cholecalciferol (vit D3)/levomefolate cal/zinc gly/theanine

50 mcg-15 mg-25 mg-250 mg — Capsule

Also known as: DEPLINPRO MOOD HEALTH

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

1 plan

Source: Excel (XLSX) · Formulary date: Jan 5, 2026 · Checked: 14 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
TRICARE Uniform Formulary 2026	Tier 3 - Non-Formulary	—	—	—	None