0.6 ML pegfilgrastim-cbqv 10 MG/ML Prefilled Syringe [Udenyca]

Verify with CMS →

pegfilgrastim-cbqv

RxCUI: 2102705

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.
42.4%
Plan Coverage
2,146
Plans Covering
T4.5
Avg Tier
85.5%
Prior Auth Required

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

Per the CMS 2026 Part D formulary file, 0.6 ML pegfilgrastim-cbqv 10 MG/ML Prefilled Syringe [Udenyca] (RxNorm concept RXCUI 2102705, generic name pegfilgrastim-cbqv) appears on 83 distinct formulary files spanning 2,146 Medicare Part D plan offerings - 42.4% 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 4.5.

Real-world access to 0.6 ML pegfilgrastim-cbqv 10 MG/ML Prefilled Syringe [Udenyca] depends on utilization management as much as tier placement: 85.5% of covering formularies require prior authorization. 0% require step therapy. 14.5% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 533 Part D beneficiaries filled 0.6 ML pegfilgrastim-cbqv 10 MG/ML Prefilled Syringe [Udenyca] in 2023, with total plan-and-beneficiary spending of $7,543,946 and an average per-beneficiary annual cost of $14,153.75. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 0.6 ML pegfilgrastim-cbqv 10 MG/ML Prefilled Syringe [Udenyca] today.

Coverage Details

Formularies covering
83
Plans covering
2,146
Coverage rate
42.4%
Tier range
Tier 1 – Tier 5
Average tier
Tier 5, Specialty

Restrictions

Prior authorization required
85.5% of formularies
Step therapy required
0% of formularies
Quantity limits
14.5% of formularies

2023 Medicare Spending

Beneficiaries
533
Total spending
$7,543,946
Avg per beneficiary
$14,153.75

Tier Distribution Across Plans

34 plans
Tier 1, Preferred Generic
66 plans
Tier 5, Specialty

Standalone Drug Plans (PDP) Covering 0.6 ML pegfilgrastim-cbqv 10 MG/ML Prefilled Syringe [Udenyca]

5 standalone prescription drug plans include this drug.

Plan Insurer Tier PA ST Premium States
AARP Medicare Rx Preferred from UHC (PDP) UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY T5 Yes No $0 -
AARP Medicare Rx Preferred from UHC (PDP) UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY T5 Yes No $0 -
AARP Medicare Rx Saver from UHC (PDP) UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY T5 Yes No $0 -
AARP Medicare Rx Saver from UHC (PDP) UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY T5 Yes No $0 -
AARP Medicare Rx Saver from UHC (PDP) UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY T5 Yes No $0 -

