promethazine hydrochloride 1.25 MG/ML Oral Solution

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promethazine hydrochloride

RxCUI: 992432

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.
72.6%
Plan Coverage
3,677
Plans Covering
T2.4
Avg Tier
56.8%
Prior Auth Required

What the CMS Formulary Data Shows for promethazine hydrochloride 1.25 MG/ML Oral Solution

Per the CMS 2026 Part D formulary file, promethazine hydrochloride 1.25 MG/ML Oral Solution (RxNorm concept RXCUI 992432, generic name promethazine hydrochloride) appears on 220 distinct formulary files spanning 3,677 Medicare Part D plan offerings - 72.6% of enrollable Part D products, mid-range placement; shopping across contracts changes access. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.4.

Real-world access to promethazine hydrochloride 1.25 MG/ML Oral Solution depends on utilization management as much as tier placement: 56.8% 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 1.25 MG/ML Oral Solution 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 1.25 MG/ML Oral Solution today.

Coverage Details

Formularies covering
220
Plans covering
3,677
Coverage rate
72.6%
Tier range
Tier 1 – Tier 4
Average tier
Tier 2, Generic

Restrictions

Prior authorization required
56.8% 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 1.25 MG/ML Oral Solution

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
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

Frequently Asked Questions

Is promethazine hydrochloride 1.25 MG/ML Oral Solution covered by Medicare Part D?

Yes, promethazine hydrochloride 1.25 MG/ML Oral Solution is covered by 3,677 Medicare Part D plans (72.6% of all Part D formularies).

What tier is promethazine hydrochloride 1.25 MG/ML Oral Solution on Medicare Part D plans?

promethazine hydrochloride 1.25 MG/ML Oral Solution averages Tier 2.4 across Part D plans, ranging from Tier 1 to Tier 4.

Does promethazine hydrochloride 1.25 MG/ML Oral Solution require prior authorization?

56.8% of Part D formularies require prior authorization for promethazine hydrochloride 1.25 MG/ML Oral Solution. Step therapy: 0%. Quantity limits: 0%.

How much does Medicare spend on promethazine hydrochloride 1.25 MG/ML Oral Solution?

In 2023, total Medicare Part D spending on promethazine hydrochloride 1.25 MG/ML Oral Solution 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