Reyvow

Generic: lasmiditan succinate

50MG, 100MG — Tablet

Also known as: REYVOW TABS 50MG, 100MG

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

1 plan

Source: PDF · Formulary date: Jul 1, 2026 · Checked: 10 hours, 18 minutes ago

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

3 plans

Source: PDF · Formulary date: Jul 1, 2026 · Checked: 10 hours, 18 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC State Health Plan - 80/20 Plus PPO 2026	Tier 3 - Non-Preferred Brand	✓	✓	✓	PA \| ST \| QL
NC State Health Plan - 70/30 Standard PPO 2026	Tier 3 - Non-Preferred Brand	✓	✓	✓	PA \| ST \| QL
NC State Health Plan - HDHP 2026	Tier 3 - Non-Preferred Brand	✓	✓	✓	PA \| ST \| QL

1 plan

Source: Excel (XLSX) · Formulary date: Jun 24, 2026 · Checked: 10 hours, 18 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
TRICARE Uniform Formulary 2026 via lasmiditan succinate	Tier 3 - Non-Formulary	✓	—	—	PA