phytonadione

1mg/0.5ml, 10mg — Tablet

NEUROMUSCULAR AGENTS

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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: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 19 hours, 14 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBS Federal Focus 2026 Tier 1 - Generic None
BCBS Federal Standard Option 2026 Tier 1 - Generic None
BCBS Federal Basic Option 2026 Tier 1 - Generic None
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 19 hours, 14 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBSNC Blue Local 2026 Tier 2 - Medium Cost Generic/Brand None
BCBSNC Blue Value 2026 Tier 2 - Medium Cost Generic/Brand None
BCBSNC Blue Care 2026 Tier 2 - Medium Cost Generic/Brand None
BCBSNC Blue Advantage 2026 Tier 2 - Medium Cost Generic/Brand None
BCBSNC Blue Home with UNC Health Alliance 2026 Tier 2 - Medium Cost Generic/Brand None
Source: PDF  ·  Formulary date: Jan 1, 2026  ·  Checked: 19 hours, 14 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Cigna Plus NC 4-Tier Formulary 2026 Tier 3 - Non-Preferred None
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 19 hours, 14 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - HDHP 2026 Tier 2 - Non-Preferred Generic None
NC State Health Plan - 80/20 Plus PPO 2026 Tier 2 - Non-Preferred Generic None
NC State Health Plan - 70/30 Standard PPO 2026 Tier 2 - Non-Preferred Generic None
Source: PDF  ·  Formulary date: Jan 1, 2026  ·  Checked: 19 hours, 14 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
UnitedHealthcare NC Individual & Family 2026 Tier 4 - Higher Cost QL
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