Medicare Part D coverage · cyclobenzaprine hydrochloride · RxCUI 828301

cyclobenzaprine hydrochloride 7.5 MG Oral Tablet [Fexmid]

Per the CMS 2026 Part D formulary file, cyclobenzaprine hydrochloride 7.5 MG Oral Tablet [Fexmid] is covered by 2 Medicare Part D plans (0% of enrollable products), averaging Tier 4, with prior authorization required on 100% of covering formularies.

0%
Plan coverage
2
Plans covering
T4
Avg tier
100%
Prior auth required

Verify with CMS →

Important: Drug coverage and costs vary by plan and location. Verify coverage directly with your Medicare plan before filling a prescription. This is informational data only and should not replace advice from your healthcare provider or pharmacist.

What the CMS Formulary Data Shows for cyclobenzaprine hydrochloride 7.5 MG Oral Tablet [Fexmid]

Per the CMS 2026 Part D formulary file, cyclobenzaprine hydrochloride 7.5 MG Oral Tablet [Fexmid] (RxNorm concept RXCUI 828301, generic name cyclobenzaprine hydrochloride) appears on 1 distinct formulary file spanning 2 Medicare Part D plan offerings - 0% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 4 to Tier 4, with a cross-plan average of Tier 4.

Real-world access to cyclobenzaprine hydrochloride 7.5 MG Oral Tablet [Fexmid] depends on utilization management as much as tier placement: 100% 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 2,458,292 Part D beneficiaries filled cyclobenzaprine hydrochloride 7.5 MG Oral Tablet [Fexmid] 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 [Fexmid] today.

Coverage Details

Formularies covering
1
Plans covering
2
Coverage rate
0%
Tier range
Tier 4, Non-Preferred
Average tier
Tier 4, Non-Preferred

Restrictions

Prior authorization required
100% of formularies
Step therapy required
0% of formularies
Quantity limits
0% of formularies

2023 Medicare Spending

Beneficiaries
2,458,292
Total spending
$70,240,119
Avg per beneficiary
$28.57

Tier Distribution Across Plans

2 plans
Tier 4, Non-Preferred

Medicare Advantage Plans (MA-PD) Covering cyclobenzaprine hydrochloride 7.5 MG Oral Tablet [Fexmid]

2 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
Community Health Plan of WA Dual Complete (HMO D-SNP) Community Health Plan OF Washington T4 Yes $0 WA
Community Health Plan of WA Dual Select (HMO D-SNP) Community Health Plan OF Washington T4 Yes $0 WA

Frequently Asked Questions

Is cyclobenzaprine hydrochloride 7.5 MG Oral Tablet [Fexmid] covered by Medicare Part D?

Yes, cyclobenzaprine hydrochloride 7.5 MG Oral Tablet [Fexmid] is covered by 2 Medicare Part D plans (0% of all Part D formularies).

What tier is cyclobenzaprine hydrochloride 7.5 MG Oral Tablet [Fexmid] on Medicare Part D plans?

cyclobenzaprine hydrochloride 7.5 MG Oral Tablet [Fexmid] averages Tier 4 across Part D plans, ranging from Tier 4 to Tier 4.

Does cyclobenzaprine hydrochloride 7.5 MG Oral Tablet [Fexmid] require prior authorization?

100% of Part D formularies require prior authorization for cyclobenzaprine hydrochloride 7.5 MG Oral Tablet [Fexmid]. Step therapy: 0%. Quantity limits: 0%.

How much does Medicare spend on cyclobenzaprine hydrochloride 7.5 MG Oral Tablet [Fexmid]?

In 2023, total Medicare Part D spending on cyclobenzaprine hydrochloride 7.5 MG Oral Tablet [Fexmid] 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

Similar prior-authorization rate

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare