dextroamphetamine sulfate 1 MG/ML Oral Solution [ProCentra]
dextroamphetamine sulfate
RxCUI: 884526
What the CMS Formulary Data Shows for dextroamphetamine sulfate 1 MG/ML Oral Solution [ProCentra]
Per the CMS 2026 Part D formulary file, dextroamphetamine sulfate 1 MG/ML Oral Solution [ProCentra] (RxNorm concept RXCUI 884526, generic name dextroamphetamine sulfate) appears on 1 distinct formulary file spanning 8 Medicare Part D plan offerings - 0.2% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 2 to Tier 2, with a cross-plan average of Tier 2.
Real-world access to dextroamphetamine sulfate 1 MG/ML Oral Solution [ProCentra] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 9,950 Part D beneficiaries filled dextroamphetamine sulfate 1 MG/ML Oral Solution [ProCentra] 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 1 MG/ML Oral Solution [ProCentra] today.
Coverage Details
- Formularies covering
- 1
- Plans covering
- 8
- Coverage rate
- 0.2%
- Tier range
- Tier 2, Generic
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 9,950
- Total spending
- $5,176,356
- Avg per beneficiary
- $520.24
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering dextroamphetamine sulfate 1 MG/ML Oral Solution [ProCentra]
8 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| 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 |
| Network Health Cares (PPO D-SNP) | NETWORK HEALTH INSURANCE CORPORATION | T2 | No | $21.10 | WI |
| Network Health PlusRx (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T2 | No | $38.60 | WI |
| Network Health PremierRx (PPO) | NETWORK HEALTH INSURANCE CORPORATION | T2 | No | $92.80 | WI |
Frequently Asked Questions
Is dextroamphetamine sulfate 1 MG/ML Oral Solution [ProCentra] covered by Medicare Part D?
Yes, dextroamphetamine sulfate 1 MG/ML Oral Solution [ProCentra] is covered by 8 Medicare Part D plans (0.2% of all Part D formularies).
What tier is dextroamphetamine sulfate 1 MG/ML Oral Solution [ProCentra] on Medicare Part D plans?
dextroamphetamine sulfate 1 MG/ML Oral Solution [ProCentra] averages Tier 2 across Part D plans, ranging from Tier 2 to Tier 2.
Does dextroamphetamine sulfate 1 MG/ML Oral Solution [ProCentra] require prior authorization?
0% of Part D formularies require prior authorization for dextroamphetamine sulfate 1 MG/ML Oral Solution [ProCentra]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on dextroamphetamine sulfate 1 MG/ML Oral Solution [ProCentra]?
In 2023, total Medicare Part D spending on dextroamphetamine sulfate 1 MG/ML Oral Solution [ProCentra] 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.