tedizolid phosphate 200 MG Injection [Sivextro]
tedizolid phosphate
RxCUI: 1540890
What the CMS Formulary Data Shows for tedizolid phosphate 200 MG Injection [Sivextro]
Per the CMS 2026 Part D formulary file, tedizolid phosphate 200 MG Injection [Sivextro] (RxNorm concept RXCUI 1540890, generic name tedizolid phosphate) appears on 68 distinct formulary files spanning 1,419 Medicare Part D plan offerings - 28% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 6, with a cross-plan average of Tier 4.5.
Real-world access to tedizolid phosphate 200 MG Injection [Sivextro] depends on utilization management as much as tier placement: 27.9% of covering formularies require prior authorization. 0% require step therapy. 20.6% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 489 Part D beneficiaries filled tedizolid phosphate 200 MG Injection [Sivextro] in 2023, with total plan-and-beneficiary spending of $11,498,831 and an average per-beneficiary annual cost of $23,514.99. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry tedizolid phosphate 200 MG Injection [Sivextro] today.
Coverage Details
- Formularies covering
- 68
- Plans covering
- 1,419
- Coverage rate
- 28%
- Tier range
- Tier 1 – Tier 6
- Average tier
- Tier 5, Specialty
Restrictions
- Prior authorization required
- 27.9% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 20.6% of formularies
2023 Medicare Spending
- Beneficiaries
- 489
- Total spending
- $11,498,831
- Avg per beneficiary
- $23,514.99
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering tedizolid phosphate 200 MG Injection [Sivextro]
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Gold Coast Health Plan Total Care Advantage (HMO D-SNP) | Ventura County Medi-Cal Managed Care Commission | T1 | No | $0 | CA |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) | Health Care Service Corporation | T1 | No | $0 | NM |
| Horizon NJ TotalCare (HMO D-SNP) | HORIZON HEALTHCARE OF NEW JERSEY, INC. | T1 | No | $0 | NJ |
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | No | $0 | MN |
| Hamaspik Medicare Choice (HMO D-SNP) | HAMASPIK, INC. | T1 | No | $0 | NY |
| Community Care's Partnership Program (HMO D-SNP) | COMMUNITY CARE HEALTH PLAN, INC. | T1 | No | $0 | WI |
| Platino Blindao (HMO D-SNP) | TRIPLE S ADVANTAGE, INC. | T1 | Yes | $0 | PR |
| Platino Enlace (HMO D-SNP) | TRIPLE S ADVANTAGE, INC. | T1 | Yes | $0 | PR |
| PLATINO ADVANCE (HMO D-SNP) | TRIPLE S ADVANTAGE, INC. | T1 | Yes | $0 | PR |
| PLATINO PLUS (HMO D-SNP) | TRIPLE S ADVANTAGE, INC. | T1 | Yes | $0 | PR |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | HCSC INSURANCE SERVICES COMPANY | T1 | No | $4.80 | TX |
| Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) | GHS INSURANCE COMPANY | T1 | No | $5.00 | OK |
| Hamaspik Medicare Select (HMO D-SNP) | HAMASPIK, INC. | T1 | No | $34.50 | NY |
| CalOptima Health OneCare Complete (HMO D-SNP) | ORANGE COUNTY HEALTH AUTHORITY | T2 | Yes | $0 | CA |
| 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 |
| Healthy Mississippi Premier Advantage (HMO-POS) | Healthy Mississippi, Inc. | T4 | No | $0 | MS |
| Aetna Medicare Signature (HMO) | AETNA HEALTH OF CALIFORNIA INC. | T5 | No | $0 | CA |
| Aetna Medicare Signature (HMO) | AETNA HEALTH OF CALIFORNIA INC. | T5 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO-POS) | AETNA HEALTH OF CALIFORNIA INC. | T5 | No | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | AETNA HEALTH OF CALIFORNIA INC. | T5 | No | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | AETNA HEALTH OF CALIFORNIA INC. | T5 | No | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | AETNA HEALTH OF CALIFORNIA INC. | T5 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | AETNA HEALTH OF CALIFORNIA INC. | T5 | No | $0 | CA |
| Aetna Medicare Prime (HMO-POS) | AETNA HEALTH OF CALIFORNIA INC. | T5 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | AETNA HEALTH OF CALIFORNIA INC. | T5 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | AETNA HEALTH OF CALIFORNIA INC. | T5 | No | $0 | CA |
| Aetna Medicare Signature Extra (HMO) | AETNA HEALTH OF CALIFORNIA INC. | T5 | No | $0 | CA |
| Aetna Medicare Signature Care (HMO-POS) | AETNA HEALTH OF OHIO INC. | T5 | No | $0 | OH |
| Aetna Medicare Signature Extra (HMO-POS) | AETNA HEALTH OF OHIO INC. | T5 | No | $0 | OH |
| Aetna Medicare Signature Care (HMO-POS) | AETNA HEALTH OF OHIO INC. | T5 | No | $0 | OH |
| Aetna Medicare Signature Extra (HMO-POS) | AETNA HEALTH OF OHIO INC. | T5 | No | $0 | KY |
| Aetna Medicare Signature (HMO-POS) | AETNA HEALTH OF OHIO INC. | T5 | No | $0 | KY |
| Aetna Medicare Signature (HMO-POS) | AETNA HEALTH OF OHIO INC. | T5 | No | $0 | KY |
| Aetna Medicare HIDE (HMO D-SNP) | AETNA HEALTH OF OHIO INC. | T5 | No | $0 | KY |
| Aetna Medicare Dual Care (HMO D-SNP) | AETNA HEALTH OF OHIO INC. | T5 | No | $0 | OH |
| Aetna Medicare Signature Care (HMO-POS) | AETNA HEALTH OF OHIO INC. | T5 | No | $0 | OH |
Frequently Asked Questions
Is tedizolid phosphate 200 MG Injection [Sivextro] covered by Medicare Part D?
Yes, tedizolid phosphate 200 MG Injection [Sivextro] is covered by 1,419 Medicare Part D plans (28% of all Part D formularies).
What tier is tedizolid phosphate 200 MG Injection [Sivextro] on Medicare Part D plans?
tedizolid phosphate 200 MG Injection [Sivextro] averages Tier 4.5 across Part D plans, ranging from Tier 1 to Tier 6.
Does tedizolid phosphate 200 MG Injection [Sivextro] require prior authorization?
27.9% of Part D formularies require prior authorization for tedizolid phosphate 200 MG Injection [Sivextro]. Step therapy: 0%. Quantity limits: 20.6%.
How much does Medicare spend on tedizolid phosphate 200 MG Injection [Sivextro]?
In 2023, total Medicare Part D spending on tedizolid phosphate 200 MG Injection [Sivextro] was $11,498,831, covering 489 beneficiaries. The average spend per beneficiary was $23,514.99.
Read our methodology - how this data is sourced, computed, and verified.