Medicare Part D coverage · deflazacort · RxCUI 1870964
deflazacort 22.75 MG/ML Oral Suspension
Per the CMS 2026 Part D formulary file, deflazacort 22.75 MG/ML Oral Suspension is covered by 819 Medicare Part D plans (16.2% of enrollable products), averaging Tier 4.3, with prior authorization required on 95.8% of covering formularies.
- 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
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 |
Show the next 30 plans
| 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 |
Showing top 50 of 100 plans.
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.
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
- 1 ML leuprolide acetate 7.5 MG/ML Prefilled Syringe [Lupron] T4.3
- 3 ML icatibant 10 MG/ML Prefilled Syringe [Sajazir] T4.3
- omadacycline 100 MG Injection [Nuzyra] T4.3
- sacrosidase 8500 UNT/ML Oral Solution [Sucraid] T4.3
- {28 (alpelisib 125 MG Oral Tablet [Vijoice]) } Pack [Vijoice 125 MG 28 Day] T4.3
- 0.5 ML interferon beta-1a 0.044 MG/ML Auto-Injector [Rebif] T4.3
Similar prior-authorization rate
- sapropterin dihydrochloride 100 MG Powder for Oral Solution 95.8% PA
- etrasimod 2 MG Oral Tablet [Velsipity] 95.9% PA
- elagolix 150 MG Oral Tablet [Orilissa] 95.9% PA
- voriconazole 200 MG Injection 96% PA
- mechlorethamine 0.00016 MG/MG Topical Gel [Valchlor] 96% PA
- sapropterin dihydrochloride 500 MG Powder for Oral Solution 95.6% PA