bacitracin 0.5 UNT/MG / polymyxin B 10 UNT/MG Ophthalmic Ointment [Polycin]
bacitracin
RxCUI: 213621
What the CMS Formulary Data Shows for bacitracin 0.5 UNT/MG / polymyxin B 10 UNT/MG Ophthalmic Ointment [Polycin]
Per the CMS 2026 Part D formulary file, bacitracin 0.5 UNT/MG / polymyxin B 10 UNT/MG Ophthalmic Ointment [Polycin] (RxNorm concept RXCUI 213621, generic name bacitracin) appears on 286 distinct formulary files spanning 3,694 Medicare Part D plan offerings - 72.9% of enrollable Part D products, mid-range placement; shopping across contracts changes access. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 1.7.
Real-world access to bacitracin 0.5 UNT/MG / polymyxin B 10 UNT/MG Ophthalmic Ointment [Polycin] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 10.8% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 14,794 Part D beneficiaries filled bacitracin 0.5 UNT/MG / polymyxin B 10 UNT/MG Ophthalmic Ointment [Polycin] in 2023, with total plan-and-beneficiary spending of $1,917,494 and an average per-beneficiary annual cost of $129.61. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry bacitracin 0.5 UNT/MG / polymyxin B 10 UNT/MG Ophthalmic Ointment [Polycin] today.
Coverage Details
- Formularies covering
- 286
- Plans covering
- 3,694
- Coverage rate
- 72.9%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 10.8% of formularies
2023 Medicare Spending
- Beneficiaries
- 14,794
- Total spending
- $1,917,494
- Avg per beneficiary
- $129.61
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering bacitracin 0.5 UNT/MG / polymyxin B 10 UNT/MG Ophthalmic Ointment [Polycin]
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 |
| HealthSun HealthAdvantage Plan (HMO) | HEALTHSUN HEALTH PLANS, INC. | T1 | No | $0 | FL |
| HealthSun MediMax (HMO) | HEALTHSUN HEALTH PLANS, INC. | T1 | No | $0 | FL |
| HealthSun HealthAdvantage Plan (HMO) | HEALTHSUN HEALTH PLANS, INC. | T1 | No | $0 | FL |
| HealthSun HealthAdvantage Plan (HMO) | HEALTHSUN HEALTH PLANS, INC. | T1 | No | $0 | FL |
| HealthSun MediSun Plus (HMO D-SNP) | HEALTHSUN HEALTH PLANS, INC. | T1 | No | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | HEALTHSUN HEALTH PLANS, INC. | T1 | No | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | HEALTHSUN HEALTH PLANS, INC. | T1 | No | $0 | FL |
| HealthSun MediSun Extra (HMO D-SNP) | HEALTHSUN HEALTH PLANS, INC. | T1 | No | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | HEALTHSUN HEALTH PLANS, INC. | T1 | No | $0 | FL |
| HealthSun VitalCare (HMO C-SNP) | HEALTHSUN HEALTH PLANS, INC. | T1 | No | $0 | FL |
| HealthSun VitalCare (HMO C-SNP) | HEALTHSUN HEALTH PLANS, INC. | T1 | No | $0 | FL |
| HealthSun MediSun Full Dual Plus (HMO D-SNP) | HEALTHSUN HEALTH PLANS, INC. | T1 | No | $0 | FL |
| HealthSun MediSun Full Dual Extra (HMO D-SNP) | HEALTHSUN HEALTH PLANS, INC. | T1 | No | $0 | FL |
| Simply Complete (HMO D-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| Simply More (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| Simply Complete (HMO D-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| Simply Level (HMO C-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| Simply Level (HMO C-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| Simply More (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| Simply Level (HMO C-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| Simply More (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| Simply Level (HMO C-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| Simply Complete (HMO D-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| Simply More (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| Simply More (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| Simply Level (HMO C-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| Simply Complete (HMO D-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| Simply More (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| Simply Extra (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| Simply Extra Platinum (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| Simply More Platinum (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| Simply Complete Platinum (HMO D-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| Simply Level Platinum (HMO C-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| Simply Extra Platinum (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| Simply Level Platinum (HMO C-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| Simply Extra Platinum (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| Simply Level Platinum (HMO C-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| Simply Extra Platinum (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| Simply More Platinum (HMO) | SIMPLY HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| Simply Complete Platinum (HMO D-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| Simply Level Platinum (HMO C-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| Simply Integrated (HMO D-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| Simply Integrated (HMO D-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| Simply Integrated (HMO D-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| Simply Integrated (HMO D-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| Simply Integrated (HMO D-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| Simply Integrated (HMO D-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
| Simply Integrated (HMO D-SNP) | SIMPLY HEALTHCARE PLANS, INC. | T1 | No | $0 | FL |
Frequently Asked Questions
Is bacitracin 0.5 UNT/MG / polymyxin B 10 UNT/MG Ophthalmic Ointment [Polycin] covered by Medicare Part D?
Yes, bacitracin 0.5 UNT/MG / polymyxin B 10 UNT/MG Ophthalmic Ointment [Polycin] is covered by 3,694 Medicare Part D plans (72.9% of all Part D formularies).
What tier is bacitracin 0.5 UNT/MG / polymyxin B 10 UNT/MG Ophthalmic Ointment [Polycin] on Medicare Part D plans?
bacitracin 0.5 UNT/MG / polymyxin B 10 UNT/MG Ophthalmic Ointment [Polycin] averages Tier 1.7 across Part D plans, ranging from Tier 1 to Tier 4.
Does bacitracin 0.5 UNT/MG / polymyxin B 10 UNT/MG Ophthalmic Ointment [Polycin] require prior authorization?
0% of Part D formularies require prior authorization for bacitracin 0.5 UNT/MG / polymyxin B 10 UNT/MG Ophthalmic Ointment [Polycin]. Step therapy: 0%. Quantity limits: 10.8%.
How much does Medicare spend on bacitracin 0.5 UNT/MG / polymyxin B 10 UNT/MG Ophthalmic Ointment [Polycin]?
In 2023, total Medicare Part D spending on bacitracin 0.5 UNT/MG / polymyxin B 10 UNT/MG Ophthalmic Ointment [Polycin] was $1,917,494, covering 14,794 beneficiaries. The average spend per beneficiary was $129.61.
Read our methodology - how this data is sourced, computed, and verified.