hydrocodone bitartrate 5 MG / ibuprofen 200 MG Oral Tablet
hydrocodone bitartrate
RxCUI: 858778
What the CMS Formulary Data Shows for hydrocodone bitartrate 5 MG / ibuprofen 200 MG Oral Tablet
Per the CMS 2026 Part D formulary file, hydrocodone bitartrate 5 MG / ibuprofen 200 MG Oral Tablet (RxNorm concept RXCUI 858778, generic name hydrocodone bitartrate) appears on 56 distinct formulary files spanning 1,151 Medicare Part D plan offerings - 22.7% 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 2.8.
Real-world access to hydrocodone bitartrate 5 MG / ibuprofen 200 MG Oral Tablet depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 80.4% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 5,184 Part D beneficiaries filled hydrocodone bitartrate 5 MG / ibuprofen 200 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $22,960,014 and an average per-beneficiary annual cost of $4,429.02. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry hydrocodone bitartrate 5 MG / ibuprofen 200 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 56
- Plans covering
- 1,151
- Coverage rate
- 22.7%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 80.4% of formularies
2023 Medicare Spending
- Beneficiaries
- 5,184
- Total spending
- $22,960,014
- Avg per beneficiary
- $4,429.02
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering hydrocodone bitartrate 5 MG / ibuprofen 200 MG Oral Tablet
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Gold Coast Health Plan Total Care Advantage (HMO D-SNP) | Ventura County Medi-Cal Managed Care Commission | T1 | No | $0 | CA |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | No | $0 | MN |
| Hamaspik Medicare Choice (HMO D-SNP) | HAMASPIK, INC. | T1 | No | $0 | NY |
| SeniorCare Complete (HMO D-SNP) | SOUTH COUNTRY HEALTH ALLIANCE | T1 | No | $0 | MN |
| AbilityCare (HMO D-SNP) | SOUTH COUNTRY HEALTH ALLIANCE | T1 | No | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | ALAMEDA ALLIANCE FOR HEALTH | T1 | No | $0 | CA |
| PHP (HMO C-SNP) | AIDS HEALTHCARE FOUNDATION | T1 | No | $0 | CA |
| VNS Health Total (HMO D-SNP) | VNS CHOICE | T1 | No | $0 | NY |
| Leon MediExtra (HMO) | LEON HEALTH, INC. | T1 | No | $0 | FL |
| Leon MediDual (HMO D-SNP) | LEON HEALTH, INC. | T1 | No | $0 | FL |
| Leon MediMore (HMO) | LEON HEALTH, INC. | T1 | No | $0 | FL |
| Leon MediMax (HMO D-SNP) | LEON HEALTH, INC. | T1 | No | $0 | FL |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | HCSC INSURANCE SERVICES COMPANY | T1 | No | $4.80 | TX |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | GOLD KIDNEY OF FLORIDA INC | T1 | No | $4.80 | FL |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | GHS INSURANCE COMPANY | T1 | No | $5.00 | OK |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | GOLD KIDNEY OF ARIZONA | T1 | No | $17.00 | AZ |
| Hamaspik Medicare Select (HMO D-SNP) | HAMASPIK, INC. | T1 | No | $34.50 | NY |
| VNS Health EasyCare Plus (HMO D-SNP) | VNS CHOICE | T1 | No | $51.60 | NY |
| Alignment Health the ONE + Walgreens (HMO) | ALIGNMENT HEALTH PLAN OF ARIZONA, INC. | T2 | No | $0 | AZ |
| Alignment Health the ONE + Walgreens (HMO) | ALIGNMENT HEALTH PLAN OF ARIZONA, INC. | T2 | No | $0 | AZ |
| Alignment Health Heart & Diabetes (HMO C-SNP) | ALIGNMENT HEALTH PLAN OF ARIZONA, INC. | T2 | No | $0 | AZ |
| Alignment Health smartHMO (HMO) | ALIGNMENT HEALTH PLAN OF ARIZONA, INC. | T2 | No | $0 | AZ |
