Medicare Part D coverage · vancomycin · RxCUI 2000127
vancomycin 25 MG/ML Oral Solution
Per the CMS 2026 Part D formulary file, vancomycin 25 MG/ML Oral Solution is covered by 542 Medicare Part D plans (10.7% of enrollable products), averaging Tier 2.8, with prior authorization required on 0% of covering formularies.
- 10.7%
- Plan coverage
- 542
- Plans covering
- T2.8
- Avg tier
- 0%
- Prior auth required
What the CMS Formulary Data Shows for vancomycin 25 MG/ML Oral Solution
Per the CMS 2026 Part D formulary file, vancomycin 25 MG/ML Oral Solution (RxNorm concept RXCUI 2000127, generic name vancomycin) appears on 50 distinct formulary files spanning 542 Medicare Part D plan offerings - 10.7% 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 2.8.
Real-world access to vancomycin 25 MG/ML Oral Solution depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 18% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 161,077 Part D beneficiaries filled vancomycin 25 MG/ML Oral Solution in 2023, with total plan-and-beneficiary spending of $66,162,664 and an average per-beneficiary annual cost of $410.75. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry vancomycin 25 MG/ML Oral Solution today.
Coverage Details
- Formularies covering
- 50
- Plans covering
- 542
- Coverage rate
- 10.7%
- 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
- 18% of formularies
2023 Medicare Spending
- Beneficiaries
- 161,077
- Total spending
- $66,162,664
- Avg per beneficiary
- $410.75
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering vancomycin 25 MG/ML Oral Solution
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| Fallon Medicare Plus Orange (HMO) | Fallon Community Health Plan | T1 | No | $0 | MA |
| NaviCare (HMO D-SNP) | Fallon Community Health Plan | T1 | No | $0 | MA |
| PHP (HMO C-snp) | Aids Healthcare Foundation | T1 | No | $0 | CA |
| VNS Health Total (HMO D-SNP) | VNS Choice | T1 | No | $0 | NY |
| Abilis Health Community (HMO I-SNP) | Signature Advantage, LLC | T1 | No | $0 | KY, TN |
| Arkansas Integrated Providers (AIP) Dual Advantage (HMO D-SNP) | Arkansas Superior Select, Inc. | T1 | No | $0 | AR |
| Community Care's Partnership Program (HMO D-SNP) | Community Care Health Plan, Inc. | T1 | No | $0 | WI |
| 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 |
| American Health Advantage of Florida (HMO I-SNP) | American Health Plan OF FL, Inc. | T1 | No | $4.80 | FL |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Florida Inc | T1 | No | $4.80 | FL |
| Texas Independence Health Plan, Inc. (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | No | $4.80 | TX |
| Texas Independence Community Plan (HMO I-SNP) | Texas Independence Health Plan, Inc. | T1 | No | $4.80 | TX |
| Tribute Select (HMO-POS I-SNP) | Arkansas Superior Select, Inc. | T1 | No | $8.90 | AR |
| Gold Dialysis & Kidney Complete (HMO-POS C-SNP) | Gold Kidney OF Arizona | T1 | No | $17.00 | AZ |
| American Health Advantage of Mississippi (HMO I-SNP) | American Health Plan OF MS, Inc. | T1 | No | $23.80 | MS |
| Georgia Health Advantage (HMO I-SNP) | Georgia Assurance, Inc. | T1 | No | $25.40 | GA |
| Georgia Health Advantage Choice (HMO I-SNP) | Georgia Assurance, Inc. | T1 | No | $25.40 | GA |
| American Health Advantage of Tennessee (HMO I-SNP) | American Health Plan, Inc. | T1 | No | $27.70 | TN |
| American Health Advantage of Oklahoma (HMO I-SNP) | Oklahoma Superior Select, Inc. | T1 | No | $28.20 | OK |
Show the next 30 plans
| Valor Health Plan (HMO I-SNP) | TSG Guard, Inc. | T1 | No | $31.40 | OH |
| American Health Advantage of Pennsylvania (HMO I-SNP) | American Health Plan OF Pennsylvania Inc | T1 | No | $32.70 | PA |
| WV Senior Advantage (HMO I-SNP) | West Virginia Senior Advantage, Inc. | T1 | No | $32.70 | WV |
