Exelon Pt24

4.6MG

(36-4.5 gm)

Also known as: EXELON PT24 4.6MG/24HR, 9.5MG/24HR, 13.3MG/24HR EXELON PT24 4.6MG/24HR, 9.5MG/24HR,

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: 6 hours, 5 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 80/20 Plus PPO 2026 Tier 3 - Non-Preferred Brand None
NC State Health Plan - 70/30 Standard PPO 2026 Tier 3 - Non-Preferred Brand None
NC State Health Plan - HDHP 2026 Tier 3 - Non-Preferred Brand None
Something not right?