doxylamine succinate 10 MG / pyridoxine hydrochloride 10 MG Delayed Release Oral Tablet
doxylamine succinate
RxCUI: 1375948
What the CMS Formulary Data Shows for doxylamine succinate 10 MG / pyridoxine hydrochloride 10 MG Delayed Release Oral Tablet
Per the CMS 2026 Part D formulary file, doxylamine succinate 10 MG / pyridoxine hydrochloride 10 MG Delayed Release Oral Tablet (RxNorm concept RXCUI 1375948, generic name doxylamine succinate) appears on 2 distinct formulary files spanning 10 Medicare Part D plan offerings - 0.2% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 2 to Tier 4, with a cross-plan average of Tier 3.
Real-world access to doxylamine succinate 10 MG / pyridoxine hydrochloride 10 MG Delayed Release Oral Tablet depends on utilization management as much as tier placement: 50% of covering formularies require prior authorization. 0% require step therapy. 50% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 203 Part D beneficiaries filled doxylamine succinate 10 MG / pyridoxine hydrochloride 10 MG Delayed Release Oral Tablet in 2023, with total plan-and-beneficiary spending of $74,098 and an average per-beneficiary annual cost of $365.01. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry doxylamine succinate 10 MG / pyridoxine hydrochloride 10 MG Delayed Release Oral Tablet today.
Coverage Details
- Formularies covering
- 2
- Plans covering
- 10
- Coverage rate
- 0.2%
- Tier range
- Tier 2 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 50% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 50% of formularies
2023 Medicare Spending
- Beneficiaries
- 203
- Total spending
- $74,098
- Avg per beneficiary
- $365.01
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering doxylamine succinate 10 MG / pyridoxine hydrochloride 10 MG Delayed Release Oral Tablet
10 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| FHCP Medicare Classic (HMO) | FLORIDA BLUE MEDICARE, INC. | T2 | No | $0 | FL |
| FHCP Medicare Rx Plus (HMO-POS) | FLORIDA BLUE MEDICARE, INC. | T2 | No | $49.00 | FL |
| Geisinger Gold Preferred Complete Rx (PPO) | GEISINGER INDEMNITY INSURANCE COMPANY | T4 | Yes | $0 | PA |
| Geisinger Gold Secure Rx (HMO D-SNP) | GEISINGER HEALTH PLAN | T4 | Yes | $0 | PA |
| Geisinger Gold Classic 360 Rx (HMO) | GEISINGER HEALTH PLAN | T4 | Yes | $0 | PA |
| Geisinger Gold Classic Essential Rx (HMO) | GEISINGER HEALTH PLAN | T4 | Yes | $0 | PA |
| Geisinger Gold Value Rx (HMO) | GEISINGER HEALTH PLAN | T4 | Yes | $23.00 | PA |
| Geisinger Gold Classic Complete Rx (HMO) | GEISINGER HEALTH PLAN | T4 | Yes | $48.00 | PA |
| Geisinger Gold Classic Advantage Rx (HMO) | GEISINGER HEALTH PLAN | T4 | Yes | $99.30 | PA |
| Geisinger Gold Preferred Advantage Rx (PPO) | GEISINGER INDEMNITY INSURANCE COMPANY | T4 | Yes | $112.00 | PA |
Frequently Asked Questions
Is doxylamine succinate 10 MG / pyridoxine hydrochloride 10 MG Delayed Release Oral Tablet covered by Medicare Part D?
Yes, doxylamine succinate 10 MG / pyridoxine hydrochloride 10 MG Delayed Release Oral Tablet is covered by 10 Medicare Part D plans (0.2% of all Part D formularies).
What tier is doxylamine succinate 10 MG / pyridoxine hydrochloride 10 MG Delayed Release Oral Tablet on Medicare Part D plans?
doxylamine succinate 10 MG / pyridoxine hydrochloride 10 MG Delayed Release Oral Tablet averages Tier 3 across Part D plans, ranging from Tier 2 to Tier 4.
Does doxylamine succinate 10 MG / pyridoxine hydrochloride 10 MG Delayed Release Oral Tablet require prior authorization?
50% of Part D formularies require prior authorization for doxylamine succinate 10 MG / pyridoxine hydrochloride 10 MG Delayed Release Oral Tablet. Step therapy: 0%. Quantity limits: 50%.
How much does Medicare spend on doxylamine succinate 10 MG / pyridoxine hydrochloride 10 MG Delayed Release Oral Tablet?
In 2023, total Medicare Part D spending on doxylamine succinate 10 MG / pyridoxine hydrochloride 10 MG Delayed Release Oral Tablet was $74,098, covering 203 beneficiaries. The average spend per beneficiary was $365.01.
Read our methodology - how this data is sourced, computed, and verified.