Medicare Part D coverage · lamotrigine · RxCUI 2724466
lamotrigine 10 MG/ML Oral Suspension [Subvenite]
Per the CMS 2026 Part D formulary file, lamotrigine 10 MG/ML Oral Suspension [Subvenite] is covered by 4,970 Medicare Part D plans (98.4% of enrollable products), averaging Tier 3.8, with prior authorization required on 32.4% of covering formularies.
- 98.4%
- Plan coverage
- 4,970
- Plans covering
- T3.8
- Avg tier
- 32.4%
- Prior auth required
What the CMS Formulary Data Shows for lamotrigine 10 MG/ML Oral Suspension [Subvenite]
Per the CMS 2026 Part D formulary file, lamotrigine 10 MG/ML Oral Suspension [Subvenite] (RxNorm concept RXCUI 2724466, generic name lamotrigine) appears on 312 distinct formulary files spanning 4,970 Medicare Part D plan offerings - 98.4% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 3.8.
Real-world access to lamotrigine 10 MG/ML Oral Suspension [Subvenite] depends on utilization management as much as tier placement: 32.4% of covering formularies require prior authorization. 17% require step therapy. 12.8% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 611,083 Part D beneficiaries filled lamotrigine 10 MG/ML Oral Suspension [Subvenite] in 2023, with total plan-and-beneficiary spending of $70,895,194 and an average per-beneficiary annual cost of $116.02. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry lamotrigine 10 MG/ML Oral Suspension [Subvenite] today.
Coverage Details
- Formularies covering
- 312
- Plans covering
- 4,970
- Coverage rate
- 98.4%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 32.4% of formularies
- Step therapy required
- 17% of formularies
- Quantity limits
- 12.8% of formularies
2023 Medicare Spending
- Beneficiaries
- 611,083
- Total spending
- $70,895,194
- Avg per beneficiary
- $116.02
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering lamotrigine 10 MG/ML Oral Suspension [Subvenite]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Sentara Community Complete Select (HMO D-SNP) | Sentara Health Plans | T1 | Yes | $0 | VA |
| Sentara Community Complete (HMO D-SNP) | Sentara Health Plans | T1 | Yes | $0 | VA |
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) | Hpmp OF Florida, Inc. | T1 | No | $0 | FL |
| ElderServe MAP (HMO D-SNP) | Elderserve Health, Inc. | T1 | No | $0 | NY |
| Cooperative Advantage (HMO D-SNP) | Group Health Cooperative OF EAU Claire | T1 | No | $0 | WI |
| Longevity Health Plan (PPO I-SNP) | Longevity Health Plan OF NEW Jersey Insurance Comp | T1 | No | $0 | NJ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | No | $0 | AZ |
| Elderplan Plus Long-Term Care (HMO-POS D-SNP) | Elderplan, Inc. | T1 | No | $0 | NY |
| Health Choice Pathway (HMO D-SNP) | Health Choice Arizona, Inc. | T1 | No | $0 | AZ |
| Healthfirst CompleteCare (HMO D-SNP) | Healthfirst Health Plan, Inc. | T1 | No | $0 | NY |
| IMCare Classic (HMO D-SNP) | Itasca Medical Care | T1 | No | $0 | MN |
| Johns Hopkins Advantage MD D-SNP (HMO D-SNP) | Hopkins Health Advantage, Inc. | T1 | No | $0 | MD |
| MetroPlus UltraCare (HMO D-SNP) | Metroplus Health Plan, Inc. | T1 | No | $0 | NY |
| Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) | Upper Peninsula Health Plan, LLC | T1 | No | $0 | MI |
| CareSource Dual Advantage (HMO D-SNP) | Caresource Georgia Co. | T1 | No | $0 | GA |
| Senior Whole Health SCO (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| Senior Whole Health SCO NHC (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
| Molina One Care (HMO D-SNP) | Senior Whole Health, LLC | T1 | No | $0 | MA |
Show the next 30 plans
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP Caresource | T1 | No | $0 | MI |
| PruittHealth Premier D-SNP (HMO D-SNP) | Pruitthealth Premier, Inc. | T1 | Yes | $0 | GA |
| Simpra Advantage Dual Care (PPO D-SNP) | Simpra Advantage, Inc. | T1 | Yes | $0 | AL |
| 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 |
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | No | $0 | MA |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $0 | NY |
