cilastatin 500 MG / imipenem 500 MG Injection [Primaxin]

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cilastatin

RxCUI: 1726216

Important: Drug coverage and costs vary by plan and location. Verify coverage directly with your Medicare plan before filling a prescription. This is informational data only and should not replace advice from your healthcare provider or pharmacist.
0.3%
Plan Coverage
15
Plans Covering
T3.5
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for cilastatin 500 MG / imipenem 500 MG Injection [Primaxin]

Per the CMS 2026 Part D formulary file, cilastatin 500 MG / imipenem 500 MG Injection [Primaxin] (RxNorm concept RXCUI 1726216, generic name cilastatin) appears on 11 distinct formulary files spanning 15 Medicare Part D plan offerings - 0.3% 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 3.5.

Real-world access to cilastatin 500 MG / imipenem 500 MG Injection [Primaxin] depends on utilization management as much as tier placement: 0% 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 22 Part D beneficiaries filled cilastatin 500 MG / imipenem 500 MG Injection [Primaxin] in 2023, with total plan-and-beneficiary spending of $21,562 and an average per-beneficiary annual cost of $980.11. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry cilastatin 500 MG / imipenem 500 MG Injection [Primaxin] today.

Coverage Details

Formularies covering
11
Plans covering
15
Coverage rate
0.3%
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

2023 Medicare Spending

Beneficiaries
22
Total spending
$21,562
Avg per beneficiary
$980.11

Tier Distribution Across Plans

3 plans
Tier 1, Preferred Generic
12 plans
Tier 4, Non-Preferred

Medicare Advantage Plans (MA-PD) Covering cilastatin 500 MG / imipenem 500 MG Injection [Primaxin]

15 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
Troy Medicare (HMO) TROY HEALTH, INC. T4 No $0 NC
Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) TROY HEALTH, INC. T4 No $0 NC
Contra Costa Health Care Plus (HMO D-SNP) CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH T4 No $0 CA
Keystone First VIP Choice (HMO D-SNP) VISTA HEALTH PLAN, INC. T4 No $0 PA
AmeriHealth Caritas VIP Care (HMO D-SNP) VISTA HEALTH PLAN, INC. T4 No $0 PA
First Choice VIP Care (HMO D-SNP) SELECT HEALTH OF SOUTH CAROLINA, INC. T4 No $0 SC
AmeriHealth Caritas VIP Care (HMO D-SNP) AmeriHealth Caritas VIP Next, Inc. T4 No $0 DE
AmeriHealth Caritas VIP Care Choice (HMO D-SNP) AmeriHealth Caritas VIP Next, Inc. T4 No $0 DE
AmeriHealth Caritas VIP Care (HMO D-SNP) AMERIHEALTH CARITAS FLORIDA INC T4 No $0 FL
AmeriHealth Caritas VIP Care (HMO D-SNP) AMERIHEALTH CARITAS LOUISIANA, INC. T4 No $0 LA
AmeriHealth Caritas VIP Care (HMO D-SNP) AMERIHEALTH CARITAS NORTH CAROLINA, INC. T4 No $0 NC
AmeriHealth Caritas VIP Care (HMO D-SNP) AMERIHEALTH MICHIGAN, INC. T4 No $0 MI

Frequently Asked Questions

Is cilastatin 500 MG / imipenem 500 MG Injection [Primaxin] covered by Medicare Part D?

Yes, cilastatin 500 MG / imipenem 500 MG Injection [Primaxin] is covered by 15 Medicare Part D plans (0.3% of all Part D formularies).

What tier is cilastatin 500 MG / imipenem 500 MG Injection [Primaxin] on Medicare Part D plans?

cilastatin 500 MG / imipenem 500 MG Injection [Primaxin] averages Tier 3.5 across Part D plans, ranging from Tier 1 to Tier 4.

Does cilastatin 500 MG / imipenem 500 MG Injection [Primaxin] require prior authorization?

0% of Part D formularies require prior authorization for cilastatin 500 MG / imipenem 500 MG Injection [Primaxin]. Step therapy: 0%. Quantity limits: 0%.

How much does Medicare spend on cilastatin 500 MG / imipenem 500 MG Injection [Primaxin]?

In 2023, total Medicare Part D spending on cilastatin 500 MG / imipenem 500 MG Injection [Primaxin] was $21,562, covering 22 beneficiaries. The average spend per beneficiary was $980.11.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial