Syringe-dual Cannula
20 G-17 G — SYRINGE, EMPTY DISPOSABLE
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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.
TRICARE
1 plan| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| TRICARE Uniform Formulary 2026 | Tier 2 - Brand Formulary | — | — | ✓ SELECT SYRINGES,NEEDLES,SUPPLIES TO BE DISPENSED AT MAX QTY OF 200 UNITS IN 22D OR 600 UNITS IN 68D | QL Quantity limit |