Medicare Part D coverage · 0.2 · RxCUI 978735
0.2 ML dalteparin sodium 25000 UNT/ML Prefilled Syringe [Fragmin]
Per the CMS 2026 Part D formulary file, 0.2 ML dalteparin sodium 25000 UNT/ML Prefilled Syringe [Fragmin] is covered by 842 Medicare Part D plans (16.7% of enrollable products), averaging Tier 4.3, with prior authorization required on 0% of covering formularies.
- 16.7%
- Plan coverage
- 842
- Plans covering
- T4.3
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for 0.2 ML dalteparin sodium 25000 UNT/ML Prefilled Syringe [Fragmin]
Per the CMS 2026 Part D formulary file, 0.2 ML dalteparin sodium 25000 UNT/ML Prefilled Syringe [Fragmin] (RxNorm concept RXCUI 978735, generic name 0.2) appears on 37 distinct formulary files spanning 842 Medicare Part D plan offerings - 16.7% 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 4.3.
Real-world access to 0.2 ML dalteparin sodium 25000 UNT/ML Prefilled Syringe [Fragmin] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 10.8% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 87 Part D beneficiaries filled 0.2 ML dalteparin sodium 25000 UNT/ML Prefilled Syringe [Fragmin] in 2023, with total plan-and-beneficiary spending of $2,204,099 and an average per-beneficiary annual cost of $25,334.47. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 0.2 ML dalteparin sodium 25000 UNT/ML Prefilled Syringe [Fragmin] today.
Coverage Details
- Formularies covering
- 37
- Plans covering
- 842
- Coverage rate
- 16.7%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 10.8% of formularies
2023 Medicare Spending
- Beneficiaries
- 87
- Total spending
- $2,204,099
- Avg per beneficiary
- $25,334.47
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 0.2 ML dalteparin sodium 25000 UNT/ML Prefilled Syringe [Fragmin]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | No | $0 | PA |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | Provider Partners Health Plan OF North Carolina | T1 | No | $0 | NC |
| Provider Partners Indiana Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Indiana | T1 | No | $0 | IN |
| Provider Partners Missouri Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Missouri, Inc. | T1 | No | $0 | MO |
| Mass General Brigham SCO (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $0 | PA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $0 | PA |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Health Options West Virginia Inc. | T1 | No | $0 | WV |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | No | $0 | DE |
| Provider Partners Texas Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Texas, Inc. | T1 | No | $4.80 | TX |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $13.10 | PA |
| Provider Partners Illinois Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Illinois | T1 | No | $15.20 | IL |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $17.60 | PA |
| Highmark Health Options Duals Select (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | No | $31.20 | DE |
| Provider Partners Pennsylvania Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | No | $32.70 | PA |
| Provider Partners Pennsylvania Essential Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | No | $32.70 | PA |
| Provider Partners North Carolina Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF North Carolina | T1 | No | $36.20 | NC |
| Provider Partners North Carolina Essential Plan (HMO I-SNP) | Provider Partners Health Plan OF North Carolina | T1 | No | $36.20 | NC |
| Provider Partners Indiana Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Indiana | T1 | No | $38.40 | IN |
Show the next 30 plans
| Provider Partners Indiana Essential Plan (HMO I-SNP) | Provider Partners Health Plan OF Indiana | T1 | No | $38.40 | IN |
| Provider Partners Kentucky Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Kentucky | T1 | No | $38.40 | KY |
| Provider Partners Missouri Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Missouri, Inc. | T1 | No | $43.00 | MO |
| Provider Partners Missouri Essential Plan (HMO I-SNP) | Provider Partners Health Plan OF Missouri, Inc. | T1 | No | $43.00 | MO |
