Use the Tricare online website ( I want you to find the website) to find out the formulary status and copay for the following medication for a 50 year old male with Hepatic Encephalopathy. He is non-active duty and this is his first fill at a retail pharmacy.

Xifaxan 550mg

#60

Group of answer choices

covered at $0 copay regardless of where he fills this medication for up to 6 fills and then he needs to obtain a prior authorization

for first 2 fills: covered for a maximum quantity of 60 tablets per 30 days at retail

not covered and must be filled at a military pharmacy or via home-delivery service

not covered because the diagnosis Hepatic Encephalopathy is not a covered diagnosis for this medication

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