FillMap45142nv0040008 · 45142-45142NV0040008-0About this plan

Does 45142nv0040008 cover botulinum toxin type A?

1 · Your plan

45142nv0040008

45142-45142NV0040008-0 · ACA · ACA Marketplace

2 · Your medication

botulinum toxin type A

botulinum toxin type Aunder 45142nv0040008

Covered — requires prior authorization

Your plan has to approve it first — your doctor’s office handles it.

What you'd pay

This plan doesn't publish a price for this tier. Your pharmacy can quote it before you fill.

Tier: Non preferred generic non preferred brand
Approval first: Required
Try another first: No
Amount limit: None

Talk to your pharmacist or doctor before acting on anything here. They can see your full history and this page cannot. Never start, stop, or switch a medication based on it. Coverage rules change and plans make exceptions — your pharmacy can check your exact benefit in seconds.As of Sep 14, 2026 · CMS QHP machine-readable. Reference information, not medical advice and not a price.

Your cost-sharing levelMarketplace plans publish a different amount for each level. Your eligibility notice says which applies. Nothing here is saved.

Covered forms and strengths (3)

incobotulinumtoxinA 100 UNT Injection [Xeomin]Approval first
incobotulinumtoxinA 200 UNT Injection [Xeomin]Approval first
incobotulinumtoxinA 50 UNT Injection [Xeomin]Approval first

← All coverage for botulinum toxin type A