ustekinumab-srlf

45 mg/0.5 mL, 90 mg/mL — Prefilled Syringe

Also known as: IMULDOSA

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: 22 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
Cigna Plus NC 4-Tier Formulary 2026 via Imuldosa	Tier 4 - Specialty	✓	—	✓ Specialty Pharmacy Required	PA \| QL

1 plan

Source: Excel (XLSX) · Formulary date: Jan 5, 2026 · Checked: 22 minutes ago

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