poliovirus vaccine inactivated, type 1 (Mahoney) 80 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 16 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 64 UNT/ML Injectable Suspension [Ipol]
poliovirus vaccine inactivated, type
RxCUI: 763106
What the CMS Formulary Data Shows for poliovirus vaccine inactivated, type 1 (Mahoney) 80 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 16 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 64 UNT/ML Injectable Suspension [Ipol]
Per the CMS 2026 Part D formulary file, poliovirus vaccine inactivated, type 1 (Mahoney) 80 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 16 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 64 UNT/ML Injectable Suspension [Ipol] (RxNorm concept RXCUI 763106, generic name poliovirus vaccine inactivated, type) appears on 330 distinct formulary files spanning 5,067 Medicare Part D plan offerings - 100% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 6, with a cross-plan average of Tier 2.2.
Real-world access to poliovirus vaccine inactivated, type 1 (Mahoney) 80 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 16 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 64 UNT/ML Injectable Suspension [Ipol] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 1.5% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 8,305 Part D beneficiaries filled poliovirus vaccine inactivated, type 1 (Mahoney) 80 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 16 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 64 UNT/ML Injectable Suspension [Ipol] in 2023, with total plan-and-beneficiary spending of $554,347 and an average per-beneficiary annual cost of $66.75. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry poliovirus vaccine inactivated, type 1 (Mahoney) 80 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 16 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 64 UNT/ML Injectable Suspension [Ipol] today.
Coverage Details
- Formularies covering
- 330
- Plans covering
- 5,067
- Coverage rate
- 100%
- Tier range
- Tier 1 – Tier 6
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 1.5% of formularies
2023 Medicare Spending
- Beneficiaries
- 8,305
- Total spending
- $554,347
- Avg per beneficiary
- $66.75
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering poliovirus vaccine inactivated, type 1 (Mahoney) 80 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 16 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 64 UNT/ML Injectable Suspension [Ipol]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Aetna Medicare Signature (HMO) | AETNA HEALTH OF CALIFORNIA INC. | T1 | No | $0 | CA |
| Aetna Medicare Signature (HMO) | AETNA HEALTH OF CALIFORNIA INC. | T1 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO-POS) | AETNA HEALTH OF CALIFORNIA INC. | T1 | No | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | AETNA HEALTH OF CALIFORNIA INC. | T1 | No | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | AETNA HEALTH OF CALIFORNIA INC. | T1 | No | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | AETNA HEALTH OF CALIFORNIA INC. | T1 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | AETNA HEALTH OF CALIFORNIA INC. | T1 | No | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | AETNA HEALTH OF CALIFORNIA INC. | T1 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | AETNA HEALTH OF CALIFORNIA INC. | T1 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | AETNA HEALTH OF CALIFORNIA INC. | T1 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | AETNA HEALTH OF CALIFORNIA INC. | T1 | No | $0 | CA |
| Aetna Medicare Signature Care (HMO-POS) | AETNA HEALTH OF OHIO INC. | T1 | No | $0 | OH |
| Aetna Medicare Signature Extra (HMO-POS) | AETNA HEALTH OF OHIO INC. | T1 | No | $0 | OH |
| Aetna Medicare Signature Care (HMO-POS) | AETNA HEALTH OF OHIO INC. | T1 | No | $0 | OH |
| Aetna Medicare Signature Extra (HMO-POS) | AETNA HEALTH OF OHIO INC. | T1 | No | $0 | KY |
| Aetna Medicare Signature (HMO-POS) | AETNA HEALTH OF OHIO INC. | T1 | No | $0 | KY |
| Aetna Medicare Signature (HMO-POS) | AETNA HEALTH OF OHIO INC. | T1 | No | $0 | KY |
| Aetna Medicare HIDE (HMO D-SNP) | AETNA HEALTH OF OHIO INC. | T1 | No | $0 | KY |
| Aetna Medicare Dual Care (HMO D-SNP) | AETNA HEALTH OF OHIO INC. | T1 | No | $0 | OH |
| Aetna Medicare Signature Care (HMO-POS) | AETNA HEALTH OF OHIO INC. | T1 | No | $0 | OH |
| Aetna Medicare Signature (HMO-POS) | AETNA HEALTH OF OHIO INC. | T1 | No | $0 | OH |
| Aetna Medicare Signature (HMO-POS) | AETNA HEALTH OF OHIO INC. | T1 | No | $0 | KY |
| Aetna Medicare Partial Dual (HMO D-SNP) | AETNA HEALTH OF OHIO INC. | T1 | No | $0 | KY |
| Aetna Medicare Partial Dual (HMO D-SNP) | AETNA HEALTH OF OHIO INC. | T1 | No | $0 | OH |
| Aetna Medicare Signature (HMO) | AETNA HEALTH INC.(GA) | T1 | No | $0 | GA |
