Medicare Part D coverage · 50 · RxCUI 204466
50 ML penicillin G potassium 40000 UNT/ML Injection
Per the CMS 2026 Part D formulary file, 50 ML penicillin G potassium 40000 UNT/ML Injection is covered by 2,628 Medicare Part D plans (52% of enrollable products), averaging Tier 3.2, with prior authorization required on 15.2% of covering formularies.
- 52%
- Plan coverage
- 2,628
- Plans covering
- T3.2
- Avg tier
- 15.2%
- Prior auth required
What the CMS Formulary Data Shows for 50 ML penicillin G potassium 40000 UNT/ML Injection
Per the CMS 2026 Part D formulary file, 50 ML penicillin G potassium 40000 UNT/ML Injection (RxNorm concept RXCUI 204466, generic name 50) appears on 132 distinct formulary files spanning 2,628 Medicare Part D plan offerings - 52% of enrollable Part D products, mid-range placement; shopping across contracts changes access. Tier placement ranges from Tier 1 to Tier 6, with a cross-plan average of Tier 3.2.
Real-world access to 50 ML penicillin G potassium 40000 UNT/ML Injection depends on utilization management as much as tier placement: 15.2% 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 50 ML penicillin G potassium 40000 UNT/ML Injection today.
Coverage Details
- Formularies covering
- 132
- Plans covering
- 2,628
- Coverage rate
- 52%
- Tier range
- Tier 1 – Tier 6
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 15.2% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 50 ML penicillin G potassium 40000 UNT/ML Injection
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Sentara Community Complete Select (HMO D-SNP) | Sentara Health Plans | T1 | No | $0 | VA |
| Sentara Community Complete (HMO D-SNP) | Sentara Health Plans | T1 | No | $0 | VA |
| 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 |
| CareAdvantage (HMO D-SNP) | SAN Mateo Health Commission | T1 | No | $0 | CA |
| Gold Coast Health Plan Total Care Advantage (HMO D-SNP) | Ventura County Medi-Cal Managed Care Commission | T1 | No | $0 | CA |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| Horizon NJ TotalCare (HMO D-SNP) | Horizon Healthcare OF NEW Jersey, Inc. | T1 | No | $0 | NJ |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | No | $0 | MN |
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | No | $0 | MA |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $0 | NY |
| 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 |
| Community Care's Partnership Program (HMO D-SNP) | Community Care Health Plan, Inc. | T1 | No | $0 | WI |
Show the next 30 plans
| 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 |
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T1 | No | $0 | CA |
| Mass General Brigham SCO (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| Longevity Health Plan (HMO I-SNP) | Longevity Health Plan OF Florida, Inc. | T1 | Yes | $4.80 | FL |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Hcsc Insurance Services Company | T1 | No | $4.80 | TX |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | GHS Insurance Company | T1 | No | $5.00 | OK |
| 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 |
| Hamaspik Medicare Select (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $34.50 | NY |
| 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 |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T2 | No | $0 | UT |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T2 | No | $0 | NV |
| Select Health Medicare Dual (HMO D-SNP) | Selecthealth, Inc. | T2 | No | $0 | UT |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T2 | No | $0 | UT |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T2 | No | $0 | NV |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T2 | No | $0 | UT |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T2 | No | $0 | CO |
| Select Health Medicare Essential (HMO) | Selecthealth, Inc. | T2 | No | $0 | CO |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T2 | No | $0 | CO |
| Select Health Medicare Flex (HMO) | Selecthealth, Inc. | T2 | No | $0 | CO |
| Select Health Medicare + Kroger (HMO) | Selecthealth, Inc. | T2 | No | $0 | CO |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is 50 ML penicillin G potassium 40000 UNT/ML Injection covered by Medicare Part D?
Yes, 50 ML penicillin G potassium 40000 UNT/ML Injection is covered by 2,628 Medicare Part D plans (52% of all Part D formularies).
What tier is 50 ML penicillin G potassium 40000 UNT/ML Injection on Medicare Part D plans?
50 ML penicillin G potassium 40000 UNT/ML Injection averages Tier 3.2 across Part D plans, ranging from Tier 1 to Tier 6.
Does 50 ML penicillin G potassium 40000 UNT/ML Injection require prior authorization?
15.2% of Part D formularies require prior authorization for 50 ML penicillin G potassium 40000 UNT/ML Injection. 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
- molindone hydrochloride 5 MG Oral Tablet T3.2
- degarelix 80 MG Injection [Firmagon] T3.2
- buprenorphine 2 MG / naloxone 0.5 MG Sublingual Film [Suboxone] T3.3
- 0.5 ML ustekinumab-ttwe 90 MG/ML Prefilled Syringe T3.3
- Modified 24 HR metformin hydrochloride 1000 MG Extended Release Oral Tablet T3.3
- prednisolone 10 MG Disintegrating Oral Tablet [Orapred] T3.3
Similar prior-authorization rate
- lisdexamfetamine dimesylate 20 MG Oral Capsule 15.2% PA
- lifitegrast 50 MG/ML Ophthalmic Solution [Xiidra] 15% PA
- oxacillin 2000 MG Injection 15% PA
- loteprednol etabonate 2.5 MG/ML Ophthalmic Suspension [Eysuvis] 15% PA
- tamoxifen 2 MG/ML Oral Solution [Soltamox] 14.9% PA
- 1 ML haloperidol decanoate 50 MG/ML Injection 14.9% PA