10 ML plazomicin 50 MG/ML Injection [Zemdri]
plazomicin
RxCUI: 2049558
What the CMS Formulary Data Shows for 10 ML plazomicin 50 MG/ML Injection [Zemdri]
Per the CMS 2026 Part D formulary file, 10 ML plazomicin 50 MG/ML Injection [Zemdri] (RxNorm concept RXCUI 2049558, generic name plazomicin) appears on 4 distinct formulary files spanning 26 Medicare Part D plan offerings - 0.5% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 4 to Tier 5, with a cross-plan average of Tier 4.5.
Real-world access to 10 ML plazomicin 50 MG/ML Injection [Zemdri] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 0% 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 10 ML plazomicin 50 MG/ML Injection [Zemdri] today.
Coverage Details
- Formularies covering
- 4
- Plans covering
- 26
- Coverage rate
- 0.5%
- Tier range
- Tier 4 – Tier 5
- Average tier
- Tier 5, Specialty
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering 10 ML plazomicin 50 MG/ML Injection [Zemdri]
2 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| Blue Rx PDP Complete (PDP) | HM HEALTH INSURANCE COMPANY | T5 | No | No | $164.80 | - |
| Blue Rx PDP Plus (PDP) | HM HEALTH INSURANCE COMPANY | T5 | No | No | $193.20 | - |
Medicare Advantage Plans (MA-PD) Covering 10 ML plazomicin 50 MG/ML Injection [Zemdri]
24 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| UPMC for Life HMO Premier Rx (HMO) | UPMC HEALTH PLAN, INC. | T4 | No | $0 | PA |
| UPMC for Life Complete Care (HMO D-SNP) | UPMC FOR YOU, INC | T4 | No | $0 | PA |
| UPMC for Life Complete Care (HMO D-SNP) | UPMC FOR YOU, INC | T4 | No | $0 | PA |
| UPMC for Life PPO Premier Rx (PPO) | UPMC HEALTH NETWORK, INC. | T4 | No | $0 | PA |
| UPMC for Life PPO Premier Rx (PPO) | UPMC HEALTH NETWORK, INC. | T4 | No | $0 | PA |
| UPMC for Life PPO Essential Care Rx (PPO) | UPMC HEALTH NETWORK, INC. | T4 | No | $0 | PA |
| UPMC for Life Complete Care (HMO D-SNP) | UPMC HEALTH COVERAGE, INC. | T4 | No | $0 | PA |
| UPMC for Life HMO Rx Choice (HMO) | UPMC HEALTH PLAN, INC. | T4 | No | $3.90 | OH, PA |
| UPMC for Life HMO Deductible Rx (HMO) | UPMC HEALTH PLAN, INC. | T4 | No | $18.10 | OH, PA |
| UPMC for Life PPO Rx Choice (PPO) | UPMC HEALTH NETWORK, INC. | T4 | No | $25.00 | PA |
| UPMC for Life PPO High Deductible Rx (PPO) | UPMC HEALTH NETWORK, INC. | T4 | No | $33.00 | PA |
| UPMC for Life HMO Rx (HMO) | UPMC HEALTH PLAN, INC. | T4 | No | $33.70 | OH, PA |
| UPMC for Life PPO Rx Enhanced (PPO) | UPMC HEALTH NETWORK, INC. | T4 | No | $42.70 | PA |
| UPMC for Life HMO Rx Enhanced (HMO) | UPMC HEALTH PLAN, INC. | T4 | No | $93.40 | OH, PA |
| UPMC for Life PPO Rx Enhanced (PPO) | UPMC HEALTH NETWORK, INC. | T4 | No | $140.00 | PA |
| MCS Classicare RxMax (HMO) | MCS ADVANTAGE, INC. | T5 | No | $0 | PR |
| Security Blue HMO-POS Standard (HMO-POS) | HIGHMARK CHOICE COMPANY | T5 | No | $51.80 | PA |
| Freedom Blue PPO Select (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T5 | No | $95.70 | PA |
| Security Blue HMO-POS Deluxe (HMO-POS) | HIGHMARK CHOICE COMPANY | T5 | No | $95.90 | PA |
| Freedom Blue PPO Standard (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T5 | No | $98.20 | PA |
| Freedom Blue PPO Select (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T5 | No | $115.70 | PA |
| Freedom Blue PPO Deluxe (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T5 | No | $122.40 | PA |
| Freedom Blue PPO Classic (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T5 | No | $140.90 | PA |
| Freedom Blue PPO Classic (PPO) | HIGHMARK SENIOR HEALTH COMPANY | T5 | No | $145.40 | PA |
Frequently Asked Questions
Is 10 ML plazomicin 50 MG/ML Injection [Zemdri] covered by Medicare Part D?
Yes, 10 ML plazomicin 50 MG/ML Injection [Zemdri] is covered by 26 Medicare Part D plans (0.5% of all Part D formularies).
What tier is 10 ML plazomicin 50 MG/ML Injection [Zemdri] on Medicare Part D plans?
10 ML plazomicin 50 MG/ML Injection [Zemdri] averages Tier 4.5 across Part D plans, ranging from Tier 4 to Tier 5.
Does 10 ML plazomicin 50 MG/ML Injection [Zemdri] require prior authorization?
0% of Part D formularies require prior authorization for 10 ML plazomicin 50 MG/ML Injection [Zemdri]. Step therapy: 0%. Quantity limits: 0%.
Read our methodology - how this data is sourced, computed, and verified.