| Aetna Medicare Signature (HMO-POS) | COVENTRY HEALTH CARE OF ILLINOIS, INC. | T1 | No | $0 | WI |
| Aetna Medicare Signature (HMO-POS) | COVENTRY HEALTH CARE OF ILLINOIS, INC. | T1 | No | $0 | IL |
| Aetna Medicare Prime Chronic Care (HMO C-SNP) | COVENTRY HEALTH CARE OF ILLINOIS, INC. | T1 | No | $0 | IL |
| Aetna Medicare Signature Extra (HMO-POS) | COVENTRY HEALTH CARE OF ILLINOIS, INC. | T1 | No | $0 | IL |
| Aetna Medicare Signature (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T1 | No | $0 | IA |
| Aetna Medicare Signature (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T1 | No | $0 | NE |
| Aetna Medicare Signature (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T1 | No | $0 | KS, MO |
| Aetna Medicare Signature Extra (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T1 | No | $0 | KS |
| Aetna Medicare Signature (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T1 | No | $0 | KS, MO |
| Aetna Medicare Signature Plus (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T1 | No | $0 | AR |
| Aetna Medicare Signature (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T1 | No | $0 | KS |
| Aetna Medicare Advantra (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T1 | No | $0 | OH |
| Aetna Medicare Advantra Signature Giveback (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T1 | No | $0 | WV |
| Aetna Medicare Elite (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T1 | No | $0 | IA |
| Aetna Medicare Signature Extra (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T1 | No | $0 | NE |
| Aetna Medicare Advantra Signature (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T1 | No | $0 | WV |
| Aetna Medicare Elite (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T1 | No | $0 | IL, MO |
| Aetna Medicare Signature (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T1 | No | $0 | MO |
| Aetna Medicare Elite (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T1 | No | $0 | KS, MO |
| Aetna Medicare Elite (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T1 | No | $0 | AR |
| Aetna Medicare Dual (PPO D-SNP) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T1 | No | $0 | SD |
| Aetna Medicare Signature (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T1 | No | $0 | MO |
| Aetna Medicare Signature (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T1 | No | $0 | KS |
| Aetna Medicare Signature (PPO) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T1 | No | $0 | KS |
| Aetna Medicare Dual Extra (PPO D-SNP) | COVENTRY HEALTH AND LIFE INSURANCE COMPANY | T1 | No | $0 | AR |
Frequently Asked Questions
Is poliovirus vaccine inactivated, type 1 (Mahoney) 80 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 16 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 64 UNT/ML Injectable Suspension [Ipol] covered by Medicare Part D?
Yes, poliovirus vaccine inactivated, type 1 (Mahoney) 80 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 16 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 64 UNT/ML Injectable Suspension [Ipol] is covered by 5,067 Medicare Part D plans (100% of all Part D formularies).
What tier is poliovirus vaccine inactivated, type 1 (Mahoney) 80 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 16 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 64 UNT/ML Injectable Suspension [Ipol] on Medicare Part D plans?
poliovirus vaccine inactivated, type 1 (Mahoney) 80 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 16 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 64 UNT/ML Injectable Suspension [Ipol] averages Tier 2.2 across Part D plans, ranging from Tier 1 to Tier 6.
Does poliovirus vaccine inactivated, type 1 (Mahoney) 80 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 16 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 64 UNT/ML Injectable Suspension [Ipol] require prior authorization?
0% of Part D formularies require prior authorization for poliovirus vaccine inactivated, type 1 (Mahoney) 80 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 16 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 64 UNT/ML Injectable Suspension [Ipol]. Step therapy: 0%. Quantity limits: 1.5%.
How much does Medicare spend on poliovirus vaccine inactivated, type 1 (Mahoney) 80 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 16 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 64 UNT/ML Injectable Suspension [Ipol]?
In 2023, total Medicare Part D spending on poliovirus vaccine inactivated, type 1 (Mahoney) 80 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 16 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 64 UNT/ML Injectable Suspension [Ipol] was $554,347, covering 8,305 beneficiaries. The average spend per beneficiary was $66.75.
Read our methodology - how this data is sourced, computed, and verified.