erythromycin ethylsuccinate
Generic: E.E.S.
200 mg/5 mL — Suspension
Also known as:
E.E.S. 200
ERYPED 200
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Coverage by Insurer
Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Ambetter (Centene)
58 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Complete Gold with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Standard Expanded Bronze with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Standard Expanded Bronze with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Standard Gold + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Standard Silver + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Elite Bronze with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Everyday Bronze with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Elite Bronze + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Everyday Bronze + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Complete Gold + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Standard Silver with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Standard Expanded Bronze + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Complete Gold with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Standard Gold with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Focused Silver with Atrium Health + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental | Tier 2 - Generic | — | — | — | None |
| Standard Gold with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Standard Silver with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Complete Gold | Tier 2 - Generic | — | — | — | None |
| Enhanced Asthma/COPD Care Silver with $0 Drug Options | Tier 2 - Generic | — | — | — | None |
| Everyday Bronze | Tier 2 - Generic | — | — | — | None |
| Elite Bronze | Tier 2 - Generic | — | — | — | None |
| Clear Silver with $0 Insulin Options | Tier 2 - Generic | — | — | — | None |
| Standard Expanded Bronze | Tier 2 - Generic | — | — | — | None |
| Standard Silver | Tier 2 - Generic | — | — | — | None |
| Standard Gold | Tier 2 - Generic | — | — | — | None |
| Everyday Bronze with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Elite Bronze with Atrium Health | Tier 2 - Generic | — | — | — | None |
| Focused Silver with Atrium Health | Tier 2 - Generic | — | — | — | None |
|
Elite Bronze with Atrium Health + Vision + Adult Dental
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
Elite Bronze with Atrium Health
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
Standard Expanded Bronze with Atrium Health
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
Standard Silver with Atrium Health
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
Standard Gold with Atrium Health
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
Complete Gold + Vision + Adult Dental
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
Everyday Bronze + Vision + Adult Dental
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
Elite Bronze + Vision + Adult Dental
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
Everyday Bronze with Atrium Health + Vision + Adult Dental
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
Focused Silver with Atrium Health + Vision + Adult Dental
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
Complete Gold with Atrium Health + Vision + Adult Dental
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
Standard Expanded Bronze + Vision + Adult Dental
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
Standard Silver + Vision + Adult Dental
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
Standard Gold + Vision + Adult Dental
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
Standard Silver with Atrium Health + Vision + Adult Dental
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
Standard Gold with Atrium Health + Vision + Adult Dental
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
Complete Gold
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
Enhanced Asthma/COPD Care Silver with $0 Drug Options
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
Everyday Bronze
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
Elite Bronze
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
Clear Silver with $0 Insulin Options
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
Standard Expanded Bronze
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
Standard Silver
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
Standard Gold
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
Everyday Bronze with Atrium Health
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
Focused Silver with Atrium Health
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
Complete Gold with Atrium Health
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
Blue Cross Blue Shield of NC
5 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
BCBSNC Blue Local 2026
via E.E.S. |
Tier 2 - Medium Cost Generic/Brand | — | — | — | None |
|
BCBSNC Blue Home with UNC Health Alliance 2026
via E.E.S. |
Tier 2 - Medium Cost Generic/Brand | — | — | — | None |
|
BCBSNC Blue Advantage 2026
via E.E.S. |
Tier 2 - Medium Cost Generic/Brand | — | — | — | None |
|
BCBSNC Blue Value 2026
via E.E.S. |
Tier 2 - Medium Cost Generic/Brand | — | — | — | None |
|
BCBSNC Blue Care 2026
via E.E.S. |
Tier 2 - Medium Cost Generic/Brand | — | — | — | None |
Medicare Part D
99 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Longevity Health Plan (HMO I-SNP) | Tier 1 - Preferred Generic | — | — | — | None |
| AmeriHealth Caritas VIP Care (HMO D-SNP) | Tier 2 - Generic | — | — | — | None |
| Troy Medicare (HMO) | Tier 2 - Generic | — | — | — | None |
| Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | Tier 2 - Generic | — | — | — | None |
| HealthSpring TotalCare Plus (HMO D-SNP) | Tier 3 - Preferred Brand | — | — | — | None |
| HealthSpring TotalCare (HMO D-SNP) | Tier 3 - Preferred Brand | — | — | — | None |
| HealthSpring True Choice (PPO) | Tier 3 - Preferred Brand | — | — | — | None |
| HealthSpring Preferred Savings (HMO) | Tier 3 - Preferred Brand | — | — | — | None |
| HealthSpring Preferred Plus (HMO) | Tier 3 - Preferred Brand | — | — | — | None |
| HealthSpring Preferred Select (HMO) | Tier 3 - Preferred Brand | — | — | — | None |
| HealthSpring Preferred (HMO) | Tier 3 - Preferred Brand | — | — | — | None |
| DEVOTED CHOICE GIVEBACK 002 NC (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| DEVOTED CHOICE 003 NC (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| DEVOTED CHOICE GIVEBACK 004 NC (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| DEVOTED CHOICE 005 NC (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| DEVOTED CHOICE GIVEBACK 006 NC (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| DEVOTED CHOICE 008 NC (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| DEVOTED CHOICE GIVEBACK 009 NC (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
|
DEVOTED CHOICE 001 NC (PPO)
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
