Radicava ORS Suspension / ORS Starter Kit Suspension / Infusion Bag

105MG/5ML — Suspension

Also known as: RADICAVA ORS SUSP 105MG/5ML

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

1 plan

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 5 hours, 16 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC Medicaid Preferred Drug List 2026	Non-Preferred	—	—	—	None