Medicare Part D coverage · phenobarbital · RxCUI 198089
phenobarbital 60 MG Oral Tablet
Per the CMS 2026 Part D formulary file, phenobarbital 60 MG Oral Tablet is covered by 5,052 Medicare Part D plans (100% of enrollable products), averaging Tier 2.3, with prior authorization required on 47.9% of covering formularies.
- 100%
- Plan coverage
- 5,052
- Plans covering
- T2.3
- Avg tier
- 47.9%
- Prior auth required
What the CMS Formulary Data Shows for phenobarbital 60 MG Oral Tablet
Per the CMS 2026 Part D formulary file, phenobarbital 60 MG Oral Tablet (RxNorm concept RXCUI 198089, generic name phenobarbital) appears on 328 distinct formulary files spanning 5,052 Medicare Part D plan offerings - 100% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.3.
Real-world access to phenobarbital 60 MG Oral Tablet depends on utilization management as much as tier placement: 47.9% of covering formularies require prior authorization. 0% require step therapy. 36% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 52,777 Part D beneficiaries filled phenobarbital 60 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $15,457,885 and an average per-beneficiary annual cost of $292.89. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry phenobarbital 60 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 328
- Plans covering
- 5,052
- Coverage rate
- 100%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 47.9% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 36% of formularies
2023 Medicare Spending
- Beneficiaries
- 52,777
- Total spending
- $15,457,885
- Avg per beneficiary
- $292.89
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering phenobarbital 60 MG Oral Tablet
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Sentara Community Complete Select (HMO D-SNP) | Sentara Health Plans | T1 | No | $0 | VA |
| Sentara Community Complete (HMO D-SNP) | Sentara Health Plans | T1 | No | $0 | VA |
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) | Hpmp OF Florida, Inc. | T1 | Yes | $0 | FL |
| ElderServe MAP (HMO D-SNP) | Elderserve Health, Inc. | T1 | Yes | $0 | NY |
| Cooperative Advantage (HMO D-SNP) | Group Health Cooperative OF EAU Claire | T1 | Yes | $0 | WI |
| Longevity Health Plan (PPO I-SNP) | Longevity Health Plan OF NEW Jersey Insurance Comp | T1 | Yes | $0 | NJ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Elderplan Plus Long-Term Care (HMO-POS D-SNP) | Elderplan, Inc. | T1 | Yes | $0 | NY |
| Health Choice Pathway (HMO D-SNP) | Health Choice Arizona, Inc. | T1 | Yes | $0 | AZ |
| Healthfirst CompleteCare (HMO D-SNP) | Healthfirst Health Plan, Inc. | T1 | Yes | $0 | NY |
| IMCare Classic (HMO D-SNP) | Itasca Medical Care | T1 | Yes | $0 | MN |
| Johns Hopkins Advantage MD D-SNP (HMO D-SNP) | Hopkins Health Advantage, Inc. | T1 | Yes | $0 | MD |
| MetroPlus UltraCare (HMO D-SNP) | Metroplus Health Plan, Inc. | T1 | Yes | $0 | NY |
| Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) | Upper Peninsula Health Plan, LLC | T1 | Yes | $0 | MI |
| CareSource Dual Advantage (HMO D-SNP) | Caresource Georgia Co. | T1 | Yes | $0 | GA |
| Senior Whole Health SCO (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
| Senior Whole Health SCO NHC (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
| Molina One Care (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
Show the next 30 plans
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP Caresource | T1 | Yes | $0 | MI |
| PruittHealth Premier D-SNP (HMO D-SNP) | Pruitthealth Premier, Inc. | T1 | No | $0 | GA |
| KeyCare Advantage Plus (HMO C-SNP) | Isnp Ventures, LLC | T1 | No | $0 | MD |
| Premier Care (HMO-POS I-SNP) | Lifeworks Advantage, LLC | T1 | No | $0 | VA |
