Medicare Part D coverage · carbinoxamine maleate · RxCUI 1012904
carbinoxamine maleate 4 MG Oral Tablet
Per the CMS 2026 Part D formulary file, carbinoxamine maleate 4 MG Oral Tablet is covered by 760 Medicare Part D plans (15% of enrollable products), averaging Tier 2.4, with prior authorization required on 73.3% of covering formularies.
- 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
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 |
Show the next 30 plans
| 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 |
Showing top 50 of 100 plans.
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.
Read our methodology - how this data is sourced, computed, and verified.
Nationwide similar Part D drugs
Data-derived peers across the CMS Part D formulary extract: nearest average tier placement and nearest prior-authorization rate. Not therapeutic alternatives or same-generic strengths.
Closest average formulary tier
Similar prior-authorization rate
- 0.5 ML interferon beta-1a 0.044 MG/ML Prefilled Syringe [Rebif] 73.3% PA
- siponimod 0.25 MG Oral Tablet [Mayzent] 73.3% PA
- tretinoin 0.0004 MG/MG Topical Gel 73.3% PA
- vigabatrin 500 MG Oral Tablet [Vigadrone] 73.2% PA
- calcium chloride 0.23 MEQ/ML / magnesium chloride 0.53 MEQ/ML / potassium chloride 0.1 MEQ/ML / sodium acetate 1.48 MEQ/ML / sodium chloride 0.27 MEQ/ML Injectable Solution 73.4% PA
- {12 (siponimod 0.25 MG Oral Tablet [Mayzent]) } Pack [Mayzent 2 MG Starter Pack] 73.1% PA