Medicare Part D coverage · 0.6 · RxCUI 2102705
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] is covered by 2,131 Medicare Part D plans (42.2% of enrollable products), averaging Tier 4.5, with prior authorization required on 86.4% of covering formularies.
- 42.2%
- Plan coverage
- 2,131
- Plans covering
- T4.5
- Avg tier
- 86.4%
- 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 0.6) appears on 81 distinct formulary files spanning 2,131 Medicare Part D plan offerings - 42.2% 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 4.5.
Real-world access to 0.6 ML pegfilgrastim-cbqv 10 MG/ML Prefilled Syringe [Udenyca] depends on utilization management as much as tier placement: 86.4% of covering formularies require prior authorization. 0% require step therapy. 14.8% 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
- 81
- Plans covering
- 2,131
- Coverage rate
- 42.2%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 5, Specialty
Restrictions
- Prior authorization required
- 86.4% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 14.8% of formularies
2023 Medicare Spending
- Beneficiaries
- 533
- Total spending
- $7,543,946
- Avg per beneficiary
- $14,153.75
Tier Distribution Across Plans
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 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 |
Show the next 30 plans
| Provider Partners Illinois Advantage Plan (HMO I-SNP) | Provider Partners Health Plan OF Illinois | T1 | Yes | $15.20 | IL |
| 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 |
| AARP Medicare Advantage from UHC AL-0001 (HMO-POS) | Unitedhealthcare OF THE Midlands, Inc. | T5 | Yes | $0 | AL |
| AARP Medicare Advantage from UHC CA-0002 (HMO-POS) | UHC OF California | T5 | Yes | $0 | CA |
| UHC Sharp Medicare Advantage CA-001P (HMO-POS) | UHC OF California | T5 | Yes | $0 | CA |
Showing top 50 of 95 plans.
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 2,131 Medicare Part D plans (42.2% 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?
86.4% of Part D formularies require prior authorization for 0.6 ML pegfilgrastim-cbqv 10 MG/ML Prefilled Syringe [Udenyca]. Step therapy: 0%. Quantity limits: 14.8%.
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.
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
- 3 ML apomorphine hydrochloride 10 MG/ML Cartridge T4.5
- revefenacin 0.0583 MG/ML Inhalation Solution [Yupelri] T4.5
- {56 (mitapivat 20 MG Oral Tablet [Pyrukynd]) } Pack [Pyrukynd 20 MG 4-Week] T4.5
- {7 (mitapivat 5 MG Oral Tablet [Pyrukynd]) } Pack [Pyrukynd 5 MG Taper] T4.5
- {28 (tolvaptan 30 MG Oral Tablet [Jynarque]) / 28 (tolvaptan 60 MG Oral Tablet [Jynarque]) } Pack [Jynarque 60/30 Carton] T4.5
- {56 (tolvaptan 15 MG Oral Tablet [Jynarque]) } Pack [Jynarque 15/15 Carton] T4.5
Similar prior-authorization rate
- 1.7 ML denosumab-nxxp 70 MG/ML Injection [Bilprevda] 86.4% PA
- ondansetron 0.8 MG/ML Oral Solution 86.3% PA
- crinecerfont 50 MG/ML Oral Solution [Crenessity] 86.7% PA
- 1.5 ML leuprolide acetate 30 MG/ML Prefilled Syringe [Lupron] 86.8% PA
- 60 ACTUAT testosterone 30 MG/ACTUAT Topical Solution 86% PA
- leuprolide acetate 5 MG/ML Injectable Solution 86% PA