Pharmacy Medicare Discount Program

Eligible retail pharmacies can receive a discount for YUPELRI

What are the requirements of the retail pharmacy?

This is a program that permits an eligible, retail pharmacy to receive a discount for eligible YUPELRI (revefenacin) inhalation solution product purchased and dispensed to Medicare Part B beneficiaries for their own use, as prescribed for the beneficiary.

To participate in the program, the retail pharmacy must:

  • Be a Medical Part B provider
  • Accept assignment on YUPELRI prescriptions dispensed to Medicare Part B beneficiaries
  • Accept the Terms and Conditions of the Viatris Specialty LLC YUPELRI Pharmacy Medicare Discount Program Agreement
  • Submit Medicare Part B claims to Medicare through a Viatris-contracted Medicare Part B claim submission service (Change Healthcare or OmniSYS)†
  • Not be currently receiving any rebates or discounts on YUPELRI

*If the Medicare Part B claim submission service that you currently use is not contracted with Viatris Specialty LLC (Change Healthcare or OmniSYS), you will be required to provide electronic reports directly to Viatris Specialty LLC. Pharmacies must keep all utilization records (including prescription numbers, dates of service, volumes dispensed for each NDC) in compliance with the Terms and Conditions. Additional details are provided in the Viatris Specialty LLC YUPELRI Pharmacy Medicare Discount Program Agreement.

Enroll in Pharmacy Medicare Discount Program

Viatris Specialty LLC, YUPELRI Pharmacy Medicare Discount Program Agreement

Retail Pharmacy Information1Retail Pharmacy Information2

Retail Pharmacy Address Information2Retail Pharmacy Address Information3

Medicare Claims Processor (MCP)
Information & Pharmacy Store Types3Medicare Claims Processor (MCP)
Information & Pharmacy Store Types

* =Required fields

Please fill in all the required fields appropriately to proceed.
Please provide Retail Pharmacy Name.
Please provide Retail Pharmacy DBA Name.
Please provide your Contact Name. Contact Name should contain only letters.
Please provide your Contact’s Title.
Please provide the NABP Number. Must be 7 digits
Please provide DEA Number of HIN Number. Must start with 2 letters followed by 7 numbers
Please provide the Medicare Provider ID. Must be 10 digits
Please provide the NPI Number. Must be 10 digits
Please provide the Primary Authorized Wholesaler.

By selecting "Continue," I confirm I have read and understand Viatris’ Privacy Notice and Terms of Use.

* =Required fields

Please fill in all the required fields appropriately to proceed.
Street Address 1 is required.
City is required.
State is required.
* ZIP Code ZIP Code is required. Zipcode is invalid
* Phone Number Phone Number is required. Phone number is invalid.
Fax Fax is required. Fax should contain only numbers.
* Email Email is required. Email contains an invalid email address.

* =Required fields

* Number of Stores Number of Stores is required. Number of Stores should contain only numbers.
Which CMS-approved accreditation organization have you been accredited by? is required.

By clicking on the Submit button below, you are certifying that you are a retail pharmacy and agree that the information you submit will be governed by our Privacy Notice.



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Thank you for requesting enrollment in the YUPELRI® Pharmacy Medicare Part B Discount Program. A member of our internal team will review your submission and contact you via email with a Viatris Pharmacy Medicare Discount Program Agreement. If you have any questions, please feel free to reach out to our team via partbrebate@viatris.com or call us at 1-800-395-3376.

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