Miro3D Wound
Pad
Also known as:
MIRO3D WOUND PAD 2X2X2CM
MIRO3D WOUND PAD 3X3X2CM
MIRO3D WOUND PAD 4X4X2CM
MIRO3D WOUND PAD 5X5X2CM
MIRO3D WOUND PAD 7X5X2CM
MIRO3D WOUND PAD 10X5X2CM
MIRO3D WOUND PAD 5X2X2CM
MIRO3D WOUND PAD 6X5X2CM
MIRO3D WOUND PAD 8X5X2CM
MIRO3D WOUND PAD 10X2X2CM
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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.
NC State Health Plan
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| NC State Health Plan - 80/20 Plus PPO 2026 | Tier 3 - Non-Preferred Brand | ✓ | — | — | PA |
| NC State Health Plan - 70/30 Standard PPO 2026 | Tier 3 - Non-Preferred Brand | ✓ | — | — | PA |
| NC State Health Plan - HDHP 2026 | Tier 3 - Non-Preferred Brand | ✓ | — | — | PA |