Vitascript

Generic: mv-mins no.119/folic/ALA/coQ10

1-75-10 MG — Tablet

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

2 plans

Source: Excel (XLSX) · Formulary date: Sep 23, 2026 · Checked: 7 hours, 2 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
TRICARE Uniform Formulary 2026 via Evervita	Tier 3 - Non-Formulary	—	—	—	None
TRICARE Uniform Formulary 2026	Tier 3 - Non-Formulary	—	—	—	None