Idacio(CF)

Generic: adalimumab-aacf

40MG/0.8ML — PEN IJ KIT

Also known as: Idacio(CF) Pen Psoriasis (4PK) Idacio(CF) Pen (2 Pack) Idacio(CF) Pen CROHN'S-UC(6PK)

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, 57 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC Medicaid Preferred Drug List 2026 via adalimumab-aacf	Non-Preferred	✓	✓	—	PA \| ST

4 plans

Source: Excel (XLSX) · Formulary date: Sep 23, 2026 · Checked: 7 hours, 57 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
TRICARE Uniform Formulary 2026 via Adalimumab-aacf(CF) (2 Pk)	Tier 3 - Non-Formulary	✓	—	—	PA PA: 1270/48001/90693 PA DRUGS, DOD PA REQUIRED
TRICARE Uniform Formulary 2026 via Adalimumab-aacf(CF)	Tier 3 - Non-Formulary	✓	—	—	PA PA: 1270/48001/90693 PA DRUGS, DOD PA REQUIRED
TRICARE Uniform Formulary 2026 via Idacio(CF) (2 Pack)	Tier 3 - Non-Formulary	✓	—	—	PA PA: 1270/48001/90693 PA DRUGS, DOD PA REQUIRED
TRICARE Uniform Formulary 2026	Tier 3 - Non-Formulary	✓	—	—	PA PA: 1270/48001/90693 PA DRUGS, DOD PA REQUIRED