phenobarbital
Generic: phenobarbital elixir
100 mg, 15 mg, 16.2 mg, 20 mg/5 mL (4 mg/mL), 20 mg/5 mL (5 mL), 30 mg, 32.4 mg, 60 mg, 64.8 mg, 97.2 mg — Tablet
Also known as:
phenobarbital oral elixir 20 mg/5ml
phenobarbital oral tablet
Phenobarbital 20 Mg/5 Ml Oral Solution
Phenobarbital 30 Mg/7.5 Ml Oral Solution
Phenobarbital 60 Mg/15 Ml Oral Solution
Phenobarbital 30 Mg Tablet
Phenobarbital 15 Mg Tablet
Phenobarbital 16.2 Mg Tablet
Phenobarbital 32.4 Mg Tablet
Phenobarbital 60 Mg Tablet
Phenobarbital 64.8 Mg Tablet
Phenobarbital 97.2 Mg Tablet
Phenobarbital 100 Mg Tablet
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Coverage by Insurer
Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Ambetter (Centene)
29 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Standard Gold with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Focused Silver with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Complete Gold with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Standard Expanded Bronze + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Standard Silver + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Elite Bronze with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Everyday Bronze with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Elite Bronze + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Everyday Bronze + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Complete Gold | Tier 2 - Generic | — | — | — | None |
| Enhanced Asthma/COPD Care Silver with $0 Drug Options | Tier 2 - Generic | — | — | — | None |
| Everyday Bronze | Tier 2 - Generic | — | — | — | None |
| Elite Bronze | Tier 2 - Generic | — | — | — | None |
| Clear Silver with $0 Insulin Options | Tier 2 - Generic | — | — | — | None |
| Standard Expanded Bronze | Tier 2 - Generic | — | — | — | None |
| Standard Silver | Tier 2 - Generic | — | — | — | None |
| Standard Gold | Tier 2 - Generic | — | — | — | None |
| Everyday Bronze with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Elite Bronze with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Focused Silver with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Complete Gold with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Standard Expanded Bronze with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Standard Silver with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Standard Gold with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Complete Gold + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Standard Gold + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Standard Expanded Bronze with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Standard Silver with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
Blue Cross Blue Shield of NC
5 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| BCBSNC Blue Value 2026 | Tier 2 - Medium Cost Generic/Brand | — | — | — | None |
| BCBSNC Blue Advantage 2026 | Tier 2 - Medium Cost Generic/Brand | — | — | — | None |
| BCBSNC Blue Home with UNC Health Alliance 2026 | Tier 2 - Medium Cost Generic/Brand | — | — | — | None |
| BCBSNC Blue Local 2026 | Tier 2 - Medium Cost Generic/Brand | — | — | — | None |
| BCBSNC Blue Care 2026 | Tier 2 - Medium Cost Generic/Brand | — | — | — | None |
