Medicare Part D coverage · 0.6 · RxCUI 2602787
0.6 ML pegfilgrastim-pbbk 10 MG/ML Prefilled Syringe [Fylnetra]
Per the CMS 2026 Part D formulary file, 0.6 ML pegfilgrastim-pbbk 10 MG/ML Prefilled Syringe [Fylnetra] is covered by 51 Medicare Part D plans (1% of enrollable products), averaging Tier 4.1, with prior authorization required on 94.1% of covering formularies.
- 1%
- Plan coverage
- 51
- Plans covering
- T4.1
- Avg tier
- 94.1%
- Prior auth required
What the CMS Formulary Data Shows for 0.6 ML pegfilgrastim-pbbk 10 MG/ML Prefilled Syringe [Fylnetra]
Per the CMS 2026 Part D formulary file, 0.6 ML pegfilgrastim-pbbk 10 MG/ML Prefilled Syringe [Fylnetra] (RxNorm concept RXCUI 2602787, generic name 0.6) appears on 17 distinct formulary files spanning 51 Medicare Part D plan offerings - 1% 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 4.1.
Real-world access to 0.6 ML pegfilgrastim-pbbk 10 MG/ML Prefilled Syringe [Fylnetra] depends on utilization management as much as tier placement: 94.1% of covering formularies require prior authorization. 0% require step therapy. 5.9% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 11 Part D beneficiaries filled 0.6 ML pegfilgrastim-pbbk 10 MG/ML Prefilled Syringe [Fylnetra] in 2023, with total plan-and-beneficiary spending of $81,033 and an average per-beneficiary annual cost of $7,366.67. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 0.6 ML pegfilgrastim-pbbk 10 MG/ML Prefilled Syringe [Fylnetra] today.
Coverage Details
- Formularies covering
- 17
- Plans covering
- 51
- Coverage rate
- 1%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 94.1% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 5.9% of formularies
2023 Medicare Spending
- Beneficiaries
- 11
- Total spending
- $81,033
- Avg per beneficiary
- $7,366.67
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 0.6 ML pegfilgrastim-pbbk 10 MG/ML Prefilled Syringe [Fylnetra]
51 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| CareAdvantage (HMO D-SNP) | SAN Mateo Health Commission | T1 | No | $0 | CA |
| SeniorCare Complete (HMO D-SNP) | South Country Health Alliance | T1 | Yes | $0 | MN |
| AbilityCare (HMO D-SNP) | South Country Health Alliance | T1 | Yes | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | Alameda Alliance FOR Health | T1 | Yes | $0 | CA |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T1 | Yes | $0 | CA |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | UT |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | NV |
| Select Health Medicare Dual (HMO D-SNP) | Selecthealth, Inc. | T5 | Yes | $0 | UT |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | UT |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | NV |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | UT |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | CO |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | CO |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | CO |
| Select Health Medicare Flex (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | CO |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | CO |
| Select Health Medicare Active (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | CO |
| Select Health Medicare Dual (HMO D-SNP) | Selecthealth, Inc. | T5 | Yes | $0 | NV |
| Select Health Medicare Wellness (HMO) | Selecthealth, Inc. | T5 | Yes | $0 | NV |
| Geisinger Gold Preferred Complete Rx (PPO) | Geisinger Indemnity Insurance Company | T5 | Yes | $0 | PA |
Show the next 30 plans
| Geisinger Gold Secure Rx (HMO D-SNP) | Geisinger Health Plan | T5 | Yes | $0 | PA |
| Geisinger Gold Classic 360 Rx (HMO) | Geisinger Health Plan | T5 | Yes | $0 | PA |
| Geisinger Gold Classic Essential Rx (HMO) | Geisinger Health Plan | T5 | Yes | $0 | PA |
| Troy Medicare (HMO) | Troy Health, Inc. | T5 | Yes | $0 | NC |
| Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | Troy Health, Inc. | T5 | Yes | $0 | NC |
| Contra Costa Health Care Plus (HMO D-SNP) | Contra Costa County Medical Service DBA Contra Costa Health | T5 | Yes | $0 | CA |
