dual Advantage (HMO D-SNP) | ANTHEM HEALTH PLANS, INC. | T1 | No | No | $0 | CT |
Medicare Advantage Plans (MA-PD) Covering carbamazepine 200 MG Oral Tablet
95 Medicare Advantage plans with Part D drug coverage include this drug.
Frequently Asked Questions
Is carbamazepine 200 MG Oral Tablet covered by Medicare Part D?
Yes, carbamazepine 200 MG Oral Tablet is covered by 5,067 Medicare Part D plans (100% of all Part D formularies).
What tier is carbamazepine 200 MG Oral Tablet on Medicare Part D plans?
carbamazepine 200 MG Oral Tablet averages Tier 2.1 across Part D plans, ranging from Tier 1 to Tier 4.
Does carbamazepine 200 MG Oral Tablet require prior authorization?
0% of Part D formularies require prior authorization for carbamazepine 200 MG Oral Tablet. Step therapy: 0%. Quantity limits: 0.6%.
How much does Medicare spend on carbamazepine 200 MG Oral Tablet?
In 2023, total Medicare Part D spending on carbamazepine 200 MG Oral Tablet was $52,182,713, covering 135,324 beneficiaries. The average spend per beneficiary was $385.61.
Read our methodology - how this data is sourced, computed, and verified.