| CareAdvantage (HMO D-SNP) | SAN Mateo Health Commission | T2 | No | $0 | CA |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T2 | No | $0 | CA |
| HealthSun HealthAdvantage Plan (HMO) | Healthsun Health Plans, Inc. | T4 | No | $0 | FL |
| HealthSun MediMax (HMO) | Healthsun Health Plans, Inc. | T4 | No | $0 | FL |
| HealthSun HealthAdvantage Plan (HMO) | Healthsun Health Plans, Inc. | T4 | No | $0 | FL |
| HealthSun HealthAdvantage Plan (HMO) | Healthsun Health Plans, Inc. | T4 | No | $0 | FL |
| HealthSun MediSun Plus (HMO D-SNP) | Healthsun Health Plans, Inc. | T4 | No | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | Healthsun Health Plans, Inc. | T4 | No | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | Healthsun Health Plans, Inc. | T4 | No | $0 | FL |
| HealthSun MediSun Extra (HMO D-SNP) | Healthsun Health Plans, Inc. | T4 | No | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | Healthsun Health Plans, Inc. | T4 | No | $0 | FL |
| HealthSun VitalCare (HMO C-SNP) | Healthsun Health Plans, Inc. | T4 | No | $0 | FL |
| HealthSun VitalCare (HMO C-SNP) | Healthsun Health Plans, Inc. | T4 | No | $0 | FL |
| HealthSun MediSun Full Dual Plus (HMO D-SNP) | Healthsun Health Plans, Inc. | T4 | No | $0 | FL |
| HealthSun MediSun Full Dual Extra (HMO D-SNP) | Healthsun Health Plans, Inc. | T4 | No | $0 | FL |
| Simply Complete (HMO D-SNP) | Simply Healthcare Plans, Inc. | T4 | No | $0 | FL |
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T4 | No | $0 | FL |
| Simply Complete (HMO D-SNP) | Simply Healthcare Plans, Inc. | T4 | No | $0 | FL |
| Simply Level (HMO C-SNP) | Simply Healthcare Plans, Inc. | T4 | No | $0 | FL |
| Simply Level (HMO C-SNP) | Simply Healthcare Plans, Inc. | T4 | No | $0 | FL |
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T4 | No | $0 | FL |
| Simply Level (HMO C-SNP) | Simply Healthcare Plans, Inc. | T4 | No | $0 | FL |
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T4 | No | $0 | FL |
| Simply Level (HMO C-SNP) | Simply Healthcare Plans, Inc. | T4 | No | $0 | FL |
| Simply Complete (HMO D-SNP) | Simply Healthcare Plans, Inc. | T4 | No | $0 | FL |
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T4 | No | $0 | FL |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is 0.2 ML dalteparin sodium 25000 UNT/ML Prefilled Syringe [Fragmin] covered by Medicare Part D?
Yes, 0.2 ML dalteparin sodium 25000 UNT/ML Prefilled Syringe [Fragmin] is covered by 842 Medicare Part D plans (16.7% of all Part D formularies).
What tier is 0.2 ML dalteparin sodium 25000 UNT/ML Prefilled Syringe [Fragmin] on Medicare Part D plans?
0.2 ML dalteparin sodium 25000 UNT/ML Prefilled Syringe [Fragmin] averages Tier 4.3 across Part D plans, ranging from Tier 1 to Tier 5.
Does 0.2 ML dalteparin sodium 25000 UNT/ML Prefilled Syringe [Fragmin] require prior authorization?
0% of Part D formularies require prior authorization for 0.2 ML dalteparin sodium 25000 UNT/ML Prefilled Syringe [Fragmin]. Step therapy: 0%. Quantity limits: 10.8%.
How much does Medicare spend on 0.2 ML dalteparin sodium 25000 UNT/ML Prefilled Syringe [Fragmin]?
In 2023, total Medicare Part D spending on 0.2 ML dalteparin sodium 25000 UNT/ML Prefilled Syringe [Fragmin] was $2,204,099, covering 87 beneficiaries. The average spend per beneficiary was $25,334.47.
Read our methodology - how this data is sourced, computed, and verified.
Nationwide similar Part D drugs
Data-derived peers across the CMS Part D formulary extract: nearest average tier placement and nearest prior-authorization rate. Not therapeutic alternatives or same-generic strengths.
Closest average formulary tier
- vigabatrin 500 MG Oral Tablet [Vigadrone] T4.3
- bosentan 32 MG Tablet for Oral Suspension T4.3
- penicillamine 250 MG Oral Capsule T4.3
- {28 (elagolix 300 MG / estradiol 1 MG / norethindrone 0.5 MG Oral Capsule) / 28 (elagolix 300 MG Oral Capsule) } Pack [Oriahnn 28 Day Kit] T4.3
- 1 ML leuprolide acetate 7.5 MG/ML Prefilled Syringe [Lupron] T4.3
- 3 ML icatibant 10 MG/ML Prefilled Syringe [Sajazir] T4.3