amikacin sulfate liposomal with

590 mg/8.4 mL — Nebulizer Solution

ANTIBIOTICS

Also known as: amikacin sulfate liposomal with nebulizer accessories ARIKAYCE
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Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: Excel (XLSX)  ·  Formulary date: Jan 5, 2026  ·  Checked: 17 hours, 59 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
TRICARE Uniform Formulary 2026 Tier 3 - Non-Formulary ✓ — — PA
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