Pogo Automatic Test

30 GAUGE — COMBINATION PACKAGE (EA)

Also known as: Pogo Automatic Test Cartridge

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: Sep 23, 2026 · Checked: 4 hours, 28 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
TRICARE Uniform Formulary 2026	Tier 3 - Non-Formulary	✓	—	—	PA PA: SELECT BLOOD GLUCOSE TEST STRIPS REQUIRES PRIOR AUTHORIZATION