Benefily
Prior authorization required

Does Wellpoint West Virginia , INC. require prior authorization for Dilantin?

Wellpoint West Virginia , 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 productPlans coveringRequire prior authStatus
phenytoin 25 MG/ML Oral Suspension [Dilantin]13138841 / 31Prior authorization required
phenytoin 50 MG Chewable Tablet [Dilantin]13138871 / 31Prior authorization required
phenytoin sodium 100 MG Extended Release Oral Capsule [Dilantin]8556733 / 33Prior authorization required
phenytoin sodium 30 MG Extended Release Oral Capsule [Dilantin]8558713 / 33Prior authorization required

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

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

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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.