Cigna
1 planMedicare Part D
140 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Longevity Health Plan (HMO I-SNP) | Tier 1 - Preferred Generic | ✓ | — | — | PA |
| Senior Care (HMO I-SNP) | Tier 1 - Preferred Generic | — | — | ✓ 120 per 30 days | QL |
| Provider Partners North Carolina Advantage Plan (HMO I-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| NHC Advantage (HMO I-SNP) | Tier 1 - Preferred Generic | — | — | ✓ 120 per 30 days | QL |
| PruittHealth Premier (HMO I-SNP) | Tier 1 - Preferred Generic | — | — | ✓ 120 per 30 days | QL |
| Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | Tier 1 - Preferred Generic | — | — | ✓ 120 per 30 days | QL |
| Liberty Medicare Dual Plan (HMO D-SNP) | Tier 1 - Preferred Generic | — | — | ✓ 120 per 30 days | QL |
| Liberty Medicare Advantage (HMO C-SNP) | Tier 1 - Preferred Generic | — | — | ✓ 120 per 30 days | QL |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Provider Partners North Carolina Essential Plan (HMO I-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | Tier 2 - Generic | ✓ | — | — | PA |
| Troy Medicare (HMO) | Tier 2 - Generic | ✓ | — | — | PA |
| AARP Medicare Advantage from UHC NC-0019 (PPO) | Tier 2 - Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0017 (PPO) | Tier 2 - Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0016 (PPO) | Tier 2 - Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0004 (PPO) | Tier 2 - Generic | — | — | — | None |
| Alignment Health AVA (PPO) | Tier 2 - Generic | — | — | — | None |
| Alignment Health Heart & Diabetes Care (HMO C-SNP) | Tier 2 - Generic | — | — | — | None |
| Alignment Health Platinum Select (HMO) | Tier 2 - Generic | — | — | — | None |
| Experience Health Medicare Advantage (HMO) | Tier 2 - Generic | — | — | — | None |
| Healthy Blue + Medicare (HMO-POS D-SNP) | Tier 2 - Generic | — | — | — | None |
| Alignment Health Platinum (HMO) | Tier 2 - Generic | — | — | — | None |
| Alignment Health NC Duals (HMO-POS D-SNP) | Tier 2 - Generic | — | — | — | None |
| Alignment Health smartHMO (HMO) | Tier 2 - Generic | — | — | — | None |
| UHC Nursing Home Plan NC-F001 (PPO I-SNP) | Tier 2 - Generic | — | — | — | None |
| Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP) | Tier 2 - Generic | — | — | — | None |
| UHC Dual Complete NC-S001 (PPO D-SNP) | Tier 2 - Generic | — | — | — | None |
| UHC Dual Complete NC-S2 (PPO D-SNP) | Tier 2 - Generic | — | — | — | None |
| AARP Medicare Advantage Access from UHC NC-23 (PPO) | Tier 2 - Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0009 (HMO-POS) | Tier 2 - Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0011 (HMO-POS) | Tier 2 - Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0012 (HMO-POS) | Tier 2 - Generic | — | — | — | None |
| AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS) | Tier 2 - Generic | — | — | — | None |
| AARP Medicare Advantage Giveback from UHC NC-14 (HMO-POS) | Tier 2 - Generic | — | — | — | None |
| UHC Dual Complete NC-V001 (HMO-POS D-SNP) | Tier 2 - Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0015 (HMO-POS) | Tier 2 - Generic | — | — | — | None |
