mometasone furoate/formoterol fumarate

100 mcg-5 mcg/actuation, 200 mcg-5 mcg/actuation, 50 mcg-5 mcg/actuation — Inhaler

Also known as: DULERA

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: Jan 5, 2026 · Checked: 13 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
TRICARE Uniform Formulary 2026	Tier 3 - Non-Formulary	✓	—	✓	PA \| QL