24 HR amphetamine 9.4 MG Extended Release Oral Tablet
amphetamine
RxCUI: 1739837
What the CMS Formulary Data Shows for 24 HR amphetamine 9.4 MG Extended Release Oral Tablet
Per the CMS 2026 Part D formulary file, 24 HR amphetamine 9.4 MG Extended Release Oral Tablet (RxNorm concept RXCUI 1739837, generic name amphetamine) appears on 20 distinct formulary files spanning 86 Medicare Part D plan offerings - 1.7% 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 3.
Real-world access to 24 HR amphetamine 9.4 MG Extended Release Oral Tablet depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.
Medicare Part D spending dashboard figures are not published for this drug. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 24 HR amphetamine 9.4 MG Extended Release Oral Tablet today.
Coverage Details
- Formularies covering
- 20
- Plans covering
- 86
- Coverage rate
- 1.7%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 24 HR amphetamine 9.4 MG Extended Release Oral Tablet
86 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| ElderServe MAP (HMO D-SNP) | ELDERSERVE HEALTH, INC. | T1 | No | $0 | NY |
| Cooperative Advantage (HMO D-SNP) | GROUP HEALTH COOPERATIVE OF EAU CLAIRE | T1 | No | $0 | WI |
| Longevity Health Plan (PPO I-SNP) | LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP | T1 | No | $0 | NJ |
| Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) | UPPER PENINSULA HEALTH PLAN, LLC | T1 | No | $0 | MI |
| CareSource Dual Advantage (HMO D-SNP) | CARESOURCE GEORGIA CO. | T1 | No | $0 | GA |
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP CARESOURCE | T1 | No | $0 | MI |
| Longevity Health Plan (HMO I-SNP) | LONGEVITY HEALTH PLAN OF FLORIDA, INC. | T1 | No | $4.80 | FL |
| Longevity Health Plan (HMO I-SNP) | LONGEVITY HEALTH PLAN OF MICHIGAN, INC. | T1 | No | $8.80 | MI |
| Longevity Health Plan (HMO I-SNP) | LONGEVITY HEALTH PLAN OF ILLINOIS, INC. | T1 | No | $15.20 | IL |
| WellSense Added Value (HMO) | BOSTON MEDICAL CENTER HEALTH PLAN, INC. | T1 | No | $21.70 | NH |
| Longevity Health Plan (HMO I-SNP) | LONGEVITY HEALTH PLAN OF COLORADO, INC. | T1 | No | $35.20 | CO |
| Longevity Health Plan (HMO I-SNP) | LONGEVITY HEALTH PLAN OF NORTH CAROLINA, INC. | T1 | No | $36.20 | NC |
| Longevity Health Plan (PPO I-SNP) | LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP | T1 | No | $40.00 | NJ |
| ElderServe Star (HMO I-SNP) | ELDERSERVE HEALTH, INC. | T1 | No | $58.80 | NY |
| Longevity Health Plan (HMO I-SNP) | LONGEVITY HEALTH PLAN OF NEW YORK, INC. | T1 | No | $58.80 | NY |
| The Health Plan SecureCare - Option II (HMO) | THE HEALTH PLAN OF WEST VIRGINIA, INC. | T4 | No | $0 | OH |
| The Health Plan SecureCare - Option II (HMO) | THE HEALTH PLAN OF WEST VIRGINIA, INC. | T4 | No | $0 | OH, WV |
| The Health Plan SecureCare Capitol Plan (HMO) | THE HEALTH PLAN OF WEST VIRGINIA, INC. | T4 | No | $0 | WV |
| The Health Plan SecureChoice Optimum (PPO) | THP INSURANCE COMPANY | T4 | No | $0 | OH, WV |
| WellSense Signature (HMO) | BOSTON MEDICAL CENTER HEALTH PLAN, INC. | T4 | No | $0 | NH |
| WellSense Signature Access (PPO) | BOSTON MEDICAL CENTER HEALTH PLAN, INC. | T4 | No | $0 | NH |
