Zelsuvmi

Generic: berdazimer sodium

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, 31 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBSNC Blue Advantage 2026	Tier 4 - Higher Cost Brand	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026	Tier 4 - Higher Cost Brand	—	—	—	None
BCBSNC Blue Local 2026	Tier 4 - Higher Cost Brand	—	—	—	None
BCBSNC Blue Care 2026	Tier 4 - Higher Cost Brand	—	—	—	None
BCBSNC Blue Value 2026	Tier 4 - Higher Cost Brand	—	—	—	None

1 plan

Source: Excel (XLSX) · Formulary date: Jan 5, 2026 · Checked: 20 hours, 31 minutes ago

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