Lescol XL

80MG — Tablet

Also known as: LESCOL XL TB24 80MG

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

1 plan

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 7 hours, 43 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBS Federal Standard Option 2026	Tier 3 - Non-Preferred Brand	—	—	—	None

1 plan

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 7 hours, 43 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC Medicaid Preferred Drug List 2026	Non-Preferred	—	—	—	None