| Community Health Plan of WA Dual Complete (HMO D-SNP) | COMMUNITY HEALTH PLAN OF WASHINGTON | T4 | No | $0 | WA |
| Community Health Plan of WA Dual Select (HMO D-SNP) | COMMUNITY HEALTH PLAN OF WASHINGTON | T4 | No | $0 | WA |
| Essence Advantage (HMO) | ESSENCE HEALTHCARE, INC. | T4 | No | $0 | IL, MO |
| Essence Advantage (HMO) | ESSENCE HEALTHCARE, INC. | T4 | No | $0 | AR, MO |
| Essence Advantage Select (HMO) | ESSENCE HEALTHCARE, INC. | T4 | No | $0 | IL, MO |
| Essence Advantage (HMO) | ESSENCE HEALTHCARE, INC. | T4 | No | $0 | IN, KY |
| Essence Advantage Select (HMO) | ESSENCE HEALTHCARE, INC. | T4 | No | $0 | IL |
| Essence Advantage Choice (PPO) | ESSENCE HEALTHCARE PPO, INC. | T4 | No | $0 | IL, MO |
| Essence Advantage Choice (PPO) | ESSENCE HEALTHCARE PPO, INC. | T4 | No | $0 | AR, MO |
| Essence Advantage Choice (PPO) | ESSENCE HEALTHCARE PPO, INC. | T4 | No | $0 | IL |
| CareSource Dual Advantage Plus (HMO D-SNP) | CARESOURCE GEORGIA CO. | T4 | No | $0 | GA |
| CareSource MyCare Ohio (HMO D-SNP) | CARESOURCE OHIO, INC. | T4 | No | $0 | OH |
| Blue adVantage Liberty (PPO) | LOUISIANA HEALTH SERVICE & INDEMNITY COMPANY | T4 | No | $0 | LA |
| Blue adVantage Thrive (PPO) | LOUISIANA HEALTH SERVICE & INDEMNITY COMPANY | T4 | No | $0 | LA |
| Blue adVantage Classic (HMO-POS) | HMO LOUISIANA, INC. | T4 | No | $0 | LA |
| Blue adVantage Giveback (HMO-POS) | HMO LOUISIANA, INC. | T4 | No | $0 | LA |
| MedMutual Advantage Access (PPO) | MEDICAL MUTUAL OF OHIO | T4 | No | $0 | OH |
| MedMutual Advantage Classic (HMO) | MEDICAL MUTUAL OF OHIO | T4 | No | $0 | OH |
| MedMutual Advantage Signature (HMO-POS) | MEDICAL MUTUAL OF OHIO | T4 | No | $0 | OH |
| Medica Advantage Solution H6154-001 (HMO-POS) | MEDICA HEALTH PLANS | T4 | No | $0 | MN |
| Medica Advantage Solution H8889-005 (PPO) | MEDICA HEALTH PLANS | T4 | No | $0 | MN |
| Medica Advantage Value (PPO) | MEDICA HEALTH PLANS | T4 | No | $0 | IA, NE |
| Medica Advantage Select (PPO) | MEDICA HEALTH PLANS | T4 | No | $0 | ND |
| Medica Advantage Value (PPO) | MEDICA HEALTH PLANS | T4 | No | $0 | ND |
| Medica Advantage Select (PPO) | MEDICA HEALTH PLANS | T4 | No | $0 | IA, NE |
| Medica Advantage Dual (PPO D-SNP) | MEDICA HEALTH PLANS | T4 | No | $0 | ND |
| Medica Advantage Value (PPO) | MEDICA HEALTH PLANS | T4 | No | $0 | SD |
| Medica Advantage Select (PPO) | MEDICA HEALTH PLANS | T4 | No | $0 | SD |
| Medica DUAL Solution (HMO D-SNP) | MEDICA HEALTH PLANS | T4 | No | $0 | MN |
Frequently Asked Questions
Is 24 HR amphetamine 9.4 MG Extended Release Oral Tablet covered by Medicare Part D?
Yes, 24 HR amphetamine 9.4 MG Extended Release Oral Tablet is covered by 86 Medicare Part D plans (1.7% of all Part D formularies).
What tier is 24 HR amphetamine 9.4 MG Extended Release Oral Tablet on Medicare Part D plans?
24 HR amphetamine 9.4 MG Extended Release Oral Tablet averages Tier 3 across Part D plans, ranging from Tier 1 to Tier 4.
Does 24 HR amphetamine 9.4 MG Extended Release Oral Tablet require prior authorization?
0% of Part D formularies require prior authorization for 24 HR amphetamine 9.4 MG Extended Release Oral Tablet. Step therapy: 0%. Quantity limits: 0%.
Read our methodology - how this data is sourced, computed, and verified.