| Premier Care (HMO I-SNP) | Align Senior Care California Inc. | T1 | No | $0 | CA |
| Advantage Care (HMO) | Align Senior Care California Inc. | T1 | No | $0 | CA |
| Premier Care (HMO-POS I-SNP) | Align Senior Care MI, LLC | T1 | No | $0 | MI |
| Premier Care (HMO I-SNP) | Align Senior Care Florida, Inc. | T1 | No | $0 | FL |
| Perennial Advantage Freedom (HMO-POS) | Perennial Advantage OF Colorado, Inc. | T1 | No | $0 | CO |
| Perennial Advantage Premier (HMO-POS I-SNP) | Perennial Advantage OF Colorado, Inc. | T1 | No | $0 | CO |
| Perennial Advantage Freedom (HMO) | Perennial Advantage OF Colorado, Inc. | T1 | No | $0 | PA |
| Perennial Advantage Premier (HMO I-SNP) | Perennial Advantage OF Colorado, Inc. | T1 | No | $0 | PA |
| Perennial Advantage Freedom (HMO-POS) | Perennial Advantage OF Ohio, Inc. | T1 | No | $0 | OH |
| Perennial Advantage Premier (HMO-POS I-SNP) | Perennial Advantage OF Ohio, Inc. | T1 | No | $0 | OH |
| ProCare Advantage - Diabetes Care Management (HMO-POS C-SNP) | Procare Advantage, LLC | T1 | No | $0 | TX |
| PruittHealth Premier Advantage (HMO I-SNP) | Pruitthealth Premier, Inc. | T1 | No | $0 | GA |
| Senior Health Plan Silver Plus (HMO) | Communitycare Government Programs, Inc. | T1 | No | $0 | OK |
| Senior Health Plan Oklahoma Dual Complete (HMO D-SNP) | Communitycare Government Programs, Inc. | T1 | No | $0 | OK |
| Community First Medicare Advantage Alamo Plan (HMO) | Community First Health Plans, Inc. | T1 | No | $0 | TX |
| Community First Medicare Advantage D-SNP (HMO D-SNP) | Community First Health Plans, Inc. | T1 | No | $0 | TX |
| Community DualCare Aligned (HMO D-SNP) | Community Health Choice Texas, Inc. | T1 | No | $0 | TX |
| Community DualCare Access (HMO D-SNP) | Community Health Choice Texas, Inc. | T1 | No | $0 | TX |
| Dean Advantage Assurance (HMO-POS) | Dean Health Plan, Inc. | T1 | No | $0 | WI |
| Dean Advantage Essential (HMO) | Dean Health Plan, Inc. | T1 | No | $0 | WI |
| El Paso Health Medicare Advantage Dual (HMO D-SNP) | EL Paso First Health Plans, Inc. | T1 | No | $0 | TX |
| El Paso Health Total (HMO) | EL Paso First Health Plans, Inc. | T1 | No | $0 | TX |
| El Paso Health Giveback (HMO) | EL Paso First Health Plans, Inc. | T1 | No | $0 | TX |
| Liberty Medicare Advantage (HMO C-SNP) | Liberty Advantage, LLC | T1 | No | $0 | NC |
| Peak Advantage Vista (PPO) | Peak Health Insurance Corporation | T1 | No | $0 | PA, WV |
| SECUR Edge (HMO I-SNP) | Secur Inc | T1 | No | $0 | FL |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is phenobarbital 60 MG Oral Tablet covered by Medicare Part D?
Yes, phenobarbital 60 MG Oral Tablet is covered by 5,052 Medicare Part D plans (100% of all Part D formularies).
What tier is phenobarbital 60 MG Oral Tablet on Medicare Part D plans?
phenobarbital 60 MG Oral Tablet averages Tier 2.3 across Part D plans, ranging from Tier 1 to Tier 4.
Does phenobarbital 60 MG Oral Tablet require prior authorization?
47.9% of Part D formularies require prior authorization for phenobarbital 60 MG Oral Tablet. Step therapy: 0%. Quantity limits: 36%.
How much does Medicare spend on phenobarbital 60 MG Oral Tablet?
In 2023, total Medicare Part D spending on phenobarbital 60 MG Oral Tablet was $15,457,885, covering 52,777 beneficiaries. The average spend per beneficiary was $292.89.
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
- zonisamide 20 MG/ML Oral Suspension [Zonisade] 47.9% PA
- diazepam 1 MG/ML Oral Solution 47.9% PA
- diazepam 5 MG/ML Oral Solution 47.9% PA
- promethazine hydrochloride 25 MG Oral Tablet 47.9% PA
- lidocaine hydrochloride 40 MG/ML Mucous Membrane Topical Solution 48% PA
- promethazine hydrochloride 50 MG Oral Tablet 48% PA