| UHC Dual Complete NC-S3 (HMO-POS D-SNP) | Tier 2 - Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-24 (HMO-POS) | Tier 2 - Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-26 (HMO-POS) | Tier 2 - Generic | — | — | — | None |
| Erickson Advantage Signature (HMO-POS) | Tier 2 - Generic | — | — | — | None |
| Erickson Advantage Guardian (HMO-POS I-SNP) | Tier 2 - Generic | — | — | — | None |
| Erickson Advantage Freedom (HMO-POS) | Tier 2 - Generic | — | — | — | None |
| Erickson Advantage Liberty (HMO-POS) | Tier 2 - Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0001 (PPO) | Tier 2 - Generic | — | — | — | None |
| Wellcare Simple Open (PPO) | Tier 2 - Generic | ✓ | — | — | PA |
| Wellcare Simple (HMO-POS) | Tier 2 - Generic | ✓ | — | — | PA |
| Wellcare Giveback Open (PPO) | Tier 2 - Generic | ✓ | — | — | PA |
| Blue Medicare PPO Enhanced (PPO) | Tier 2 - Generic | — | — | — | None |
| Blue Medicare Essential Plus (HMO-POS) | Tier 2 - Generic | — | — | — | None |
| Blue Medicare Enhanced (HMO-POS) | Tier 2 - Generic | — | — | — | None |
| Blue Medicare Choice (HMO) | Tier 2 - Generic | — | — | — | None |
| Blue Medicare Essential (HMO) | Tier 2 - Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0021 (HMO-POS) | Tier 2 - Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0022 (HMO-POS) | Tier 2 - Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0007 (HMO-POS) | Tier 2 - Generic | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0008 (HMO-POS) | Tier 2 - Generic | — | — | — | None |
| UHC Dual Complete NC-D001 (HMO-POS D-SNP) | Tier 2 - Generic | — | — | — | None |
| UHC Complete Care NC-25 (HMO-POS C-SNP) | Tier 2 - Generic | — | — | — | None |
| UHC Complete Care NC-27 (HMO-POS C-SNP) | Tier 2 - Generic | — | — | — | None |
| UHC Complete Care NC-28 (HMO-POS C-SNP) | Tier 2 - Generic | — | — | — | None |
| Erickson Advantage Champion (HMO-POS C-SNP) | Tier 2 - Generic | — | — | — | None |
| Wellcare Dual Reserve (HMO-POS D-SNP) | Tier 2 - Generic | ✓ | — | — | PA |
| Wellcare Dual Liberty (HMO-POS D-SNP) | Tier 2 - Generic | ✓ | — | — | PA |
| Wellcare Dual Access (HMO-POS D-SNP) | Tier 2 - Generic | ✓ | — | — | PA |
| Wellcare Assist Open (PPO) | Tier 2 - Generic | ✓ | — | — | PA |
| Wellcare Dual Liberty Open (PPO D-SNP) | Tier 2 - Generic | ✓ | — | — | PA |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Tier 2 - Generic | ✓ | — | — | PA |
| DEVOTED DUAL FULL 013 NC (HMO D-SNP) | Tier 3 - Preferred Brand | ✓ | — | ✓ 120 per 30 days | PA | QL |
| HealthSpring True Choice (PPO) | Tier 3 - Preferred Brand | ✓ | — | ✓ 120 per 30 days | PA | QL |
| HealthSpring TotalCare (HMO D-SNP) | Tier 3 - Preferred Brand | ✓ | — | ✓ 120 per 30 days | PA | QL |
| HealthSpring TotalCare Plus (HMO D-SNP) | Tier 3 - Preferred Brand | ✓ | — | ✓ 120 per 30 days | PA | QL |
| HealthSpring Preferred (HMO) | Tier 3 - Preferred Brand | ✓ | — | ✓ 120 per 30 days | PA | QL |
| HealthSpring Preferred Select (HMO) | Tier 3 - Preferred Brand | ✓ | — | ✓ 120 per 30 days | PA | QL |
| HealthSpring Preferred Savings (HMO) | Tier 3 - Preferred Brand | ✓ | — | ✓ 120 per 30 days | PA | QL |
| HealthSpring Preferred Plus (HMO) | Tier 3 - Preferred Brand | ✓ | — | ✓ 120 per 30 days | PA | QL |
| DEVOTED C-SNP PREMIUM 014 NC (HMO C-SNP) | Tier 3 - Preferred Brand | ✓ | — | ✓ 120 per 30 days | PA | QL |
| DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | Tier 3 - Preferred Brand | ✓ | — | ✓ 120 per 30 days | PA | QL |
| DEVOTED C-SNP PREMIUM 016 NC (HMO C-SNP) | Tier 3 - Preferred Brand | ✓ | — | ✓ 120 per 30 days | PA | QL |
| DEVOTED C-SNP PREMIUM 017 NC (HMO C-SNP) | Tier 3 - Preferred Brand | ✓ | — | ✓ 120 per 30 days | PA | QL |
| DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) | Tier 3 - Preferred Brand | ✓ | — | ✓ 120 per 30 days | PA | QL |
| DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | Tier 3 - Preferred Brand | ✓ | — | ✓ 120 per 30 days | PA | QL |
| DEVOTED DUAL 009 NC (HMO D-SNP) | Tier 3 - Preferred Brand | ✓ | — | ✓ 120 per 30 days | PA | QL |
| DEVOTED CORE 001 NC (HMO) | Tier 3 - Preferred Brand | ✓ | — | ✓ 120 per 30 days | PA | QL |
| DEVOTED GIVEBACK 002 NC (HMO) | Tier 3 - Preferred Brand | ✓ | — | ✓ 120 per 30 days | PA | QL |
| DEVOTED GIVEBACK 012 NC (HMO) | Tier 3 - Preferred Brand | ✓ | — | ✓ 120 per 30 days | PA | QL |
| DEVOTED CHOICE 001 NC (PPO) | Tier 3 - Preferred Brand | ✓ | — | ✓ 120 per 30 days | PA | QL |
| DEVOTED CHOICE GIVEBACK 002 NC (PPO) | Tier 3 - Preferred Brand | ✓ | — | ✓ 120 per 30 days | PA | QL |
| DEVOTED CHOICE 003 NC (PPO) | Tier 3 - Preferred Brand | ✓ | — | ✓ 120 per 30 days | PA | QL |
| DEVOTED CHOICE GIVEBACK 004 NC (PPO) | Tier 3 - Preferred Brand | ✓ | — | ✓ 120 per 30 days | PA | QL |
| DEVOTED CHOICE 005 NC (PPO) | Tier 3 - Preferred Brand | ✓ | — | ✓ 120 per 30 days | PA | QL |
| DEVOTED CHOICE GIVEBACK 006 NC (PPO) | Tier 3 - Preferred Brand | ✓ | — | ✓ 120 per 30 days | PA | QL |
| DEVOTED CHOICE 008 NC (PPO) | Tier 3 - Preferred Brand | ✓ | — | ✓ 120 per 30 days | PA | QL |
| DEVOTED CHOICE GIVEBACK 009 NC (PPO) | Tier 3 - Preferred Brand | ✓ | — | ✓ 120 per 30 days | PA | QL |
| Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | Tier 3 - Preferred Brand | — | — | ✓ 90 per 30 days | QL |
| Humana Gold Plus H1036-233 (HMO-POS) | Tier 3 - Preferred Brand | — | — | ✓ 90 per 30 days | QL |
| Humana Dual Select H1036-307 (HMO D-SNP) | Tier 3 - Preferred Brand | — | — | ✓ 90 per 30 days | QL |
| Humana Gold Plus Giveback H1036-318 (HMO-POS) | Tier 3 - Preferred Brand | — | — | ✓ 90 per 30 days | QL |
| Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | Tier 3 - Preferred Brand | — | — | ✓ 90 per 30 days | QL |
| Humana Gold Plus H1036-335 (HMO-POS) | Tier 3 - Preferred Brand | — | — | ✓ 90 per 30 days | QL |
| HumanaChoice Giveback H5216-017 (PPO) | Tier 3 - Preferred Brand | — | — | ✓ 90 per 30 days | QL |
| HumanaChoice H5216-211 (PPO) | Tier 3 - Preferred Brand | — | — | ✓ 90 per 30 days | QL |
| Humana Full Access H5525-034 (PPO) | Tier 3 - Preferred Brand | — | — | ✓ 90 per 30 days | QL |
| HumanaChoice Giveback H5525-035 (PPO) | Tier 3 - Preferred Brand | — | — | ✓ 90 per 30 days | QL |
| HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | Tier 3 - Preferred Brand | — | — | ✓ 90 per 30 days | QL |
| HumanaChoice H5525-049 (PPO) | Tier 3 - Preferred Brand | — | — | ✓ 90 per 30 days | QL |
| HumanaChoice H5525-050 (PPO) | Tier 3 - Preferred Brand | — | — | ✓ 90 per 30 days | QL |
| HumanaChoice H5525-070 (PPO) | Tier 3 - Preferred Brand | — | — | ✓ 90 per 30 days | QL |