| American Health Advantage of Louisiana (HMO I-SNP) | Dignity Care Corporation | T1 | No | $32.90 | LA |
| Abilis Health (HMO I-SNP) | Signature Advantage, LLC | T1 | No | $35.90 | KY, TN |
| American Health Advantage of Utah (HMO I-SNP) | American Health Plan OF UT, Inc. | T1 | No | $37.60 | UT |
| American Health Advantage of Idaho (HMO I-SNP) | American Health Plan OF UT, Inc. | T1 | No | $37.60 | ID |
| American Health Advantage of Indiana (HMO I-SNP) | American Health Plan OF Indiana Inc | T1 | No | $38.40 | IN |
| CommuniCare Advantage ISNP (HMO I-SNP) | OH CHS SNP Inc. | T1 | No | $38.40 | IN, MD, OH |
| Iowa Health Advantage (HMO I-SNP) | American Health Plan OF Iowa Inc | T1 | No | $41.50 | IA |
| Iowa Health Advantage Choice (HMO I-SNP) | American Health Plan OF Iowa Inc | T1 | No | $41.50 | IA |
| American Health Advantage of Missouri (HMO I-SNP) | American Health Plan OF Missouri, Inc. | T1 | No | $43.00 | MO |
| American Health Advantage of Missouri Choice (HMO I-SNP) | American Health Plan OF Missouri, Inc. | T1 | No | $43.00 | MO |
| VNS Health EasyCare Plus (HMO D-SNP) | VNS Choice | T1 | No | $51.60 | NY |
| Kansas Health Advantage (HMO I-SNP) | Kansas Superior Select, Inc. | T1 | No | $55.20 | KS |
| Kansas Health Advantage Choice (HMO I-SNP) | Kansas Superior Select, Inc. | T1 | No | $55.20 | KS |
| Fallon Medicare Plus Green (HMO) | Fallon Community Health Plan | T1 | No | $56.40 | MA |
| Fallon Medicare Plus Blue (HMO) | Fallon Community Health Plan | T1 | No | $72.10 | MA |
| HealthSun HealthAdvantage Plan (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun MediMax (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun HealthAdvantage Plan (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun HealthAdvantage Plan (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun MediSun Plus (HMO D-SNP) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun MediSun Extra (HMO D-SNP) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun VitalCare (HMO C-SNP) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun VitalCare (HMO C-SNP) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
| HealthSun MediSun Full Dual Plus (HMO D-SNP) | Healthsun Health Plans, Inc. | T2 | No | $0 | FL |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is vancomycin 25 MG/ML Oral Solution covered by Medicare Part D?
Yes, vancomycin 25 MG/ML Oral Solution is covered by 542 Medicare Part D plans (10.7% of all Part D formularies).
What tier is vancomycin 25 MG/ML Oral Solution on Medicare Part D plans?
vancomycin 25 MG/ML Oral Solution averages Tier 2.8 across Part D plans, ranging from Tier 1 to Tier 4.
Does vancomycin 25 MG/ML Oral Solution require prior authorization?
0% of Part D formularies require prior authorization for vancomycin 25 MG/ML Oral Solution. Step therapy: 0%. Quantity limits: 18%.
How much does Medicare spend on vancomycin 25 MG/ML Oral Solution?
In 2023, total Medicare Part D spending on vancomycin 25 MG/ML Oral Solution was $66,162,664, covering 161,077 beneficiaries. The average spend per beneficiary was $410.75.
Read our methodology - how this data is sourced, computed, and verified.
Nationwide similar Part D drugs
Data-derived peers across the CMS Part D formulary extract: nearest average tier placement and nearest prior-authorization rate. Not therapeutic alternatives or same-generic strengths.
Closest average formulary tier
Similar prior-authorization rate
- metronidazole 10 MG/ML Topical Cream [Noritate] 0% PA
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- diflunisal 375 MG Oral Tablet [Dolobid] 0% PA
- hydrocortisone 1 MG/ML Oral Solution [Khindivi] 0% PA
- indomethacin 50 MG Rectal Suppository [Indocin] 0% PA