bismuth subcitrate 140 MG / metronidazole 125 MG / tetracycline hydrochloride 125 MG Oral Capsule [Pylera]

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bismuth subcitrate

RxCUI: 1294621

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.
0.6%
Plan Coverage
32
Plans Covering
T3.4
Avg Tier
20%
Prior Auth Required

What the CMS Formulary Data Shows for bismuth subcitrate 140 MG / metronidazole 125 MG / tetracycline hydrochloride 125 MG Oral Capsule [Pylera]

Per the CMS 2026 Part D formulary file, bismuth subcitrate 140 MG / metronidazole 125 MG / tetracycline hydrochloride 125 MG Oral Capsule [Pylera] (RxNorm concept RXCUI 1294621, generic name bismuth subcitrate) appears on 5 distinct formulary files spanning 32 Medicare Part D plan offerings - 0.6% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 3.4.

Real-world access to bismuth subcitrate 140 MG / metronidazole 125 MG / tetracycline hydrochloride 125 MG Oral Capsule [Pylera] depends on utilization management as much as tier placement: 20% of covering formularies require prior authorization. 0% require step therapy. 20% 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 bismuth subcitrate 140 MG / metronidazole 125 MG / tetracycline hydrochloride 125 MG Oral Capsule [Pylera] today.

Coverage Details

Formularies covering
5
Plans covering
32
Coverage rate
0.6%
Tier range
Tier 1 – Tier 4
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
20% of formularies
Step therapy required
0% of formularies
Quantity limits
20% of formularies

Tier Distribution Across Plans

2 plans
Tier 1, Preferred Generic
30 plans
Tier 4, Non-Preferred

Medicare Advantage Plans (MA-PD) Covering bismuth subcitrate 140 MG / metronidazole 125 MG / tetracycline hydrochloride 125 MG Oral Capsule [Pylera]

32 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
Hamaspik Medicare Choice (HMO D-SNP) HAMASPIK, INC. T1 No $0 NY
Hamaspik Medicare Select (HMO D-SNP) HAMASPIK, INC. T1 No $34.50 NY
Medicare BlueEssential (PPO) EXCELLUS HEALTH PLAN, INC. T4 No $0 NY
Medicare BlueActive (PPO) EXCELLUS HEALTH PLAN, INC. T4 No $0 NY
Medicare BlueVital (PPO) EXCELLUS HEALTH PLAN, INC. T4 No $0 NY
Univera SeniorChoice Basic (HMO) EXCELLUS HEALTH PLAN, INC. T4 No $0 NY
Univera SeniorChoice Extra (HMO) EXCELLUS HEALTH PLAN, INC. T4 No $0 NY
Medicare Blue Choice Core (HMO) EXCELLUS HEALTH PLAN, INC. T4 No $0 NY
Univera Medicare Dual (HMO D-SNP) EXCELLUS HEALTH PLAN COMMUNITY CARE LLC T4 No $0 NY
Medicare Blue Dual (HMO D-SNP) EXCELLUS HEALTH PLAN COMMUNITY CARE LLC T4 No $0 NY
DrMax (HMO) DOCTORS HEALTHCARE PLANS, INC. T4 Yes $0 FL
DrExtraCare (HMO C-SNP) DOCTORS HEALTHCARE PLANS, INC. T4 Yes $0 FL
DrSelect (HMO) DOCTORS HEALTHCARE PLANS, INC. T4 Yes $0 FL
DrSelect-CFL (HMO) DOCTORS HEALTHCARE PLANS, INC. T4 Yes $0 FL
DrPlatinum-CFL (HMO D-SNP) DOCTORS HEALTHCARE PLANS, INC. T4 Yes $0 FL
DrTotalCare-CFL (HMO C-SNP) DOCTORS HEALTHCARE PLANS, INC. T4 Yes $0 FL
DrElite-SFL (HMO) DOCTORS HEALTHCARE PLANS, INC. T4 Yes $0 FL
CDPHP $0 Medicare Rx (HMO) CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. T4 No $0 NY
DrFlex (HMO D-SNP) DOCTORS HEALTHCARE PLANS, INC. T4 Yes $1.10 FL
DrPlus (HMO D-SNP) DOCTORS HEALTHCARE PLANS, INC. T4 Yes $4.80 FL
Univera SeniorChoice Core (PPO) EXCELLUS HEALTH PLAN, INC. T4 No $33.00 NY
Univera SeniorChoice Advanced (HMO-POS) EXCELLUS HEALTH PLAN, INC. T4 No $36.90 NY
Medicare BlueClassic (PPO) EXCELLUS HEALTH PLAN, INC. T4 No $51.00 NY
Univera SeniorChoice Secure (HMO-POS) EXCELLUS HEALTH PLAN, INC. T4 No $54.90 NY
Medicare BlueBalanced (PPO) EXCELLUS HEALTH PLAN, INC. T4 No $55.00 NY
Medicare Blue Choice Prime (HMO) EXCELLUS HEALTH PLAN, INC. T4 No $55.00 NY
Univera SeniorChoice Value Plus (HMO-POS) EXCELLUS HEALTH PLAN, INC. T4 No $58.60 NY
Medicare BlueEnhanced (PPO) EXCELLUS HEALTH PLAN, INC. T4 No $70.30 NY
Medicare BluePlus (PPO) EXCELLUS HEALTH PLAN, INC. T4 No $86.40 NY
CDPHP Clear Rx (HMO) CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. T4 No $100.00 NY
CDPHP Choice Rx (HMO) CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. T4 No $135.00 NY
Medicare Blue Choice Optimum (HMO-POS) EXCELLUS HEALTH PLAN, INC. T4 No $146.00 NY

Frequently Asked Questions

Is bismuth subcitrate 140 MG / metronidazole 125 MG / tetracycline hydrochloride 125 MG Oral Capsule [Pylera] covered by Medicare Part D?

Yes, bismuth subcitrate 140 MG / metronidazole 125 MG / tetracycline hydrochloride 125 MG Oral Capsule [Pylera] is covered by 32 Medicare Part D plans (0.6% of all Part D formularies).

What tier is bismuth subcitrate 140 MG / metronidazole 125 MG / tetracycline hydrochloride 125 MG Oral Capsule [Pylera] on Medicare Part D plans?

bismuth subcitrate 140 MG / metronidazole 125 MG / tetracycline hydrochloride 125 MG Oral Capsule [Pylera] averages Tier 3.4 across Part D plans, ranging from Tier 1 to Tier 4.

Does bismuth subcitrate 140 MG / metronidazole 125 MG / tetracycline hydrochloride 125 MG Oral Capsule [Pylera] require prior authorization?

20% of Part D formularies require prior authorization for bismuth subcitrate 140 MG / metronidazole 125 MG / tetracycline hydrochloride 125 MG Oral Capsule [Pylera]. Step therapy: 0%. Quantity limits: 20%.

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