Medicare Part D coverage · 200 · RxCUI 1809513
200 ML immunoglobulin G, human 50 MG/ML Injection [Gammaplex]
Per the CMS 2026 Part D formulary file, 200 ML immunoglobulin G, human 50 MG/ML Injection [Gammaplex] is covered by 1,172 Medicare Part D plans (23.2% of enrollable products), averaging Tier 4.2, with prior authorization required on 98.1% of covering formularies.
- 23.2%
- Plan coverage
- 1,172
- Plans covering
- T4.2
- Avg tier
- 98.1%
- Prior auth required
What the CMS Formulary Data Shows for 200 ML immunoglobulin G, human 50 MG/ML Injection [Gammaplex]
Per the CMS 2026 Part D formulary file, 200 ML immunoglobulin G, human 50 MG/ML Injection [Gammaplex] (RxNorm concept RXCUI 1809513, generic name 200) appears on 106 distinct formulary files spanning 1,172 Medicare Part D plan offerings - 23.2% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 6, with a cross-plan average of Tier 4.2.
Real-world access to 200 ML immunoglobulin G, human 50 MG/ML Injection [Gammaplex] depends on utilization management as much as tier placement: 98.1% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 40 Part D beneficiaries filled 200 ML immunoglobulin G, human 50 MG/ML Injection [Gammaplex] in 2023, with total plan-and-beneficiary spending of $5,071,918 and an average per-beneficiary annual cost of $126,797.94. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 200 ML immunoglobulin G, human 50 MG/ML Injection [Gammaplex] today.
Coverage Details
- Formularies covering
- 106
- Plans covering
- 1,172
- Coverage rate
- 23.2%
- Tier range
- Tier 1 – Tier 6
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 98.1% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 40
- Total spending
- $5,071,918
- Avg per beneficiary
- $126,797.94
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 200 ML immunoglobulin G, human 50 MG/ML Injection [Gammaplex]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) | Hpmp OF Florida, Inc. | T1 | Yes | $0 | FL |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | Mercy Care | T1 | Yes | $0 | AZ |
| Elderplan Plus Long-Term Care (HMO-POS D-SNP) | Elderplan, Inc. | T1 | Yes | $0 | NY |
| Health Choice Pathway (HMO D-SNP) | Health Choice Arizona, Inc. | T1 | Yes | $0 | AZ |
| Healthfirst CompleteCare (HMO D-SNP) | Healthfirst Health Plan, Inc. | T1 | Yes | $0 | NY |
| IMCare Classic (HMO D-SNP) | Itasca Medical Care | T1 | Yes | $0 | MN |
| Johns Hopkins Advantage MD D-SNP (HMO D-SNP) | Hopkins Health Advantage, Inc. | T1 | Yes | $0 | MD |
| MetroPlus UltraCare (HMO D-SNP) | Metroplus Health Plan, Inc. | T1 | Yes | $0 | NY |
| Senior Whole Health SCO (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
| Senior Whole Health SCO NHC (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
| Molina One Care (HMO D-SNP) | Senior Whole Health, LLC | T1 | Yes | $0 | MA |
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | Yes | $0 | MA |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | Yes | $0 | NY |
| SeniorCare Complete (HMO D-SNP) | South Country Health Alliance | T1 | Yes | $0 | MN |
| AbilityCare (HMO D-SNP) | South Country Health Alliance | T1 | Yes | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | Alameda Alliance FOR Health | T1 | Yes | $0 | CA |
| CCA One Care (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | Yes | $0 | MA |
| CCA Senior Care Options (HMO D-SNP) | Commonwealth Care Alliance, Inc. | T1 | Yes | $0 | MA |
Show the next 30 plans
| Community Care's Partnership Program (HMO D-SNP) | Community Care Health Plan, Inc. | T1 | Yes | $0 | WI |
| Platino Blindao (HMO D-SNP) | Triple S Advantage, Inc. | T1 | Yes | $0 | PR |
| Platino Enlace (HMO D-SNP) | Triple S Advantage, Inc. | T1 | Yes | $0 | PR |
| Platino Advance (HMO D-snp) | Triple S Advantage, Inc. | T1 | Yes | $0 | PR |
| Platino Plus (HMO D-snp) | Triple S Advantage, Inc. | T1 | Yes | $0 | PR |
| Mass General Brigham SCO (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | Yes | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | Yes | $0 | MA |
| Tufts Health One Care (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | Yes | $0 | MA |
| Tufts Health One Care CW (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | Yes | $0 | MA |
| Tufts Health Plan Senior Care Options (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | Yes | $0 | MA |
| Tufts Health Plan Senior Care Options CW (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | Yes | $0 | MA |
