polymyxin B sulf/trimethoprim

10000-1/ML — Drops

OPHTHALMIC

Also known as: Polymyxin B Sul-trimethoprim
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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, 21 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
TRICARE Uniform Formulary 2026 Tier 1 - Generic Formulary (Basic Core) — — — None
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