New fuel filter went on yesterday. And no idling issues. Looks like the fuel filter cleared up the rough idle
Awesome news! Glad I was wrong!
FYI: I'd still do a seafoam cleanse on the intake and the injectors. You let the fuel level in the tank get so low that the light comes on. Add two cans of seafoam to the tank and go for a drive, and don't be scared of using the skinny pedal. The idea is to suck large volumes of detergents through the injectors and fuel rails to help dissolve any varnish.
Second, unhook a vacuum line - like the one to the PCV - and slightly pinch it off and start the truck. Gently and slowly pour about 1/3 can of seafoam into the vacuum hose. If the truck runs smooth, you're not pouring fast enough. If the truck is about to stall, you're pouring too fast. At 1/3 can, shut engine off and let sit about 10-min. Reconnect the vacuum hose before re-starting. When you crank back up, you'll look like you just lit a tire on fire with all the smoke. Let it idle for a while and burn off the varnish and carbon from the piston head and valves. Once it quits smoking, give it a few revs for good measure, then give it another 1/3 dose. Repeat, then give the final 1/3 dose. At that point, take it for another spin and blow out the remaining carbon and varnish. Stop by a gas station on your way home and fill up.
Done.