Medicare Part D coverage · cyclobenzaprine hydrochloride · RxCUI 828299
cyclobenzaprine hydrochloride 7.5 MG Oral Tablet
Per the CMS 2026 Part D formulary file, cyclobenzaprine hydrochloride 7.5 MG Oral Tablet is covered by 177 Medicare Part D plans (3.5% of enrollable products), averaging Tier 2.7, with prior authorization required on 41.2% of covering formularies.
- 3.5%
- Plan coverage
- 177
- Plans covering
- T2.7
- Avg tier
- 41.2%
- Prior auth required
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 17 distinct formulary files spanning 177 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 2.7.
Real-world access to cyclobenzaprine hydrochloride 7.5 MG Oral Tablet depends on utilization management as much as tier placement: 41.2% of covering formularies require prior authorization. 0% require step therapy. 11.8% 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 $70,240,119 and an average per-beneficiary annual cost of $28.57. 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
- 17
- Plans covering
- 177
- Coverage rate
- 3.5%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 41.2% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 11.8% of formularies
2023 Medicare Spending
- Beneficiaries
- 2,458,292
- Total spending
- $70,240,119
- Avg per beneficiary
- $28.57
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 |
Show the next 30 plans
| 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 |
Showing top 50 of 100 plans.
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 177 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 2.7 across Part D plans, ranging from Tier 1 to Tier 4.
Does cyclobenzaprine hydrochloride 7.5 MG Oral Tablet require prior authorization?
41.2% of Part D formularies require prior authorization for cyclobenzaprine hydrochloride 7.5 MG Oral Tablet. Step therapy: 0%. Quantity limits: 11.8%.
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 $70,240,119, covering 2,458,292 beneficiaries. The average spend per beneficiary was $28.57.
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
- 12 HR carbamazepine 200 MG Extended Release Oral Tablet T2.7
- 100 ML fluconazole 2 MG/ML Injection T2.7
- Augmented betamethasone 0.5 MG/ML Topical Lotion T2.7
- amylase 180000 UNT / lipase 36000 UNT / protease 114000 UNT Delayed Release Oral Capsule [Creon] T2.7
- 2 ML clindamycin 150 MG/ML Injection T2.7
- 0.5 ML tirzepatide 10 MG/ML Auto-Injector [Mounjaro] T2.7
Similar prior-authorization rate
- lactulose 10000 MG Powder for Oral Solution 41.2% PA
- prednisone 5 MG/ML Oral Solution 41.2% PA
- topiramate 25 MG/ML Oral Solution [Eprontia] 41.4% PA
- isotretinoin 30 MG Oral Capsule 41.4% PA
- isotretinoin 20 MG Oral Capsule 41.4% PA
- 8 HR methylphenidate hydrochloride 10 MG Extended Release Oral Tablet 41% PA