Ezallor Sprinkle Cpsp

5MG, 10MG, 20MG, 40MG

4gm/dose

Also known as: EZALLOR SPRINKLE CPSP 5MG, 10MG, 20MG, 40MG EZALLOR SPRINKLE CPSP 5MG, 10MG, 20MG,

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: 3 hours, 28 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 80/20 Plus PPO 2026 Not Covered None
NC State Health Plan - 70/30 Standard PPO 2026 Not Covered None
NC State Health Plan - HDHP 2026 Not Covered None
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