milsaperidone

1 MG, 1-2-4-6 MG, 1-2-6 MG, 1-2-6-8 MG, 10 MG, 12 MG, 2 MG, 4 MG, 6 MG, 8 MG — Tablet

Also known as: BYSANTI

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

1 plan

Source: Excel (XLSX) · Formulary date: Oct 29, 2026 · Checked: 15 hours, 31 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
TRICARE Uniform Formulary 2026 via Bysanti	Tier 3 - Non-Formulary	✓	—	—	PA PA: TPA - SELECT DRUGS REQUIRES PRIOR AUTHORIZATION (NEW TO MARKET DRUGS)