Medicare Part D coverage · phenytoin sodium · RxCUI 855863
phenytoin sodium 200 MG Extended Release Oral Capsule [Phenytek]
Per the CMS 2026 Part D formulary file, phenytoin sodium 200 MG Extended Release Oral Capsule [Phenytek] is covered by 3,438 Medicare Part D plans (68.1% of enrollable products), averaging Tier 2.2, with prior authorization required on 0% of covering formularies.
- 68.1%
- Plan coverage
- 3,438
- Plans covering
- T2.2
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for phenytoin sodium 200 MG Extended Release Oral Capsule [Phenytek]
Per the CMS 2026 Part D formulary file, phenytoin sodium 200 MG Extended Release Oral Capsule [Phenytek] (RxNorm concept RXCUI 855863, generic name phenytoin sodium) appears on 266 distinct formulary files spanning 3,438 Medicare Part D plan offerings - 68.1% of enrollable Part D products, mid-range placement; shopping across contracts changes access. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.2.
Real-world access to phenytoin sodium 200 MG Extended Release Oral Capsule [Phenytek] depends on utilization management as much as tier placement: 0% 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 11 Part D beneficiaries filled phenytoin sodium 200 MG Extended Release Oral Capsule [Phenytek] 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 200 MG Extended Release Oral Capsule [Phenytek] today.
Coverage Details
- Formularies covering
- 266
- Plans covering
- 3,438
- Coverage rate
- 68.1%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% 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 200 MG Extended Release Oral Capsule [Phenytek]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) | Hpmp OF Florida, Inc. | T1 | No | $0 | FL |
| 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 |
| 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 |
| PruittHealth Premier D-SNP (HMO D-SNP) | Pruitthealth Premier, Inc. | T1 | No | $0 | GA |
| Simpra Advantage Dual Care (PPO D-SNP) | Simpra Advantage, Inc. | T1 | No | $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 |
Show the next 30 plans
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | No | $0 | MA |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $0 | NY |
| SeniorCare Complete (HMO D-SNP) | South Country Health Alliance | T1 | No | $0 | MN |
| AbilityCare (HMO D-SNP) | South Country Health Alliance | T1 | No | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | Alameda Alliance FOR Health | T1 | No | $0 | CA |
| PHP (HMO C-snp) | Aids Healthcare Foundation | T1 | No | $0 | CA |
| 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 | No | $0 | CO |
| AllCare Advantage Redwood Rx (HMO D-SNP) | Allcare Health Plan, Inc. | T1 | No | $0 | OR |
| PrimeWest Senior Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | No | $0 | MN |
| Prime Health Complete (HMO D-SNP) | Primewest Rural MN Health Care Access Initiative | T1 | No | $0 | MN |
| DualConnect (HMO D-SNP) | Santa Clara County Health Authority | T1 | No | $0 | CA |
| VNS Health Total (HMO D-SNP) | VNS Choice | T1 | No | $0 | NY |
| Alterwood Advantage Dual Secure (HMO D-SNP) | Alterwood Advantage, Inc. | T1 | No | $0 | MD |
| Generations Classic Rewards (HMO) | Globalhealth, Inc. | T1 | No | $0 | OK |
| Generations Classic Plus (HMO) | Globalhealth, Inc. | T1 | No | $0 | OK |
| Generations Chronic Care (HMO C-SNP) | Globalhealth, Inc. | T1 | No | $0 | OK |
| Generations Chronic Care Savings (HMO C-SNP) | Globalhealth, Inc. | T1 | No | $0 | OK |
| Generations Dual Support (HMO D-SNP) | Globalhealth, Inc. | T1 | No | $0 | OK |
| Generations Dual Premier (HMO D-SNP) | Globalhealth, Inc. | T1 | No | $0 | OK |
| Nascentia Dual Advantage (HMO D-SNP) | Visiting Nurse Association OF Central NEW York | T1 | No | $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 | No | $0 | KY, TN |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) | Arkansas Superior Select, Inc. | T1 | No | $0 | AR |
| 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 |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is phenytoin sodium 200 MG Extended Release Oral Capsule [Phenytek] covered by Medicare Part D?
Yes, phenytoin sodium 200 MG Extended Release Oral Capsule [Phenytek] is covered by 3,438 Medicare Part D plans (68.1% of all Part D formularies).
What tier is phenytoin sodium 200 MG Extended Release Oral Capsule [Phenytek] on Medicare Part D plans?
phenytoin sodium 200 MG Extended Release Oral Capsule [Phenytek] averages Tier 2.2 across Part D plans, ranging from Tier 1 to Tier 4.
Does phenytoin sodium 200 MG Extended Release Oral Capsule [Phenytek] require prior authorization?
0% of Part D formularies require prior authorization for phenytoin sodium 200 MG Extended Release Oral Capsule [Phenytek]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on phenytoin sodium 200 MG Extended Release Oral Capsule [Phenytek]?
In 2023, total Medicare Part D spending on phenytoin sodium 200 MG Extended Release Oral Capsule [Phenytek] 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
- 0.5 ML Haemophilus influenzae type b strain 1482, capsular polysaccharide inactivated tetanus toxoid conjugate vaccine 0.068 MG/ML Injection [ActHIB] T2.2
- desmopressin acetate 0.1 MG Oral Tablet T2.2
- divalproex sodium 125 MG Delayed Release Oral Capsule T2.2
- mercaptopurine 50 MG Oral Tablet T2.2
- misoprostol 0.2 MG Oral Tablet T2.2
- selegiline hydrochloride 5 MG Oral Capsule T2.2
Similar prior-authorization rate
- metronidazole 10 MG/ML Topical Cream [Noritate] 0% PA
- 24 HR minocycline 40 MG Extended Release Oral Capsule [Emrosi] 0% PA
- buspirone hydrochloride 10 MG Oral Capsule [Bucapsol] 0% PA
- diflunisal 375 MG Oral Tablet [Dolobid] 0% PA
- hydrocortisone 1 MG/ML Oral Solution [Khindivi] 0% PA
- indomethacin 50 MG Rectal Suppository [Indocin] 0% PA