bupivacaine

9 MG, 12.5 MG, 15 MG, 25 MG, 50 MG, 67.39 MG, 75 MG, 133 MG, 150 MG, 205.1 MG, 225 MG, 266 MG, 307.65 MG, 410.2 MG, 660 MG — Injection

Amide Local Anesthetic

Also known as: bupivacaine inj 0.5% w/ epinephrine 1:200000 bupivacaine inj 0.5% w/ epinephrine 1:200000 (pf) bupivacaine inj 0.25% w/ epinephrine 1:200000 bupivacaine inj 0.25% w/ epinephrine 1:200000 (pf) bupivacaine inj spinal Bupivacaine Inj Spinal

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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.

NC State Health Plan

3 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 16 hours, 10 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC State Health Plan - 80/20 Plus PPO 2026	Tier 1 - Preferred Generic	—	—	—	None
NC State Health Plan - 70/30 Standard PPO 2026	Tier 1 - Preferred Generic	—	—	—	None
NC State Health Plan - HDHP 2026	Tier 1 - Preferred Generic	—	—	—	None