pediatric multivitamin no.192

250-50/ML — Prefilled Syringe

VITAMINS

Also known as: INFANT-TODDLER MULTIVITAMIN
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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.
Source: Excel (XLSX)  ·  Formulary date: Oct 29, 2026  ·  Checked: 5 hours, 33 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
TRICARE Uniform Formulary 2026
via Infant-toddler Multivitamin 		Tier 3 - Non-Formulary — — — None
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