cephalexin 25 MG/ML Oral Suspension
cephalexin
RxCUI: 309110
What the CMS Formulary Data Shows for cephalexin 25 MG/ML Oral Suspension
Per the CMS 2026 Part D formulary file, cephalexin 25 MG/ML Oral Suspension (RxNorm concept RXCUI 309110, generic name cephalexin) 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 1.9.
Real-world access to cephalexin 25 MG/ML Oral Suspension depends on utilization management as much as tier placement: 0% 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 5,051,787 Part D beneficiaries filled cephalexin 25 MG/ML Oral Suspension in 2023, with total plan-and-beneficiary spending of $64,269,317 and an average per-beneficiary annual cost of $12.72. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry cephalexin 25 MG/ML Oral Suspension 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% of formularies
2023 Medicare Spending
- Beneficiaries
- 5,051,787
- Total spending
- $64,269,317
- Avg per beneficiary
- $12.72
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering cephalexin 25 MG/ML Oral Suspension
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 cephalexin 25 MG/ML Oral Suspension
95 Medicare Advantage plans with Part D drug coverage include this drug.
Frequently Asked Questions
Is cephalexin 25 MG/ML Oral Suspension covered by Medicare Part D?
Yes, cephalexin 25 MG/ML Oral Suspension is covered by 5,067 Medicare Part D plans (100% of all Part D formularies).
What tier is cephalexin 25 MG/ML Oral Suspension on Medicare Part D plans?
cephalexin 25 MG/ML Oral Suspension averages Tier 1.9 across Part D plans, ranging from Tier 1 to Tier 4.
Does cephalexin 25 MG/ML Oral Suspension require prior authorization?
0% of Part D formularies require prior authorization for cephalexin 25 MG/ML Oral Suspension. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on cephalexin 25 MG/ML Oral Suspension?
In 2023, total Medicare Part D spending on cephalexin 25 MG/ML Oral Suspension was $64,269,317, covering 5,051,787 beneficiaries. The average spend per beneficiary was $12.72.
Read our methodology - how this data is sourced, computed, and verified.