cyclobenzaprine hydrochloride 7.5 MG Oral Tablet
cyclobenzaprine hydrochloride
RxCUI: 828299
What the CMS Formulary Data Shows for cyclobenzaprine hydrochloride 7.5 MG Oral Tablet
Per the CMS 2026 Part D formulary file, cyclobenzaprine hydrochloride 7.5 MG Oral Tablet (RxNorm concept RXCUI 828299, generic name cyclobenzaprine hydrochloride) appears on 16 distinct formulary files spanning 175 Medicare Part D plan offerings - 3.5% 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 2.6.
Real-world access to cyclobenzaprine hydrochloride 7.5 MG Oral Tablet depends on utilization management as much as tier placement: 37.5% of covering formularies require prior authorization. 0% require step therapy. 12.5% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 2,458,292 Part D beneficiaries filled cyclobenzaprine hydrochloride 7.5 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $70,256,097 and an average per-beneficiary annual cost of $28.58. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry cyclobenzaprine hydrochloride 7.5 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 16
- Plans covering
- 175
- Coverage rate
- 3.5%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 37.5% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 12.5% of formularies
2023 Medicare Spending
- Beneficiaries
- 2,458,292
- Total spending
- $70,256,097
- Avg per beneficiary
- $28.58
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering cyclobenzaprine hydrochloride 7.5 MG Oral Tablet
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Community Care's Partnership Program (HMO D-SNP) | COMMUNITY CARE HEALTH PLAN, INC. | T1 | No | $0 | WI |
| Platino Blindao (HMO D-SNP) | TRIPLE S ADVANTAGE, INC. | T1 | Yes | $0 | PR |
| Platino Enlace (HMO D-SNP) | TRIPLE S ADVANTAGE, INC. | T1 | Yes | $0 | PR |
| PLATINO ADVANCE (HMO D-SNP) | TRIPLE S ADVANTAGE, INC. | T1 | Yes | $0 | PR |
| PLATINO PLUS (HMO D-SNP) | TRIPLE S ADVANTAGE, INC. | T1 | Yes | $0 | PR |
| Tufts Health One Care (HMO D-SNP) | TUFTS HEALTH PUBLIC PLANS, INC. | T1 | No | $0 | MA |
| Tufts Health One Care CW (HMO D-SNP) | TUFTS HEALTH PUBLIC PLANS, INC. | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options (HMO D-SNP) | TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options CW (HMO D-SNP) | TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION | T1 | No | $0 | MA |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T2 | No | $0 | UT |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T2 | No | $0 | NV |
| Select Health Medicare Dual (HMO D-SNP) | SELECTHEALTH, INC. | T2 | No | $0 | UT |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T2 | No | $0 | UT |
| Select Health Medicare + Kroger (HMO) | SELECTHEALTH, INC. | T2 | No | $0 | NV |
| Select Health Medicare + Kroger (HMO) | SELECTHEALTH, INC. | T2 | No | $0 | UT |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T2 | No | $0 | CO |
| Select Health Medicare Essential (HMO) | SELECTHEALTH, INC. | T2 | No | $0 | CO |
| Select Health Medicare + Kroger (HMO) | SELECTHEALTH, INC. | T2 | No | $0 | CO |
| Select Health Medicare Flex (HMO) | SELECTHEALTH, INC. | T2 | No | $0 | CO |
| Select Health Medicare + Kroger (HMO) | SELECTHEALTH, INC. | T2 | No | $0 | CO |
| Select Health Medicare Active (HMO) | SELECTHEALTH, INC. | T2 | No | $0 | CO |
| Select Health Medicare Dual (HMO D-SNP) | SELECTHEALTH, INC. | T2 | No | $0 | NV |
| Select Health Medicare Wellness (HMO) | SELECTHEALTH, INC. | T2 | No | $0 | NV |
| Healthy Mississippi Premier Advantage (HMO-POS) | Healthy Mississippi, Inc. | T2 | No | $0 | MS |
| MMM Supremo (HMO C-SNP) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| MMM Diamante Platino (HMO D-SNP) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| MMM Unico (HMO-POS) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| MMM Elite (HMO-POS) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| MMM Deluxe (HMO-POS) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| MMM Dorado Platino (HMO D-SNP) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| PMC Premier Platino (HMO D-SNP) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| PMC Max (HMO-POS) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| MMM Plenitud (HMO-POS) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| MMM Valioso (HMO-POS) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| MMM Combo Platino (HMO D-SNP) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| MMM Flexi Platino (HMO D-SNP) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| MMM Grandioso (HMO-POS) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| MMM Mega Flex (HMO-POS) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| MMM Relax Platino (HMO D-SNP) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| MMM Balance (HMO-POS) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| Presbyterian Senior Care Plan 2 with Rx (HMO) | PRESBYTERIAN HEALTH PLAN | T2 | Yes | $0 | NM |
| Presbyterian Dual Plus (HMO D-SNP) | PRESBYTERIAN HEALTH PLAN | T2 | Yes | $0 | NM |
| Presbyterian Senior Care Extra Health Plan with Rx (HMO) | PRESBYTERIAN HEALTH PLAN | T2 | Yes | $0 | NM |
| Óptimo Plus (PPO) | TRIPLE S ADVANTAGE, INC. | T2 | Yes | $0 | PR |
| Contigo Plus (HMO C-SNP) | TRIPLE S ADVANTAGE, INC. | T2 | Yes | $0 | PR |
| Brillante (HMO-POS) | TRIPLE S ADVANTAGE, INC. | T2 | Yes | $0 | PR |
| Enlace Plus (HMO) | TRIPLE S ADVANTAGE, INC. | T2 | Yes | $0 | PR |
| ContigoEnMente (HMO C-SNP) | TRIPLE S ADVANTAGE, INC. | T2 | Yes | $0 | PR |
| Ahorro Plus (HMO) | TRIPLE S ADVANTAGE, INC. | T2 | Yes | $0 | PR |
| SCAN Connections (HMO D-SNP) | SCAN HEALTH PLAN | T2 | Yes | $0 | CA |
Frequently Asked Questions
Is cyclobenzaprine hydrochloride 7.5 MG Oral Tablet covered by Medicare Part D?
Yes, cyclobenzaprine hydrochloride 7.5 MG Oral Tablet is covered by 175 Medicare Part D plans (3.5% of all Part D formularies).
What tier is cyclobenzaprine hydrochloride 7.5 MG Oral Tablet on Medicare Part D plans?
cyclobenzaprine hydrochloride 7.5 MG Oral Tablet averages Tier 2.6 across Part D plans, ranging from Tier 1 to Tier 4.
Does cyclobenzaprine hydrochloride 7.5 MG Oral Tablet require prior authorization?
37.5% of Part D formularies require prior authorization for cyclobenzaprine hydrochloride 7.5 MG Oral Tablet. Step therapy: 0%. Quantity limits: 12.5%.
How much does Medicare spend on cyclobenzaprine hydrochloride 7.5 MG Oral Tablet?
In 2023, total Medicare Part D spending on cyclobenzaprine hydrochloride 7.5 MG Oral Tablet was $70,256,097, covering 2,458,292 beneficiaries. The average spend per beneficiary was $28.58.
Read our methodology - how this data is sourced, computed, and verified.