tedizolid phosphate 200 MG Injection [Sivextro]

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tedizolid phosphate

RxCUI: 1540890

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.
28%
Plan Coverage
1,419
Plans Covering
T4.5
Avg Tier
27.9%
Prior Auth Required

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

14 plans
Tier 1, Preferred Generic
1 plans
Tier 2, Generic
15 plans
Tier 4, Non-Preferred
70 plans
Tier 5, Specialty

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.

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