ziprasidone 40 MG Oral Capsule [Geodon]
ziprasidone
RxCUI: 284548
What the CMS Formulary Data Shows for ziprasidone 40 MG Oral Capsule [Geodon]
Per the CMS 2026 Part D formulary file, ziprasidone 40 MG Oral Capsule [Geodon] (RxNorm concept RXCUI 284548, generic name ziprasidone) appears on 1 distinct formulary file spanning 2 Medicare Part D plan offerings - 0% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 1, with a cross-plan average of Tier 1.
Real-world access to ziprasidone 40 MG Oral Capsule [Geodon] depends on utilization management as much as tier placement: 100% of covering formularies require prior authorization. 0% require step therapy. 100% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 82,972 Part D beneficiaries filled ziprasidone 40 MG Oral Capsule [Geodon] in 2023, with total plan-and-beneficiary spending of $57,384,219 and an average per-beneficiary annual cost of $691.61. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry ziprasidone 40 MG Oral Capsule [Geodon] today.
Coverage Details
- Formularies covering
- 1
- Plans covering
- 2
- Coverage rate
- 0%
- Tier range
- Tier 1, Preferred Generic
- Average tier
- Tier 1, Preferred Generic
Restrictions
- Prior authorization required
- 100% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 100% of formularies
2023 Medicare Spending
- Beneficiaries
- 82,972
- Total spending
- $57,384,219
- Avg per beneficiary
- $691.61
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering ziprasidone 40 MG Oral Capsule [Geodon]
2 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Hamaspik Medicare Choice (HMO D-SNP) | HAMASPIK, INC. | T1 | Yes | $0 | NY |
| Hamaspik Medicare Select (HMO D-SNP) | HAMASPIK, INC. | T1 | Yes | $34.50 | NY |
Frequently Asked Questions
Is ziprasidone 40 MG Oral Capsule [Geodon] covered by Medicare Part D?
Yes, ziprasidone 40 MG Oral Capsule [Geodon] is covered by 2 Medicare Part D plans (0% of all Part D formularies).
What tier is ziprasidone 40 MG Oral Capsule [Geodon] on Medicare Part D plans?
ziprasidone 40 MG Oral Capsule [Geodon] averages Tier 1 across Part D plans, ranging from Tier 1 to Tier 1.
Does ziprasidone 40 MG Oral Capsule [Geodon] require prior authorization?
100% of Part D formularies require prior authorization for ziprasidone 40 MG Oral Capsule [Geodon]. Step therapy: 0%. Quantity limits: 100%.
How much does Medicare spend on ziprasidone 40 MG Oral Capsule [Geodon]?
In 2023, total Medicare Part D spending on ziprasidone 40 MG Oral Capsule [Geodon] was $57,384,219, covering 82,972 beneficiaries. The average spend per beneficiary was $691.61.
Read our methodology - how this data is sourced, computed, and verified.