Medicare Part D coverage · 200 · RxCUI 2725135
200 ML vancomycin 5 MG/ML Injection [Tyzavan]
Per the CMS 2026 Part D formulary file, 200 ML vancomycin 5 MG/ML Injection [Tyzavan] is covered by 668 Medicare Part D plans (13.2% of enrollable products), averaging Tier 2.7, with prior authorization required on 0% of covering formularies.
- 13.2%
- Plan coverage
- 668
- Plans covering
- T2.7
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for 200 ML vancomycin 5 MG/ML Injection [Tyzavan]
Per the CMS 2026 Part D formulary file, 200 ML vancomycin 5 MG/ML Injection [Tyzavan] (RxNorm concept RXCUI 2725135, generic name 200) appears on 25 distinct formulary files spanning 668 Medicare Part D plan offerings - 13.2% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.7.
Real-world access to 200 ML vancomycin 5 MG/ML Injection [Tyzavan] 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 200 ML vancomycin 5 MG/ML Injection [Tyzavan] today.
Coverage Details
- Formularies covering
- 25
- Plans covering
- 668
- Coverage rate
- 13.2%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 200 ML vancomycin 5 MG/ML Injection [Tyzavan]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| SeniorCare Complete (HMO D-SNP) | South Country Health Alliance | T1 | No | $0 | MN |
| AbilityCare (HMO D-SNP) | South Country Health Alliance | T1 | No | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | Alameda Alliance FOR Health | T1 | No | $0 | CA |
| Abilis Health Community (HMO I-SNP) | Signature Advantage, LLC | T1 | No | $0 | KY, TN |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) | Arkansas Superior Select, Inc. | T1 | No | $0 | AR |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $0 | PA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $0 | PA |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Health Options West Virginia Inc. | T1 | No | $0 | WV |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | No | $0 | DE |
| American Health Advantage of Florida (HMO I-SNP) | American Health Plan OF FL, Inc. | T1 | No | $4.80 | FL |
| Texas Independence Health Plan, Inc. (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | No | $4.80 | TX |
| Texas Independence Community Plan (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | No | $4.80 | TX |
| Tribute Select (HMO-POS I-SNP) | Arkansas Superior Select, Inc. | T1 | No | $8.90 | AR |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $13.10 | PA |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $17.60 | PA |
| American Health Advantage of Mississippi (HMO I-SNP) | American Health Plan OF MS, Inc. | T1 | No | $23.80 | MS |
| Georgia Health Advantage (HMO I-SNP) | Georgia Assurance, Inc. | T1 | No | $25.40 | GA |
| Georgia Health Advantage Choice (HMO I-SNP) | Georgia Assurance, Inc. | T1 | No | $25.40 | GA |
| American Health Advantage of Tennessee (HMO I-SNP) | American Health Plan, Inc. | T1 | No | $27.70 | TN |
| American Health Advantage of Oklahoma (HMO I-SNP) | Oklahoma Superior Select, Inc. | T1 | No | $28.20 | OK |
Show the next 30 plans
| Highmark Health Options Duals Select (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | No | $31.20 | DE |
| Valor Health Plan (HMO I-SNP) | TSG Guard, Inc. | T1 | No | $31.40 | OH |
| American Health Advantage of Pennsylvania (HMO I-SNP) | American Health Plan OF Pennsylvania Inc | T1 | No | $32.70 | PA |
| WV Senior Advantage (HMO I-SNP) | West Virginia Senior Advantage, Inc. | T1 | No | $32.70 | WV |
| American Health Advantage of Louisiana (HMO I-SNP) | Dignity Care Corporation | T1 | No | $32.90 | LA |
| Abilis Health (HMO I-SNP) | Signature Advantage, LLC | T1 | No | $35.90 | KY, TN |
| American Health Advantage of Utah (HMO I-SNP) | American Health Plan OF UT, Inc. | T1 | No | $37.60 | UT |
| American Health Advantage of Idaho (HMO I-SNP) | American Health Plan OF UT, Inc. | T1 | No | $37.60 | ID |
| American Health Advantage of Indiana (HMO I-SNP) | American Health Plan OF Indiana Inc | T1 | No | $38.40 | IN |
| CommuniCare Advantage ISNP (HMO I-SNP) | OH CHS SNP Inc. | T1 | No | $38.40 | IN, MD, OH |
| Iowa Health Advantage (HMO I-SNP) | American Health Plan OF Iowa Inc | T1 | No | $41.50 | IA |
| Iowa Health Advantage Choice (HMO I-SNP) | American Health Plan OF Iowa Inc | T1 | No | $41.50 | IA |
| American Health Advantage of Missouri (HMO I-SNP) | American Health Plan OF Missouri, Inc. | T1 | No | $43.00 | MO |
| American Health Advantage of Missouri Choice (HMO I-SNP) | American Health Plan OF Missouri, Inc. | T1 | No | $43.00 | MO |
| Kansas Health Advantage (HMO I-SNP) | Kansas Superior Select, Inc. | T1 | No | $55.20 | KS |
| Kansas Health Advantage Choice (HMO I-SNP) | Kansas Superior Select, Inc. | T1 | No | $55.20 | KS |
| Aetna Medicare Signature (HMO) | Aetna Health OF California Inc. | T4 | No | $0 | CA |
| Aetna Medicare Signature (HMO) | Aetna Health OF California Inc. | T4 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO-POS) | Aetna Health OF California Inc. | T4 | No | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T4 | No | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T4 | No | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T4 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T4 | No | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | Aetna Health OF California Inc. | T4 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T4 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T4 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | Aetna Health OF California Inc. | T4 | No | $0 | CA |
| Aetna Medicare Signature Care (HMO-POS) | Aetna Health OF Ohio Inc. | T4 | No | $0 | OH |
| Aetna Medicare Signature Extra (HMO-POS) | Aetna Health OF Ohio Inc. | T4 | No | $0 | OH |
| Aetna Medicare Signature Care (HMO-POS) | Aetna Health OF Ohio Inc. | T4 | No | $0 | OH |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is 200 ML vancomycin 5 MG/ML Injection [Tyzavan] covered by Medicare Part D?
Yes, 200 ML vancomycin 5 MG/ML Injection [Tyzavan] is covered by 668 Medicare Part D plans (13.2% of all Part D formularies).
What tier is 200 ML vancomycin 5 MG/ML Injection [Tyzavan] on Medicare Part D plans?
200 ML vancomycin 5 MG/ML Injection [Tyzavan] averages Tier 2.7 across Part D plans, ranging from Tier 1 to Tier 4.
Does 200 ML vancomycin 5 MG/ML Injection [Tyzavan] require prior authorization?
0% of Part D formularies require prior authorization for 200 ML vancomycin 5 MG/ML Injection [Tyzavan]. Step therapy: 0%. Quantity limits: 0%.
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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