deflazacort 22.75 MG/ML Oral Suspension

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deflazacort

RxCUI: 1870964

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.
16.2%
Plan Coverage
819
Plans Covering
T4.3
Avg Tier
95.8%
Prior Auth Required

What the CMS Formulary Data Shows for deflazacort 22.75 MG/ML Oral Suspension

Per the CMS 2026 Part D formulary file, deflazacort 22.75 MG/ML Oral Suspension (RxNorm concept RXCUI 1870964, generic name deflazacort) appears on 24 distinct formulary files spanning 819 Medicare Part D plan offerings - 16.2% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 4.3.

Real-world access to deflazacort 22.75 MG/ML Oral Suspension depends on utilization management as much as tier placement: 95.8% 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 99 Part D beneficiaries filled deflazacort 22.75 MG/ML Oral Suspension in 2023, with total plan-and-beneficiary spending of $15,369,330 and an average per-beneficiary annual cost of $155,245.76. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry deflazacort 22.75 MG/ML Oral Suspension today.

Coverage Details

Formularies covering
24
Plans covering
819
Coverage rate
16.2%
Tier range
Tier 1 – Tier 5
Average tier
Tier 4, Non-Preferred

Restrictions

Prior authorization required
95.8% of formularies
Step therapy required
0% of formularies
Quantity limits
0% of formularies

2023 Medicare Spending

Beneficiaries
99
Total spending
$15,369,330
Avg per beneficiary
$155,245.76

Tier Distribution Across Plans

3 plans
Tier 1, Preferred Generic
26 plans
Tier 4, Non-Preferred
71 plans
Tier 5, Specialty

Medicare Advantage Plans (MA-PD) Covering deflazacort 22.75 MG/ML Oral Suspension

