Medicare Part D coverage · lisdexamfetamine dimesylate · RxCUI 1871464
lisdexamfetamine dimesylate 10 MG Chewable Tablet
Per the CMS 2026 Part D formulary file, lisdexamfetamine dimesylate 10 MG Chewable Tablet is covered by 2,201 Medicare Part D plans (43.6% of enrollable products), averaging Tier 3.7, with prior authorization required on 27.1% of covering formularies.
- 43.6%
- Plan coverage
- 2,201
- Plans covering
- T3.7
- Avg tier
- 27.1%
- Prior auth required
What the CMS Formulary Data Shows for lisdexamfetamine dimesylate 10 MG Chewable Tablet
Per the CMS 2026 Part D formulary file, lisdexamfetamine dimesylate 10 MG Chewable Tablet (RxNorm concept RXCUI 1871464, generic name lisdexamfetamine dimesylate) appears on 48 distinct formulary files spanning 2,201 Medicare Part D plan offerings - 43.6% 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 3.7.
Real-world access to lisdexamfetamine dimesylate 10 MG Chewable Tablet depends on utilization management as much as tier placement: 27.1% of covering formularies require prior authorization. 0% require step therapy. 89.6% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 57,529 Part D beneficiaries filled lisdexamfetamine dimesylate 10 MG Chewable Tablet in 2023, with total plan-and-beneficiary spending of $138,990,768 and an average per-beneficiary annual cost of $2,416.01. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry lisdexamfetamine dimesylate 10 MG Chewable Tablet today.
Coverage Details
- Formularies covering
- 48
- Plans covering
- 2,201
- Coverage rate
- 43.6%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 27.1% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 89.6% of formularies
2023 Medicare Spending
- Beneficiaries
- 57,529
- Total spending
- $138,990,768
- Avg per beneficiary
- $2,416.01
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering lisdexamfetamine dimesylate 10 MG Chewable Tablet
2 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T4 | No | No | $0 | - |
| AARP Medicare Rx Preferred from UHC (PDP) | Unitedhealthcare INS. Co. & UHC INS. Co. OF NY | T4 | No | No | $0 | - |
Medicare Advantage Plans (MA-PD) Covering lisdexamfetamine dimesylate 10 MG Chewable Tablet
98 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| CareAdvantage (HMO D-SNP) | SAN Mateo Health Commission | T1 | No | $0 | CA |
| 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 |
| Devoted Core 001 FL (HMO) | Devoted Health Plan OF Florida, Inc. | T2 | Yes | $0 | FL |
| Devoted Core 002 FL (HMO) | Devoted Health Plan OF Florida, Inc. | T2 | Yes | $0 | FL |
| Devoted Core 003 FL (HMO) | Devoted Health Plan OF Florida, Inc. | T2 | Yes | $0 | FL |
| Devoted Core 005 FL (HMO) | Devoted Health Plan OF Florida, Inc. | T2 | Yes | $0 | FL |
| Devoted Giveback 013 FL (HMO) | Devoted Health Plan OF Florida, Inc. | T2 | Yes | $0 | FL |
| Devoted Giveback 014 FL (HMO) | Devoted Health Plan OF Florida, Inc. | T2 | Yes | $0 | FL |
| Devoted Giveback 015 FL (HMO) | Devoted Health Plan OF Florida, Inc. | T2 | Yes | $0 | FL |
| Devoted Giveback 018 FL (HMO) | Devoted Health Plan OF Florida, Inc. | T2 | Yes | $0 | FL |
| Devoted Core 025 FL (HMO) | Devoted Health Plan OF Florida, Inc. | T2 | Yes | $0 | FL |
| Devoted Core 027 FL (HMO) | Devoted Health Plan OF Florida, Inc. | T2 | Yes | $0 | FL |
| Devoted Core 029 FL (HMO) | Devoted Health Plan OF Florida, Inc. | T2 | Yes | $0 | FL |
| Devoted Giveback 031 FL (HMO) | Devoted Health Plan OF Florida, Inc. | T2 | Yes | $0 | FL |
| Devoted Giveback 032 FL (HMO) | Devoted Health Plan OF Florida, Inc. | T2 | Yes | $0 | FL |
| Devoted Giveback 035 FL (HMO) | Devoted Health Plan OF Florida, Inc. | T2 | Yes | $0 | FL |
| Devoted Core 036 FL (HMO) | Devoted Health Plan OF Florida, Inc. | T2 | Yes | $0 | FL |
| Devoted Giveback 045 FL (HMO) | Devoted Health Plan OF Florida, Inc. | T2 | Yes | $0 | FL |
| Devoted Core 046 FL (HMO) | Devoted Health Plan OF Florida, Inc. | T2 | Yes | $0 | FL |
Show the next 30 plans
| Devoted Giveback 049 FL (HMO) | Devoted Health Plan OF Florida, Inc. | T2 | Yes | $0 | FL |
| Devoted Core 050 FL (HMO) | Devoted Health Plan OF Florida, Inc. | T2 | Yes | $0 | FL |
| Devoted Giveback 051 FL (HMO) | Devoted Health Plan OF Florida, Inc. | T2 | Yes | $0 | FL |
| Devoted Core 001 AZ (HMO) | Devoted Health Plan OF Arizona, Inc. | T2 | Yes | $0 | AZ |
