cefpodoxime 10 MG/ML Oral Suspension
cefpodoxime
RxCUI: 309079
What the CMS Formulary Data Shows for cefpodoxime 10 MG/ML Oral Suspension
Per the CMS 2026 Part D formulary file, cefpodoxime 10 MG/ML Oral Suspension (RxNorm concept RXCUI 309079, generic name cefpodoxime) appears on 269 distinct formulary files spanning 3,902 Medicare Part D plan offerings - 77% 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 2.9.
Real-world access to cefpodoxime 10 MG/ML Oral Suspension depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 330,545 Part D beneficiaries filled cefpodoxime 10 MG/ML Oral Suspension in 2023, with total plan-and-beneficiary spending of $24,258,363 and an average per-beneficiary annual cost of $73.39. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry cefpodoxime 10 MG/ML Oral Suspension today.
Coverage Details
- Formularies covering
- 269
- Plans covering
- 3,902
- Coverage rate
- 77%
- 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
2023 Medicare Spending
- Beneficiaries
- 330,545
- Total spending
- $24,258,363
- Avg per beneficiary
- $73.39
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering cefpodoxime 10 MG/ML Oral Suspension
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 |
| Florida Complete Care-Duals VIP (HMO-POS D-SNP) | HPMP OF FLORIDA, INC. | T1 | No | $0 | FL |
| 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 |
| Mercy Care Advantage (HMO D-SNP) | MERCY CARE | T1 | No | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | MERCY CARE | T1 | No | $0 | AZ |
| Mercy Care Advantage (HMO D-SNP) | MERCY CARE | T1 | No | $0 | AZ |
| Elderplan Plus Long-Term Care (HMO-POS D-SNP) | ELDERPLAN, INC. | T1 | No | $0 | NY |
| Health Choice Pathway (HMO D-SNP) | HEALTH CHOICE ARIZONA, INC. | T1 | No | $0 | AZ |
| Healthfirst CompleteCare (HMO D-SNP) | HEALTHFIRST HEALTH PLAN, INC. | T1 | No | $0 | NY |
| IMCare Classic (HMO D-SNP) | ITASCA MEDICAL CARE | T1 | No | $0 | MN |
| Johns Hopkins Advantage MD D-SNP (HMO D-SNP) | HOPKINS HEALTH ADVANTAGE, INC. | T1 | No | $0 | MD |
| MetroPlus UltraCare (HMO D-SNP) | METROPLUS HEALTH PLAN, INC. | T1 | No | $0 | NY |
| 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 |
| Senior Whole Health SCO (HMO D-SNP) | SENIOR WHOLE HEALTH, LLC | T1 | No | $0 | MA |
| Senior Whole Health SCO NHC (HMO D-SNP) | SENIOR WHOLE HEALTH, LLC | T1 | No | $0 | MA |
| Molina One Care (HMO D-SNP) | SENIOR WHOLE HEALTH, LLC | T1 | No | $0 | MA |
| HAP CareSource MI Coordinated Health (HMO D-SNP) | HAP CARESOURCE | T1 | No | $0 | MI |
| PruittHealth Premier D-SNP (HMO D-SNP) | PRUITTHEALTH PREMIER, INC. | T1 | No | $0 | GA |
| Simpra Advantage Dual Care (PPO D-SNP) | SIMPRA ADVANTAGE, INC. | T1 | No | $0 | AL |
| 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 |
| MCS Classicare RxMax (HMO) | MCS ADVANTAGE, INC. | T1 | No | $0 | PR |
| MCS Classicare Platino Ideal (HMO D-SNP) | MCS ADVANTAGE, INC. | T1 | No | $0 | PR |
| MCS Classicare Efectivo (HMO) | MCS ADVANTAGE, INC. | T1 | No | $0 | PR |
| MCS Classicare Essential (HMO-POS) | MCS ADVANTAGE, INC. | T1 | No | $0 | PR |
| MCS Classicare Platino Progreso (HMO D-SNP) | MCS ADVANTAGE, INC. | T1 | No | $0 | PR |
| MCS Classicare Primero (HMO C-SNP) | MCS ADVANTAGE, INC. | T1 | No | $0 | PR |
| MCS Classicare Firme (HMO) | MCS ADVANTAGE, INC. | T1 | No | $0 | PR |
| MCS Classicare En Tu Hogar (HMO) | MCS ADVANTAGE, INC. | T1 | No | $0 | PR |
| MCS Classicare Hero (HMO) | MCS ADVANTAGE, INC. | T1 | No | $0 | PR |
| MCS Classicare Platino Total (HMO D-SNP) | MCS ADVANTAGE, INC. | T1 | No | $0 | PR |
| MCS Classicare InteliCare (HMO) | MCS ADVANTAGE, INC. | T1 | No | $0 | PR |
| MCS Classicare Platino Maximo (HMO D-SNP) | MCS ADVANTAGE, INC. | T1 | No | $0 | PR |
| MCS Classicare Excede (HMO) | MCS ADVANTAGE, INC. | T1 | No | $0 | PR |
| MCS Classicare Estrella (HMO) | MCS ADVANTAGE, INC. | T1 | No | $0 | PR |
| MCS Classicare Platino Superior (HMO D-SNP) | MCS ADVANTAGE, INC. | T1 | No | $0 | PR |
| MCS Classicare Platino 185 (HMO D-SNP) | MCS ADVANTAGE, INC. | T1 | No | $0 | PR |
| 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 |
| Horizon NJ TotalCare (HMO D-SNP) | HORIZON HEALTHCARE OF NEW JERSEY, INC. | T1 | No | $0 | NJ |
| 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 |
Frequently Asked Questions
Is cefpodoxime 10 MG/ML Oral Suspension covered by Medicare Part D?
Yes, cefpodoxime 10 MG/ML Oral Suspension is covered by 3,902 Medicare Part D plans (77% of all Part D formularies).
What tier is cefpodoxime 10 MG/ML Oral Suspension on Medicare Part D plans?
cefpodoxime 10 MG/ML Oral Suspension averages Tier 2.9 across Part D plans, ranging from Tier 1 to Tier 4.
Does cefpodoxime 10 MG/ML Oral Suspension require prior authorization?
0% of Part D formularies require prior authorization for cefpodoxime 10 MG/ML Oral Suspension. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on cefpodoxime 10 MG/ML Oral Suspension?
In 2023, total Medicare Part D spending on cefpodoxime 10 MG/ML Oral Suspension was $24,258,363, covering 330,545 beneficiaries. The average spend per beneficiary was $73.39.
Read our methodology - how this data is sourced, computed, and verified.