dextroamphetamine sulfate 20 MG Oral Tablet
dextroamphetamine sulfate
RxCUI: 1535454
What the CMS Formulary Data Shows for dextroamphetamine sulfate 20 MG Oral Tablet
Per the CMS 2026 Part D formulary file, dextroamphetamine sulfate 20 MG Oral Tablet (RxNorm concept RXCUI 1535454, generic name dextroamphetamine sulfate) appears on 48 distinct formulary files spanning 2,141 Medicare Part D plan offerings - 42.3% 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 2.9.
Real-world access to dextroamphetamine sulfate 20 MG Oral Tablet depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 72.9% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 9,950 Part D beneficiaries filled dextroamphetamine sulfate 20 MG Oral Tablet in 2023, with total plan-and-beneficiary spending of $5,176,356 and an average per-beneficiary annual cost of $520.24. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry dextroamphetamine sulfate 20 MG Oral Tablet today.
Coverage Details
- Formularies covering
- 48
- Plans covering
- 2,141
- Coverage rate
- 42.3%
- 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
- 72.9% of formularies
2023 Medicare Spending
- Beneficiaries
- 9,950
- Total spending
- $5,176,356
- Avg per beneficiary
- $520.24
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering dextroamphetamine sulfate 20 MG Oral Tablet
2 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| Wellcare Dual Liberty (HMO D-SNP) | WELLCARE OF CONNECTICUT, INC. | T2 | No | No | $0 | CT |
| Wellcare Dual Access (HMO-POS D-SNP) | WELLCARE OF CONNECTICUT, INC. | T2 | No | No | $0 | CT |
Medicare Advantage Plans (MA-PD) Covering dextroamphetamine sulfate 20 MG Oral Tablet
98 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 |
| PHP (HMO C-SNP) | AIDS HEALTHCARE FOUNDATION | T1 | No | $0 | CA |
| VNS Health Total (HMO D-SNP) | VNS CHOICE | T1 | No | $0 | NY |
| Community Care's Partnership Program (HMO D-SNP) | COMMUNITY CARE HEALTH PLAN, INC. | T1 | No | $0 | WI |
| 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 |
| 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 |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | GOLD KIDNEY OF FLORIDA INC | T1 | No | $4.80 | FL |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | GOLD KIDNEY OF ARIZONA | T1 | No | $17.00 | AZ |
| VNS Health EasyCare Plus (HMO D-SNP) | VNS CHOICE | T1 | No | $51.60 | NY |
| Network Health Select (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T2 | No | $0 | WI |
| Network Health Go (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T2 | No | $0 | WI |
| Network Health Anywhere (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T2 | No | $0 | WI |
| Network Health Choice (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T2 | No | $0 | WI |
| Network Health Zero (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T2 | No | $0 | WI |
| DrMax (HMO) | DOCTORS HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| DrExtraCare (HMO C-SNP) | DOCTORS HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| DrSelect (HMO) | DOCTORS HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| DrSelect-CFL (HMO) | DOCTORS HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| DrPlatinum-CFL (HMO D-SNP) | DOCTORS HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| DrTotalCare-CFL (HMO C-SNP) | DOCTORS HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| DrElite-SFL (HMO) | DOCTORS HEALTHCARE PLANS, INC. | T2 | No | $0 | FL |
