Quillivant Xr

25MG/5ML — Sustained Release Tablet

STIMULANTS - MISC.

Also known as: QUILLIVANT XR SRER 25MG/5ML
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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: 11 hours, 12 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBS Federal Standard Option 2026 Tier 3 - Non-Preferred Brand ✓ — — PA
BCBS Federal Basic Option 2026 Tier 3 - Non-Preferred Brand ✓ — — PA
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