multivitamin with minerals no.69/iron,carbonyl/folic acid

50 mg iron-1.25 mg — Tablet

Also known as: ELITE-OB OB COMPLETE

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

1 plan

Source: PDF · Formulary date: Jan 1, 2026 · Checked: 1 hour, 56 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
Cigna Plus NC 4-Tier Formulary 2026 via Elite-Ob	Tier 1 - Generic	—	—	—	None

6 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 1 hour, 56 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC State Health Plan - HDHP 2026 via Elite-Ob	Tier 1 - Preferred Generic	—	—	—	None
NC State Health Plan - 80/20 Plus PPO 2026 via Elite-Ob	Tier 1 - Preferred Generic	—	—	—	None
NC State Health Plan - 70/30 Standard PPO 2026 via Elite-Ob	Tier 1 - Preferred Generic	—	—	—	None
NC State Health Plan - HDHP 2026 via Ob Complete	Not Covered	—	—	—	None
NC State Health Plan - 80/20 Plus PPO 2026 via Ob Complete	Not Covered	—	—	—	None
NC State Health Plan - 70/30 Standard PPO 2026 via Ob Complete	Not Covered	—	—	—	None

1 plan

Source: Excel (XLSX) · Formulary date: Jan 5, 2026 · Checked: 1 hour, 56 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
TRICARE Uniform Formulary 2026	Tier 3 - Non-Formulary	—	—	—	None