spinosad 9 MG/ML Medicated Shampoo

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spinosad

RxCUI: 1085816

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.
1.1%
Plan Coverage
55
Plans Covering
T3.8
Avg Tier
0%
Prior Auth Required

What the CMS Formulary Data Shows for spinosad 9 MG/ML Medicated Shampoo

Per the CMS 2026 Part D formulary file, spinosad 9 MG/ML Medicated Shampoo (RxNorm concept RXCUI 1085816, generic name spinosad) appears on 8 distinct formulary files spanning 55 Medicare Part D plan offerings - 1.1% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 2 to Tier 4, with a cross-plan average of Tier 3.8.

Real-world access to spinosad 9 MG/ML Medicated Shampoo depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 12.5% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 638 Part D beneficiaries filled spinosad 9 MG/ML Medicated Shampoo in 2023, with total plan-and-beneficiary spending of $313,204 and an average per-beneficiary annual cost of $490.91. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry spinosad 9 MG/ML Medicated Shampoo today.

Coverage Details

Formularies covering
8
Plans covering
55
Coverage rate
1.1%
Tier range
Tier 2 – Tier 4
Average tier
Tier 4, Non-Preferred

Restrictions

Prior authorization required
0% of formularies
Step therapy required
0% of formularies
Quantity limits
12.5% of formularies

