Medicare Part D coverage · 12 · RxCUI 617995
12 HR amoxicillin 1000 MG / clavulanate 62.5 MG Extended Release Oral Tablet
Per the CMS 2026 Part D formulary file, 12 HR amoxicillin 1000 MG / clavulanate 62.5 MG Extended Release Oral Tablet is covered by 2,891 Medicare Part D plans (57.2% of enrollable products), averaging Tier 3.1, with prior authorization required on 0% of covering formularies.
- 57.2%
- Plan coverage
- 2,891
- Plans covering
- T3.1
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for 12 HR amoxicillin 1000 MG / clavulanate 62.5 MG Extended Release Oral Tablet
Per the CMS 2026 Part D formulary file, 12 HR amoxicillin 1000 MG / clavulanate 62.5 MG Extended Release Oral Tablet (RxNorm concept RXCUI 617995, generic name 12) appears on 146 distinct formulary files spanning 2,891 Medicare Part D plan offerings - 57.2% of enrollable Part D products, mid-range placement; shopping across contracts changes access. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 3.1.
Real-world access to 12 HR amoxicillin 1000 MG / clavulanate 62.5 MG Extended Release Oral Tablet depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.
Medicare Part D spending dashboard figures are not published for this drug. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry 12 HR amoxicillin 1000 MG / clavulanate 62.5 MG Extended Release Oral Tablet today.
Coverage Details
- Formularies covering
- 146
- Plans covering
- 2,891
- Coverage rate
- 57.2%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering 12 HR amoxicillin 1000 MG / clavulanate 62.5 MG Extended Release Oral Tablet
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Sentara Community Complete Select (HMO D-SNP) | Sentara Health Plans | T1 | No | $0 | VA |
| Sentara Community Complete (HMO D-SNP) | Sentara Health Plans | T1 | No | $0 | VA |
| ElderServe MAP (HMO D-SNP) | Elderserve Health, Inc. | T1 | No | $0 | NY |
| Cooperative Advantage (HMO D-SNP) | Group Health Cooperative OF EAU Claire | T1 | No | $0 | WI |
| Longevity Health Plan (PPO I-SNP) | Longevity Health Plan OF NEW Jersey Insurance Comp | T1 | No | $0 | NJ |
| Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) | Upper Peninsula Health Plan, LLC | T1 | No | $0 | MI |
| CareSource Dual Advantage (HMO D-SNP) | Caresource Georgia Co. | T1 | No | $0 | GA |
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP Caresource | T1 | No | $0 | MI |
| BlueAdvantage Sapphire (PPO) | Bluecross Blueshield OF Tennessee, Inc. | T1 | No | $0 | TN |
| BlueAdvantage Sapphire (PPO) | Bluecross Blueshield OF Tennessee, Inc. | T1 | No | $0 | TN |
| BlueAdvantage Garnet (PPO) | Bluecross Blueshield OF Tennessee, Inc. | T1 | No | $0 | TN |
| BlueAdvantage Garnet (PPO) | Bluecross Blueshield OF Tennessee, Inc. | T1 | No | $0 | TN |
| BlueAdvantage Sapphire (PPO) | Bluecross Blueshield OF Tennessee, Inc. | T1 | No | $0 | TN |
| BlueAdvantage Sapphire (PPO) | Bluecross Blueshield OF Tennessee, Inc. | T1 | No | $0 | GA |
| BlueAdvantage Total Heart and Diabetes (PPO C-SNP) | Bluecross Blueshield OF Tennessee, Inc. | T1 | No | $0 | GA, TN |
| BlueAdvantage Total Heart and Diabetes (PPO C-SNP) | Bluecross Blueshield OF Tennessee, Inc. | T1 | No | $0 | TN |
| CareAdvantage (HMO D-SNP) | SAN Mateo Health Commission | T1 | No | $0 | CA |
| 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 |
Show the next 30 plans
| SecureBlue (HMO D-SNP) | HMO Minnesota | T1 | No | $0 | MN |
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | No | $0 | MA |
