dexlansoprazole 60 MG Delayed Release Oral Capsule
dexlansoprazole
RxCUI: 833213
What the CMS Formulary Data Shows for dexlansoprazole 60 MG Delayed Release Oral Capsule
Per the CMS 2026 Part D formulary file, dexlansoprazole 60 MG Delayed Release Oral Capsule (RxNorm concept RXCUI 833213, generic name dexlansoprazole) appears on 46 distinct formulary files spanning 2,105 Medicare Part D plan offerings - 41.5% 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 3.2.
Real-world access to dexlansoprazole 60 MG Delayed Release Oral Capsule depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 10.9% require step therapy. 84.8% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 178,875 Part D beneficiaries filled dexlansoprazole 60 MG Delayed Release Oral Capsule in 2023, with total plan-and-beneficiary spending of $315,328,215 and an average per-beneficiary annual cost of $1,762.84. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry dexlansoprazole 60 MG Delayed Release Oral Capsule today.
Coverage Details
- Formularies covering
- 46
- Plans covering
- 2,105
- Coverage rate
- 41.5%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 10.9% of formularies
- Quantity limits
- 84.8% of formularies
2023 Medicare Spending
- Beneficiaries
- 178,875
- Total spending
- $315,328,215
- Avg per beneficiary
- $1,762.84
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering dexlansoprazole 60 MG Delayed Release Oral Capsule
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| NaviCare (HMO D-SNP) | FALLON COMMUNITY HEALTH PLAN | T1 | No | $0 | MA |
| Platino Blindao (HMO D-SNP) | TRIPLE S ADVANTAGE, INC. | T1 | No | $0 | PR |
| Platino Enlace (HMO D-SNP) | TRIPLE S ADVANTAGE, INC. | T1 | No | $0 | PR |
| PLATINO ADVANCE (HMO D-SNP) | TRIPLE S ADVANTAGE, INC. | T1 | No | $0 | PR |
| PLATINO PLUS (HMO D-SNP) | TRIPLE S ADVANTAGE, INC. | T1 | No | $0 | PR |
| Mass General Brigham SCO (HMO D-SNP) | MASS GENERAL BRIGHAM HEALTH PLAN, INC | T1 | No | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | MASS GENERAL BRIGHAM HEALTH PLAN, INC | T1 | No | $0 | MA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | No | $0 | PA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | No | $0 | PA |
| Highmark Health Options Duals (HMO D-SNP) | HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC. | T1 | No | $0 | WV |
| Highmark Health Options Duals (HMO D-SNP) | HIGHMARK BCBSD, INC. | T1 | No | $0 | DE |
| Tufts Health One Care (HMO D-SNP) | TUFTS HEALTH PUBLIC PLANS, INC. | T1 | No | $0 | MA |
| Tufts Health One Care CW (HMO D-SNP) | TUFTS HEALTH PUBLIC PLANS, INC. | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options (HMO D-SNP) | TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options CW (HMO D-SNP) | TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION | T1 | No | $0 | MA |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | No | $13.10 | PA |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | No | $17.60 | PA |
| Highmark Health Options Duals Select (HMO D-SNP) | HIGHMARK BCBSD, INC. | T1 | No | $31.20 | DE |
| Wellpoint Medicare Advantage (HMO-POS) | WELLPOINT WEST VIRGINIA , INC. | T2 | No | $0 | WV |
| Anthem Medicare Advantage 3 (HMO-POS) | HealthKeepers, Inc. | T2 | No | $0 | VA |
| Anthem Medicare Advantage 3 (HMO-POS) | HealthKeepers, Inc. | T2 | No | $0 | VA |
| Anthem Medicare Advantage 3 (HMO-POS) | HealthKeepers, Inc. | T2 | No | $0 | VA |
| Wellpoint Medicare Advantage 2 (HMO-POS) | WELLPOINT TENNESSEE, INC. | T2 | No | $0 | TN |
| Wellpoint Medicare Advantage 2 (HMO-POS) | WELLPOINT TENNESSEE, INC. | T2 | No | $0 | TN |
| Wellpoint Medicare Advantage 2 (HMO-POS) | WELLPOINT TENNESSEE, INC. | T2 | No | $0 | TN |
| Wellpoint Medicare Advantage 2 (HMO-POS) | WELLPOINT TENNESSEE, INC. | T2 | No | $0 | TN |
| HealthSun HealthAdvantage Plan (HMO) | HEALTHSUN HEALTH PLANS, INC. | T2 | No | $0 | FL |
| HealthSun MediMax (HMO) | HEALTHSUN HEALTH PLANS, INC. | T2 | No | $0 | FL |
| HealthSun HealthAdvantage Plan (HMO) | HEALTHSUN HEALTH PLANS, INC. | T2 | No | $0 | FL |
| HealthSun HealthAdvantage Plan (HMO) | HEALTHSUN HEALTH PLANS, INC. | T2 | No | $0 | FL |
| HealthSun MediSun Plus (HMO D-SNP) | HEALTHSUN HEALTH PLANS, INC. | T2 | No | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | HEALTHSUN HEALTH PLANS, INC. | T2 | No | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | HEALTHSUN HEALTH PLANS, INC. | T2 | No | $0 | FL |
| HealthSun MediSun Extra (HMO D-SNP) | HEALTHSUN HEALTH PLANS, INC. | T2 | No | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | HEALTHSUN HEALTH PLANS, INC. | T2 | No | $0 | FL |
| HealthSun VitalCare (HMO C-SNP) | HEALTHSUN HEALTH PLANS, INC. | T2 | No | $0 | FL |
| HealthSun VitalCare (HMO C-SNP) | HEALTHSUN HEALTH PLANS, INC. | T2 | No | $0 | FL |
| HealthSun MediSun Full Dual Plus (HMO D-SNP) | HEALTHSUN HEALTH PLANS, INC. | T2 | No | $0 | FL |
| HealthSun MediSun Full Dual Extra (HMO D-SNP) | HEALTHSUN HEALTH PLANS, INC. | T2 | No | $0 | FL |
| Simply Complete (HMO D-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply More (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply Complete (HMO D-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply Level (HMO C-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply Level (HMO C-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply More (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply Level (HMO C-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply More (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply Level (HMO C-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply Complete (HMO D-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| Simply More (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
Frequently Asked Questions
Is dexlansoprazole 60 MG Delayed Release Oral Capsule covered by Medicare Part D?
Yes, dexlansoprazole 60 MG Delayed Release Oral Capsule is covered by 2,105 Medicare Part D plans (41.5% of all Part D formularies).
What tier is dexlansoprazole 60 MG Delayed Release Oral Capsule on Medicare Part D plans?
dexlansoprazole 60 MG Delayed Release Oral Capsule averages Tier 3.2 across Part D plans, ranging from Tier 1 to Tier 4.
Does dexlansoprazole 60 MG Delayed Release Oral Capsule require prior authorization?
0% of Part D formularies require prior authorization for dexlansoprazole 60 MG Delayed Release Oral Capsule. Step therapy: 10.9%. Quantity limits: 84.8%.
How much does Medicare spend on dexlansoprazole 60 MG Delayed Release Oral Capsule?
In 2023, total Medicare Part D spending on dexlansoprazole 60 MG Delayed Release Oral Capsule was $315,328,215, covering 178,875 beneficiaries. The average spend per beneficiary was $1,762.84.
Read our methodology - how this data is sourced, computed, and verified.