Pen- Needle
29 G X1/2", 30 GX3/16", 30 GX5/16", 31 G X1/4", 31 GX3/16", 31 GX5/16", 31GX15/64", 32 GX 1/4", 32GX 5/32", 33 GX5/32" — NEEDLE, DISPOSABLE
Coverage by Insurer
TRICARE
1 plan| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| TRICARE Uniform Formulary 2026 | Tier 2 - Brand Formulary | — | — | ✓ SELECT SYRINGES,NEEDLES,SUPPLIES TO BE DISPENSED AT MAX QTY OF 200 UNITS IN 22D OR 600 UNITS IN 68D | QL Quantity limit |