esomeprazole magnesium packet

Generic: esomeprazole magnesium pack

2.5mg, 5mg, 10mg, 20mg, 40mg

Also known as: Nexium Rx Packet esomeprazole magnesium pack 2.5mg, 5mg, 10mg, 20mg, 40mg esomeprazole magnesium pack 2.5mg, 5mg,

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

2 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 3 hours, 32 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC Medicaid Preferred Drug List 2026 via Nexium Rx Packet	Preferred	—	✓	—	ST
NC Medicaid Preferred Drug List 2026	Non-Preferred	—	✓	—	ST

3 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 3 hours, 32 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC State Health Plan - 80/20 Plus PPO 2026	Tier 2 - Non-Preferred Generic	—	—	—	None
NC State Health Plan - 70/30 Standard PPO 2026	Tier 2 - Non-Preferred Generic	—	—	—	None
NC State Health Plan - HDHP 2026	Tier 2 - Non-Preferred Generic	—	—	—	None