1 ML infliximab-dyyb 120 MG/ML Prefilled Syringe [Zymfentra]
infliximab-dyyb
RxCUI: 2675757
What the CMS Formulary Data Shows for 1 ML infliximab-dyyb 120 MG/ML Prefilled Syringe [Zymfentra]
Per the CMS 2026 Part D formulary file, 1 ML infliximab-dyyb 120 MG/ML Prefilled Syringe [Zymfentra] (RxNorm concept RXCUI 2675757, generic name infliximab-dyyb) appears on 25 distinct formulary files spanning 209 Medicare Part D plan offerings - 4.1% 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 3.7.
Real-world access to 1 ML infliximab-dyyb 120 MG/ML Prefilled Syringe [Zymfentra] depends on utilization management as much as tier placement: 88% of covering formularies require prior authorization. 0% require step therapy. 88% 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 1 ML infliximab-dyyb 120 MG/ML Prefilled Syringe [Zymfentra] today.
Coverage Details
- Formularies covering
- 25
- Plans covering
- 209
- Coverage rate
- 4.1%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 88% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 88% of formularies
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 1 ML infliximab-dyyb 120 MG/ML Prefilled Syringe [Zymfentra]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| ElderServe MAP (HMO D-SNP) | ELDERSERVE HEALTH, INC. | T1 | Yes | $0 | NY |
| Cooperative Advantage (HMO D-SNP) | GROUP HEALTH COOPERATIVE OF EAU CLAIRE | T1 | Yes | $0 | WI |
| Longevity Health Plan (PPO I-SNP) | LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP | T1 | Yes | $0 | NJ |
| Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) | UPPER PENINSULA HEALTH PLAN, LLC | T1 | Yes | $0 | MI |
| CareSource Dual Advantage (HMO D-SNP) | CARESOURCE GEORGIA CO. | T1 | Yes | $0 | GA |
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP CARESOURCE | T1 | Yes | $0 | MI |
| NaviCare (HMO D-SNP) | FALLON COMMUNITY HEALTH PLAN | T1 | Yes | $0 | MA |
| Longevity Health Plan (HMO I-SNP) | LONGEVITY HEALTH PLAN OF FLORIDA, INC. | T1 | Yes | $4.80 | FL |
| Longevity Health Plan (HMO I-SNP) | LONGEVITY HEALTH PLAN OF MICHIGAN, INC. | T1 | Yes | $8.80 | MI |
| Longevity Health Plan (HMO I-SNP) | LONGEVITY HEALTH PLAN OF ILLINOIS, INC. | T1 | Yes | $15.20 | IL |
| WellSense Added Value (HMO) | BOSTON MEDICAL CENTER HEALTH PLAN, INC. | T1 | Yes | $21.70 | NH |
| Longevity Health Plan (HMO I-SNP) | LONGEVITY HEALTH PLAN OF COLORADO, INC. | T1 | Yes | $35.20 | CO |
| Longevity Health Plan (HMO I-SNP) | LONGEVITY HEALTH PLAN OF NORTH CAROLINA, INC. | T1 | Yes | $36.20 | NC |
| Longevity Health Plan (PPO I-SNP) | LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP | T1 | Yes | $40.00 | NJ |
| ElderServe Star (HMO I-SNP) | ELDERSERVE HEALTH, INC. | T1 | Yes | $58.80 | NY |
| Longevity Health Plan (HMO I-SNP) | LONGEVITY HEALTH PLAN OF NEW YORK, INC. | T1 | Yes | $58.80 | NY |
| The Health Plan SecureCare - Option II (HMO) | THE HEALTH PLAN OF WEST VIRGINIA, INC. | T5 | Yes | $0 | OH |
| The Health Plan SecureCare - Option II (HMO) | THE HEALTH PLAN OF WEST VIRGINIA, INC. | T5 | Yes | $0 | OH, WV |
| The Health Plan SecureCare Capitol Plan (HMO) | THE HEALTH PLAN OF WEST VIRGINIA, INC. | T5 | Yes | $0 | WV |
| The Health Plan SecureChoice Optimum (PPO) | THP INSURANCE COMPANY | T5 | Yes | $0 | OH, WV |
| WellSense Signature (HMO) | BOSTON MEDICAL CENTER HEALTH PLAN, INC. | T5 | Yes | $0 | NH |
| WellSense Signature Access (PPO) | BOSTON MEDICAL CENTER HEALTH PLAN, INC. | T5 | Yes | $0 | NH |
