pyridostigmine bromide 12 MG/ML Oral Solution

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pyridostigmine bromide

RxCUI: 903843

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.
12%
Plan Coverage
610
Plans Covering
T3
Avg Tier
0%
Prior Auth Required

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

21 plans
Tier 1, Preferred Generic
41 plans
Tier 2, Generic
38 plans
Tier 3, Preferred Brand

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.

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