Salmonella typhi Ty21a live antigen 2000000000 UNT Delayed Release Oral Capsule [Vivotif]
Salmonella
RxCUI: 762602
What the CMS Formulary Data Shows for Salmonella typhi Ty21a live antigen 2000000000 UNT Delayed Release Oral Capsule [Vivotif]
Per the CMS 2026 Part D formulary file, Salmonella typhi Ty21a live antigen 2000000000 UNT Delayed Release Oral Capsule [Vivotif] (RxNorm concept RXCUI 762602, generic name Salmonella) 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 Salmonella typhi Ty21a live antigen 2000000000 UNT Delayed Release Oral Capsule [Vivotif] depends on utilization management as much as tier placement: 0.6% of covering formularies require prior authorization. 0% require step therapy. 7.3% apply quantity limits.
Medicare Part D spending dashboard figures are not published for this drug. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry Salmonella typhi Ty21a live antigen 2000000000 UNT Delayed Release Oral Capsule [Vivotif] 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
- 0.6% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 7.3% of formularies
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering Salmonella typhi Ty21a live antigen 2000000000 UNT Delayed Release Oral Capsule [Vivotif]
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 Salmonella typhi Ty21a live antigen 2000000000 UNT Delayed Release Oral Capsule [Vivotif] covered by Medicare Part D?
Yes, Salmonella typhi Ty21a live antigen 2000000000 UNT Delayed Release Oral Capsule [Vivotif] is covered by 5,067 Medicare Part D plans (100% of all Part D formularies).
What tier is Salmonella typhi Ty21a live antigen 2000000000 UNT Delayed Release Oral Capsule [Vivotif] on Medicare Part D plans?
Salmonella typhi Ty21a live antigen 2000000000 UNT Delayed Release Oral Capsule [Vivotif] averages Tier 2.2 across Part D plans, ranging from Tier 1 to Tier 6.
Does Salmonella typhi Ty21a live antigen 2000000000 UNT Delayed Release Oral Capsule [Vivotif] require prior authorization?
0.6% of Part D formularies require prior authorization for Salmonella typhi Ty21a live antigen 2000000000 UNT Delayed Release Oral Capsule [Vivotif]. Step therapy: 0%. Quantity limits: 7.3%.
Read our methodology - how this data is sourced, computed, and verified.