pyridostigmine bromide 12 MG/ML Oral Solution
pyridostigmine bromide
RxCUI: 903843
What the CMS Formulary Data Shows for pyridostigmine bromide 12 MG/ML Oral Solution
Per the CMS 2026 Part D formulary file, pyridostigmine bromide 12 MG/ML Oral Solution (RxNorm concept RXCUI 903843, generic name pyridostigmine bromide) appears on 42 distinct formulary files spanning 610 Medicare Part D plan offerings - 12% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 5, with a cross-plan average of Tier 3.
Real-world access to pyridostigmine bromide 12 MG/ML Oral Solution 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 56,300 Part D beneficiaries filled pyridostigmine bromide 12 MG/ML Oral Solution in 2023, with total plan-and-beneficiary spending of $25,515,944 and an average per-beneficiary annual cost of $453.21. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry pyridostigmine bromide 12 MG/ML Oral Solution today.
Coverage Details
- Formularies covering
- 42
- Plans covering
- 610
- Coverage rate
- 12%
- Tier range
- Tier 1 – Tier 5
- 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
- 56,300
- Total spending
- $25,515,944
- Avg per beneficiary
- $453.21
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering pyridostigmine bromide 12 MG/ML Oral Solution
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| CareAdvantage (HMO D-SNP) | SAN MATEO HEALTH COMMISSION | T1 | No | $0 | CA |
| Hamaspik Medicare Choice (HMO D-SNP) | HAMASPIK, INC. | T1 | No | $0 | NY |
| PHP (HMO C-SNP) | AIDS HEALTHCARE FOUNDATION | T1 | No | $0 | CA |
| VNS Health Total (HMO D-SNP) | VNS CHOICE | T1 | No | $0 | NY |
| Community Care's Partnership Program (HMO D-SNP) | COMMUNITY CARE HEALTH PLAN, INC. | T1 | No | $0 | WI |
| CalOptima Health OneCare Complete (HMO D-SNP) | ORANGE COUNTY HEALTH AUTHORITY | T1 | No | $0 | CA |
| 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 |
| 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 |
| Leon MediMax (HMO D-SNP) | LEON HEALTH, INC. | T1 | No | $0 | FL |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | GOLD KIDNEY OF FLORIDA INC | T1 | No | $4.80 | FL |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | No | $13.10 | PA |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | GOLD KIDNEY OF ARIZONA | T1 | No | $17.00 | AZ |
| Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) | GATEWAY HEALTH PLAN, INC. | T1 | No | $17.60 | PA |
| Highmark Health Options Duals Select (HMO D-SNP) | HIGHMARK BCBSD, INC. | T1 | No | $31.20 | DE |
| Hamaspik Medicare Select (HMO D-SNP) | HAMASPIK, INC. | T1 | No | $34.50 | NY |
| VNS Health EasyCare Plus (HMO D-SNP) | VNS CHOICE | T1 | No | $51.60 | NY |
| Healthy Mississippi Premier Advantage (HMO-POS) | Healthy Mississippi, Inc. | T2 | No | $0 | MS |
| Gold Heart & Diabetes (HMO-POS C-SNP) | GOLD KIDNEY OF FLORIDA INC | T2 | No | $0 | FL |
| Gold Heart & Diabetes Complete (HMO-POS C-SNP) | GOLD KIDNEY OF FLORIDA INC | T2 | No | $0 | FL |
| Gold Dialysis & Kidney (HMO-POS C-SNP) | GOLD KIDNEY OF FLORIDA INC | T2 | No | $0 | FL |
| Gold Health (HMO-POS C-SNP) | GOLD KIDNEY OF FLORIDA INC | T2 | No | $0 | FL |
| Gold Dialysis & Kidney (HMO-POS C-SNP) | GOLD KIDNEY OF FLORIDA INC | T2 | No | $0 | FL |
| Gold Heart & Diabetes (HMO-POS C-SNP) | GOLD KIDNEY OF ARIZONA | T2 | No | $0 | AZ |
| Gold Dialysis & Kidney (HMO-POS C-SNP) | GOLD KIDNEY OF ARIZONA | T2 | No | $0 | AZ |
| Gold Heart & Diabetes (HMO-POS C-SNP) | GOLD KIDNEY OF ARIZONA | T2 | No | $0 | AZ |
| Gold Dialysis & Kidney (HMO-POS C-SNP) | GOLD KIDNEY OF ARIZONA | T2 | No | $0 | AZ |
| MMM Supremo (HMO C-SNP) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| MMM Diamante Platino (HMO D-SNP) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| MMM Unico (HMO-POS) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| MMM Elite (HMO-POS) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| MMM Deluxe (HMO-POS) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| MMM Dorado Platino (HMO D-SNP) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| PMC Premier Platino (HMO D-SNP) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| PMC Max (HMO-POS) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| MMM Plenitud (HMO-POS) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| MMM Valioso (HMO-POS) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| MMM Combo Platino (HMO D-SNP) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| MMM Flexi Platino (HMO D-SNP) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| MMM Grandioso (HMO-POS) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| MMM Mega Flex (HMO-POS) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| MMM Relax Platino (HMO D-SNP) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| MMM Balance (HMO-POS) | MMM HEALTHCARE, LLC | T2 | No | $0 | PR |
| PacificSource Medicare Essentials Rx 27 (HMO) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T2 | No | $0 | OR |
| PacificSource Medicare MyCare Choice Rx 29 (HMO-POS) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T2 | No | $0 | MT |
| PacificSource Medicare Essentials Choice Rx 36 (HMO-POS) | PACIFICSOURCE COMMUNITY HEALTH PLANS | T2 | No | $0 | OR |
Frequently Asked Questions
Is pyridostigmine bromide 12 MG/ML Oral Solution covered by Medicare Part D?
Yes, pyridostigmine bromide 12 MG/ML Oral Solution is covered by 610 Medicare Part D plans (12% of all Part D formularies).
What tier is pyridostigmine bromide 12 MG/ML Oral Solution on Medicare Part D plans?
pyridostigmine bromide 12 MG/ML Oral Solution averages Tier 3 across Part D plans, ranging from Tier 1 to Tier 5.
Does pyridostigmine bromide 12 MG/ML Oral Solution require prior authorization?
0% of Part D formularies require prior authorization for pyridostigmine bromide 12 MG/ML Oral Solution. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on pyridostigmine bromide 12 MG/ML Oral Solution?
In 2023, total Medicare Part D spending on pyridostigmine bromide 12 MG/ML Oral Solution was $25,515,944, covering 56,300 beneficiaries. The average spend per beneficiary was $453.21.
Read our methodology - how this data is sourced, computed, and verified.