ADDERALL XR 1.25/1.25/1.25/1.25 mg Capsule, Extended Release
Also known as Dextroamphetamine Sulfate, Dextroamphetamine Saccharate, Amphetamine Sulfate And Amphetamine Aspartate. Coverage in Pennsylvania and West Virginia (CMS PDP Region 06).
Not on any stand-alone Part D formulary in Pennsylvania and West Virginia
None of the 12 stand-alone Part D (PDP) plans in CMS PDP Region 06 list this drug. On one of those plans the patient would pay the full retail price, or you would need a formulary exception.