prenatal vits no.118/iron asparto glycinate/folate no.6/dha

30 mg iron-1 mg-300 mg — Capsule

VITAMINS

Also known as: PRIMACARE

Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 13 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 80/20 Plus PPO 2026
via Primacare
Not Covered None
NC State Health Plan - 70/30 Standard PPO 2026
via Primacare
Not Covered None
NC State Health Plan - HDHP 2026
via Primacare
Not Covered None
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
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