DEVOTED CHOICE GIVEBACK 002 NC (PPO)
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
DEVOTED CHOICE 003 NC (PPO)
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
DEVOTED CHOICE GIVEBACK 004 NC (PPO)
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
DEVOTED CHOICE 005 NC (PPO)
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
DEVOTED CHOICE 008 NC (PPO)
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
DEVOTED CHOICE GIVEBACK 009 NC (PPO)
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
DEVOTED CHOICE GIVEBACK 006 NC (PPO)
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
| UHC Nursing Home Plan NC-F001 (PPO I-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
| UHC Dual Complete NC-S001 (PPO D-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
| UHC Dual Complete NC-S2 (PPO D-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
| AARP Medicare Advantage Access from UHC NC-23 (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0001 (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0004 (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0016 (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0017 (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0019 (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0021 (HMO-POS) | Tier 4 - Non-Preferred | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0022 (HMO-POS) | Tier 4 - Non-Preferred | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0007 (HMO-POS) | Tier 4 - Non-Preferred | — | — | — | None |
| UHC Dual Complete NC-D001 (HMO-POS D-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0008 (HMO-POS) | Tier 4 - Non-Preferred | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0009 (HMO-POS) | Tier 4 - Non-Preferred | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0011 (HMO-POS) | Tier 4 - Non-Preferred | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0012 (HMO-POS) | Tier 4 - Non-Preferred | — | — | — | None |
| AARP Medicare Advantage Giveback from UHC NC-13 (HMO-POS) | Tier 4 - Non-Preferred | — | — | — | None |
| AARP Medicare Advantage Giveback from UHC NC-14 (HMO-POS) | Tier 4 - Non-Preferred | — | — | — | None |
| UHC Dual Complete NC-V001 (HMO-POS D-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
| AARP Medicare Advantage from UHC NC-0015 (HMO-POS) | Tier 4 - Non-Preferred | — | — | — | None |
| UHC Dual Complete NC-S3 (HMO-POS D-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
| AARP Medicare Advantage from UHC NC-24 (HMO-POS) | Tier 4 - Non-Preferred | — | — | — | None |
| AARP Medicare Advantage from UHC NC-26 (HMO-POS) | Tier 4 - Non-Preferred | — | — | — | None |
| Erickson Advantage Signature (HMO-POS) | Tier 4 - Non-Preferred | — | — | — | None |
| Erickson Advantage Guardian (HMO-POS I-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
| Erickson Advantage Freedom (HMO-POS) | Tier 4 - Non-Preferred | — | — | — | None |
| Erickson Advantage Liberty (HMO-POS) | Tier 4 - Non-Preferred | — | — | — | None |
| UHC Complete Care NC-25 (HMO-POS C-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
| UHC Complete Care NC-27 (HMO-POS C-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
| UHC Complete Care NC-28 (HMO-POS C-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
| Erickson Advantage Champion (HMO-POS C-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
| Aetna Medicare Signature (HMO) | Tier 4 - Non-Preferred | — | — | — | None |
| Aetna Medicare Dual (HMO D-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
| Aetna Medicare Signature (HMO) | Tier 4 - Non-Preferred | — | — | — | None |
| Aetna Medicare Value Plus (HMO) | Tier 4 - Non-Preferred | — | — | — | None |
| Aetna Medicare Prime (HMO) | Tier 4 - Non-Preferred | — | — | — | None |
| Aetna Medicare Signature Care (HMO) | Tier 4 - Non-Preferred | — | — | — | None |
| Aetna Medicare Full Dual Care (HMO D-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
| Aetna Medicare Enhanced (HMO) | Tier 4 - Non-Preferred | — | — | — | None |
| Aetna Medicare Signature (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| Aetna Medicare Enhanced (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| Aetna Medicare Enhanced (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| Aetna Medicare Signature Extra (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| Aetna Medicare Signature (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| Aetna Medicare Signature (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| Aetna Medicare Signature Giveback (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| Aetna Medicare Signature (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
| Aetna Medicare Chronic Care (HMO C-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
| Aetna Medicare Chronic Care Value (HMO C-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
| DEVOTED DUAL FULL 013 NC (HMO D-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
| DEVOTED C-SNP PREMIUM 014 NC (HMO C-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
| DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
| DEVOTED C-SNP PREMIUM 016 NC (HMO C-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
| DEVOTED C-SNP PREMIUM 017 NC (HMO C-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
| DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
|
DEVOTED DUAL FULL 013 NC (HMO D-SNP)
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
DEVOTED C-SNP PREMIUM 014 NC (HMO C-SNP)
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
DEVOTED C-SNP PLUS 015 NC (HMO C-SNP)
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
DEVOTED C-SNP PREMIUM 016 NC (HMO C-SNP)
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
DEVOTED C-SNP PREMIUM 017 NC (HMO C-SNP)
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP)
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
| DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
| DEVOTED DUAL 009 NC (HMO D-SNP) | Tier 4 - Non-Preferred | — | — | — | None |
|
DEVOTED DUAL PLUS 006 NC (HMO D-SNP)
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
DEVOTED DUAL 009 NC (HMO D-SNP)
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
| DEVOTED CORE 001 NC (HMO) | Tier 4 - Non-Preferred | — | — | — | None |
| DEVOTED GIVEBACK 002 NC (HMO) | Tier 4 - Non-Preferred | — | — | — | None |
| DEVOTED GIVEBACK 012 NC (HMO) | Tier 4 - Non-Preferred | — | — | — | None |
|
DEVOTED CORE 001 NC (HMO)
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
DEVOTED GIVEBACK 002 NC (HMO)
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
|
DEVOTED GIVEBACK 012 NC (HMO)
via E.E.S. |
Tier 4 - Non-Preferred | — | — | — | None |
| DEVOTED CHOICE 001 NC (PPO) | Tier 4 - Non-Preferred | — | — | — | None |
NC State Health Plan
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
NC State Health Plan - HDHP 2026
via E.E.S. |
Not Covered | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via E.E.S. |
Not Covered | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via E.E.S. |
Not Covered | — | — | — | None |