carbinoxamine maleate 4 MG Oral Tablet

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carbinoxamine maleate

RxCUI: 1012904

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.
15%
Plan Coverage
760
Plans Covering
T2.4
Avg Tier
73.3%
Prior Auth Required

What the CMS Formulary Data Shows for carbinoxamine maleate 4 MG Oral Tablet

Per the CMS 2026 Part D formulary file, carbinoxamine maleate 4 MG Oral Tablet (RxNorm concept RXCUI 1012904, generic name carbinoxamine maleate) appears on 15 distinct formulary files spanning 760 Medicare Part D plan offerings - 15% 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 carbinoxamine maleate 4 MG Oral Tablet depends on utilization management as much as tier placement: 73.3% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 1,400 Part D beneficiaries filled carbinoxamine maleate 4 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $921,020 and an average per-beneficiary annual cost of $657.87. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry carbinoxamine maleate 4 MG Oral Tablet today.

Coverage Details

Formularies covering
15
Plans covering
760
Coverage rate
15%
Tier range
Tier 1 – Tier 4
Average tier
Tier 2, Generic

Restrictions

Prior authorization required
73.3% of formularies
Step therapy required
0% of formularies
Quantity limits
0% of formularies

2023 Medicare Spending

Beneficiaries
1,400
Total spending
$921,020
Avg per beneficiary
$657.87

Tier Distribution Across Plans

40 plans
Tier 1, Preferred Generic
60 plans
Tier 2, Generic

Medicare Advantage Plans (MA-PD) Covering carbinoxamine maleate 4 MG Oral Tablet

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

Plan Insurer Tier PA Premium States
Freedom VIP Care (HMO C-SNP) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom VIP Savings (HMO C-SNP) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom VIP Savings (HMO C-SNP) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom VIP Rewards (HMO C-SNP) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom VIP Rewards (HMO C-SNP) FREEDOM HEALTH, INC. T1 Yes $0 FL
Optimum Diamond Rewards (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 Yes $0 FL
Optimum Diamond Savings (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 Yes $0 FL
Optimum Diamond Rewards (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 Yes $0 FL
Optimum Diamond (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 Yes $0 FL
Freedom Medi-Medi Partial (HMO D-SNP) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom Medi-Medi Full (HMO D-SNP) FREEDOM HEALTH, INC. T1 Yes $0 FL
Optimum Emerald Partial (HMO D-SNP) OPTIMUM HEALTHCARE, INC. T1 Yes $0 FL
Optimum Emerald Full (HMO D-SNP) OPTIMUM HEALTHCARE, INC. T1 Yes $0 FL
Freedom Medicare Plan Rx (HMO) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom Medicare Plan Rx (HMO) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom VIP Savings COPD (HMO C-SNP) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom VIP Savings COPD (HMO C-SNP) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom Máximo (HMO-POS) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom Máximo (HMO-POS) FREEDOM HEALTH, INC. T1 Yes $0 FL
Optimum Gold Rewards Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 Yes $0 FL
Optimum Platinum Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 Yes $0 FL
Optimum Gold Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 Yes $0 FL
Optimum Gold Rewards Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 Yes $0 FL
Optimum Gold Rewards Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 Yes $0 FL
Optimum Diamond Rewards COPD (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 Yes $0 FL
Optimum Diamond Savings COPD (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 Yes $0 FL
Optimum Gold Plus Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 Yes $0 FL
Optimum Diamond Rewards COPD (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 Yes $0 FL
CareAdvantage (HMO D-SNP) SAN MATEO HEALTH COMMISSION T1 No $0 CA
Wellpoint Medicare Advantage (HMO-POS) WELLPOINT WEST VIRGINIA , INC. T2 Yes $0 WV
Anthem Medicare Advantage 3 (HMO-POS) HealthKeepers, Inc. T2 Yes $0 VA
Anthem Medicare Advantage 3 (HMO-POS) HealthKeepers, Inc. T2 Yes $0 VA
Anthem Medicare Advantage 3 (HMO-POS) HealthKeepers, Inc. T2 Yes $0 VA
Wellpoint Medicare Advantage 2 (HMO-POS) WELLPOINT TENNESSEE, INC. T2 Yes $0 TN
Wellpoint Medicare Advantage 2 (HMO-POS) WELLPOINT TENNESSEE, INC. T2 Yes $0 TN
Wellpoint Medicare Advantage 2 (HMO-POS) WELLPOINT TENNESSEE, INC. T2 Yes $0 TN
Wellpoint Medicare Advantage 2 (HMO-POS) WELLPOINT TENNESSEE, INC. T2 Yes $0 TN
Anthem I CareMore Medicare Advantage 2 (HMO-POS) BLUE CROSS OF CALIFORNIA T2 Yes $0 CA
Anthem I CareMore Chronic Care (HMO-POS C-SNP) BLUE CROSS OF CALIFORNIA T2 Yes $0 CA

Frequently Asked Questions

Is carbinoxamine maleate 4 MG Oral Tablet covered by Medicare Part D?

Yes, carbinoxamine maleate 4 MG Oral Tablet is covered by 760 Medicare Part D plans (15% of all Part D formularies).

What tier is carbinoxamine maleate 4 MG Oral Tablet on Medicare Part D plans?

carbinoxamine maleate 4 MG Oral Tablet averages Tier 2.4 across Part D plans, ranging from Tier 1 to Tier 4.

Does carbinoxamine maleate 4 MG Oral Tablet require prior authorization?

73.3% of Part D formularies require prior authorization for carbinoxamine maleate 4 MG Oral Tablet. Step therapy: 0%. Quantity limits: 0%.

How much does Medicare spend on carbinoxamine maleate 4 MG Oral Tablet?

In 2023, total Medicare Part D spending on carbinoxamine maleate 4 MG Oral Tablet was $921,020, covering 1,400 beneficiaries. The average spend per beneficiary was $657.87.

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