No prior authorization
Does Zing Health Of Michigan, INC. require prior authorization for PEDIARIX?
Zing Health Of Michigan, INC. does not require prior authorization for PEDIARIX on the Medicare Part D plans that cover it.
No covering plan from this payer files a prior-authorization requirement for this drug.
By product strength
| RxNorm product | Plans covering | Require prior auth | Step therapy | Qty limit | Status |
|---|---|---|---|---|---|
| 0.5 ML acellular pertussis vaccine, inactivated 0.116 MG/ML / diphtheria toxoid vaccine, inactivated 50 UNT/ML / hepatitis B surface antigen vaccine 0.02 MG/ML / poliovirus vaccine inactivated, type 1 (Mahoney) 80 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 16 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 64 UNT/ML / tetanus toxoid vaccine, inactivated 20 UNT/ML Prefilled Syringe [PEDIARIX]829989 | 33 / 33 | 0 | 0 | 0 | No prior authorization |
Product names come from RxNorm (U.S. National Library of Medicine).
Plan-by-plan detail — 0.5 ML acellular pertussis vaccine, inactivated 0.116 MG/ML / diphtheria toxoid vaccine, inactivated 50 UNT/ML / hepatitis B surface antigen vaccine 0.02 MG/ML / poliovirus vaccine inactivated, type 1 (Mahoney) 80 UNT/ML / poliovirus vaccine inactivated, type 2 (MEF-1) 16 UNT/ML / poliovirus vaccine inactivated, type 3 (Saukett) 64 UNT/ML / tetanus toxoid vaccine, inactivated 20 UNT/ML Prefilled Syringe [PEDIARIX]
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| Zing Choice IL (HMO) | H4624-001 | 1 | No | No | No |
| Zing Elite Balance MI (HMO C-SNP) | H4624-046 | 1 | No | No | No |
| Zing Elite Diabetes & Heart IL (HMO C-SNP) | H4624-028 | 1 | No | No | No |
| Zing Elite Diabetes & Heart IN (HMO C-SNP) | H4624-031 | 1 | No | No | No |
| Zing Elite Diabetes & Heart MI (HMO C-SNP) | H4624-032 | 1 | No | No | No |
| Zing Elite Diabetes & Heart OH (HMO C-SNP) | H4624-033 | 1 | No | No | No |
| Zing Elite Diabetes & Heart TN-MS (HMO C-SNP) | H4624-039 | 1 | No | No | No |
| Zing Elite Essentials Diabetes & Heart IL-IN (HMO C-SNP) | H4624-045 | 1 | No | No | No |
| Zing Elite Select IL-IN (HMO) | H4624-026 | 1 | No | No | No |
| Zing Elite Select MI (HMO) | H4624-022 | 1 | No | No | No |
| Zing Elite Select OH (HMO) | H4624-037 | 1 | No | No | No |
| Zing Elite Select TN-MS (HMO) | H4624-043 | 1 | No | No | No |
| Zing Essential Wellness Diabetes & Heart IL (HMO C-SNP) | H4624-010 | 1 | No | No | No |
| Zing Open Choice Diabetes & Heart IN (PPO C-SNP) | H6876-005 | 1 | No | No | No |
| Zing Open Choice Diabetes & Heart MI (PPO C-SNP) | H6876-003 | 1 | No | No | No |
| Zing Open Choice Diabetes & Heart TN (PPO C-SNP) | H6876-007 | 1 | No | No | No |
| Zing Open Choice IN (PPO) | H6876-004 | 1 | No | No | No |
| Zing Open Choice MI (PPO) | H6876-001 | 1 | No | No | No |
| Zing Open Choice TN (PPO) | H6876-009 | 1 | No | No | No |
| Zing Select Care IN (HMO) | H4624-003 | 1 | No | No | No |
| Zing Select Care MI (HMO) | H4624-006 | 1 | No | No | No |
| Zing Select Care OH (HMO) | H4624-038 | 1 | No | No | No |
| Zing Select Care TN-MS (HMO) | H4624-044 | 1 | No | No | No |
| Zing Select Diabetes & Heart Complete IL (HMO C-SNP) | H4624-027 | 1 | No | No | No |
| Zing Select Diabetes & Heart IN (HMO C-SNP) | H4624-011 | 1 | No | No | No |
| Zing Select Diabetes & Heart MI (HMO C-SNP) | H4624-012 | 1 | No | No | No |
| Zing Select Diabetes & Heart OH (HMO C-SNP) | H4624-034 | 1 | No | No | No |
| Zing Select Diabetes & Heart TN-MS (HMO C-SNP) | H4624-040 | 1 | No | No | No |
| Zing Select Dialysis IL (HMO C-SNP) | H4624-029 | 1 | No | No | No |
| Zing Select Dialysis IN (HMO C-SNP) | H4624-025 | 1 | No | No | No |
| Zing Select Dialysis MI (HMO C-SNP) | H4624-023 | 1 | No | No | No |
| Zing Select Dialysis OH (HMO C-SNP) | H4624-036 | 1 | No | No | No |
| Zing Select Dialysis TN-MS (HMO C-SNP) | H4624-042 | 1 | No | No | No |
Source
Monthly Prescription Drug Plan Formulary and Pharmacy Network Information — Basic Drugs Formulary File- Effective
- 2026-06-30
- Retrieved
- 2026-07-19
- SHA-256
- e626e6bcda1aa6a0071e6f0df6bafe686ae41842cdf0a9feffdc649b6d3ff3ae
We publish the hash of the exact file we ingested so any answer can be audited against the bytes CMS served that day.
PEDIARIX at other payers
Administrative information only. Benefily reports what a payer has published in its own prior-authorization policy as of the effective date shown. It is not medical advice, not a coverage or payment guarantee, and not an authorization. Requirements vary by plan, place of service and member benefits — always verify with the payer before rendering service.