12 HR amoxicillin 1000 MG / clavulanate 62.5 MG Extended Release Oral Tablet

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amoxicillin

RxCUI: 617995

Important: Drug coverage and costs vary by plan and location. Verify coverage directly with your Medicare plan before filling a prescription. This is informational data only and should not replace advice from your healthcare provider or pharmacist.
57.4%
Plan Coverage
2,906
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 amoxicillin) appears on 148 distinct formulary files spanning 2,906 Medicare Part D plan offerings - 57.4% 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
148
Plans covering
2,906
Coverage rate
57.4%
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

92 plans
Tier 1, Preferred Generic
8 plans
Tier 2, Generic

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
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 Maryland Community Plan (HMO I-SNP) PROVIDER PARTNERS HEALTH PLAN, INC. T1 No $0 MD
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

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 2,906 Medicare Part D plans (57.4% 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%.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial