Medicare Part D coverage · phenytoin sodium · RxCUI 855673
phenytoin sodium 100 MG Extended Release Oral Capsule [Dilantin]
Per the CMS 2026 Part D formulary file, phenytoin sodium 100 MG Extended Release Oral Capsule [Dilantin] is covered by 2,298 Medicare Part D plans (45.5% of enrollable products), averaging Tier 3.4, with prior authorization required on 8% of covering formularies.
- 45.5%
- Plan coverage
- 2,298
- Plans covering
- T3.4
- Avg tier
- 8%
- Prior auth required
What the CMS Formulary Data Shows for phenytoin sodium 100 MG Extended Release Oral Capsule [Dilantin]
Per the CMS 2026 Part D formulary file, phenytoin sodium 100 MG Extended Release Oral Capsule [Dilantin] (RxNorm concept RXCUI 855673, generic name phenytoin sodium) appears on 50 distinct formulary files spanning 2,298 Medicare Part D plan offerings - 45.5% 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 3.4.
Real-world access to phenytoin sodium 100 MG Extended Release Oral Capsule [Dilantin] depends on utilization management as much as tier placement: 8% of covering formularies require prior authorization. 0% require step therapy. 4% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 11 Part D beneficiaries filled phenytoin sodium 100 MG Extended Release Oral Capsule [Dilantin] in 2023, with total plan-and-beneficiary spending of $3,559 and an average per-beneficiary annual cost of $323.56. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry phenytoin sodium 100 MG Extended Release Oral Capsule [Dilantin] today.
Coverage Details
- Formularies covering
- 50
- Plans covering
- 2,298
- Coverage rate
- 45.5%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 8% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 4% of formularies
2023 Medicare Spending
- Beneficiaries
- 11
- Total spending
- $3,559
- Avg per beneficiary
- $323.56
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering phenytoin sodium 100 MG Extended Release Oral Capsule [Dilantin]
100 Medicare Advantage plans with Part D drug coverage include this drug.
Show the next 30 plans
Showing top 50 of 100 plans.
Frequently Asked Questions
Is phenytoin sodium 100 MG Extended Release Oral Capsule [Dilantin] covered by Medicare Part D?
Yes, phenytoin sodium 100 MG Extended Release Oral Capsule [Dilantin] is covered by 2,298 Medicare Part D plans (45.5% of all Part D formularies).
What tier is phenytoin sodium 100 MG Extended Release Oral Capsule [Dilantin] on Medicare Part D plans?
phenytoin sodium 100 MG Extended Release Oral Capsule [Dilantin] averages Tier 3.4 across Part D plans, ranging from Tier 1 to Tier 4.
Does phenytoin sodium 100 MG Extended Release Oral Capsule [Dilantin] require prior authorization?
8% of Part D formularies require prior authorization for phenytoin sodium 100 MG Extended Release Oral Capsule [Dilantin]. Step therapy: 0%. Quantity limits: 4%.
How much does Medicare spend on phenytoin sodium 100 MG Extended Release Oral Capsule [Dilantin]?
In 2023, total Medicare Part D spending on phenytoin sodium 100 MG Extended Release Oral Capsule [Dilantin] was $3,559, covering 11 beneficiaries. The average spend per beneficiary was $323.56.
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
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