| Devoted C-snp 011 AZ (HMO C-snp) | Devoted Health Plan OF Arizona, Inc. | T2 | Yes | $0 | AZ |
| Devoted Premium 037 FL (HMO) | Devoted Health Plan OF Florida, Inc. | T2 | Yes | $4.80 | FL |
| Devoted Premium 044 FL (HMO) | Devoted Health Plan OF Florida, Inc. | T2 | Yes | $4.80 | FL |
| Network Health Select (PPO) | Network Health Insurance Corporation | T3 | No | $0 | WI |
| Network Health Go (PPO) | Network Health Insurance Corporation | T3 | No | $0 | WI |
| Network Health Anywhere (PPO) | Network Health Insurance Corporation | T3 | No | $0 | WI |
| Network Health Choice (PPO) | Network Health Insurance Corporation | T3 | No | $0 | WI |
| Network Health Zero (PPO) | Network Health Insurance Corporation | T3 | No | $0 | WI |
| Mass General Brigham Advantage (PPO) | Mass General Brigham Health Plan, Inc. | T3 | No | $0 | MA |
| Network Health Cares (PPO D-SNP) | Network Health Insurance Corporation | T3 | No | $21.10 | WI |
| Network Health PlusRx (PPO) | Network Health Insurance Corporation | T3 | No | $38.60 | WI |
| Mass General Brigham Advantage Secure (HMO-POS) | Mass General Brigham Health Plan, Inc. | T3 | No | $62.00 | MA |
| Mass General Brigham Advantage Premier (PPO) | Mass General Brigham Health Plan, Inc. | T3 | No | $79.70 | MA |
| Network Health PremierRx (PPO) | Network Health Insurance Corporation | T3 | No | $92.80 | WI |
| Mass General Brigham Advantage Signature (PPO) | Mass General Brigham Health Plan, Inc. | T3 | No | $147.20 | MA |
| UHC Dual Complete IA-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T4 | No | $0 | IA |
| UHC Dual Complete MO-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T4 | No | $0 | MO |
| UHC Dual Complete NE-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T4 | No | $0 | NE |
| UHC Dual Complete KS-S001 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T4 | No | $0 | KS |
| UHC Dual Complete MO-S3 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T4 | No | $0 | MO |
| UHC Dual Complete KS-Q1 (HMO-POS D-SNP) | Unitedhealthcare OF Wisconsin, Inc. | T4 | No | $0 | KS |
| UHC Dual Complete TN-S001 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T4 | No | $0 | TN |
| UHC Dual Complete TN-Y001 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T4 | No | $0 | TN |
| UHC Dual Complete TN-Y2 (HMO-POS D-SNP) | Unitedhealthcare Plan OF THE River Valley, Inc. | T4 | No | $0 | TN |
| AARP Medicare Advantage from UHC MI-0001 (PPO) | Unitedhealthcare Insurance Company | T4 | No | $0 | MI |
| UHC Dual Complete NM-Y1 (PPO D-SNP) | Unitedhealthcare Insurance Company | T4 | No | $0 | NM |
Showing top 50 of 98 plans.
Frequently Asked Questions
Is lisdexamfetamine dimesylate 10 MG Chewable Tablet covered by Medicare Part D?
Yes, lisdexamfetamine dimesylate 10 MG Chewable Tablet is covered by 2,201 Medicare Part D plans (43.6% of all Part D formularies).
What tier is lisdexamfetamine dimesylate 10 MG Chewable Tablet on Medicare Part D plans?
lisdexamfetamine dimesylate 10 MG Chewable Tablet averages Tier 3.7 across Part D plans, ranging from Tier 1 to Tier 4.
Does lisdexamfetamine dimesylate 10 MG Chewable Tablet require prior authorization?
27.1% of Part D formularies require prior authorization for lisdexamfetamine dimesylate 10 MG Chewable Tablet. Step therapy: 0%. Quantity limits: 89.6%.
How much does Medicare spend on lisdexamfetamine dimesylate 10 MG Chewable Tablet?
In 2023, total Medicare Part D spending on lisdexamfetamine dimesylate 10 MG Chewable Tablet was $138,990,768, covering 57,529 beneficiaries. The average spend per beneficiary was $2,416.01.
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
- zonisamide 20 MG/ML Oral Suspension [Zonisade] T3.7
- mometasone furoate 0.025 MG/ACTUAT / olopatadine hydrochloride 0.665 MG/ACTUAT Metered Dose Nasal Spray [Ryaltris] T3.7
- roflumilast 3 MG/ML Topical Foam [Zoryve] T3.7
- tacrolimus 5 MG Oral Capsule [Prograf] T3.7
- droxidopa 200 MG Oral Capsule T3.7
- lactulose 10000 MG Powder for Oral Solution [Kristalose] T3.7
Similar prior-authorization rate
- methotrexate 2.5 MG Oral Tablet 27.1% PA
- midazolam 50 MG/ML Nasal Spray [Nayzilam] 27.1% PA
- aspirin 325 MG / butalbital 50 MG / caffeine 40 MG Oral Capsule 27.2% PA
- 1 ML heparin sodium, porcine 10000 UNT/ML Injection 27% PA
- guanfacine 1 MG Oral Tablet 27% PA
- Osmotic 24 HR metformin hydrochloride 500 MG Extended Release Oral Tablet 27.3% PA