Medicare Part D coverage · promethazine hydrochloride · RxCUI 992454
promethazine hydrochloride 25 MG Rectal Suppository
Per the CMS 2026 Part D formulary file, promethazine hydrochloride 25 MG Rectal Suppository is covered by 2,281 Medicare Part D plans (45.2% of enrollable products), averaging Tier 2.7, with prior authorization required on 33.3% of covering formularies.
- 45.2%
- Plan coverage
- 2,281
- Plans covering
- T2.7
- Avg tier
- 33.3%
- Prior auth required
What the CMS Formulary Data Shows for promethazine hydrochloride 25 MG Rectal Suppository
Per the CMS 2026 Part D formulary file, promethazine hydrochloride 25 MG Rectal Suppository (RxNorm concept RXCUI 992454, generic name promethazine hydrochloride) appears on 144 distinct formulary files spanning 2,281 Medicare Part D plan offerings - 45.2% 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 2.7.
Real-world access to promethazine hydrochloride 25 MG Rectal Suppository depends on utilization management as much as tier placement: 33.3% of covering formularies require prior authorization. 0% require step therapy. 7.6% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 523,738 Part D beneficiaries filled promethazine hydrochloride 25 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 25 MG Rectal Suppository today.
Coverage Details
- Formularies covering
- 144
- Plans covering
- 2,281
- Coverage rate
- 45.2%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 33.3% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 7.6% 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 25 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 |
| Elevate Medicare Choice (HMO D-SNP) | Denver Health Medical Plan, Inc. | T1 | No | $0 | CO |
| AllCare Advantage Redwood Rx (HMO D-SNP) | Allcare Health Plan, Inc. | T1 | Yes | $0 | OR |
| PrimeWest Senior Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | Yes | $0 | MN |
| Prime Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | Yes | $0 | MN |
| DualConnect (HMO D-SNP) | Santa Clara County Health Authority | T1 | Yes | $0 | CA |
| VNS Health Total (HMO D-SNP) | VNS Choice | T1 | No | $0 | NY |
| Alterwood Advantage Dual Secure (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | No | $0 | MD |
| Nascentia Dual Advantage (HMO D-SNP) | Visiting Nurse Association OF Central NEW York | T1 | No | $0 | NY |
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | No | $0 | PA |
Show the next 30 plans
| 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 |
| Abilis Health Community (HMO I-SNP) | Signature Advantage, LLC | T1 | No | $0 | KY, TN |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) | Arkansas Superior Select, Inc. | T1 | Yes | $0 | AR |
| 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 |
| Platino Plus (HMO D-snp) | Triple S Advantage, Inc. | T1 | Yes | $0 | PR |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T1 | No | $0 | CA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $0 | PA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $0 | PA |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Health Options West Virginia Inc. | T1 | No | $0 | WV |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | No | $0 | DE |
| 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 |
| American Health Advantage of Florida (HMO I-SNP) | American Health Plan OF FL, Inc. | T1 | No | $4.80 | 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 |
| Provider Partners Texas Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Texas, Inc. | T1 | No | $4.80 | TX |
| Texas Independence Health Plan, Inc. (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | No | $4.80 | TX |
| Texas Independence Community Plan (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | No | $4.80 | TX |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | GHS Insurance Company | T1 | No | $5.00 | OK |
| Tribute Select (HMO-POS I-SNP) | Arkansas Superior Select, Inc. | T1 | Yes | $8.90 | AR |
| ATRIO Special Needs Plan (HMO D-SNP) | Atrio Health Plans | T1 | Yes | $10.50 | OR |
| ATRIO Special Needs Plan (HMO D-SNP) | Atrio Health Plans | T1 | Yes | $10.50 | OR |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $13.10 | PA |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is promethazine hydrochloride 25 MG Rectal Suppository covered by Medicare Part D?
Yes, promethazine hydrochloride 25 MG Rectal Suppository is covered by 2,281 Medicare Part D plans (45.2% of all Part D formularies).
What tier is promethazine hydrochloride 25 MG Rectal Suppository on Medicare Part D plans?
promethazine hydrochloride 25 MG Rectal Suppository averages Tier 2.7 across Part D plans, ranging from Tier 1 to Tier 4.
Does promethazine hydrochloride 25 MG Rectal Suppository require prior authorization?
33.3% of Part D formularies require prior authorization for promethazine hydrochloride 25 MG Rectal Suppository. Step therapy: 0%. Quantity limits: 7.6%.
How much does Medicare spend on promethazine hydrochloride 25 MG Rectal Suppository?
In 2023, total Medicare Part D spending on promethazine hydrochloride 25 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.
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
- 3 ML insulin aspart, human 100 UNT/ML Cartridge [NovoLog] T2.7
- aliskiren 150 MG Oral Tablet T2.7
- cyclosporine, modified 100 MG Oral Capsule T2.7
- Niacinamide insulin aspart, human 100 UNT/ML Injectable Solution [Fiasp] T2.7
- tazarotene 1 MG/ML Topical Cream T2.7
- tenofovir disoproxil fumarate 300 MG Oral Tablet T2.7
Similar prior-authorization rate
- pretomanid 200 MG Oral Tablet 33.3% PA
- meperidine hydrochloride 50 MG Oral Tablet 33.3% PA
- chlordiazepoxide hydrochloride 5 MG / clidinium bromide 2.5 MG Oral Capsule 33.3% PA
- sevelamer carbonate 800 MG Oral Tablet 33.3% PA
- aspirin 325 MG / butalbital 50 MG / caffeine 40 MG / codeine phosphate 30 MG Oral Capsule [Ascomp] 33.3% PA
- lumateperone 42 MG Oral Capsule [Caplyta] 33.2% PA