| Community Health Plan of WA Dual Complete (HMO D-SNP) | COMMUNITY HEALTH PLAN OF WASHINGTON | T5 | Yes | $0 | WA |
| Community Health Plan of WA Dual Select (HMO D-SNP) | COMMUNITY HEALTH PLAN OF WASHINGTON | T5 | Yes | $0 | WA |
| Essence Advantage (HMO) | ESSENCE HEALTHCARE, INC. | T5 | Yes | $0 | IL, MO |
| Essence Advantage (HMO) | ESSENCE HEALTHCARE, INC. | T5 | Yes | $0 | AR, MO |
| Essence Advantage Select (HMO) | ESSENCE HEALTHCARE, INC. | T5 | Yes | $0 | IL, MO |
| Essence Advantage (HMO) | ESSENCE HEALTHCARE, INC. | T5 | Yes | $0 | IN, KY |
| Essence Advantage Select (HMO) | ESSENCE HEALTHCARE, INC. | T5 | Yes | $0 | IL |
| Essence Advantage Choice (PPO) | ESSENCE HEALTHCARE PPO, INC. | T5 | Yes | $0 | IL, MO |
| Essence Advantage Choice (PPO) | ESSENCE HEALTHCARE PPO, INC. | T5 | Yes | $0 | AR, MO |
| Essence Advantage Choice (PPO) | ESSENCE HEALTHCARE PPO, INC. | T5 | Yes | $0 | IL |
| CareSource Dual Advantage Plus (HMO D-SNP) | CARESOURCE GEORGIA CO. | T5 | Yes | $0 | GA |
| CareSource MyCare Ohio (HMO D-SNP) | CARESOURCE OHIO, INC. | T5 | Yes | $0 | OH |
| Blue adVantage Liberty (PPO) | LOUISIANA HEALTH SERVICE & INDEMNITY COMPANY | T5 | Yes | $0 | LA |
| Blue adVantage Thrive (PPO) | LOUISIANA HEALTH SERVICE & INDEMNITY COMPANY | T5 | Yes | $0 | LA |
| Blue adVantage Classic (HMO-POS) | HMO LOUISIANA, INC. | T5 | Yes | $0 | LA |
| Blue adVantage Giveback (HMO-POS) | HMO LOUISIANA, INC. | T5 | Yes | $0 | LA |
| MedMutual Advantage Access (PPO) | MEDICAL MUTUAL OF OHIO | T5 | Yes | $0 | OH |
| MedMutual Advantage Classic (HMO) | MEDICAL MUTUAL OF OHIO | T5 | Yes | $0 | OH |
| MedMutual Advantage Signature (HMO-POS) | MEDICAL MUTUAL OF OHIO | T5 | Yes | $0 | OH |
| Fallon Medicare Plus Orange (HMO) | FALLON COMMUNITY HEALTH PLAN | T5 | Yes | $0 | MA |
| Presbyterian Senior Care Plan 2 with Rx (HMO) | PRESBYTERIAN HEALTH PLAN | T5 | No | $0 | NM |
| Presbyterian Dual Plus (HMO D-SNP) | PRESBYTERIAN HEALTH PLAN | T5 | No | $0 | NM |
| Presbyterian Senior Care Extra Health Plan with Rx (HMO) | PRESBYTERIAN HEALTH PLAN | T5 | No | $0 | NM |
| Kaiser Permanente Senior Advantage LA, Orange Co. (HMO) | KAISER FOUNDATION HP, INC. | T5 | No | $0 | CA |
| Kaiser Permanente Senior Advantage Enhanced Solano (HMO) | KAISER FOUNDATION HP, INC. | T5 | No | $0 | CA |
| Kaiser Permanente Senior Advantage Inland Empire (HMO) | KAISER FOUNDATION HP, INC. | T5 | No | $0 | CA |
| Kaiser Permanente Sr Adv Enhanced Marin San Mateo (HMO) | KAISER FOUNDATION HP, INC. | T5 | No | $0 | CA |
| Kaiser Permanente Senior Advantage Ventura (HMO) | KAISER FOUNDATION HP, INC. | T5 | No | $0 | CA |
Frequently Asked Questions
Is 1 ML infliximab-dyyb 120 MG/ML Prefilled Syringe [Zymfentra] covered by Medicare Part D?
Yes, 1 ML infliximab-dyyb 120 MG/ML Prefilled Syringe [Zymfentra] is covered by 209 Medicare Part D plans (4.1% of all Part D formularies).
What tier is 1 ML infliximab-dyyb 120 MG/ML Prefilled Syringe [Zymfentra] on Medicare Part D plans?
1 ML infliximab-dyyb 120 MG/ML Prefilled Syringe [Zymfentra] averages Tier 3.7 across Part D plans, ranging from Tier 1 to Tier 5.
Does 1 ML infliximab-dyyb 120 MG/ML Prefilled Syringe [Zymfentra] require prior authorization?
88% of Part D formularies require prior authorization for 1 ML infliximab-dyyb 120 MG/ML Prefilled Syringe [Zymfentra]. Step therapy: 0%. Quantity limits: 88%.
Read our methodology - how this data is sourced, computed, and verified.