Exforge Hct

Generic: Amlodipine-Valsartan-Hctz

10-160-25, 10-320-25, 10MG-160MG, 5-160-12.5, 5-160-25MG — Tablet

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

1 plan

Source: PDF · Formulary date: Oct 1, 2026 · Checked: 7 hours, 12 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC Medicaid Preferred Drug List 2026 via Amlodipine-Valsartan-Hctz	Non-Preferred	—	—	—	None

2 plans

Source: Excel (XLSX) · Formulary date: Sep 23, 2026 · Checked: 7 hours, 12 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
TRICARE Uniform Formulary 2026 via Amlodipine-Valsartan-Hctz	Tier 1 - Generic Formulary	✓	—	—	PA PA: TPA - ALDACTONE TABLET FOR MALE PTS 11 THRU 18 YRS OF AGE W/O QUALIFIERS IN 360 DAYS REQ PA
TRICARE Uniform Formulary 2026	Tier 2 - Brand Formulary	✓	—	—	PA PA: TPA - ALDACTONE TABLET FOR MALE PTS 11 THRU 18 YRS OF AGE W/O QUALIFIERS IN 360 DAYS REQ PA