| MCS Classicare RxMax (HMO) | MCS ADVANTAGE, INC. | T2 | No | $0 | PR |
| MCS Classicare Platino Ideal (HMO D-SNP) | MCS ADVANTAGE, INC. | T2 | No | $0 | PR |
| MCS Classicare Efectivo (HMO) | MCS ADVANTAGE, INC. | T2 | No | $0 | PR |
| MCS Classicare Essential (HMO-POS) | MCS ADVANTAGE, INC. | T2 | No | $0 | PR |
| MCS Classicare Platino Progreso (HMO D-SNP) | MCS ADVANTAGE, INC. | T2 | No | $0 | PR |
| MCS Classicare Primero (HMO C-SNP) | MCS ADVANTAGE, INC. | T2 | No | $0 | PR |
| MCS Classicare Firme (HMO) | MCS ADVANTAGE, INC. | T2 | No | $0 | PR |
| MCS Classicare En Tu Hogar (HMO) | MCS ADVANTAGE, INC. | T2 | No | $0 | PR |
| MCS Classicare Hero (HMO) | MCS ADVANTAGE, INC. | T2 | No | $0 | PR |
| MCS Classicare Platino Total (HMO D-SNP) | MCS ADVANTAGE, INC. | T2 | No | $0 | PR |
| MCS Classicare InteliCare (HMO) | MCS ADVANTAGE, INC. | T2 | No | $0 | PR |
| MCS Classicare Platino Maximo (HMO D-SNP) | MCS ADVANTAGE, INC. | T2 | No | $0 | PR |
| MCS Classicare Excede (HMO) | MCS ADVANTAGE, INC. | T2 | No | $0 | PR |
| MCS Classicare Estrella (HMO) | MCS ADVANTAGE, INC. | T2 | No | $0 | PR |
| MCS Classicare Platino Superior (HMO D-SNP) | MCS ADVANTAGE, INC. | T2 | No | $0 | PR |
| MCS Classicare Platino 185 (HMO D-SNP) | MCS ADVANTAGE, INC. | T2 | No | $0 | PR |
| Fallon Medicare Plus Orange (HMO) | FALLON COMMUNITY HEALTH PLAN | T2 | No | $0 | MA |
| Healthy Mississippi Premier Advantage (HMO-POS) | Healthy Mississippi, Inc. | T2 | No | $0 | MS |
| Wellcare Superior HealthPlan Dual Align (HMO D-SNP) | SUPERIOR HEALTHPLAN, INC. | T2 | No | $0 | TX |
| Wellcare Superior HealthPlan Dual Align (HMO D-SNP) | SUPERIOR HEALTHPLAN, INC. | T2 | No | $0 | TX |
| Wellcare Dual Access Open (PPO D-SNP) | WELLCARE OF MISSISSIPPI, INC. | T2 | No | $0 | MS |
| Wellcare Dual Access Open (PPO D-SNP) | WELLCARE OF GEORGIA, INC. | T2 | No | $0 | GA |
| Wellcare Dual Liberty Sync (HMO D-SNP) | WELLCARE OF TEXAS, INC. | T2 | No | $0 | TX |
| Wellcare Dual Liberty Sync (HMO D-SNP) | WELLCARE OF TEXAS, INC. | T2 | No | $0 | TX |
| Wellcare Dual Liberty (HMO-POS D-SNP) | BUCKEYE COMMUNITY HEALTH PLAN, INC. | T2 | No | $0 | OH |
Frequently Asked Questions
Is dextroamphetamine sulfate 20 MG Oral Tablet covered by Medicare Part D?
Yes, dextroamphetamine sulfate 20 MG Oral Tablet is covered by 2,141 Medicare Part D plans (42.3% of all Part D formularies).
What tier is dextroamphetamine sulfate 20 MG Oral Tablet on Medicare Part D plans?
dextroamphetamine sulfate 20 MG Oral Tablet averages Tier 2.9 across Part D plans, ranging from Tier 1 to Tier 4.
Does dextroamphetamine sulfate 20 MG Oral Tablet require prior authorization?
0% of Part D formularies require prior authorization for dextroamphetamine sulfate 20 MG Oral Tablet. Step therapy: 0%. Quantity limits: 72.9%.
How much does Medicare spend on dextroamphetamine sulfate 20 MG Oral Tablet?
In 2023, total Medicare Part D spending on dextroamphetamine sulfate 20 MG Oral Tablet was $5,176,356, covering 9,950 beneficiaries. The average spend per beneficiary was $520.24.
Read our methodology - how this data is sourced, computed, and verified.