| Florida Complete Care (HMO I-SNP) | Hpmp OF Florida, Inc. | T1 | Yes | $4.80 | FL |
| Florida Complete Care- In The Community (HMO-POS I-SNP) | Hpmp OF Florida, Inc. | T1 | Yes | $4.80 | FL |
| Elderplan For Medicaid Beneficiaries (HMO-POS D-SNP) | Elderplan, Inc. | T1 | Yes | $22.70 | NY |
| VIVA Medicare Extra Value (HMO D-SNP) | Viva Health, Inc. | T1 | Yes | $27.70 | AL |
| VIVA Medicare Extra Care (HMO D-SNP) | Viva Health, Inc. | T1 | Yes | $27.70 | AL |
| Hamaspik Medicare Select (HMO D-SNP) | Hamaspik, Inc. | T1 | Yes | $34.50 | NY |
| Elderplan Advantage For Nursing Home Residents (HMO-POS I-SNP) | Elderplan, Inc. | T1 | Yes | $44.80 | NY |
| MetroPlus Platinum Plan (HMO) | Metroplus Health Plan, Inc. | T1 | Yes | $58.80 | NY |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T2 | Yes | $0 | CA |
| Óptimo Plus (PPO) | Triple S Advantage, Inc. | T3 | Yes | $0 | PR |
| Contigo Plus (HMO C-SNP) | Triple S Advantage, Inc. | T3 | Yes | $0 | PR |
| Brillante (HMO-POS) | Triple S Advantage, Inc. | T3 | Yes | $0 | PR |
| Enlace Plus (HMO) | Triple S Advantage, Inc. | T3 | Yes | $0 | PR |
| ContigoEnMente (HMO C-SNP) | Triple S Advantage, Inc. | T3 | Yes | $0 | PR |
| Ahorro Plus (HMO) | Triple S Advantage, Inc. | T3 | Yes | $0 | PR |
| BlueCare Plus (HMO D-SNP) | Volunteer State Health Plan | T4 | Yes | $0 | TN |
| BlueCare Plus Choice (HMO D-SNP) | Volunteer State Health Plan | T4 | Yes | $0 | TN |
| BlueCare Plus Select (HMO D-SNP) | Volunteer State Health Plan | T4 | Yes | $0 | TN |
| Leon MediExtra (HMO) | Leon Health, Inc. | T4 | Yes | $0 | FL |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is 200 ML immunoglobulin G, human 50 MG/ML Injection [Gammaplex] covered by Medicare Part D?
Yes, 200 ML immunoglobulin G, human 50 MG/ML Injection [Gammaplex] is covered by 1,172 Medicare Part D plans (23.2% of all Part D formularies).
What tier is 200 ML immunoglobulin G, human 50 MG/ML Injection [Gammaplex] on Medicare Part D plans?
200 ML immunoglobulin G, human 50 MG/ML Injection [Gammaplex] averages Tier 4.2 across Part D plans, ranging from Tier 1 to Tier 6.
Does 200 ML immunoglobulin G, human 50 MG/ML Injection [Gammaplex] require prior authorization?
98.1% of Part D formularies require prior authorization for 200 ML immunoglobulin G, human 50 MG/ML Injection [Gammaplex]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on 200 ML immunoglobulin G, human 50 MG/ML Injection [Gammaplex]?
In 2023, total Medicare Part D spending on 200 ML immunoglobulin G, human 50 MG/ML Injection [Gammaplex] was $5,071,918, covering 40 beneficiaries. The average spend per beneficiary was $126,797.94.
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
- 24 HR selegiline 0.25 MG/HR Transdermal System [Emsam] T4.2
- lotilaner 2.5 MG/ML Ophthalmic Solution [Xdemvy] T4.2
- glutamine 5000 MG Powder for Oral Solution T4.2
- 1.7 ML denosumab-bbdz 70 MG/ML Injection [Wyost] T4.2
- {4 (apremilast 10 MG Oral Tablet [Otezla]) / 51 (apremilast 20 MG Oral Tablet [Otezla]) } Pack [Otezla 28-Day 10/20 Starter Pack] T4.2
- apremilast 20 MG Oral Tablet [Otezla] T4.2
Similar prior-authorization rate
- atogepant 10 MG Oral Tablet [Qulipta] 98.1% PA
- alanine 21.7 MG/ML / arginine 14.7 MG/ML / aspartate 4.34 MG/ML / glutamate 7.49 MG/ML / glycine 10.4 MG/ML / histidine 8.94 MG/ML / isoleucine 7.49 MG/ML / leucine 10.4 MG/ML / lysine 11.8 MG/ML / methionine 7.49 MG/ML / phenylalanine 10.4 MG/ML / proline 8.94 MG/ML / serine 5.92 MG/ML / threonine 7.49 MG/ML / tryptophan 2.5 MG/ML / tyrosine 0.39 MG/ML / valine 9.6 MG/ML Injectable Solution [Plenamine] 98.1% PA
- alanine 5.4 MG/ML / arginine 12 MG/ML / aspartate 3.2 MG/ML / cysteine 0.24 MG/ML / glutamate 5 MG/ML / glycine 3.6 MG/ML / histidine 4.8 MG/ML / isoleucine 8.2 MG/ML / leucine 1.4 MG/ML / lysine 1.2 MG/ML / methionine 3.4 MG/ML / phenylalanine 4.8 MG/ML / proline 6.8 MG/ML / serine 3.8 MG/ML / sodium acetate 0.097 MEQ/ML / sodium chloride 0.003 MEQ/ML / sodium metabisulfite 0.5 MG/ML / taurine 0.25 MG/ML / threonine 4.2 MG/ML / tryptophan 2 MG/ML / tyrosine 2.84 MG/ML / valine 7.8 MG/ML Injectable Solution [Trophamine 10 %] 98.1% PA
- {56 (mitapivat 20 MG Oral Tablet [Pyrukynd]) } Pack [Pyrukynd 20 MG 4-Week] 98.1% PA
- {7 (mitapivat 5 MG Oral Tablet [Pyrukynd]) } Pack [Pyrukynd 5 MG Taper] 98.1% PA
- 1 ML tralokinumab-ldrm 150 MG/ML Prefilled Syringe [Adbry] 98.1% PA