Pyridium

Generic: phenazopyridine HCl

100 mg, 200 mg — Tablet

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

2 plans

Source: Excel (XLSX) · Formulary date: Sep 23, 2026 · Checked: 8 hours, 50 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
TRICARE Uniform Formulary 2026 via phenazopyridine hcl	Tier 1 - Generic Formulary (Basic Core)	—	—	—	None
TRICARE Uniform Formulary 2026	Tier 2 - Brand Formulary (Basic Core)	—	—	—	None