| Alignment Health My Choice (HMO) | ALIGNMENT HEALTH PLAN | T2 | No | $0 | CA |
| Alignment Health Platinum + Instacart (HMO) | ALIGNMENT HEALTH PLAN | T2 | No | $0 | CA |
| Alignment Health Heart & Diabetes (HMO C-SNP) | ALIGNMENT HEALTH PLAN | T2 | No | $0 | CA |
| Alignment Health AllCare Preferred (HMO) | ALIGNMENT HEALTH PLAN | T2 | No | $0 | CA |
| Alignment Health smartHMO (HMO) | ALIGNMENT HEALTH PLAN | T2 | No | $0 | CA |
| Alignment Health Platinum + Instacart (HMO-POS) | ALIGNMENT HEALTH PLAN | T2 | No | $0 | CA |
| Alignment Health My Choice (HMO) | ALIGNMENT HEALTH PLAN | T2 | No | $0 | CA |
| Alignment Health Harmony (HMO) | ALIGNMENT HEALTH PLAN | T2 | No | $0 | CA |
| Alignment Health Balance (HMO C-SNP) | ALIGNMENT HEALTH PLAN | T2 | No | $0 | CA |
| Alignment Health the ONE (HMO) | ALIGNMENT HEALTH PLAN | T2 | No | $0 | CA |
| Alignment Health the ONE + Walgreens (HMO) | ALIGNMENT HEALTH PLAN | T2 | No | $0 | CA |
| Alignment Health smartHMO (HMO) | ALIGNMENT HEALTH PLAN | T2 | No | $0 | CA |
| Alignment Health smartHMO (HMO) | ALIGNMENT HEALTH PLAN | T2 | No | $0 | CA |
| Alignment Health CommUnity (HMO) | ALIGNMENT HEALTH PLAN | T2 | No | $0 | CA |
| Alignment Health smartSavings (HMO) | ALIGNMENT HEALTH PLAN | T2 | No | $0 | CA |
| Alignment Health Heart & Diabetes Care (HMO C-SNP) | ALIGNMENT HEALTH PLAN | T2 | No | $0 | CA |
| Alignment Health My Choice Select (HMO) | ALIGNMENT HEALTH PLAN | T2 | No | $0 | CA |
| Alignment Health My Choice CalCare (HMO) | ALIGNMENT HEALTH PLAN | T2 | No | $0 | CA |
| Alignment Health Honor+ Plan (HMO) | ALIGNMENT HEALTH PLAN | T2 | No | $0 | CA |
| Alignment Health ValorCare (HMO) | ALIGNMENT HEALTH PLAN | T2 | No | $0 | CA |
| Alignment Health Heart & Diabetes Care (HMO C-SNP) | ALIGNMENT HEALTH PLAN | T2 | No | $0 | CA |
| Alignment Health L.A. Premium Giveback (HMO) | ALIGNMENT HEALTH PLAN | T2 | No | $0 | CA |
| Alignment Health S.D. Premium Giveback (HMO) | ALIGNMENT HEALTH PLAN | T2 | No | $0 | CA |
| Alignment Health Platinum (HMO) | ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC. | T2 | No | $0 | NC |
| Alignment Health NC Duals (HMO-POS D-SNP) | ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC. | T2 | No | $0 | NC |
| Alignment Health smartHMO (HMO) | ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC. | T2 | No | $0 | NC |
Frequently Asked Questions
Is hydrocodone bitartrate 5 MG / ibuprofen 200 MG Oral Tablet covered by Medicare Part D?
Yes, hydrocodone bitartrate 5 MG / ibuprofen 200 MG Oral Tablet is covered by 1,151 Medicare Part D plans (22.7% of all Part D formularies).
What tier is hydrocodone bitartrate 5 MG / ibuprofen 200 MG Oral Tablet on Medicare Part D plans?
hydrocodone bitartrate 5 MG / ibuprofen 200 MG Oral Tablet averages Tier 2.8 across Part D plans, ranging from Tier 1 to Tier 4.
Does hydrocodone bitartrate 5 MG / ibuprofen 200 MG Oral Tablet require prior authorization?
0% of Part D formularies require prior authorization for hydrocodone bitartrate 5 MG / ibuprofen 200 MG Oral Tablet. Step therapy: 0%. Quantity limits: 80.4%.
How much does Medicare spend on hydrocodone bitartrate 5 MG / ibuprofen 200 MG Oral Tablet?
In 2023, total Medicare Part D spending on hydrocodone bitartrate 5 MG / ibuprofen 200 MG Oral Tablet was $22,960,014, covering 5,184 beneficiaries. The average spend per beneficiary was $4,429.02.
Read our methodology - how this data is sourced, computed, and verified.