| Hamaspik Medicare Choice (HMO D-SNP) | Hamaspik, Inc. | T1 | No | $0 | NY |
| SeniorCare Complete (HMO D-SNP) | South Country Health Alliance | T1 | No | $0 | MN |
| AbilityCare (HMO D-SNP) | South Country Health Alliance | T1 | No | $0 | MN |
| Alameda Alliance Wellness (HMO D-SNP) | Alameda Alliance FOR Health | T1 | No | $0 | CA |
| PHP (HMO C-snp) | Aids Healthcare Foundation | T1 | No | $0 | CA |
| VNS Health Total (HMO D-SNP) | VNS Choice | T1 | No | $0 | NY |
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Pennsylvania, Inc | T1 | No | $0 | PA |
| Provider Partners North Carolina Community Plan (HMO I-SNP) | Provider Partners Health Plan OF North Carolina | T1 | No | $0 | NC |
| Provider Partners Indiana Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Indiana | T1 | No | $0 | IN |
| Provider Partners Missouri Community Plan (HMO I-SNP) | Provider Partners Health Plan OF Missouri, Inc. | T1 | No | $0 | MO |
| 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 | No | $0 | PR |
| Platino Enlace (HMO D-SNP) | Triple S Advantage, Inc. | T1 | No | $0 | PR |
| Platino Advance (HMO D-snp) | Triple S Advantage, Inc. | T1 | No | $0 | PR |
| Platino Plus (HMO D-snp) | Triple S Advantage, Inc. | T1 | No | $0 | PR |
| Mass General Brigham SCO (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| Mass General Brigham One Care (HMO D-SNP) | Mass General Brigham Health Plan, Inc | T1 | No | $0 | MA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $0 | PA |
| Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) | Gateway Health Plan, Inc. | T1 | No | $0 | PA |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Health Options West Virginia Inc. | T1 | No | $0 | WV |
| Highmark Health Options Duals (HMO D-SNP) | Highmark Bcbsd, Inc. | T1 | No | $0 | DE |
| Tufts Health One Care (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
| Tufts Health One Care CW (HMO D-SNP) | Tufts Health Public Plans, Inc. | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | No | $0 | MA |
| Tufts Health Plan Senior Care Options CW (HMO D-SNP) | Tufts Associated Health Maintenance Organization | T1 | No | $0 | MA |
| Leon MediExtra (HMO) | Leon Health, Inc. | T1 | No | $0 | FL |
| Leon MediDual (HMO D-SNP) | Leon Health, Inc. | T1 | No | $0 | FL |
| Leon MediMore (HMO) | Leon Health, Inc. | T1 | No | $0 | FL |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is 12 HR amoxicillin 1000 MG / clavulanate 62.5 MG Extended Release Oral Tablet covered by Medicare Part D?
Yes, 12 HR amoxicillin 1000 MG / clavulanate 62.5 MG Extended Release Oral Tablet is covered by 2,891 Medicare Part D plans (57.2% of all Part D formularies).
What tier is 12 HR amoxicillin 1000 MG / clavulanate 62.5 MG Extended Release Oral Tablet on Medicare Part D plans?
12 HR amoxicillin 1000 MG / clavulanate 62.5 MG Extended Release Oral Tablet averages Tier 3.1 across Part D plans, ranging from Tier 1 to Tier 4.
Does 12 HR amoxicillin 1000 MG / clavulanate 62.5 MG Extended Release Oral Tablet require prior authorization?
0% of Part D formularies require prior authorization for 12 HR amoxicillin 1000 MG / clavulanate 62.5 MG Extended Release Oral Tablet. Step therapy: 0%. Quantity limits: 0%.
Read our methodology - how this data is sourced, computed, and verified.
Nationwide similar Part D drugs
Data-derived peers across the CMS Part D formulary extract: nearest average tier placement and nearest prior-authorization rate. Not therapeutic alternatives or same-generic strengths.