Hydrocodone

100 Mg — Tablet

Also known as: Zohydro ER Hysingla ER Hydrocodone Er 20 Mg Tablet Hydrocodone Er 30 Mg Tablet Hydrocodone Er 40 Mg Tablet Hydrocodone Er 60 Mg Tablet Hydrocodone Er 80 Mg Tablet Hydrocodone Er 100 Mg Tablet Hydrocodone Er 120 Mg Tablet

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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.

Blue Cross Blue Shield Federal

1 plan

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 2 hours, 52 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBS Federal Standard Option 2026 via Hysingla	Tier 3 - Non-Preferred Brand	✓	—	—	PA

Cigna

1 plan

Source: PDF · Formulary date: Jan 1, 2026 · Checked: 2 hours, 51 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
Cigna Plus NC 4-Tier Formulary 2026	Tier 1 - Generic	✓	—	—	PA

NC Medicaid PDL

2 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 2 hours, 51 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC Medicaid Preferred Drug List 2026 via Hysingla	Non-Preferred	✓	—	—	PA
NC Medicaid Preferred Drug List 2026	Non-Preferred	✓	—	—	PA

NC State Health Plan

3 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 2 hours, 51 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC State Health Plan - 80/20 Plus PPO 2026 via Hysingla	Not Covered	—	—	—	None
NC State Health Plan - 70/30 Standard PPO 2026 via Hysingla	Not Covered	—	—	—	None
NC State Health Plan - HDHP 2026 via Hysingla	Not Covered	—	—	—	None