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

95 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
Gold Coast Health Plan Total Care Advantage (HMO D-SNP) Ventura County Medi-Cal Managed Care Commission T1 Yes $0 CA
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) Health Care Service Corporation T1 Yes $0 NM
Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) Health Care Service Corporation T1 Yes $0 NM
SecureBlue (HMO D-SNP) HMO Minnesota T1 Yes $0 MN
Hamaspik Medicare Choice (HMO D-SNP) HAMASPIK, INC. T1 Yes $0 NY
Provider Partners Pennsylvania Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC T1 Yes $0 PA
Provider Partners North Carolina Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA T1 Yes $0 NC
Provider Partners Indiana Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF INDIANA T1 Yes $0 IN
Provider Partners Maryland Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN, INC. T1 Yes $0 MD
Provider Partners Missouri Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC. T1 Yes $0 MO
CalOptima Health OneCare Complete (HMO D-SNP) ORANGE COUNTY HEALTH AUTHORITY T1 Yes $0 CA
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
Tufts Health One Care (HMO D-SNP) TUFTS HEALTH PUBLIC PLANS, INC. T1 No $0 MA
Tufts Health One Care CW (HMO D-SNP) TUFTS HEALTH PUBLIC PLANS, INC. T1 No $0 MA
Tufts Health Plan Senior Care Options (HMO D-SNP) TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION T1 No $0 MA
Tufts Health Plan Senior Care Options CW (HMO D-SNP) TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION T1 No $0 MA
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) HCSC INSURANCE SERVICES COMPANY T1 Yes $4.80 TX
Provider Partners Texas Advantage Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF TEXAS, INC. T1 Yes $4.80 TX
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) GHS INSURANCE COMPANY T1 Yes $5.00 OK
Provider Partners Illinois Advantage Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF ILLINOIS T1 Yes $15.20 IL
Provider Partners Maryland Advantage Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN, INC. T1 Yes $31.20 MD
Provider Partners Maryland Essential Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN, INC. T1 Yes $31.20 MD
Provider Partners Pennsylvania Advantage Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC T1 Yes $32.70 PA
Provider Partners Pennsylvania Essential Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC T1 Yes $32.70 PA
Hamaspik Medicare Select (HMO D-SNP) HAMASPIK, INC. T1 Yes $34.50 NY
Provider Partners North Carolina Advantage Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA T1 Yes $36.20 NC
Provider Partners North Carolina Essential Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA T1 Yes $36.20 NC
Provider Partners Indiana Advantage Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF INDIANA T1 Yes $38.40 IN
Provider Partners Indiana Essential Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF INDIANA T1 Yes $38.40 IN
Provider Partners Kentucky Advantage Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF KENTUCKY T1 Yes $38.40 KY
Provider Partners Missouri Advantage Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC. T1 Yes $43.00 MO
Provider Partners Missouri Essential Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC. T1 Yes $43.00 MO
UHC Dual Complete IA-S001 (HMO-POS D-SNP) UNITEDHEALTHCARE OF WISCONSIN, INC. T5 Yes $0 IA
UHC Dual Complete MO-S001 (HMO-POS D-SNP) UNITEDHEALTHCARE OF WISCONSIN, INC. T5 Yes $0 MO
UHC Dual Complete NE-S001 (HMO-POS D-SNP) UNITEDHEALTHCARE OF WISCONSIN, INC. T5 Yes $0 NE
UHC Dual Complete KS-S001 (HMO-POS D-SNP) UNITEDHEALTHCARE OF WISCONSIN, INC. T5 Yes $0 KS
UHC Dual Complete MO-S3 (HMO-POS D-SNP) UNITEDHEALTHCARE OF WISCONSIN, INC. T5 Yes $0 MO
UHC Dual Complete KS-Q1 (HMO-POS D-SNP) UNITEDHEALTHCARE OF WISCONSIN, INC. T5 Yes $0 KS
UHC Dual Complete TN-S001 (HMO-POS D-SNP) UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. T5 Yes $0 TN
UHC Dual Complete TN-Y001 (HMO-POS D-SNP) UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. T5 Yes $0 TN
UHC Dual Complete TN-Y2 (HMO-POS D-SNP) UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. T5 Yes $0 TN
AARP Medicare Advantage from UHC MI-0001 (PPO) UNITEDHEALTHCARE INSURANCE COMPANY T5 Yes $0 MI
UHC Dual Complete NM-Y1 (PPO D-SNP) UNITEDHEALTHCARE INSURANCE COMPANY T5 Yes $0 NM
UHC Dual Complete NM-S1 (PPO D-SNP) UNITEDHEALTHCARE INSURANCE COMPANY T5 Yes $0 NM
UHC Dual Complete NM-V1 (PPO D-SNP) UNITEDHEALTHCARE INSURANCE COMPANY T5 Yes $0 NM
UHC Dual Complete AZ-S001 (HMO-POS D-SNP) ARIZONA PHYSICIANS IPA, INC. T5 Yes $0 AZ
UHC Dual Complete AZ-Y001 (HMO-POS D-SNP) ARIZONA PHYSICIANS IPA, INC. T5 Yes $0 AZ
UHC Dual Complete VA-Y4 (PPO D-SNP) CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. T5 Yes $0 VA

Frequently Asked Questions

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

Yes, 0.6 ML pegfilgrastim-cbqv 10 MG/ML Prefilled Syringe [Udenyca] is covered by 2,146 Medicare Part D plans (42.4% of all Part D formularies).

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

0.6 ML pegfilgrastim-cbqv 10 MG/ML Prefilled Syringe [Udenyca] averages Tier 4.5 across Part D plans, ranging from Tier 1 to Tier 5.

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

85.5% of Part D formularies require prior authorization for 0.6 ML pegfilgrastim-cbqv 10 MG/ML Prefilled Syringe [Udenyca]. Step therapy: 0%. Quantity limits: 14.5%.

How much does Medicare spend on 0.6 ML pegfilgrastim-cbqv 10 MG/ML Prefilled Syringe [Udenyca]?

In 2023, total Medicare Part D spending on 0.6 ML pegfilgrastim-cbqv 10 MG/ML Prefilled Syringe [Udenyca] was $7,543,946, covering 533 beneficiaries. The average spend per beneficiary was $14,153.75.

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