Medicare Part D coverage · cefixime · RxCUI 197451
cefixime 400 MG Oral Tablet
Per the CMS 2026 Part D formulary file, cefixime 400 MG Oral Tablet is covered by 2,028 Medicare Part D plans (40.1% of enrollable products), averaging Tier 3, with prior authorization required on 0% of covering formularies.
- 40.1%
- Plan coverage
- 2,028
- Plans covering
- T3
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for cefixime 400 MG Oral Tablet
Per the CMS 2026 Part D formulary file, cefixime 400 MG Oral Tablet (RxNorm concept RXCUI 197451, generic name cefixime) appears on 64 distinct formulary files spanning 2,028 Medicare Part D plan offerings - 40.1% 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 3.
Real-world access to cefixime 400 MG Oral Tablet depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 3.1% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 11,613 Part D beneficiaries filled cefixime 400 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $2,164,069 and an average per-beneficiary annual cost of $186.35. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry cefixime 400 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 64
- Plans covering
- 2,028
- Coverage rate
- 40.1%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 3.1% of formularies
2023 Medicare Spending
- Beneficiaries
- 11,613
- Total spending
- $2,164,069
- Avg per beneficiary
- $186.35
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering cefixime 400 MG Oral Tablet
5 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T4 | No | No | $0 | - |
| AARP Medicare Rx Preferred from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T4 | No | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T4 | No | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T4 | No | No | $0 | - |
| AARP Medicare Rx Saver from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T4 | No | No | $0 | - |
Medicare Advantage Plans (MA-PD) Covering cefixime 400 MG Oral Tablet
95 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 | No | $0 | CA |
| Elevate Medicare Choice (HMO D-SNP) | Denver Health Medical Plan, Inc. | T1 | No | $0 | CO |
| AllCare Advantage Redwood Rx (HMO D-SNP) | Allcare Health Plan, Inc. | T1 | No | $0 | OR |
| PrimeWest Senior Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | No | $0 | MN |
| Prime Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | No | $0 | MN |
| DualConnect (HMO D-SNP) | Santa Clara County Health Authority | T1 | No | $0 | CA |
| VNS Health Total (HMO D-SNP) | VNS Choice | T1 | No | $0 | NY |
| Community Care's Partnership Program (HMO D-SNP) | Community Care Health Plan, Inc. | T1 | No | $0 | WI |
| Mass General Brigham SCO (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T1 | No | $4.80 | FL |
| ATRIO Special Needs Plan (HMO D-SNP) | Atrio Health Plans | T1 | No | $10.50 | OR |
| ATRIO Special Needs Plan (HMO D-SNP) | Atrio Health Plans | T1 | No | $10.50 | OR |
| 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 |
| ATRIO Prime Rx (HMO) | Atrio Health Plans | T2 | No | $0 | OR |
| ATRIO Choice Rx (PPO) | Atrio Health Plans | T2 | No | $0 | OR |
| ATRIO Choice Rx (PPO) | Atrio Health Plans | T2 | No | $0 | OR |
| ATRIO Prime Rx (PPO) | Atrio Health Plans | T2 | No | $0 | OR |
Show the next 30 plans
| ATRIO Prime Rx (PPO) | Atrio Health Plans | T2 | No | $0 | OR |
| ATRIO Prime Rx (PPO) | Atrio Health Plans | T2 | No | $0 | OR |
| ATRIO Choice Rx (PPO) | Atrio Health Plans | T2 | No | $0 | OR |
| ATRIO Choice Rx (PPO) | Atrio Health Plans | T2 | No | $0 | OR |
| ATRIO Support Rx (PPO C-SNP) | Atrio Health Plans | T2 | No | $0 | OR |
| BayCarePlus Complete (HMO) | Baycare Select Health Plans, Inc. | T2 | No | $0 | FL |
| BayCarePlus Rewards (HMO) | Baycare Select Health Plans, Inc. | T2 | No | $0 | FL |
| BayCarePlus Premier (HMO) | Baycare Select Health Plans, Inc. | T2 | No | $0 | FL |
| TotalCare (HMO D-SNP) | Santa Cruz Monterey Merced SAN Benito Mariposa Managed Medic | T2 | No | $0 | CA |
| CommuniCare Advantage (HMO D-SNP) | Community Health Group | T2 | No | $0 | CA |
| Community y Más (HMO C-SNP) | Community Health Group | T2 | No | $0 | CA |
| Elevate Medicare Select (HMO) | Denver Health Medical Plan, Inc. | T2 | No | $0 | CO |
| 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 |
| Advantage D-SNP (HMO) (HMO D-SNP) | SAN Joaquin County Health Commission | T2 | No | $0 | CA |
| Community Advantage Plus (HMO D-SNP) | Imperial County Local Health Authority | T2 | No | $0 | CA |
| McLaren Medicare Inspire (HMO) | Mclaren Health Plan, Inc. | T2 | No | $0 | MI |
| McLaren Medicare Inspire Select (HMO) | Mclaren Health Plan, Inc. | T2 | No | $0 | MI |
| Champion Advantage (HMO-POS C-SNP) | Champion Health Plan OF California Inc | T2 | No | $0 | CA |
| Champion Connect (HMO-POS C-SNP) | Champion Health Plan OF California Inc | T2 | No | $0 | CA |
| Champion Ally (HMO) | Champion Health Plan OF California Inc | T2 | No | $0 | CA |
| Champion Care (HMO C-SNP) | Champion Health Plan OF California Inc | T2 | No | $0 | CA |
| Champion Advantage (HMO-POS C-SNP) | Champion Health Plan OF Nevada, Inc. | T2 | No | $0 | NV |
Showing top 50 of 95 plans.
Frequently Asked Questions
Is cefixime 400 MG Oral Tablet covered by Medicare Part D?
Yes, cefixime 400 MG Oral Tablet is covered by 2,028 Medicare Part D plans (40.1% of all Part D formularies).
What tier is cefixime 400 MG Oral Tablet on Medicare Part D plans?
cefixime 400 MG Oral Tablet averages Tier 3 across Part D plans, ranging from Tier 1 to Tier 4.
Does cefixime 400 MG Oral Tablet require prior authorization?
0% of Part D formularies require prior authorization for cefixime 400 MG Oral Tablet. Step therapy: 0%. Quantity limits: 3.1%.
How much does Medicare spend on cefixime 400 MG Oral Tablet?
In 2023, total Medicare Part D spending on cefixime 400 MG Oral Tablet was $2,164,069, covering 11,613 beneficiaries. The average spend per beneficiary was $186.35.
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
- {1 (aprepitant 125 MG Oral Capsule) / 2 (aprepitant 80 MG Oral Capsule) } Pack T3
- atovaquone 150 MG/ML Oral Suspension T3
- chlorpromazine hydrochloride 10 MG Oral Tablet T3
- nitroglycerin 0.004 MG/MG Rectal Ointment T3
- raltegravir 25 MG Chewable Tablet [Isentress] T3
- risperidone 2 MG Disintegrating Oral Tablet T3
Similar prior-authorization rate
- metronidazole 10 MG/ML Topical Cream [Noritate] 0% PA
- 24 HR minocycline 40 MG Extended Release Oral Capsule [Emrosi] 0% PA
- buspirone hydrochloride 10 MG Oral Capsule [Bucapsol] 0% PA
- diflunisal 375 MG Oral Tablet [Dolobid] 0% PA
- hydrocortisone 1 MG/ML Oral Solution [Khindivi] 0% PA
- indomethacin 50 MG Rectal Suppository [Indocin] 0% PA