promethazine hydrochloride 25 MG Oral Tablet

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promethazine hydrochloride

RxCUI: 992447

Important: Drug coverage and costs vary by plan and location. Verify coverage directly with your Medicare plan before filling a prescription. This is informational data only and should not replace advice from your healthcare provider or pharmacist.
99.8%
Plan Coverage
5,057
Plans Covering
T2.2
Avg Tier
60.7%
Prior Auth Required

What the CMS Formulary Data Shows for promethazine hydrochloride 25 MG Oral Tablet

Per the CMS 2026 Part D formulary file, promethazine hydrochloride 25 MG Oral Tablet (RxNorm concept RXCUI 992447, generic name promethazine hydrochloride) appears on 328 distinct formulary files spanning 5,057 Medicare Part D plan offerings - 99.8% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.2.

Real-world access to promethazine hydrochloride 25 MG Oral Tablet depends on utilization management as much as tier placement: 60.7% of covering formularies require prior authorization. 0% require step therapy. 0% 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 Oral Tablet 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 Oral Tablet today.

Coverage Details

Formularies covering
328
Plans covering
5,057
Coverage rate
99.8%
Tier range
Tier 1 – Tier 4
Average tier
Tier 2, Generic

Restrictions

Prior authorization required
60.7% of formularies
Step therapy required
0% of formularies
Quantity limits
0% of formularies

2023 Medicare Spending

Beneficiaries
523,738
Total spending
$16,549,733
Avg per beneficiary
$31.60

Tier Distribution Across Plans

100 plans
Tier 1, Preferred Generic

Medicare Advantage Plans (MA-PD) Covering promethazine hydrochloride 25 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
Freedom VIP Care (HMO C-SNP) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom VIP Savings (HMO C-SNP) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom VIP Savings (HMO C-SNP) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom VIP Rewards (HMO C-SNP) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom VIP Rewards (HMO C-SNP) FREEDOM HEALTH, INC. T1 Yes $0 FL
Optimum Diamond Rewards (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 Yes $0 FL
Optimum Diamond Savings (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 Yes $0 FL
Optimum Diamond Rewards (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 Yes $0 FL
Optimum Diamond (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 Yes $0 FL
Freedom Medi-Medi Partial (HMO D-SNP) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom Medi-Medi Full (HMO D-SNP) FREEDOM HEALTH, INC. T1 Yes $0 FL
Optimum Emerald Partial (HMO D-SNP) OPTIMUM HEALTHCARE, INC. T1 Yes $0 FL
Optimum Emerald Full (HMO D-SNP) OPTIMUM HEALTHCARE, INC. T1 Yes $0 FL
Freedom Medicare Plan Rx (HMO) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom Medicare Plan Rx (HMO) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom VIP Savings COPD (HMO C-SNP) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom VIP Savings COPD (HMO C-SNP) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom Platinum Plan Rx (HMO) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom Platinum Rewards Plan Rx (HMO) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom Máximo (HMO-POS) FREEDOM HEALTH, INC. T1 Yes $0 FL
Freedom Máximo (HMO-POS) FREEDOM HEALTH, INC. T1 Yes $0 FL
Optimum Gold Rewards Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 Yes $0 FL
Optimum Platinum Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 Yes $0 FL
Optimum Gold Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 Yes $0 FL
Optimum Gold Rewards Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 Yes $0 FL
Optimum Gold Rewards Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 Yes $0 FL
Optimum Diamond Rewards COPD (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 Yes $0 FL
Optimum Diamond Savings COPD (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 Yes $0 FL
Optimum Gold Plus Plan (HMO) OPTIMUM HEALTHCARE, INC. T1 Yes $0 FL
Optimum Diamond Rewards COPD (HMO C-SNP) OPTIMUM HEALTHCARE, INC. T1 Yes $0 FL
HealthSun HealthAdvantage Plan (HMO) HEALTHSUN HEALTH PLANS, INC. T1 Yes $0 FL
HealthSun MediMax (HMO) HEALTHSUN HEALTH PLANS, INC. T1 Yes $0 FL
HealthSun HealthAdvantage Plan (HMO) HEALTHSUN HEALTH PLANS, INC. T1 Yes $0 FL
HealthSun HealthAdvantage Plan (HMO) HEALTHSUN HEALTH PLANS, INC. T1 Yes $0 FL
HealthSun MediSun Plus (HMO D-SNP) HEALTHSUN HEALTH PLANS, INC. T1 Yes $0 FL
HealthSun HealthAdvantage Plus (HMO) HEALTHSUN HEALTH PLANS, INC. T1 Yes $0 FL
HealthSun HealthAdvantage Plus (HMO) HEALTHSUN HEALTH PLANS, INC. T1 Yes $0 FL
HealthSun MediSun Extra (HMO D-SNP) HEALTHSUN HEALTH PLANS, INC. T1 Yes $0 FL
HealthSun HealthAdvantage Plus (HMO) HEALTHSUN HEALTH PLANS, INC. T1 Yes $0 FL

Frequently Asked Questions

Is promethazine hydrochloride 25 MG Oral Tablet covered by Medicare Part D?

Yes, promethazine hydrochloride 25 MG Oral Tablet is covered by 5,057 Medicare Part D plans (99.8% of all Part D formularies).

What tier is promethazine hydrochloride 25 MG Oral Tablet on Medicare Part D plans?

promethazine hydrochloride 25 MG Oral Tablet averages Tier 2.2 across Part D plans, ranging from Tier 1 to Tier 4.

Does promethazine hydrochloride 25 MG Oral Tablet require prior authorization?

60.7% of Part D formularies require prior authorization for promethazine hydrochloride 25 MG Oral Tablet. Step therapy: 0%. Quantity limits: 0%.

How much does Medicare spend on promethazine hydrochloride 25 MG Oral Tablet?

In 2023, total Medicare Part D spending on promethazine hydrochloride 25 MG Oral Tablet was $16,549,733, covering 523,738 beneficiaries. The average spend per beneficiary was $31.60.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial