Benefily
No prior authorization

Does California Physicians' Service require prior authorization for Dilantin?

California Physicians' Service does not require prior authorization for Dilantin on the Medicare Part D plans that cover it.

No covering plan from this payer files a prior-authorization requirement for this drug.

  • This drug does not appear on any of this payer's Medicare Part D formularies. That means it is NOT COVERED under those plans — which is a different and generally worse outcome than requiring prior authorization. An exception or formulary-exception request may still be possible.

By product strength

RxNorm productPlans coveringRequire prior authStep therapyQty limitStatus
phenytoin 25 MG/ML Oral Suspension [Dilantin]13138840 / 17000Not on formulary
phenytoin 50 MG Chewable Tablet [Dilantin]13138870 / 17000Not on formulary
phenytoin sodium 100 MG Extended Release Oral Capsule [Dilantin]85567315 / 17000No prior authorization
phenytoin sodium 30 MG Extended Release Oral Capsule [Dilantin]85587117 / 17000No prior authorization

Product names come from RxNorm (U.S. National Library of Medicine).

Plan-by-plan detail — phenytoin sodium 30 MG Extended Release Oral Capsule [Dilantin]

Dilantin has 4 products in the corpus; this table is for phenytoin sodium 30 MG Extended Release Oral Capsule [Dilantin], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Blue Shield 65 Plus (HMO)H0504-0154NoNoNo
Blue Shield 65 Plus (HMO)H0504-0174NoNoNo
Blue Shield 65 Plus (HMO)H0504-0264NoNoNo
Blue Shield 65 Plus (HMO)H0504-0284NoNoNo
Blue Shield 65 Plus (HMO)H0504-0384NoNoNo
Blue Shield 65 Plus (HMO)H0504-0394NoNoNo
Blue Shield 65 Plus Choice Plan (HMO)H0504-0404NoNoNo
Blue Shield 65 Plus Plan 2 (HMO)H0504-0214NoNoNo
Blue Shield Advantage (HMO)H0504-0504NoNoNo
Blue Shield AdvantageOptimum Plan (HMO)H5928-0044NoNoNo
Blue Shield AdvantageOptimum Plan 1 (HMO)H5928-0104NoNoNo
Blue Shield Inspire (HMO)H0504-0414NoNoNo
Blue Shield Inspire (HMO)H0504-0434NoNoNo
Blue Shield Inspire (HMO)H0504-0474NoNoNo
Blue Shield Rx Enhanced (PDP)S2468-0044NoNoNo
Blue Shield Rx Plus (PDP)S2468-0034NoNoNo
Blue Shield TotalDual Plan (HMO D-SNP)H2819-0014NoNoNo
Source
Monthly Prescription Drug Plan Formulary and Pharmacy Network Information — Basic Drugs Formulary File
Effective
2026-06-30
Retrieved
2026-07-19
SHA-256
e626e6bcda1aa6a0071e6f0df6bafe686ae41842cdf0a9feffdc649b6d3ff3ae

We publish the hash of the exact file we ingested so any answer can be audited against the bytes CMS served that day.

Dilantin at other payers

Or see Dilantin across every payer at once.

Administrative information only. Benefily reports what a payer has published in its own prior-authorization policy as of the effective date shown. It is not medical advice, not a coverage or payment guarantee, and not an authorization. Requirements vary by plan, place of service and member benefits — always verify with the payer before rendering service.