vonoprazan fumarate/amoxicillin trihydrate

20 mg (28)-500 mg (84) — Pack

Also known as: VOQUEZNA DUAL PAK

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

1 plan

Source: Excel (XLSX) · Formulary date: May 29, 2026 · Checked: 13 hours, 41 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
TRICARE Uniform Formulary 2026	Tier 3 - Non-Formulary	✓	—	✓	PA \| QL