Medicare Part D coverage · promethazine hydrochloride · RxCUI 992441
promethazine hydrochloride 12.5 MG Rectal Suppository
Per the CMS 2026 Part D formulary file, promethazine hydrochloride 12.5 MG Rectal Suppository is covered by 2,166 Medicare Part D plans (42.9% of enrollable products), averaging Tier 3.1, with prior authorization required on 18.3% of covering formularies.
- 42.9%
- Plan coverage
- 2,166
- Plans covering
- T3.1
- Avg tier
- 18.3%
- Prior auth required
What the CMS Formulary Data Shows for promethazine hydrochloride 12.5 MG Rectal Suppository
Per the CMS 2026 Part D formulary file, promethazine hydrochloride 12.5 MG Rectal Suppository (RxNorm concept RXCUI 992441, generic name promethazine hydrochloride) appears on 104 distinct formulary files spanning 2,166 Medicare Part D plan offerings - 42.9% 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 3.1.
Real-world access to promethazine hydrochloride 12.5 MG Rectal Suppository depends on utilization management as much as tier placement: 18.3% of covering formularies require prior authorization. 0% require step therapy. 10.6% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 523,738 Part D beneficiaries filled promethazine hydrochloride 12.5 MG Rectal Suppository in 2023, with total plan-and-beneficiary spending of $16,549,733 and an average per-beneficiary annual cost of $31.60. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry promethazine hydrochloride 12.5 MG Rectal Suppository today.
Coverage Details
- Formularies covering
- 104
- Plans covering
- 2,166
- Coverage rate
- 42.9%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 18.3% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 10.6% of formularies
2023 Medicare Spending
- Beneficiaries
- 523,738
- Total spending
- $16,549,733
- Avg per beneficiary
- $31.60
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering promethazine hydrochloride 12.5 MG Rectal Suppository
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| CareAdvantage (HMO D-SNP) | SAN Mateo Health Commission | T1 | No | $0 | CA |
| 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 |
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | No | $0 | MA |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $0 | NY |
| SeniorCare Complete (HMO D-SNP) | South Country Health Alliance | T1 | Yes | $0 | MN |
| AbilityCare (HMO D-SNP) | South Country Health Alliance | T1 | Yes | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | Alameda Alliance FOR Health | T1 | Yes | $0 | CA |
| PHP (HMO C-snp) | Aids Healthcare Foundation | T1 | Yes | $0 | CA |
| VNS Health Total (HMO D-SNP) | VNS Choice | T1 | No | $0 | NY |
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | No | $0 | PA |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | Provider Partners Health Plan OF North Carolina | T1 | No | $0 | NC |
| Provider Partners Indiana Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Indiana | T1 | No | $0 | IN |
| Provider Partners Missouri Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Missouri, Inc. | T1 | No | $0 | MO |
| 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 |
Show the next 30 plans
Showing top 50 of 100 plans.
Frequently Asked Questions
Is promethazine hydrochloride 12.5 MG Rectal Suppository covered by Medicare Part D?
Yes, promethazine hydrochloride 12.5 MG Rectal Suppository is covered by 2,166 Medicare Part D plans (42.9% of all Part D formularies).
What tier is promethazine hydrochloride 12.5 MG Rectal Suppository on Medicare Part D plans?
promethazine hydrochloride 12.5 MG Rectal Suppository averages Tier 3.1 across Part D plans, ranging from Tier 1 to Tier 4.
Does promethazine hydrochloride 12.5 MG Rectal Suppository require prior authorization?
18.3% of Part D formularies require prior authorization for promethazine hydrochloride 12.5 MG Rectal Suppository. Step therapy: 0%. Quantity limits: 10.6%.
How much does Medicare spend on promethazine hydrochloride 12.5 MG Rectal Suppository?
In 2023, total Medicare Part D spending on promethazine hydrochloride 12.5 MG Rectal Suppository was $16,549,733, covering 523,738 beneficiaries. The average spend per beneficiary was $31.60.
Read our methodology - how this data is sourced, computed, and verified.
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