Mirodry
Miscellaneous
Also known as:
MIRODRY MIS 2X2CM
MIRODRY MIS 3X3CM
MIRODRY MIS 4X4CM
MIRODRY MIS 5X5CM
MIRODRY MIS 7X5CM
MIRODRY MIS 10X5CM
MIRODRY MIS 5X2CM
MIRODRY MIS 6X5CM
MIRODRY MIS 8X5CM
MIRODRY MIS 10X2CM
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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 |