2023 Medicare Spending

Beneficiaries
638
Total spending
$313,204
Avg per beneficiary
$490.91

Tier Distribution Across Plans

2 plans
Tier 2, Generic
53 plans
Tier 4, Non-Preferred

Medicare Advantage Plans (MA-PD) Covering spinosad 9 MG/ML Medicated Shampoo

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

Plan Insurer Tier PA Premium States
FHCP Medicare Classic (HMO) FLORIDA BLUE MEDICARE, INC. T2 No $0 FL
FHCP Medicare Rx Plus (HMO-POS) FLORIDA BLUE MEDICARE, INC. T2 No $49.00 FL
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T4 No $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T4 No $0 NV
Select Health Medicare Dual (HMO D-SNP) SELECTHEALTH, INC. T4 No $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T4 No $0 UT
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T4 No $0 NV
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T4 No $0 UT
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T4 No $0 CO
Select Health Medicare Essential (HMO) SELECTHEALTH, INC. T4 No $0 CO
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T4 No $0 CO
Select Health Medicare Flex (HMO) SELECTHEALTH, INC. T4 No $0 CO
Select Health Medicare + Kroger (HMO) SELECTHEALTH, INC. T4 No $0 CO
Select Health Medicare Active (HMO) SELECTHEALTH, INC. T4 No $0 CO
Select Health Medicare Dual (HMO D-SNP) SELECTHEALTH, INC. T4 No $0 NV
Select Health Medicare Wellness (HMO) SELECTHEALTH, INC. T4 No $0 NV
Network Health Select (PPO) NETWORK HEALTH INSURANCE CORPORATION T4 No $0 WI
Network Health Go (PPO) NETWORK HEALTH INSURANCE CORPORATION T4 No $0 WI
Network Health Anywhere (PPO) NETWORK HEALTH INSURANCE CORPORATION T4 No $0 WI
Network Health Choice (PPO) NETWORK HEALTH INSURANCE CORPORATION T4 No $0 WI
Network Health Zero (PPO) NETWORK HEALTH INSURANCE CORPORATION T4 No $0 WI
Personal Choice 65 Achieve Rx (PPO) QCC INSURANCE COMPANY T4 No $0 PA
Keystone 65 Focus Rx (HMO-POS) KEYSTONE HEALTH PLAN EAST, INC. T4 No $0 PA
Keystone 65 Focus Rx (HMO-POS) KEYSTONE HEALTH PLAN EAST, INC. T4 No $0 PA
Keystone 65 Basic Rx (HMO) KEYSTONE HEALTH PLAN EAST, INC. T4 No $0 PA
AmeriHealth Medicare Core (PPO) AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY T4 No $0 NJ
AmeriHealth Medicare Ultimate (PPO) AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY T4 No $0 NJ
UPMC for Life HMO Premier Rx (HMO) UPMC HEALTH PLAN, INC. T4 No $0 PA
UPMC for Life Complete Care (HMO D-SNP) UPMC FOR YOU, INC T4 No $0 PA
UPMC for Life Complete Care (HMO D-SNP) UPMC FOR YOU, INC T4 No $0 PA
UPMC for Life PPO Premier Rx (PPO) UPMC HEALTH NETWORK, INC. T4 No $0 PA
UPMC for Life PPO Premier Rx (PPO) UPMC HEALTH NETWORK, INC. T4 No $0 PA
UPMC for Life PPO Essential Care Rx (PPO) UPMC HEALTH NETWORK, INC. T4 No $0 PA
UPMC for Life Complete Care (HMO D-SNP) UPMC HEALTH COVERAGE, INC. T4 No $0 PA
Healthy Mississippi Premier Advantage (HMO-POS) Healthy Mississippi, Inc. T4 No $0 MS
UPMC for Life HMO Rx Choice (HMO) UPMC HEALTH PLAN, INC. T4 No $3.90 OH, PA
UPMC for Life HMO Deductible Rx (HMO) UPMC HEALTH PLAN, INC. T4 No $18.10 OH, PA
Network Health Cares (PPO D-SNP) NETWORK HEALTH INSURANCE CORPORATION T4 No $21.10 WI
UPMC for Life PPO Rx Choice (PPO) UPMC HEALTH NETWORK, INC. T4 No $25.00 PA
Keystone 65 Essential Rx (HMO-POS) KEYSTONE HEALTH PLAN EAST, INC. T4 No $31.00 PA
UPMC for Life PPO High Deductible Rx (PPO) UPMC HEALTH NETWORK, INC. T4 No $33.00 PA
UPMC for Life HMO Rx (HMO) UPMC HEALTH PLAN, INC. T4 No $33.70 OH, PA
AmeriHealth Medicare Enhanced (PPO) AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY T4 No $36.00 NJ
Network Health PlusRx (PPO) NETWORK HEALTH INSURANCE CORPORATION T4 No $38.60 WI
UPMC for Life PPO Rx Enhanced (PPO) UPMC HEALTH NETWORK, INC. T4 No $42.70 PA
Keystone 65 Select Rx (HMO) KEYSTONE HEALTH PLAN EAST, INC. T4 No $47.00 PA
Keystone 65 Preferred Rx (HMO) KEYSTONE HEALTH PLAN EAST, INC. T4 No $59.70 PA
Keystone 65 Select Rx (HMO) KEYSTONE HEALTH PLAN EAST, INC. T4 No $63.50 PA
Keystone 65 Preferred Rx (HMO) KEYSTONE HEALTH PLAN EAST, INC. T4 No $79.70 PA
Personal Choice 65 Plus Rx (PPO) QCC INSURANCE COMPANY T4 No $81.20 PA

Frequently Asked Questions

Is spinosad 9 MG/ML Medicated Shampoo covered by Medicare Part D?

Yes, spinosad 9 MG/ML Medicated Shampoo is covered by 55 Medicare Part D plans (1.1% of all Part D formularies).

What tier is spinosad 9 MG/ML Medicated Shampoo on Medicare Part D plans?

spinosad 9 MG/ML Medicated Shampoo averages Tier 3.8 across Part D plans, ranging from Tier 2 to Tier 4.

Does spinosad 9 MG/ML Medicated Shampoo require prior authorization?

0% of Part D formularies require prior authorization for spinosad 9 MG/ML Medicated Shampoo. Step therapy: 0%. Quantity limits: 12.5%.

How much does Medicare spend on spinosad 9 MG/ML Medicated Shampoo?

In 2023, total Medicare Part D spending on spinosad 9 MG/ML Medicated Shampoo was $313,204, covering 638 beneficiaries. The average spend per beneficiary was $490.91.

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