piflufolastat F 18

37 MBq/mL to 4,440 MBq/mL (1 mCi/mL to 120 mCi/mL) — Vial

Also known as: PYLARIFY TRUVU

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

1 plan

Source: Excel (XLSX) · Formulary date: May 29, 2026 · Checked: 6 hours, 34 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
TRICARE Uniform Formulary 2026	Tier 3 - Non-Formulary	—	—	—	None