dexmethylphenidate hydrochloride 2.5 MG Oral Tablet
dexmethylphenidate hydrochloride
RxCUI: 899557
What the CMS Formulary Data Shows for dexmethylphenidate hydrochloride 2.5 MG Oral Tablet
Per the CMS 2026 Part D formulary file, dexmethylphenidate hydrochloride 2.5 MG Oral Tablet (RxNorm concept RXCUI 899557, generic name dexmethylphenidate hydrochloride) appears on 257 distinct formulary files spanning 4,569 Medicare Part D plan offerings - 90.2% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.4.
Real-world access to dexmethylphenidate hydrochloride 2.5 MG Oral Tablet depends on utilization management as much as tier placement: 38.9% of covering formularies require prior authorization. 0% require step therapy. 79.8% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 9,197 Part D beneficiaries filled dexmethylphenidate hydrochloride 2.5 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $6,100,623 and an average per-beneficiary annual cost of $663.33. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry dexmethylphenidate hydrochloride 2.5 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 257
- Plans covering
- 4,569
- Coverage rate
- 90.2%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 38.9% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 79.8% of formularies
2023 Medicare Spending
- Beneficiaries
- 9,197
- Total spending
- $6,100,623
- Avg per beneficiary
- $663.33
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering dexmethylphenidate hydrochloride 2.5 MG Oral Tablet
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) | HPMP OF FLORIDA, INC. | T1 | Yes | $0 | FL |
| 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 |
| Healthfirst CompleteCare (HMO D-SNP) | HEALTHFIRST HEALTH PLAN, INC. | T1 | Yes | $0 | NY |
| IMCare Classic (HMO D-SNP) | ITASCA MEDICAL CARE | T1 | Yes | $0 | MN |
| Johns Hopkins Advantage MD D-SNP (HMO D-SNP) | HOPKINS HEALTH ADVANTAGE, INC. | T1 | Yes | $0 | MD |
| MetroPlus UltraCare (HMO D-SNP) | METROPLUS HEALTH PLAN, INC. | T1 | Yes | $0 | NY |
| Senior Whole Health SCO (HMO D-SNP) | SENIOR WHOLE HEALTH, LLC | T1 | Yes | $0 | MA |
| Senior Whole Health SCO NHC (HMO D-SNP) | SENIOR WHOLE HEALTH, LLC | T1 | Yes | $0 | MA |
| Molina One Care (HMO D-SNP) | SENIOR WHOLE HEALTH, LLC | T1 | Yes | $0 | MA |
| PruittHealth Premier D-SNP (HMO D-SNP) | PRUITTHEALTH PREMIER, INC. | T1 | No | $0 | GA |
| KeyCare Advantage Plus (HMO C-SNP) | ISNP VENTURES, LLC | T1 | No | $0 | MD |
| Premier Care (HMO-POS I-SNP) | LIFEWORKS ADVANTAGE, LLC | T1 | No | $0 | VA |
| Premier Care (HMO I-SNP) | ALIGN SENIOR CARE CALIFORNIA INC. | T1 | No | $0 | CA |
| Advantage Care (HMO) | ALIGN SENIOR CARE CALIFORNIA INC. | T1 | No | $0 | CA |
| Premier Care (HMO-POS I-SNP) | ALIGN SENIOR CARE MI, LLC | T1 | No | $0 | MI |
| Premier Care (HMO I-SNP) | ALIGN SENIOR CARE FLORIDA, INC. | T1 | No | $0 | FL |
| Perennial Advantage Freedom (HMO-POS) | PERENNIAL ADVANTAGE OF COLORADO, INC. | T1 | No | $0 | CO |
| Perennial Advantage Premier (HMO-POS I-SNP) | PERENNIAL ADVANTAGE OF COLORADO, INC. | T1 | No | $0 | CO |
| Perennial Advantage Freedom (HMO) | PERENNIAL ADVANTAGE OF COLORADO, INC. | T1 | No | $0 | PA |
| Perennial Advantage Premier (HMO I-SNP) | PERENNIAL ADVANTAGE OF COLORADO, INC. | T1 | No | $0 | PA |
| Perennial Advantage Freedom (HMO-POS) | PERENNIAL ADVANTAGE OF OHIO, INC. | T1 | No | $0 | OH |
