Nudroxipak

Kit

Also known as: NUDROXIPAK KIT DSDR-50 NUDROXIPAK KIT DSDR-75 NUDROXIPAK KIT E-400 NUDROXIPAK KIT I-800 NUDROXIPAK KIT M-15 NUDROXIPAK KIT N-500

Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 23 hours, 45 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 80/20 Plus PPO 2026 Not Covered None
NC State Health Plan - 70/30 Standard PPO 2026 Not Covered None
NC State Health Plan - HDHP 2026 Not Covered None
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