| CCA One Care (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | No | $0 | MA |
| CCA Senior Care Options (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | No | $0 | MA |
| Elevate Medicare Choice (HMO D-SNP) | Denver Health Medical Plan, Inc. | T1 | Yes | $0 | CO |
| AllCare Advantage Redwood Rx (HMO D-SNP) | Allcare Health Plan, Inc. | T1 | Yes | $0 | OR |
| PrimeWest Senior Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | Yes | $0 | MN |
| Prime Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | Yes | $0 | MN |
| Alterwood Advantage Dual Secure (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | Yes | $0 | MD |
| Nascentia Dual Advantage (HMO D-SNP) | Visiting Nurse Association OF Central NEW York | T1 | Yes | $0 | NY |
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | No | $0 | PA |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | Provider Partners Health Plan OF North Carolina | T1 | No | $0 | NC |
| Provider Partners Indiana Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Indiana | T1 | No | $0 | IN |
| Provider Partners Missouri Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Missouri, Inc. | T1 | No | $0 | MO |
| Abilis Health Community (HMO I-SNP) | Signature Advantage, LLC | T1 | Yes | $0 | KY, TN |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) | Arkansas Superior Select, Inc. | T1 | Yes | $0 | AR |
| Community Care's Partnership Program (HMO D-SNP) | Community Care Health Plan, Inc. | T1 | No | $0 | WI |
| Platino Blindao (HMO D-SNP) | Triple S Advantage, Inc. | T1 | No | $0 | PR |
| Platino Enlace (HMO D-SNP) | Triple S Advantage, Inc. | T1 | No | $0 | PR |
| Platino Advance (HMO D-snp) | Triple S Advantage, Inc. | T1 | No | $0 | PR |
| Platino Plus (HMO D-snp) | Triple S Advantage, Inc. | T1 | No | $0 | PR |
| Mass General Brigham SCO (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is lamotrigine 10 MG/ML Oral Suspension [Subvenite] covered by Medicare Part D?
Yes, lamotrigine 10 MG/ML Oral Suspension [Subvenite] is covered by 4,970 Medicare Part D plans (98.4% of all Part D formularies).
What tier is lamotrigine 10 MG/ML Oral Suspension [Subvenite] on Medicare Part D plans?
lamotrigine 10 MG/ML Oral Suspension [Subvenite] averages Tier 3.8 across Part D plans, ranging from Tier 1 to Tier 5.
Does lamotrigine 10 MG/ML Oral Suspension [Subvenite] require prior authorization?
32.4% of Part D formularies require prior authorization for lamotrigine 10 MG/ML Oral Suspension [Subvenite]. Step therapy: 17%. Quantity limits: 12.8%.
How much does Medicare spend on lamotrigine 10 MG/ML Oral Suspension [Subvenite]?
In 2023, total Medicare Part D spending on lamotrigine 10 MG/ML Oral Suspension [Subvenite] was $70,895,194, covering 611,083 beneficiaries. The average spend per beneficiary was $116.02.
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
- etravirine 100 MG Oral Tablet T3.8
- risperidone 37.5 MG Injection T3.8
- perampanel 4 MG Oral Tablet T3.8
- {7 (sodium oxybate 4500 MG Granules for Oral Suspension [Lumryz]) / 14 (sodium oxybate 6000 MG Granules for Oral Suspension [Lumryz]) / 7 (sodium oxybate 7500 MG Granules for Oral Suspension [Lumryz]) } Pack [Lumryz 28-Day Starter Pack] T3.8
- loteprednol etabonate 0.005 MG/MG Ophthalmic Gel [Lotemax] T3.8
- carbidopa 4.63 MG/ML / levodopa 20 MG/ML Oral Suspension [Duopa] T3.8
Similar prior-authorization rate
- methylphenidate hydrochloride 10 MG Chewable Tablet 32.3% PA
- {14 (cenobamate 12.5 MG Oral Tablet [Xcopri]) / 14 (cenobamate 25 MG Oral Tablet [Xcopri]) } Pack [Xcopri Titration Pack - 12.5 MG (14), 25 MG (14) 28 Count] 32.3% PA
- {14 (cenobamate 100 MG Oral Tablet [Xcopri]) / 14 (cenobamate 50 MG Oral Tablet [Xcopri]) } Pack [Xcopri Titration Pack - 50 MG (14), 100 MG (14) 28 Count] 32.3% PA
- {28 (cenobamate 150 MG Oral Tablet [Xcopri]) / 28 (cenobamate 200 MG Oral Tablet) } Pack [Xcopri 350 MG Maintenance Pack] 32.3% PA
- cenobamate 50 MG Oral Tablet [Xcopri] 32.3% PA
- cenobamate 25 MG Oral Tablet [Xcopri] 32.3% PA