chlordiazepoxide hydrochloride 5 MG / clidinium bromide 2.5 MG Oral Capsule
chlordiazepoxide hydrochloride
RxCUI: 889614
What the CMS Formulary Data Shows for chlordiazepoxide hydrochloride 5 MG / clidinium bromide 2.5 MG Oral Capsule
Per the CMS 2026 Part D formulary file, chlordiazepoxide hydrochloride 5 MG / clidinium bromide 2.5 MG Oral Capsule (RxNorm concept RXCUI 889614, generic name chlordiazepoxide hydrochloride) appears on 18 distinct formulary files spanning 242 Medicare Part D plan offerings - 4.8% 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 chlordiazepoxide hydrochloride 5 MG / clidinium bromide 2.5 MG Oral Capsule depends on utilization management as much as tier placement: 33.3% 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 25,948 Part D beneficiaries filled chlordiazepoxide hydrochloride 5 MG / clidinium bromide 2.5 MG Oral Capsule in 2023, with total plan-and-beneficiary spending of $1,142,073 and an average per-beneficiary annual cost of $44.01. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry chlordiazepoxide hydrochloride 5 MG / clidinium bromide 2.5 MG Oral Capsule today.
Coverage Details
- Formularies covering
- 18
- Plans covering
- 242
- Coverage rate
- 4.8%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 33.3% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 25,948
- Total spending
- $1,142,073
- Avg per beneficiary
- $44.01
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering chlordiazepoxide hydrochloride 5 MG / clidinium bromide 2.5 MG Oral Capsule
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Abilis Health Community (HMO I-SNP) | SIGNATURE ADVANTAGE, LLC | T1 | No | $0 | KY, TN |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) | ARKANSAS SUPERIOR SELECT, INC. | T1 | Yes | $0 | AR |
| Texas Independence Health Plan, Inc. (HMO I-SNP) | TEXAS INDEPENDENCE HEALTH PLAN, INC. | T1 | No | $4.80 | TX |
| Texas Independence Community Plan (HMO I-SNP) | TEXAS INDEPENDENCE HEALTH PLAN, INC. | T1 | No | $4.80 | TX |
| Tribute Select (HMO-POS I-SNP) | ARKANSAS SUPERIOR SELECT, INC. | T1 | Yes | $8.90 | AR |
| Valor Health Plan (HMO I-SNP) | TSG GUARD, INC. | T1 | No | $31.40 | OH |
| WV Senior Advantage (HMO I-SNP) | WEST VIRGINIA SENIOR ADVANTAGE, INC. | T1 | No | $32.70 | WV |
| Abilis Health (HMO I-SNP) | SIGNATURE ADVANTAGE, LLC | T1 | No | $35.90 | KY, TN |
| CommuniCare Advantage ISNP (HMO I-SNP) | OH CHS SNP INC. | T1 | No | $38.40 | IN, MD, OH |
| HealthSun HealthAdvantage Plan (HMO) | HEALTHSUN HEALTH PLANS, INC. | T2 | Yes | $0 | FL |
| HealthSun MediMax (HMO) | HEALTHSUN HEALTH PLANS, INC. | T2 | Yes | $0 | FL |
| HealthSun HealthAdvantage Plan (HMO) | HEALTHSUN HEALTH PLANS, INC. | T2 | Yes | $0 | FL |
| HealthSun HealthAdvantage Plan (HMO) | HEALTHSUN HEALTH PLANS, INC. | T2 | Yes | $0 | FL |
| HealthSun MediSun Plus (HMO D-SNP) | HEALTHSUN HEALTH PLANS, INC. | T2 | Yes | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | HEALTHSUN HEALTH PLANS, INC. | T2 | Yes | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | HEALTHSUN HEALTH PLANS, INC. | T2 | Yes | $0 | FL |
| HealthSun MediSun Extra (HMO D-SNP) | HEALTHSUN HEALTH PLANS, INC. | T2 | Yes | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | HEALTHSUN HEALTH PLANS, INC. | T2 | Yes | $0 | FL |
| HealthSun VitalCare (HMO C-SNP) | HEALTHSUN HEALTH PLANS, INC. | T2 | Yes | $0 | FL |
| HealthSun VitalCare (HMO C-SNP) | HEALTHSUN HEALTH PLANS, INC. | T2 | Yes | $0 | FL |
| HealthSun MediSun Full Dual Plus (HMO D-SNP) | HEALTHSUN HEALTH PLANS, INC. | T2 | Yes | $0 | FL |
| HealthSun MediSun Full Dual Extra (HMO D-SNP) | HEALTHSUN HEALTH PLANS, INC. | T2 | Yes | $0 | FL |
| Simply Complete (HMO D-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | Yes | $0 | FL |
| Simply More (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T2 | Yes | $0 | FL |
| Simply Complete (HMO D-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | Yes | $0 | FL |
| Simply Level (HMO C-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | Yes | $0 | FL |
| Simply Level (HMO C-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | Yes | $0 | FL |
| Simply More (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T2 | Yes | $0 | FL |
| Simply Level (HMO C-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | Yes | $0 | FL |
| Simply More (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T2 | Yes | $0 | FL |
| Simply Level (HMO C-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | Yes | $0 | FL |
| Simply Complete (HMO D-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | Yes | $0 | FL |
| Simply More (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T2 | Yes | $0 | FL |
| Simply More (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T2 | Yes | $0 | FL |
| Simply Level (HMO C-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | Yes | $0 | FL |
| Simply Complete (HMO D-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | Yes | $0 | FL |
| Simply More (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T2 | Yes | $0 | FL |
| Simply Extra (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T2 | Yes | $0 | FL |
| Simply Extra Platinum (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T2 | Yes | $0 | FL |
| Simply More Platinum (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T2 | Yes | $0 | FL |
| Simply Complete Platinum (HMO D-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | Yes | $0 | FL |
| Simply Level Platinum (HMO C-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | Yes | $0 | FL |
| Simply Extra Platinum (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T2 | Yes | $0 | FL |
| Simply Level Platinum (HMO C-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | Yes | $0 | FL |
| Simply Extra Platinum (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T2 | Yes | $0 | FL |
| Simply Level Platinum (HMO C-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | Yes | $0 | FL |
| Simply Extra Platinum (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T2 | Yes | $0 | FL |
| Simply More Platinum (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T2 | Yes | $0 | FL |
| Simply Complete Platinum (HMO D-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | Yes | $0 | FL |
| Simply Level Platinum (HMO C-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | Yes | $0 | FL |
Frequently Asked Questions
Is chlordiazepoxide hydrochloride 5 MG / clidinium bromide 2.5 MG Oral Capsule covered by Medicare Part D?
Yes, chlordiazepoxide hydrochloride 5 MG / clidinium bromide 2.5 MG Oral Capsule is covered by 242 Medicare Part D plans (4.8% of all Part D formularies).
What tier is chlordiazepoxide hydrochloride 5 MG / clidinium bromide 2.5 MG Oral Capsule on Medicare Part D plans?
chlordiazepoxide hydrochloride 5 MG / clidinium bromide 2.5 MG Oral Capsule averages Tier 2.4 across Part D plans, ranging from Tier 1 to Tier 4.
Does chlordiazepoxide hydrochloride 5 MG / clidinium bromide 2.5 MG Oral Capsule require prior authorization?
33.3% of Part D formularies require prior authorization for chlordiazepoxide hydrochloride 5 MG / clidinium bromide 2.5 MG Oral Capsule. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on chlordiazepoxide hydrochloride 5 MG / clidinium bromide 2.5 MG Oral Capsule?
In 2023, total Medicare Part D spending on chlordiazepoxide hydrochloride 5 MG / clidinium bromide 2.5 MG Oral Capsule was $1,142,073, covering 25,948 beneficiaries. The average spend per beneficiary was $44.01.
Read our methodology - how this data is sourced, computed, and verified.