Medicare Part D coverage · 1.2 · RxCUI 2717182
1.2 ML garadacimab-gxii 167 MG/ML Auto-Injector [Andembry]
Per the CMS 2026 Part D formulary file, 1.2 ML garadacimab-gxii 167 MG/ML Auto-Injector [Andembry] is covered by 152 Medicare Part D plans (3% of enrollable products), averaging Tier 3.9, with prior authorization required on 83.3% of covering formularies.
- 3%
- Plan coverage
- 152
- Plans covering
- T3.9
- Avg tier
- 83.3%
- Prior auth required
What the CMS Formulary Data Shows for 1.2 ML garadacimab-gxii 167 MG/ML Auto-Injector [Andembry]
Per the CMS 2026 Part D formulary file, 1.2 ML garadacimab-gxii 167 MG/ML Auto-Injector [Andembry] (RxNorm concept RXCUI 2717182, generic name 1.2) appears on 12 distinct formulary files spanning 152 Medicare Part D plan offerings - 3% 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 3.9.
Real-world access to 1.2 ML garadacimab-gxii 167 MG/ML Auto-Injector [Andembry] depends on utilization management as much as tier placement: 83.3% of covering formularies require prior authorization. 0% require step therapy. 16.7% 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 1.2 ML garadacimab-gxii 167 MG/ML Auto-Injector [Andembry] today.
Coverage Details
- Formularies covering
- 12
- Plans covering
- 152
- Coverage rate
- 3%
- Tier range
- Tier 1 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 83.3% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 16.7% of formularies
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 1.2 ML garadacimab-gxii 167 MG/ML Auto-Injector [Andembry]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | Yes | $0 | MA |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T1 | Yes | $4.80 | FL |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Arizona | T1 | Yes | $17.00 | AZ |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T2 | Yes | $0 | CA |
| PHP (HMO C-snp) | Aids Healthcare Foundation | T4 | Yes | $0 | CA |
| VNS Health Total (HMO D-SNP) | VNS Choice | T4 | Yes | $0 | NY |
| VNS Health EasyCare Plus (HMO D-SNP) | VNS Choice | T4 | Yes | $51.60 | NY |
| Fallon Medicare Plus Orange (HMO) | Fallon Community Health Plan | T5 | Yes | $0 | MA |
| SummaCare Medicare Topaz (HMO) | Summacare Inc. | T5 | Yes | $0 | OH |
| SummaCare Medicare Quartz (HMO) | Summacare Inc. | T5 | Yes | $0 | OH |
| Gold Heart & Diabetes (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T5 | Yes | $0 | FL |
| Gold Heart & Diabetes Complete (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T5 | Yes | $0 | FL |
| Gold Dialysis & Kidney (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T5 | Yes | $0 | FL |
| Gold Health (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T5 | Yes | $0 | FL |
| Gold Dialysis & Kidney (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T5 | Yes | $0 | FL |
| Gold Heart & Diabetes (HMO-POS C-SNP) | Gold Kidney OF Arizona | T5 | Yes | $0 | AZ |
| Gold Dialysis & Kidney (HMO-POS C-SNP) | Gold Kidney OF Arizona | T5 | Yes | $0 | AZ |
| Gold Heart & Diabetes (HMO-POS C-SNP) | Gold Kidney OF Arizona | T5 | Yes | $0 | AZ |
| Gold Dialysis & Kidney (HMO-POS C-SNP) | Gold Kidney OF Arizona | T5 | Yes | $0 | AZ |
| VillageCareMAX Medicare Health Advantage Plan (HMO D-SNP) | Village Senior Services Corporation | T5 | Yes | $0 | NY |
Show the next 30 plans
Showing top 50 of 100 plans.
Frequently Asked Questions
Is 1.2 ML garadacimab-gxii 167 MG/ML Auto-Injector [Andembry] covered by Medicare Part D?
Yes, 1.2 ML garadacimab-gxii 167 MG/ML Auto-Injector [Andembry] is covered by 152 Medicare Part D plans (3% of all Part D formularies).
What tier is 1.2 ML garadacimab-gxii 167 MG/ML Auto-Injector [Andembry] on Medicare Part D plans?
1.2 ML garadacimab-gxii 167 MG/ML Auto-Injector [Andembry] averages Tier 3.9 across Part D plans, ranging from Tier 1 to Tier 5.
Does 1.2 ML garadacimab-gxii 167 MG/ML Auto-Injector [Andembry] require prior authorization?
83.3% of Part D formularies require prior authorization for 1.2 ML garadacimab-gxii 167 MG/ML Auto-Injector [Andembry]. Step therapy: 0%. Quantity limits: 16.7%.
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
Similar prior-authorization rate
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