Adzenys Xr-Odt
Generic: Amphetamine
3.1MG, 6.3MG, 9.4MG, 12.5MG, 15.7MG, 18.8MG — Tablet
Central Nervous System Stimulant
Also known as:
ADZENYS XR-ODT TBED 3.1MG, 6.3MG, 9.4MG, 12.5MG, 15.7MG, 18.8MG
ADZENYS XR-ODT TBED 3.1MG, 6.3MG,
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Coverage by Insurer
Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Cigna
1 planMedicare Part D
1 planNC Medicaid PDL
1 planNC State Health Plan
9 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
NC State Health Plan - 80/20 Plus PPO 2026
via Amphetamine |
Tier 1 - Preferred Generic | ✓ | — | ✓ | PA | QL |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Amphetamine |
Tier 1 - Preferred Generic | ✓ | — | ✓ | PA | QL |
|
NC State Health Plan - HDHP 2026
via Amphetamine |
Tier 1 - Preferred Generic | ✓ | — | ✓ | PA | QL |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Dyanavel XR |
Not Covered | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Dyanavel XR |
Not Covered | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Dyanavel XR |
Not Covered | — | — | — | None |
| NC State Health Plan - 80/20 Plus PPO 2026 | Not Covered | — | — | — | None |
| NC State Health Plan - 70/30 Standard PPO 2026 | Not Covered | — | — | — | None |
| NC State Health Plan - HDHP 2026 | Not Covered | — | — | — | None |