Icotyde

Generic: icotrokinra HCl

200 Mg — Tablet

Also known as: Icotyde 200 Mg Tablet

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: Jun 24, 2026 · Checked: 4 hours, 51 minutes ago

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