Pivya

Generic: pivmecillinam HCl

185MG — Tablet

1500UNIT

Also known as: PIVYA TABS 185MG

Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: PDF  ·  Formulary date: Jul 1, 2026  ·  Checked: 11 hours, 9 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 80/20 Plus PPO 2026 Tier 3 - Non-Preferred Brand None
NC State Health Plan - 70/30 Standard PPO 2026 Tier 3 - Non-Preferred Brand None
NC State Health Plan - HDHP 2026 Tier 3 - Non-Preferred Brand None
Source: Excel (XLSX)  ·  Formulary date: Jun 24, 2026  ·  Checked: 11 hours, 9 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
TRICARE Uniform Formulary 2026
via pivmecillinam HCl
Tier 3 - Non-Formulary None
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