Medicare Part D coverage · 0.6 · RxCUI 2260709
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] is covered by 227 Medicare Part D plans (4.5% of enrollable products), averaging Tier 4, with prior authorization required on 93.1% of covering formularies.
- 4.5%
- Plan coverage
- 227
- Plans covering
- T4
- Avg tier
- 93.1%
- Prior auth required
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 0.6) 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.
Show the next 30 plans
| 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 North Carolina | 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 |
Showing top 50 of 100 plans.
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.
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
- lomustine 100 MG Oral Capsule T4
- 1 ML glatiramer acetate 40 MG/ML Prefilled Syringe T4
- 1 ML glatiramer acetate 20 MG/ML Prefilled Syringe T4
- 1 ML glatiramer acetate 20 MG/ML Prefilled Syringe [Glatopa] T4
- posaconazole 40 MG/ML Oral Suspension T4
- 24 HR tacrolimus 5 MG Extended Release Oral Capsule [Astagraf] T4
Similar prior-authorization rate
- caplacizumab-yhdp 11 MG Injection [Cablivi] 93.1% PA
- insulin lispro 100 UNT/ML Injectable Solution [Admelog] 93% PA
- 0.5 ML tbo-filgrastim 0.6 MG/ML Prefilled Syringe [Granix] 93% PA
- 0.8 ML tbo-filgrastim 0.6 MG/ML Prefilled Syringe [Granix] 93% PA
- {28 (alpelisib 50 MG Oral Granules [Vijoice]) } Pack [Vijoice 50 MG Granules 28 Day] 93% PA
- 0.4 ML adalimumab-adbm 100 MG/ML Prefilled Syringe 92.9% PA