tramadol hcl tb24

Generic: tramadol hcl

100mg, 200mg, 300mg

Also known as: tramadol hcl tb24 100mg, 200mg, 300mg

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

5 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 20 hours, 52 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBSNC Blue Value 2026 via tramadol hcl	Tier 1 - Lowest Cost Generic	—	—	✓	QL
BCBSNC Blue Advantage 2026 via tramadol hcl	Tier 1 - Lowest Cost Generic	—	—	✓	QL
BCBSNC Blue Home with UNC Health Alliance 2026 via tramadol hcl	Tier 1 - Lowest Cost Generic	—	—	✓	QL
BCBSNC Blue Local 2026 via tramadol hcl	Tier 1 - Lowest Cost Generic	—	—	✓	QL
BCBSNC Blue Care 2026 via tramadol hcl	Tier 1 - Lowest Cost Generic	—	—	✓	QL

6 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 20 hours, 52 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC State Health Plan - 80/20 Plus PPO 2026	Tier 1 - Preferred Generic	✓	✓	✓	PA \| ST \| QL
NC State Health Plan - HDHP 2026 via tramadol hcl	Tier 1 - Preferred Generic	✓	—	✓	PA \| QL
NC State Health Plan - HDHP 2026	Tier 1 - Preferred Generic	✓	✓	✓	PA \| ST \| QL
NC State Health Plan - 70/30 Standard PPO 2026	Tier 1 - Preferred Generic	✓	✓	✓	PA \| ST \| QL
NC State Health Plan - 80/20 Plus PPO 2026 via tramadol hcl	Tier 1 - Preferred Generic	✓	—	✓	PA \| QL
NC State Health Plan - 70/30 Standard PPO 2026 via tramadol hcl	Tier 1 - Preferred Generic	✓	—	✓	PA \| QL

1 plan

Source: Excel (XLSX) · Formulary date: Jan 5, 2026 · Checked: 20 hours, 52 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
TRICARE Uniform Formulary 2026 via tramadol hcl	Tier 1 - Basic Core Formulary	✓	—	✓	PA \| QL

2 plans

Source: PDF · Formulary date: Jan 1, 2026 · Checked: 20 hours, 52 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
UnitedHealthcare NC Individual & Family 2026 via tramadol hcl er	Tier 3 - Mid-Range Cost	✓	—	✓	PA \| QL
UnitedHealthcare NC Individual & Family 2026 via tramadol hcl	Unknown	—	—	✓	QL