PEDIARIX 25/10/25/25/8/10/40/8/32 [iU]/.5mL/ug/.5mL Injection, Suspension
Also known as Diphtheria And Tetanus Toxoids And Acellular Pertussis Adsorbed, Hepatitis B (Recombinant) And Inactivated Poliovirus Vaccine Combined. Coverage in Florida (CMS PDP Region 11).
10 of 10 stand-alone Part D plans in Florida cover this drug on tier 1–6.
Lowest 30-day cost $0.00 at a preferred pharmacy. 2 of 10 plans apply a prior authorization, step therapy or quantity limit.
583 Medicare Advantage plans in FL do cover it
Medicare Advantage plans carry their own formularies, separate from stand-alone Part D. A patient on an MA-PD plan may have coverage even where no PDP lists the drug. FL: 583 plans.
Every plan that covers it
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Value Rx Plan (PDP)$25.90/mo premium · $601.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $206.9501 | — | None |
| Humana Basic Rx Plan (PDP)$92.70/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $206.9501 | — | None |
| SilverScript Choice (PDP)$98.30/mo premium · $615.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $207.0152 | — | None |
| Humana Premier Rx Plan (PDP)$115.90/mo premium · $0.00 deductible | 1Preferred Generic | $0.00 | $0.00 | $206.9501 | — | None |
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $204.1083 | — | None |
| Wellcare Value Script (PDP)$0.00/mo premium · $615.00 deductible | 3Preferred Brand | 25% | 25% | $204.1083 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$98.70/mo premium · $615.00 deductible | 3Preferred Brand | 18% | 18% | $232.6710 | $3,490.0715 units |
|
| AARP Medicare Rx Preferred from UHC (PDP)$119.10/mo premium · $130.00 deductible | 3Preferred Brand | 17% | 17% | $232.6710 | $3,490.0715 units |
|
| BlueMedicare Premier Rx (PDP)$98.60/mo premium · $615.00 deductible | 6Select Care Drugs | $3.00 | $9.00 | $227.7983 | — | None |
| BlueMedicare Complete Rx (PDP)$217.00/mo premium · $615.00 deductible | 6Select Care Drugs | $0.00 | $0.00 | $227.7983 | — | None |
Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity.