Medicare Part D coverage · 0.6 · RxCUI 2613769

0.6 ML pegfilgrastim-fpgk 10 MG/ML Prefilled Syringe [Stimufend]

Per the CMS 2026 Part D formulary file, 0.6 ML pegfilgrastim-fpgk 10 MG/ML Prefilled Syringe [Stimufend] is covered by 60 Medicare Part D plans (1.2% of enrollable products), averaging Tier 4.2, with prior authorization required on 90% of covering formularies.

1.2%
Plan coverage
60
Plans covering
T4.2
Avg tier
90%
Prior auth required

Verify with CMS →

Important: Drug coverage and costs vary by plan and location. Verify coverage directly with your Medicare plan before filling a prescription. This is informational data only and should not replace advice from your healthcare provider or pharmacist.

What the CMS Formulary Data Shows for 0.6 ML pegfilgrastim-fpgk 10 MG/ML Prefilled Syringe [Stimufend]

Per the CMS 2026 Part D formulary file, 0.6 ML pegfilgrastim-fpgk 10 MG/ML Prefilled Syringe [Stimufend] (RxNorm concept RXCUI 2613769, generic name 0.6) appears on 10 distinct formulary files spanning 60 Medicare Part D plan offerings - 1.2% 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 4.2.

Real-world access to 0.6 ML pegfilgrastim-fpgk 10 MG/ML Prefilled Syringe [Stimufend] depends on utilization management as much as tier placement: 90% of covering formularies require prior authorization. 0% require step therapy. 10% 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 0.6 ML pegfilgrastim-fpgk 10 MG/ML Prefilled Syringe [Stimufend] today.

Coverage Details

Formularies covering
10
Plans covering
60
Coverage rate
1.2%
Tier range
Tier 1 – Tier 5
Average tier
Tier 4, Non-Preferred

Restrictions

Prior authorization required
90% of formularies
Step therapy required
0% of formularies
Quantity limits
10% of formularies

Tier Distribution Across Plans

2 plans
Tier 1, Preferred Generic
58 plans
Tier 5, Specialty

Medicare Advantage Plans (MA-PD) Covering 0.6 ML pegfilgrastim-fpgk 10 MG/ML Prefilled Syringe [Stimufend]

60 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
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
Network Health Select (PPO) Network Health Insurance Corporation T5 Yes $0 WI
Network Health Go (PPO) Network Health Insurance Corporation T5 Yes $0 WI
Network Health Anywhere (PPO) Network Health Insurance Corporation T5 Yes $0 WI
Network Health Choice (PPO) Network Health Insurance Corporation T5 Yes $0 WI
Show the next 30 plans
Network Health Zero (PPO) Network Health Insurance Corporation T5 Yes $0 WI
Geisinger Gold Preferred Complete Rx (PPO) Geisinger Indemnity Insurance Company T5 Yes $0 PA
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
UPMC for Life HMO Premier Rx (HMO) Upmc Health Plan, Inc. T5 Yes $0 PA
UPMC for Life Complete Care (HMO D-SNP) Upmc FOR YOU, Inc T5 Yes $0 PA
UPMC for Life Complete Care (HMO D-SNP) Upmc FOR YOU, Inc T5 Yes $0 PA
UPMC for Life PPO Premier Rx (PPO) Upmc Health Network, Inc. T5 Yes $0 PA
UPMC for Life PPO Premier Rx (PPO) Upmc Health Network, Inc. T5 Yes $0 PA
UPMC for Life PPO Essential Care Rx (PPO) Upmc Health Network, Inc. T5 Yes $0 PA
UPMC for Life Complete Care (HMO D-SNP) Upmc Health Coverage, Inc. T5 Yes $0 PA
Healthy Mississippi Premier Advantage (HMO-POS) Healthy Mississippi, Inc. T5 Yes $0 MS
CareOregon Advantage Plus (HMO D-SNP) Health Plan OF Careoregon, Inc. T5 Yes $0 OR
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
UPMC for Life HMO Rx Choice (HMO) Upmc Health Plan, Inc. T5 Yes $3.90 OH, PA
UPMC for Life HMO Deductible Rx (HMO) Upmc Health Plan, Inc. T5 Yes $18.10 OH, PA
PacificSource Medicare MyCare Choice Rx 34 (HMO-POS) Pacificsource Community Health Plans T5 Yes $19.00 ID
Network Health Cares (PPO D-SNP) Network Health Insurance Corporation T5 Yes $21.10 WI
Geisinger Gold Value Rx (HMO) Geisinger Health Plan T5 Yes $23.00 PA
UPMC for Life PPO Rx Choice (PPO) Upmc Health Network, Inc. T5 Yes $25.00 PA
PacificSource Medicare Essentials Choice Rx 14 (HMO-POS) Pacificsource Community Health Plans T5 Yes $29.10 OR
UPMC for Life PPO High Deductible Rx (PPO) Upmc Health Network, Inc. T5 Yes $33.00 PA
UPMC for Life HMO Rx (HMO) Upmc Health Plan, Inc. T5 Yes $33.70 OH, PA
Network Health PlusRx (PPO) Network Health Insurance Corporation T5 Yes $38.60 WI
UPMC for Life PPO Rx Enhanced (PPO) Upmc Health Network, Inc. T5 Yes $42.70 PA

Showing top 50 of 60 plans.

Frequently Asked Questions

Is 0.6 ML pegfilgrastim-fpgk 10 MG/ML Prefilled Syringe [Stimufend] covered by Medicare Part D?

Yes, 0.6 ML pegfilgrastim-fpgk 10 MG/ML Prefilled Syringe [Stimufend] is covered by 60 Medicare Part D plans (1.2% of all Part D formularies).

What tier is 0.6 ML pegfilgrastim-fpgk 10 MG/ML Prefilled Syringe [Stimufend] on Medicare Part D plans?

0.6 ML pegfilgrastim-fpgk 10 MG/ML Prefilled Syringe [Stimufend] averages Tier 4.2 across Part D plans, ranging from Tier 1 to Tier 5.

Does 0.6 ML pegfilgrastim-fpgk 10 MG/ML Prefilled Syringe [Stimufend] require prior authorization?

90% of Part D formularies require prior authorization for 0.6 ML pegfilgrastim-fpgk 10 MG/ML Prefilled Syringe [Stimufend]. Step therapy: 0%. Quantity limits: 10%.

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.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare