Ojemda Susr

25MG — Tablet

Also known as: OJEMDA SUSR 25MG/ML; TABS 100MG

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

2 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 13 hours, 20 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBS Federal Standard Option 2026	Tier 5 - Non-Preferred Specialty	✓	—	—	PA
BCBS Federal Basic Option 2026	Tier 5 - Non-Preferred Specialty	✓	—	—	PA