10 Mg/Ml Base Equiv

Generic: caffeine citrate

ADHD/ANTI-NARCOLEPSY/ANTI-OBESITY/ ANOREXIANTS

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: Apr 1, 2026  ·  Checked: 5 hours, 54 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBSNC Blue Advantage 2026 Tier 2 - Medium Cost Generic/Brand None
BCBSNC Blue Home with UNC Health Alliance 2026 Tier 2 - Medium Cost Generic/Brand None
BCBSNC Blue Local 2026 Tier 2 - Medium Cost Generic/Brand None
BCBSNC Blue Care 2026 Tier 2 - Medium Cost Generic/Brand None
BCBSNC Blue Value 2026 Tier 2 - Medium Cost Generic/Brand None
Source: PDF  ·  Formulary date: Jan 1, 2026  ·  Checked: 5 hours, 54 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Cigna Plus NC 4-Tier Formulary 2026
via caffeine citrate
Tier 1 - Generic None
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 5 hours, 54 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - HDHP 2026
via caffeine citrate
Tier 1 - Preferred Generic None
NC State Health Plan - 80/20 Plus PPO 2026
via caffeine citrate
Tier 1 - Preferred Generic None
NC State Health Plan - 70/30 Standard PPO 2026
via caffeine citrate
Tier 1 - Preferred Generic None
Source: PDF  ·  Formulary date: Jan 1, 2026  ·  Checked: 5 hours, 54 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
UnitedHealthcare NC Individual & Family 2026
via caffeine citrate
Tier 2 - Lower Cost None
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