Peg-3350 And Electrolytes

Generic: peg 3350/sod sulf/sod bicarb/sod chloride/potassium chloride

Tablet

Also known as: Peg-3350 And Electrolytes Oral Solution

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: 19 hours, 9 minutes ago

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

1 plan

Source: Excel (XLSX) · Formulary date: Jan 5, 2026 · Checked: 19 hours, 9 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
TRICARE Uniform Formulary 2026 via peg 3350/sod sulf/sod bicarb/sod chloride/potassium chloride	Tier 1 - Basic Core Formulary	—	—	—	None