0.2 ML adalimumab-adbm 50 MG/ML Prefilled Syringe [Cyltezo]
adalimumab-adbm
RxCUI: 2640892
What the CMS Formulary Data Shows for 0.2 ML adalimumab-adbm 50 MG/ML Prefilled Syringe [Cyltezo]
Per the CMS 2026 Part D formulary file, 0.2 ML adalimumab-adbm 50 MG/ML Prefilled Syringe [Cyltezo] (RxNorm concept RXCUI 2640892, generic name adalimumab-adbm) appears on 61 distinct formulary files spanning 476 Medicare Part D plan offerings - 9.4% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 4.
Real-world access to 0.2 ML adalimumab-adbm 50 MG/ML Prefilled Syringe [Cyltezo] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 21.3% apply quantity limits.
Medicare Part D spending dashboard figures are not published for this drug. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 0.2 ML adalimumab-adbm 50 MG/ML Prefilled Syringe [Cyltezo] today.
Coverage Details
- Formularies covering
- 61
- Plans covering
- 476
- Coverage rate
- 9.4%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 100% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 21.3% of formularies
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering 0.2 ML adalimumab-adbm 50 MG/ML Prefilled Syringe [Cyltezo]
2 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| Wellcare Simple (HMO-POS) | WELLCARE OF CONNECTICUT, INC. | T5 | Yes | No | $0 | CT |
| Wellcare Giveback (HMO-POS) | WELLCARE OF CONNECTICUT, INC. | T5 | Yes | No | $0 | CT |
Medicare Advantage Plans (MA-PD) Covering 0.2 ML adalimumab-adbm 50 MG/ML Prefilled Syringe [Cyltezo]
98 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Elevate Medicare Choice (HMO D-SNP) | DENVER HEALTH MEDICAL PLAN, INC. | T1 | Yes | $0 | CO |
| AllCare Advantage Redwood Rx (HMO D-SNP) | ALLCARE HEALTH PLAN, INC. | T1 | Yes | $0 | OR |
| PrimeWest Senior Health Complete (HMO D-SNP) | PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE | T1 | Yes | $0 | MN |
| Prime Health Complete (HMO D-SNP) | PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE | T1 | Yes | $0 | MN |
| Alterwood Advantage Dual Secure (HMO D-SNP) | ALTERWOOD ADVANTAGE, INC. | T1 | Yes | $0 | MD |
| Nascentia Dual Advantage (HMO D-SNP) | VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK | T1 | Yes | $0 | NY |
| Abilis Health Community (HMO I-SNP) | SIGNATURE ADVANTAGE, LLC | T1 | Yes | $0 | KY, TN |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) | ARKANSAS SUPERIOR SELECT, INC. | T1 | Yes | $0 | AR |
| Mass General Brigham SCO (HMO D-SNP) | MASS GENERAL BRIGHAM HEALTH PLAN, INC | T1 | Yes | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | MASS GENERAL BRIGHAM HEALTH PLAN, INC | T1 | Yes | $0 | MA |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | GOLD KIDNEY OF FLORIDA INC | T1 | Yes | $4.80 | FL |
| Texas Independence Health Plan, Inc. (HMO I-SNP) | TEXAS INDEPENDENCE HEALTH PLAN, INC. | T1 | Yes | $4.80 | TX |
| Texas Independence Community Plan (HMO I-SNP) | TEXAS INDEPENDENCE HEALTH PLAN, INC. | T1 | Yes | $4.80 | TX |
| Tribute Select (HMO-POS I-SNP) | ARKANSAS SUPERIOR SELECT, INC. | T1 | Yes | $8.90 | AR |
| ATRIO Special Needs Plan (HMO D-SNP) | ATRIO HEALTH PLANS | T1 | Yes | $10.50 | OR |
| ATRIO Special Needs Plan (HMO D-SNP) | ATRIO HEALTH PLANS | T1 | Yes | $10.50 | OR |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | GOLD KIDNEY OF ARIZONA | T1 | Yes | $17.00 | AZ |
| Alterwood Advantage Dual Value (HMO D-SNP) | ALTERWOOD ADVANTAGE, INC. | T1 | Yes | $31.20 | MD |
| Valor Health Plan (HMO I-SNP) | TSG GUARD, INC. | T1 | Yes | $31.40 | OH |
