dextroamphetamine sulfate 5 MG Oral Tablet [Zenzedi]
dextroamphetamine sulfate
RxCUI: 1425339
What the CMS Formulary Data Shows for dextroamphetamine sulfate 5 MG Oral Tablet [Zenzedi]
Per the CMS 2026 Part D formulary file, dextroamphetamine sulfate 5 MG Oral Tablet [Zenzedi] (RxNorm concept RXCUI 1425339, generic name dextroamphetamine sulfate) appears on 58 distinct formulary files spanning 1,106 Medicare Part D plan offerings - 21.8% 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 3.3.
Real-world access to dextroamphetamine sulfate 5 MG Oral Tablet [Zenzedi] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 98.3% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 9,950 Part D beneficiaries filled dextroamphetamine sulfate 5 MG Oral Tablet [Zenzedi] 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 5 MG Oral Tablet [Zenzedi] today.
Coverage Details
- Formularies covering
- 58
- Plans covering
- 1,106
- Coverage rate
- 21.8%
- 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
- 98.3% 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 5 MG Oral Tablet [Zenzedi]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Freedom VIP Care (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom VIP Savings (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom VIP Rewards (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Optimum Diamond Savings (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Optimum Diamond Rewards (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Optimum Diamond (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Freedom Medi-Medi Partial (HMO D-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Medi-Medi Full (HMO D-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Optimum Emerald Partial (HMO D-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Optimum Emerald Full (HMO D-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Medicare Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom VIP Savings COPD (HMO C-SNP) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Platinum Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Platinum Rewards Plan Rx (HMO) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Máximo (HMO-POS) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Freedom Máximo (HMO-POS) | FREEDOM HEALTH, INC. | T1 | No | $0 | FL |
| Optimum Gold Rewards Plan (HMO) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Optimum Platinum Plan (HMO) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Optimum Gold Plan (HMO) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Optimum Gold Rewards Plan (HMO) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Optimum Gold Rewards Plan (HMO) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Optimum Diamond Rewards COPD (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Optimum Diamond Savings COPD (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Optimum Gold Plus Plan (HMO) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Optimum Diamond Rewards COPD (HMO C-SNP) | OPTIMUM HEALTHCARE, INC. | T1 | No | $0 | FL |
| Gold Coast Health Plan Total Care Advantage (HMO D-SNP) | Ventura County Medi-Cal Managed Care Commission | T1 | No | $0 | CA |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| Horizon NJ TotalCare (HMO D-SNP) | HORIZON HEALTHCARE OF NEW JERSEY, INC. | T1 | No | $0 | NJ |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | No | $0 | MN |
| Hamaspik Medicare Choice (HMO D-SNP) | HAMASPIK, INC. | T1 | No | $0 | NY |
| 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 |
Frequently Asked Questions
Is dextroamphetamine sulfate 5 MG Oral Tablet [Zenzedi] covered by Medicare Part D?
Yes, dextroamphetamine sulfate 5 MG Oral Tablet [Zenzedi] is covered by 1,106 Medicare Part D plans (21.8% of all Part D formularies).
What tier is dextroamphetamine sulfate 5 MG Oral Tablet [Zenzedi] on Medicare Part D plans?
dextroamphetamine sulfate 5 MG Oral Tablet [Zenzedi] averages Tier 3.3 across Part D plans, ranging from Tier 1 to Tier 4.
Does dextroamphetamine sulfate 5 MG Oral Tablet [Zenzedi] require prior authorization?
0% of Part D formularies require prior authorization for dextroamphetamine sulfate 5 MG Oral Tablet [Zenzedi]. Step therapy: 0%. Quantity limits: 98.3%.
How much does Medicare spend on dextroamphetamine sulfate 5 MG Oral Tablet [Zenzedi]?
In 2023, total Medicare Part D spending on dextroamphetamine sulfate 5 MG Oral Tablet [Zenzedi] 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.