prenatal vit no.85/iron carb,asp.gly/folic acid/dha/fish oil

40 mg-10 mg-1 mg-300 mg-476 mg — Capsule

Also known as: OB COMPLETE ONE

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: Jan 5, 2026 · Checked: 13 minutes ago

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