| Humana Dual Select H5525-072 (PPO D-SNP) | Tier 3 - Preferred Brand | — | — | ✓ 90 per 30 days | QL |
| HumanaChoice H5525-083 (PPO) | Tier 3 - Preferred Brand | — | — | ✓ 90 per 30 days | QL |
| Humana Gold Plus H6622-025 (HMO-POS) | Tier 3 - Preferred Brand | — | — | ✓ 90 per 30 days | QL |
| Humana Gold Plus H6622-026 (HMO-POS) | Tier 3 - Preferred Brand | — | — | ✓ 90 per 30 days | QL |
| Humana Dual Select H6622-027 (HMO-POS D-SNP) | Tier 3 - Preferred Brand | — | — | ✓ 90 per 30 days | QL |
| Humana Gold Plus H6622-057 (HMO-POS) | Tier 3 - Preferred Brand | — | — | ✓ 90 per 30 days | QL |
| Humana Gold Plus H6622-060 (HMO-POS) | Tier 3 - Preferred Brand | — | — | ✓ 90 per 30 days | QL |
| Humana Gold Plus H6622-061 (HMO-POS) | Tier 3 - Preferred Brand | — | — | ✓ 90 per 30 days | QL |
| Humana Gold Choice H8145-004 (PFFS) | Tier 3 - Preferred Brand | — | — | ✓ 90 per 30 days | QL |
| Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | Tier 3 - Preferred Brand | — | — | ✓ 90 per 30 days | QL |
| Humana Gold Plus H1036-137 (HMO-POS) | Tier 3 - Preferred Brand | — | — | ✓ 90 per 30 days | QL |
| HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
| HealthTeam Advantage Vitality Plan (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| HealthTeam Advantage Plan II (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| HealthTeam Advantage Plan I (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| Aetna Medicare Dual (HMO D-SNP) | Tier 4 - Non-Preferred | ✓ | — | ✓ 120 per 30 days | PA | QL |
| Aetna Medicare Signature (HMO) | Tier 4 - Non-Preferred | ✓ | — | ✓ 120 per 30 days | PA | QL |
| Aetna Medicare Chronic Care Value (HMO C-SNP) | Tier 4 - Non-Preferred | ✓ | — | ✓ 120 per 30 days | PA | QL |
| Aetna Medicare Chronic Care (HMO C-SNP) | Tier 4 - Non-Preferred | ✓ | — | ✓ 120 per 30 days | PA | QL |
| Aetna Medicare Signature (PPO) | Tier 4 - Non-Preferred | ✓ | — | ✓ 120 per 30 days | PA | QL |
| Aetna Medicare Signature Giveback (PPO) | Tier 4 - Non-Preferred | ✓ | — | ✓ 120 per 30 days | PA | QL |
| Aetna Medicare Signature (PPO) | Tier 4 - Non-Preferred | ✓ | — | ✓ 120 per 30 days | PA | QL |
| Aetna Medicare Signature (PPO) | Tier 4 - Non-Preferred | ✓ | — | ✓ 120 per 30 days | PA | QL |
| Aetna Medicare Signature Extra (PPO) | Tier 4 - Non-Preferred | ✓ | — | ✓ 120 per 30 days | PA | QL |
| Aetna Medicare Enhanced (PPO) | Tier 4 - Non-Preferred | ✓ | — | ✓ 120 per 30 days | PA | QL |
| Aetna Medicare Enhanced (PPO) | Tier 4 - Non-Preferred | ✓ | — | ✓ 120 per 30 days | PA | QL |
| Aetna Medicare Signature (PPO) | Tier 4 - Non-Preferred | ✓ | — | ✓ 120 per 30 days | PA | QL |
| Aetna Medicare Enhanced (HMO) | Tier 4 - Non-Preferred | ✓ | — | ✓ 120 per 30 days | PA | QL |
| Aetna Medicare Full Dual Care (HMO D-SNP) | Tier 4 - Non-Preferred | ✓ | — | ✓ 120 per 30 days | PA | QL |
| Aetna Medicare Signature Care (HMO) | Tier 4 - Non-Preferred | ✓ | — | ✓ 120 per 30 days | PA | QL |
| Aetna Medicare Prime (HMO) | Tier 4 - Non-Preferred | ✓ | — | ✓ 120 per 30 days | PA | QL |
| Aetna Medicare Value Plus (HMO) | Tier 4 - Non-Preferred | ✓ | — | ✓ 120 per 30 days | PA | QL |
| Aetna Medicare Signature (HMO) | Tier 4 - Non-Preferred | ✓ | — | ✓ 120 per 30 days | PA | QL |