Does Wellpoint South Carolina, INC. require prior authorization for Dilantin?
Wellpoint South Carolina, INC. requires prior authorization for Dilantin on every Medicare Part D plan of theirs that covers it.
Every plan from this payer that covers the drug requires authorization before it is dispensed.
By product strength
| RxNorm product | Plans covering | Require prior auth | Step therapy | Qty limit | Status |
|---|---|---|---|---|---|
| phenytoin 25 MG/ML Oral Suspension [Dilantin]1313884 | 1 / 1 | 1 | 0 | 0 | Prior authorization required |
| phenytoin 50 MG Chewable Tablet [Dilantin]1313887 | 1 / 1 | 1 | 0 | 0 | Prior authorization required |
| phenytoin sodium 100 MG Extended Release Oral Capsule [Dilantin]855673 | 1 / 1 | 1 | 0 | 0 | Prior authorization required |
| phenytoin sodium 30 MG Extended Release Oral Capsule [Dilantin]855871 | 1 / 1 | 1 | 0 | 0 | Prior authorization required |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — phenytoin 25 MG/ML Oral Suspension [Dilantin]
Dilantin has 4 products in the corpus; this table is for phenytoin 25 MG/ML Oral Suspension [Dilantin], the one carried on the most plans. The product table above covers every strength.
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| Wellpoint Medicare Advantage (HMO) | H2687-001 | 4 | Yes | No | No |
- 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
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.