DAPTOMYCIN 500 mg/10mL Injection, Powder, Lyophilized, For Solution
Coverage in Alaska (CMS PDP Region 34).
9 of 9 stand-alone Part D plans in Alaska cover this drug on tier 4–5.
No plan applies a prior authorization, step therapy or quantity limit.
Every plan that covers it
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| Humana Basic Rx Plan (PDP)$0.00/mo premium · $615.00 deductible | 4Non-Preferred Drug | 28% | — | $34.8293 | — | None |
| Humana Value Rx Plan (PDP)$10.60/mo premium · $601.00 deductible | 4Non-Preferred Drug | 33% | — | $34.9099 | — | None |
| AARP Medicare Rx Saver from UHC (PDP)$53.20/mo premium · $615.00 deductible | 4Non-Preferred Drug | 33% | — | $49.0922 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$100.20/mo premium · $130.00 deductible | 4Non-Preferred Drug | 35% | — | $49.1714 | — | None |
| Humana Premier Rx Plan (PDP)$112.40/mo premium · $0.00 deductible | 4Non-Preferred Drug | 50% | 50% | $34.7839 | — | None |
| Wellcare Classic (PDP)$0.00/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $68.1910 | — | None |
| HealthSpring Assurance Rx (PDP)$0.00/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $65.9556 | — | None |
| Wellcare Value Script (PDP)$19.70/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $63.8975 | — | None |
| SilverScript Choice (PDP)$94.90/mo premium · $615.00 deductible | 5Specialty Tier | 25% | — | $250.4482 | — | 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.