0.6 ML pegfilgrastim-bmez 10 MG/ML Prefilled Syringe [Ziextenzo]
pegfilgrastim-bmez
RxCUI: 2260709
What the CMS Formulary Data Shows for 0.6 ML pegfilgrastim-bmez 10 MG/ML Prefilled Syringe [Ziextenzo]
Per the CMS 2026 Part D formulary file, 0.6 ML pegfilgrastim-bmez 10 MG/ML Prefilled Syringe [Ziextenzo] (RxNorm concept RXCUI 2260709, generic name pegfilgrastim-bmez) appears on 29 distinct formulary files spanning 227 Medicare Part D plan offerings - 4.5% 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.
Real-world access to 0.6 ML pegfilgrastim-bmez 10 MG/ML Prefilled Syringe [Ziextenzo] depends on utilization management as much as tier placement: 93.1% of covering formularies require prior authorization. 3.4% require step therapy. 6.9% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 809 Part D beneficiaries filled 0.6 ML pegfilgrastim-bmez 10 MG/ML Prefilled Syringe [Ziextenzo] in 2023, with total plan-and-beneficiary spending of $10,427,658 and an average per-beneficiary annual cost of $12,889.56. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 0.6 ML pegfilgrastim-bmez 10 MG/ML Prefilled Syringe [Ziextenzo] today.
Coverage Details
- Formularies covering
- 29
- Plans covering
- 227
- Coverage rate
- 4.5%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 93.1% of formularies
- Step therapy required
- 3.4% of formularies
- Quantity limits
- 6.9% of formularies
2023 Medicare Spending
- Beneficiaries
- 809
- Total spending
- $10,427,658
- Avg per beneficiary
- $12,889.56
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 0.6 ML pegfilgrastim-bmez 10 MG/ML Prefilled Syringe [Ziextenzo]
100 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 |
| CalOptima Health OneCare Complete (HMO D-SNP) | ORANGE COUNTY HEALTH AUTHORITY | T1 | Yes | $0 | CA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | Yes | $0 | PA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | Yes | $0 | PA |
| Highmark Health Options Duals (HMO D-SNP) | HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC. | T1 | Yes | $0 | WV |
| Highmark Health Options Duals (HMO D-SNP) | HIGHMARK BCBSD, INC. | T1 | Yes | $0 | DE |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | HCSC INSURANCE SERVICES COMPANY | T1 | Yes | $4.80 | TX |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | GHS INSURANCE COMPANY | T1 | Yes | $5.00 | OK |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | Yes | $13.10 | PA |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | Yes | $17.60 | PA |
| Highmark Health Options Duals Select (HMO D-SNP) | HIGHMARK BCBSD, INC. | T1 | Yes | $31.20 | DE |
| Hamaspik Medicare Select (HMO D-SNP) | HAMASPIK, INC. | T1 | Yes | $34.50 | NY |
| 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 |
| Blue Medicare Essential Plus (HMO-POS) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | T5 | Yes | $0 | NC |
| Blue Medicare Choice (HMO) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | T5 | Yes | $0 | NC |
| Blue Medicare Essential (HMO) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | T5 | Yes | $0 | NC |
| Experience Health Medicare Advantage (HMO) | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | T5 | Yes | $0 | NC |
| Healthy Blue + Medicare (HMO-POS D-SNP) | BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH | T5 | Yes | $0 | NC |
| Blue Advantage Complete (PPO) | BLUE CROSS AND BLUE SHIELD OF ALABAMA | T5 | Yes | $0 | AL |
| 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 |
| Alignment Health the ONE + Walgreens (HMO) | ALIGNMENT HEALTH PLAN OF ARIZONA, INC. | T5 | Yes | $0 | AZ |
| Alignment Health the ONE + Walgreens (HMO) | ALIGNMENT HEALTH PLAN OF ARIZONA, INC. | T5 | Yes | $0 | AZ |
| Alignment Health Heart & Diabetes (HMO C-SNP) | ALIGNMENT HEALTH PLAN OF ARIZONA, INC. | T5 | Yes | $0 | AZ |
| Alignment Health smartHMO (HMO) | ALIGNMENT HEALTH PLAN OF ARIZONA, INC. | T5 | Yes | $0 | AZ |
| Alignment Health My Choice (HMO) | ALIGNMENT HEALTH PLAN | T5 | Yes | $0 | CA |
| Alignment Health Platinum + Instacart (HMO) | ALIGNMENT HEALTH PLAN | T5 | Yes | $0 | CA |
| Alignment Health Heart & Diabetes (HMO C-SNP) | ALIGNMENT HEALTH PLAN | T5 | Yes | $0 | CA |
| Alignment Health AllCare Preferred (HMO) | ALIGNMENT HEALTH PLAN | T5 | Yes | $0 | CA |
| Alignment Health smartHMO (HMO) | ALIGNMENT HEALTH PLAN | T5 | Yes | $0 | CA |
Frequently Asked Questions
Is 0.6 ML pegfilgrastim-bmez 10 MG/ML Prefilled Syringe [Ziextenzo] covered by Medicare Part D?
Yes, 0.6 ML pegfilgrastim-bmez 10 MG/ML Prefilled Syringe [Ziextenzo] is covered by 227 Medicare Part D plans (4.5% of all Part D formularies).
What tier is 0.6 ML pegfilgrastim-bmez 10 MG/ML Prefilled Syringe [Ziextenzo] on Medicare Part D plans?
0.6 ML pegfilgrastim-bmez 10 MG/ML Prefilled Syringe [Ziextenzo] averages Tier 4 across Part D plans, ranging from Tier 1 to Tier 5.
Does 0.6 ML pegfilgrastim-bmez 10 MG/ML Prefilled Syringe [Ziextenzo] require prior authorization?
93.1% of Part D formularies require prior authorization for 0.6 ML pegfilgrastim-bmez 10 MG/ML Prefilled Syringe [Ziextenzo]. Step therapy: 3.4%. Quantity limits: 6.9%.
How much does Medicare spend on 0.6 ML pegfilgrastim-bmez 10 MG/ML Prefilled Syringe [Ziextenzo]?
In 2023, total Medicare Part D spending on 0.6 ML pegfilgrastim-bmez 10 MG/ML Prefilled Syringe [Ziextenzo] was $10,427,658, covering 809 beneficiaries. The average spend per beneficiary was $12,889.56.
Read our methodology - how this data is sourced, computed, and verified.