| Keystone First VIP Choice (HMO D-SNP) | Vista Health Plan, Inc. | T5 | Yes | $0 | PA |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Vista Health Plan, Inc. | T5 | Yes | $0 | PA |
| First Choice VIP Care (HMO D-SNP) | Select Health OF South Carolina, Inc. | T5 | Yes | $0 | SC |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | AmeriHealth Caritas VIP Next, Inc. | T5 | Yes | $0 | DE |
| AmeriHealth Caritas VIP Care Choice (HMO D-SNP) | AmeriHealth Caritas VIP Next, Inc. | T5 | Yes | $0 | DE |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Amerihealth Caritas Florida, Inc. | T5 | Yes | $0 | FL |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Amerihealth Caritas Louisiana, Inc. | T5 | Yes | $0 | LA |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Amerihealth Caritas North Carolina, Inc. | T5 | Yes | $0 | NC |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Amerihealth Michigan, Inc. | T5 | Yes | $0 | MI |
| Healthy Mississippi Premier Advantage (HMO-POS) | Healthy Mississippi, Inc. | T5 | Yes | $0 | MS |
| PacificSource Medicare Essentials Rx 27 (HMO) | Pacificsource Community Health Plans | T5 | Yes | $0 | OR |
| PacificSource Medicare MyCare Choice Rx 29 (HMO-POS) | Pacificsource Community Health Plans | T5 | Yes | $0 | MT |
| PacificSource Medicare Essentials Choice Rx 36 (HMO-POS) | Pacificsource Community Health Plans | T5 | Yes | $0 | OR |
| PacificSource Medicare MyCare Rx 40 (HMO) | Pacificsource Community Health Plans | T5 | Yes | $0 | OR |
| PacificSource Dual Care (HMO D-SNP) | Pacificsource Community Health Plans | T5 | Yes | $0 | OR |
| PacificSource Medicare MyCare Choice Rx 34 (HMO-POS) | Pacificsource Community Health Plans | T5 | Yes | $19.00 | ID |
| Geisinger Gold Value Rx (HMO) | Geisinger Health Plan | T5 | Yes | $23.00 | PA |
| PacificSource Medicare Essentials Choice Rx 14 (HMO-POS) | Pacificsource Community Health Plans | T5 | Yes | $29.10 | OR |
| Geisinger Gold Classic Complete Rx (HMO) | Geisinger Health Plan | T5 | Yes | $48.00 | PA |
| PacificSource Medicare MyCare Choice Rx 24 (HMO-POS) | Pacificsource Community Health Plans | T5 | Yes | $52.00 | ID |
| PacificSource Medicare Essentials Rx 41 (HMO) | Pacificsource Community Health Plans | T5 | Yes | $69.30 | OR |
| PacificSource Medicare Explorer Rx 4 (PPO) | Pacificsource Community Health Plans | T5 | Yes | $88.70 | OR |
| Geisinger Gold Classic Advantage Rx (HMO) | Geisinger Health Plan | T5 | Yes | $99.30 | PA |
| PacificSource Medicare Essentials Rx 6 (HMO) | Pacificsource Community Health Plans | T5 | Yes | $105.90 | OR |
Showing top 50 of 51 plans.
Frequently Asked Questions
Is 0.6 ML pegfilgrastim-pbbk 10 MG/ML Prefilled Syringe [Fylnetra] covered by Medicare Part D?
Yes, 0.6 ML pegfilgrastim-pbbk 10 MG/ML Prefilled Syringe [Fylnetra] is covered by 51 Medicare Part D plans (1% of all Part D formularies).
What tier is 0.6 ML pegfilgrastim-pbbk 10 MG/ML Prefilled Syringe [Fylnetra] on Medicare Part D plans?
0.6 ML pegfilgrastim-pbbk 10 MG/ML Prefilled Syringe [Fylnetra] averages Tier 4.1 across Part D plans, ranging from Tier 1 to Tier 5.
Does 0.6 ML pegfilgrastim-pbbk 10 MG/ML Prefilled Syringe [Fylnetra] require prior authorization?
94.1% of Part D formularies require prior authorization for 0.6 ML pegfilgrastim-pbbk 10 MG/ML Prefilled Syringe [Fylnetra]. Step therapy: 0%. Quantity limits: 5.9%.
How much does Medicare spend on 0.6 ML pegfilgrastim-pbbk 10 MG/ML Prefilled Syringe [Fylnetra]?
In 2023, total Medicare Part D spending on 0.6 ML pegfilgrastim-pbbk 10 MG/ML Prefilled Syringe [Fylnetra] was $81,033, covering 11 beneficiaries. The average spend per beneficiary was $7,366.67.
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
Similar prior-authorization rate
- deferasirox 360 MG Oral Tablet 94.1% PA
- 1.5 ML brodalumab 140 MG/ML Prefilled Syringe [Siliq] 94.1% PA
- {10 (cladribine 10 MG Oral Tablet [Mavenclad]) } Pack [Mavenclad 10 Tablet Pack] 94.1% PA
- {4 (cladribine 10 MG Oral Tablet [Mavenclad]) } Pack [Mavenclad 4 Tablet Pack] 94.1% PA
- {5 (cladribine 10 MG Oral Tablet [Mavenclad]) } Pack [Mavenclad 5 Tablet Pack] 94.1% PA
- {6 (cladribine 10 MG Oral Tablet [Mavenclad]) } Pack [Mavenclad 6 Tablet Pack] 94.1% PA