berdazimer sodium

10.3 % — Gel

Also known as: ZELSUVMI

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.

5 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 22 hours, 17 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBSNC Blue Advantage 2026 via Zelsuvmi	Tier 4 - Higher Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026 via Zelsuvmi	Tier 4 - Higher Cost Brand	—	—	—	None
BCBSNC Blue Local 2026 via Zelsuvmi	Tier 4 - Higher Cost Brand	—	—	—	None
BCBSNC Blue Care 2026 via Zelsuvmi	Tier 4 - Higher Cost Brand	—	—	—	None
BCBSNC Blue Value 2026 via Zelsuvmi	Tier 4 - Higher Cost Brand	—	—	—	None

1 plan

Source: Excel (XLSX) · Formulary date: Jan 5, 2026 · Checked: 22 hours, 17 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
TRICARE Uniform Formulary 2026	Tier 3 - Non-Formulary	✓	—	—	PA