100 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
CalOptima Health OneCare Complete (HMO D-SNP) ORANGE COUNTY HEALTH AUTHORITY T1 Yes $0 CA
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
Prominence Plus (HMO) PROMINENCE HEALTHFIRST T4 Yes $0 NV
Prominence Plus (HMO) PROMINENCE HEALTHFIRST T4 Yes $0 NV
Prominence Dual (HMO D-SNP) PROMINENCE HEALTHFIRST T4 Yes $0 NV
Prominence Dual (HMO D-SNP) PROMINENCE HEALTHFIRST T4 Yes $0 NV
Prominence Giveback (HMO) PROMINENCE HEALTHFIRST T4 Yes $0 NV
Prominence Plus (HMO) PROMINENCE HEALTHFIRST OF FLORIDA INC T4 Yes $0 FL
Prominence Giveback (HMO) PROMINENCE HEALTHFIRST OF FLORIDA INC T4 Yes $0 FL
Prominence Plus (HMO) PROMINENCE HEALTHFIRST OF TEXAS T4 Yes $0 TX
Prominence Plus (HMO) PROMINENCE HEALTHFIRST OF TEXAS T4 Yes $0 TX
Prominence Dual (HMO D-SNP) PROMINENCE HEALTHFIRST OF TEXAS T4 Yes $0 TX
Prominence Extra Help (HMO) PROMINENCE HEALTHFIRST OF TEXAS T4 Yes $0 TX
Prominence Beyond (HMO) PROMINENCE HEALTHFIRST OF TEXAS T4 Yes $0 TX
Prominence Giveback (HMO) PROMINENCE HEALTHFIRST OF TEXAS T4 Yes $0 TX
Prominence Giveback (HMO) PROMINENCE HEALTHFIRST OF TEXAS T4 Yes $0 TX
Prominence Dual (HMO D-SNP) PROMINENCE HEALTHFIRST OF TEXAS T4 Yes $0 TX
Prominence Beyond (HMO-POS) PROMINENCE HEALTHFIRST OF TEXAS T4 Yes $0 TX
Prominence Dual (HMO D-SNP) PROMINENCE HEALTHFIRST OF FLORIDA INC T4 Yes $0 FL
Prominence Diabetes and Heart Giveback (HMO C-SNP) PROMINENCE HEALTHFIRST T4 Yes $0 NV
Prominence Diabetes and Heart Giveback (HMO C-SNP) PROMINENCE HEALTHFIRST OF FLORIDA INC T4 Yes $0 FL
Prominence Diabetes and Heart Giveback (HMO C-SNP) PROMINENCE HEALTHFIRST OF TEXAS T4 Yes $0 TX
Prominence Diabetes and Heart Care Plus (HMO C-SNP) PROMINENCE HEALTHFIRST OF TEXAS T4 Yes $0 TX
Prominence Diabetes and Heart Giveback (HMO C-SNP) PROMINENCE HEALTHFIRST OF TEXAS T4 Yes $0 TX
Prominence Extra Help (HMO) PROMINENCE HEALTHFIRST T4 Yes $4.20 NV
Prominence Extra Help (HMO) PROMINENCE HEALTHFIRST OF FLORIDA INC T4 Yes $4.80 FL
Prominence Extra Help (HMO) PROMINENCE HEALTHFIRST OF TEXAS T4 Yes $4.80 TX
Prominence Extra Help (HMO) PROMINENCE HEALTHFIRST T4 Yes $9.50 NV
UHC Dual Complete IA-S001 (HMO-POS D-SNP) UNITEDHEALTHCARE OF WISCONSIN, INC. T5 Yes $0 IA
UHC Dual Complete MO-S001 (HMO-POS D-SNP) UNITEDHEALTHCARE OF WISCONSIN, INC. T5 Yes $0 MO
UHC Dual Complete NE-S001 (HMO-POS D-SNP) UNITEDHEALTHCARE OF WISCONSIN, INC. T5 Yes $0 NE
UHC Dual Complete KS-S001 (HMO-POS D-SNP) UNITEDHEALTHCARE OF WISCONSIN, INC. T5 Yes $0 KS
UHC Dual Complete MO-S3 (HMO-POS D-SNP) UNITEDHEALTHCARE OF WISCONSIN, INC. T5 Yes $0 MO
UHC Dual Complete KS-Q1 (HMO-POS D-SNP) UNITEDHEALTHCARE OF WISCONSIN, INC. T5 Yes $0 KS
UHC Dual Complete TN-S001 (HMO-POS D-SNP) UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. T5 Yes $0 TN
UHC Dual Complete TN-Y001 (HMO-POS D-SNP) UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. T5 Yes $0 TN
UHC Dual Complete TN-Y2 (HMO-POS D-SNP) UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. T5 Yes $0 TN
AARP Medicare Advantage from UHC MI-0001 (PPO) UNITEDHEALTHCARE INSURANCE COMPANY T5 Yes $0 MI
UHC Dual Complete NM-Y1 (PPO D-SNP) UNITEDHEALTHCARE INSURANCE COMPANY T5 Yes $0 NM
UHC Dual Complete NM-S1 (PPO D-SNP) UNITEDHEALTHCARE INSURANCE COMPANY T5 Yes $0 NM
UHC Dual Complete NM-V1 (PPO D-SNP) UNITEDHEALTHCARE INSURANCE COMPANY T5 Yes $0 NM
UHC Dual Complete AZ-S001 (HMO-POS D-SNP) ARIZONA PHYSICIANS IPA, INC. T5 Yes $0 AZ
UHC Dual Complete AZ-Y001 (HMO-POS D-SNP) ARIZONA PHYSICIANS IPA, INC. T5 Yes $0 AZ
UHC Dual Complete VA-Y4 (PPO D-SNP) CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. T5 Yes $0 VA
AARP Medicare Advantage from UHC AL-0001 (HMO-POS) UNITEDHEALTHCARE OF THE MIDLANDS, INC. T5 Yes $0 AL
AARP Medicare Advantage from UHC CA-0002 (HMO-POS) UHC OF CALIFORNIA T5 Yes $0 CA
UHC Sharp Medicare Advantage CA-001P (HMO-POS) UHC OF CALIFORNIA T5 Yes $0 CA
AARP Medicare Advantage from UHC CA-003P (HMO-POS) UHC OF CALIFORNIA T5 Yes $0 CA
AARP Medicare Advantage from UHC CA-0012 (HMO-POS) UHC OF CALIFORNIA T5 Yes $0 CA

Frequently Asked Questions

Is deflazacort 22.75 MG/ML Oral Suspension covered by Medicare Part D?

Yes, deflazacort 22.75 MG/ML Oral Suspension is covered by 819 Medicare Part D plans (16.2% of all Part D formularies).

What tier is deflazacort 22.75 MG/ML Oral Suspension on Medicare Part D plans?

deflazacort 22.75 MG/ML Oral Suspension averages Tier 4.3 across Part D plans, ranging from Tier 1 to Tier 5.

Does deflazacort 22.75 MG/ML Oral Suspension require prior authorization?

95.8% of Part D formularies require prior authorization for deflazacort 22.75 MG/ML Oral Suspension. Step therapy: 0%. Quantity limits: 0%.

How much does Medicare spend on deflazacort 22.75 MG/ML Oral Suspension?

In 2023, total Medicare Part D spending on deflazacort 22.75 MG/ML Oral Suspension was $15,369,330, covering 99 beneficiaries. The average spend per beneficiary was $155,245.76.

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