| WV Senior Advantage (HMO I-SNP) | WEST VIRGINIA SENIOR ADVANTAGE, INC. | T1 | Yes | $32.70 | WV |
| Abilis Health (HMO I-SNP) | SIGNATURE ADVANTAGE, LLC | T1 | Yes | $35.90 | KY, TN |
| CommuniCare Advantage ISNP (HMO I-SNP) | OH CHS SNP INC. | T1 | Yes | $38.40 | IN, MD, OH |
| Nascentia Skilled Nursing Facility (HMO I-SNP) | VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK | T1 | Yes | $58.80 | NY |
| PHP (HMO C-SNP) | AIDS HEALTHCARE FOUNDATION | T4 | Yes | $0 | CA |
| DualConnect (HMO D-SNP) | SANTA CLARA COUNTY HEALTH AUTHORITY | T4 | Yes | $0 | CA |
| VNS Health Total (HMO D-SNP) | VNS CHOICE | T4 | Yes | $0 | NY |
| VNS Health EasyCare Plus (HMO D-SNP) | VNS CHOICE | T4 | Yes | $51.60 | NY |
| Wellcare Simple (HMO-POS) | COORDINATED CARE OF WASHINGTON, INC. | T5 | Yes | $0 | WA |
| Wellcare Simple Open (PPO) | WELLCARE OF MISSISSIPPI, INC. | T5 | Yes | $0 | MS |
| Wellcare Simple Open (PPO) | WELLCARE OF GEORGIA, INC. | T5 | Yes | $0 | GA |
| Wellcare Simple (HMO) | WELLCARE OF TEXAS, INC. | T5 | Yes | $0 | TX |
| Wellcare Simple (HMO) | WELLCARE OF TEXAS, INC. | T5 | Yes | $0 | TX |
| Wellcare Simple (HMO) | WELLCARE OF TEXAS, INC. | T5 | Yes | $0 | TX |
| Wellcare Simple (HMO) | WELLCARE OF TEXAS, INC. | T5 | Yes | $0 | TX |
| Wellcare Simple Open (PPO) | WELLCARE HEALTH INSURANCE COMPANY OF AMERICA | T5 | Yes | $0 | AR |
| Wellcare Simple (HMO) | HEALTH NET OF ARIZONA, INC. | T5 | Yes | $0 | AZ |
| Wellcare Simple (HMO) | HEALTH NET OF ARIZONA, INC. | T5 | Yes | $0 | AZ |
| Wellcare Simple Value (HMO) | HEALTH NET OF ARIZONA, INC. | T5 | Yes | $0 | AZ |
| Wellcare Simple (HMO-POS) | HEALTH NET OF ARIZONA, INC. | T5 | Yes | $0 | NV |
| Wellcare Simple (HMO-POS) | HEALTH NET OF ARIZONA, INC. | T5 | Yes | $0 | NV |
| Wellcare Low Premium (HMO) | HEALTH NET OF CALIFORNIA, INC. | T5 | Yes | $0 | CA |
| Wellcare Simple Focus (HMO) | HEALTH NET OF CALIFORNIA, INC. | T5 | Yes | $0 | CA |
| Wellcare Simple Focus (HMO) | HEALTH NET OF CALIFORNIA, INC. | T5 | Yes | $0 | CA |
| Wellcare Low Premium (HMO) | HEALTH NET OF CALIFORNIA, INC. | T5 | Yes | $0 | CA |
| Wellcare Low Premium (HMO) | HEALTH NET OF CALIFORNIA, INC. | T5 | Yes | $0 | CA |
| Wellcare Simple (HMO-POS) | BUCKEYE COMMUNITY HEALTH PLAN, INC. | T5 | Yes | $0 | OH |
| Wellcare Low Premium (HMO-POS) | WELLCARE HEALTH PLANS OF NEW JERSEY, INC. | T5 | Yes | $0 | NJ |
| Wellcare Giveback (HMO-POS) | WELLCARE HEALTH PLANS OF NEW JERSEY, INC. | T5 | Yes | $0 | NJ |
| Wellcare Simple (HMO-POS) | WELLCARE HEALTH PLANS OF NEW JERSEY, INC. | T5 | Yes | $0 | NJ |
| Wellcare Simple (HMO) | Sunshine State Health Plan, Inc. | T5 | Yes | $0 | FL |
Frequently Asked Questions
Is 0.2 ML adalimumab-adbm 50 MG/ML Prefilled Syringe [Cyltezo] covered by Medicare Part D?
Yes, 0.2 ML adalimumab-adbm 50 MG/ML Prefilled Syringe [Cyltezo] is covered by 476 Medicare Part D plans (9.4% of all Part D formularies).
What tier is 0.2 ML adalimumab-adbm 50 MG/ML Prefilled Syringe [Cyltezo] on Medicare Part D plans?
0.2 ML adalimumab-adbm 50 MG/ML Prefilled Syringe [Cyltezo] averages Tier 4 across Part D plans, ranging from Tier 1 to Tier 5.
Does 0.2 ML adalimumab-adbm 50 MG/ML Prefilled Syringe [Cyltezo] require prior authorization?
100% of Part D formularies require prior authorization for 0.2 ML adalimumab-adbm 50 MG/ML Prefilled Syringe [Cyltezo]. Step therapy: 0%. Quantity limits: 21.3%.
Read our methodology - how this data is sourced, computed, and verified.