| Perennial Advantage Premier (HMO-POS I-SNP) | PERENNIAL ADVANTAGE OF OHIO, INC. | T1 | No | $0 | OH |
| ProCare Advantage - Diabetes Care Management (HMO-POS C-SNP) | PROCARE ADVANTAGE, LLC | T1 | No | $0 | TX |
| PruittHealth Premier Advantage (HMO I-SNP) | PRUITTHEALTH PREMIER, INC. | T1 | No | $0 | GA |
| Senior Health Plan Silver Plus (HMO) | COMMUNITYCARE GOVERNMENT PROGRAMS, INC. | T1 | No | $0 | OK |
| Senior Health Plan Oklahoma Dual Complete (HMO D-SNP) | COMMUNITYCARE GOVERNMENT PROGRAMS, INC. | T1 | No | $0 | OK |
| Community First Medicare Advantage Alamo Plan (HMO) | COMMUNITY FIRST HEALTH PLANS, INC. | T1 | No | $0 | TX |
| Community First Medicare Advantage D-SNP (HMO D-SNP) | COMMUNITY FIRST HEALTH PLANS, INC. | T1 | No | $0 | TX |
| Community DualCare Aligned (HMO D-SNP) | COMMUNITY HEALTH CHOICE TEXAS, INC. | T1 | No | $0 | TX |
| Community DualCare Access (HMO D-SNP) | COMMUNITY HEALTH CHOICE TEXAS, INC. | T1 | No | $0 | TX |
| El Paso Health Medicare Advantage Dual (HMO D-SNP) | EL PASO FIRST HEALTH PLANS, INC. | T1 | No | $0 | TX |
| El Paso Health Total (HMO) | EL PASO FIRST HEALTH PLANS, INC. | T1 | No | $0 | TX |
| El Paso Health Giveback (HMO) | EL PASO FIRST HEALTH PLANS, INC. | T1 | No | $0 | TX |
| Liberty Medicare Advantage (HMO C-SNP) | LIBERTY ADVANTAGE, LLC | T1 | No | $0 | NC |
| Peak Advantage Vista (PPO) | PEAK HEALTH INSURANCE CORPORATION | T1 | No | $0 | PA, WV |
| SECUR Edge (HMO I-SNP) | SECUR INC | T1 | No | $0 | FL |
| Simpra Advantage Dual Care (PPO D-SNP) | SIMPRA ADVANTAGE, INC. | T1 | No | $0 | AL |
| CareAdvantage (HMO D-SNP) | SAN MATEO HEALTH COMMISSION | T1 | Yes | $0 | CA |
| Gold Coast Health Plan Total Care Advantage (HMO D-SNP) | Ventura County Medi-Cal Managed Care Commission | T1 | Yes | $0 | CA |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Health Care Service Corporation | T1 | Yes | $0 | NM |
| Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) | Health Care Service Corporation | T1 | Yes | $0 | NM |
| Horizon NJ TotalCare (HMO D-SNP) | HORIZON HEALTHCARE OF NEW JERSEY, INC. | T1 | Yes | $0 | NJ |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | Yes | $0 | MN |
| NaviCare (HMO D-SNP) | FALLON COMMUNITY HEALTH PLAN | T1 | No | $0 | MA |
| Hamaspik Medicare Choice (HMO D-SNP) | HAMASPIK, INC. | T1 | Yes | $0 | NY |
| SeniorCare Complete (HMO D-SNP) | SOUTH COUNTRY HEALTH ALLIANCE | T1 | No | $0 | MN |
Frequently Asked Questions
Is dexmethylphenidate hydrochloride 2.5 MG Oral Tablet covered by Medicare Part D?
Yes, dexmethylphenidate hydrochloride 2.5 MG Oral Tablet is covered by 4,569 Medicare Part D plans (90.2% of all Part D formularies).
What tier is dexmethylphenidate hydrochloride 2.5 MG Oral Tablet on Medicare Part D plans?
dexmethylphenidate hydrochloride 2.5 MG Oral Tablet averages Tier 2.4 across Part D plans, ranging from Tier 1 to Tier 4.
Does dexmethylphenidate hydrochloride 2.5 MG Oral Tablet require prior authorization?
38.9% of Part D formularies require prior authorization for dexmethylphenidate hydrochloride 2.5 MG Oral Tablet. Step therapy: 0%. Quantity limits: 79.8%.
How much does Medicare spend on dexmethylphenidate hydrochloride 2.5 MG Oral Tablet?
In 2023, total Medicare Part D spending on dexmethylphenidate hydrochloride 2.5 MG Oral Tablet was $6,100,623, covering 9,197 beneficiaries. The average spend per beneficiary was $663.33.
Read our methodology - how this data is sourced, computed, and verified.