Medicare Part D coverage · dichlorphenamide · RxCUI 1661799

dichlorphenamide 50 MG Oral Tablet [Keveyis]

Per the CMS 2026 Part D formulary file, dichlorphenamide 50 MG Oral Tablet [Keveyis] is covered by 6 Medicare Part D plans (0.1% of enrollable products), averaging Tier 3, with prior authorization required on 100% of covering formularies.

0.1%
Plan coverage
6
Plans covering
T3
Avg tier
100%
Prior auth required

Verify with CMS →

Important: Drug coverage and costs vary by plan and location. Verify coverage directly with your Medicare plan before filling a prescription. This is informational data only and should not replace advice from your healthcare provider or pharmacist.

What the CMS Formulary Data Shows for dichlorphenamide 50 MG Oral Tablet [Keveyis]

Per the CMS 2026 Part D formulary file, dichlorphenamide 50 MG Oral Tablet [Keveyis] (RxNorm concept RXCUI 1661799, generic name dichlorphenamide) appears on 4 distinct formulary files spanning 6 Medicare Part D plan offerings - 0.1% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 3.

Real-world access to dichlorphenamide 50 MG Oral Tablet [Keveyis] depends on utilization management as much as tier placement: 100% 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 98 Part D beneficiaries filled dichlorphenamide 50 MG Oral Tablet [Keveyis] in 2023, with total plan-and-beneficiary spending of $20,667,743 and an average per-beneficiary annual cost of $210,895.34. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry dichlorphenamide 50 MG Oral Tablet [Keveyis] today.

Coverage Details

Formularies covering
4
Plans covering
6
Coverage rate
0.1%
Tier range
Tier 1 – Tier 5
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
100% of formularies
Step therapy required
0% of formularies
Quantity limits
0% of formularies

2023 Medicare Spending

Beneficiaries
98
Total spending
$20,667,743
Avg per beneficiary
$210,895.34

Tier Distribution Across Plans

2 plans
Tier 1, Preferred Generic
4 plans
Tier 5, Specialty

Medicare Advantage Plans (MA-PD) Covering dichlorphenamide 50 MG Oral Tablet [Keveyis]

6 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
Mass General Brigham SCO (HMO D-SNP) Mass General Brigham Health Plan, Inc T1 Yes $0 MA
Mass General Brigham One Care (HMO D-SNP) Mass General Brigham Health Plan, Inc T1 Yes $0 MA
Mass General Brigham Advantage (PPO) Mass General Brigham Health Plan, Inc. T5 Yes $0 MA
Mass General Brigham Advantage Secure (HMO-POS) Mass General Brigham Health Plan, Inc. T5 Yes $62.00 MA
Mass General Brigham Advantage Premier (PPO) Mass General Brigham Health Plan, Inc. T5 Yes $79.70 MA
Mass General Brigham Advantage Signature (PPO) Mass General Brigham Health Plan, Inc. T5 Yes $147.20 MA

Frequently Asked Questions

Is dichlorphenamide 50 MG Oral Tablet [Keveyis] covered by Medicare Part D?

Yes, dichlorphenamide 50 MG Oral Tablet [Keveyis] is covered by 6 Medicare Part D plans (0.1% of all Part D formularies).

What tier is dichlorphenamide 50 MG Oral Tablet [Keveyis] on Medicare Part D plans?

dichlorphenamide 50 MG Oral Tablet [Keveyis] averages Tier 3 across Part D plans, ranging from Tier 1 to Tier 5.

Does dichlorphenamide 50 MG Oral Tablet [Keveyis] require prior authorization?

100% of Part D formularies require prior authorization for dichlorphenamide 50 MG Oral Tablet [Keveyis]. Step therapy: 0%. Quantity limits: 0%.

How much does Medicare spend on dichlorphenamide 50 MG Oral Tablet [Keveyis]?

In 2023, total Medicare Part D spending on dichlorphenamide 50 MG Oral Tablet [Keveyis] was $20,667,743, covering 98 beneficiaries. The average spend per beneficiary was $210,895.34.

Read our methodology - how this data is sourced, computed, and verified.

Nationwide similar Part D drugs

Data-derived peers across the CMS Part D formulary extract: nearest average tier placement and nearest prior-authorization rate. Not therapeutic alternatives or same-generic strengths.

Closest average formulary tier

Similar prior-authorization rate

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare