Bildyos

Generic: denosumab-nxxp

60 MG — Prefilled Syringe

RANK Ligand Inhibitor

Also known as: denosumab-nxxp Prolia Biosimilar Bildyos Subcutaneous Solution Prefilled Syringe
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Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: CMS QHP JSON  ·  Formulary date: Jan 1, 2026  ·  Checked: 21 hours, 49 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Signature Gold with Atrium Health Tier 5 - Specialty ✓ — ✓ PA | QL
Complete Gold + Vision + Adult Dental Tier 5 - Specialty ✓ — ✓ PA | QL
Everyday Bronze + Vision + Adult Dental Tier 5 - Specialty ✓ — ✓ PA | QL
Elite Bronze + Vision + Adult Dental Tier 5 - Specialty ✓ — ✓ PA | QL
Everyday Bronze with Atrium Health + Vision + Adult Dental Tier 5 - Specialty ✓ — ✓ PA | QL
Elite Bronze with Atrium Health + Vision + Adult Dental Tier 5 - Specialty ✓ — ✓ PA | QL
Focused Silver with Atrium Health + Vision + Adult Dental Tier 5 - Specialty ✓ — ✓ PA | QL
Complete Gold with Atrium Health + Vision + Adult Dental Tier 5 - Specialty ✓ — ✓ PA | QL
Signature Expanded Bronze + Vision + Adult Dental Tier 5 - Specialty ✓ — ✓ PA | QL
Signature Silver + Vision + Adult Dental Tier 5 - Specialty ✓ — ✓ PA | QL
Signature Gold + Vision + Adult Dental Tier 5 - Specialty ✓ — ✓ PA | QL
Signature Expanded Bronze with Atrium Health + Vision + Adult Dental Tier 5 - Specialty ✓ — ✓ PA | QL
Signature Silver with Atrium Health + Vision + Adult Dental Tier 5 - Specialty ✓ — ✓ PA | QL
Signature Gold with Atrium Health + Vision + Adult Dental Tier 5 - Specialty ✓ — ✓ PA | QL
Enhanced CHF Heart Care Silver $0 Rx Options + Vision + Adult Dental Tier 5 - Specialty ✓ — ✓ PA | QL
Enhanced Asthma/COPD Care Silver $0 Rx Options Tier 5 - Specialty ✓ — ✓ PA | QL
Everyday Bronze Tier 5 - Specialty ✓ — ✓ PA | QL
Elite Bronze Tier 5 - Specialty ✓ — ✓ PA | QL
Complete Gold Tier 5 - Specialty ✓ — ✓ PA | QL
Clear Silver with $0 Insulin Options Tier 5 - Specialty ✓ — ✓ PA | QL
Signature Expanded Bronze Tier 5 - Specialty ✓ — ✓ PA | QL
Signature Silver Tier 5 - Specialty ✓ — ✓ PA | QL
Signature Gold Tier 5 - Specialty ✓ — ✓ PA | QL
Streamlined Silver with Atrium Health Tier 5 - Specialty ✓ — ✓ PA | QL
Streamlined Silver Tier 5 - Specialty ✓ — ✓ PA | QL
Clear Silver with $0 Insulin Options + Vision + Adult Dental Tier 5 - Specialty ✓ — ✓ PA | QL
Everyday Bronze with Atrium Health Tier 5 - Specialty ✓ — ✓ PA | QL
Elite Bronze with Atrium Health Tier 5 - Specialty ✓ — ✓ PA | QL
Focused Silver with Atrium Health Tier 5 - Specialty ✓ — ✓ PA | QL
Complete Gold with Atrium Health Tier 5 - Specialty ✓ — ✓ PA | QL
Signature Expanded Bronze with Atrium Health Tier 5 - Specialty ✓ — ✓ PA | QL
Signature Silver with Atrium Health Tier 5 - Specialty ✓ — ✓ PA | QL
Enhanced Asthma/COPD Care Silver $0 Rx Options + Vision + Adult Dental Tier 5 - Specialty ✓ — ✓ PA | QL
Enhanced CHF Heart Care Silver $0 Rx Options Tier 5 - Specialty ✓ — ✓ PA | QL
Source: CMS QHP JSON  ·  Formulary date: Sep 22, 2026  ·  Checked: 21 hours, 49 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
AmeriHealth Caritas Next Bronze Essential + Three Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Bronze Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Silver Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Gold Signature + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Silver Off-Marketplace High + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Bronze Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Silver Premier + No Referrals Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Silver Essential + Two Free PCP Visits + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Gold Enhanced + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 5 - Specialty ✓ — — PA
AmeriHealth Caritas Next Silver Off-Marketplace Low + Free 24/7 Preferred Provider PCP/Urgent Virtual Care + No Referrals Tier 5 - Specialty ✓ — — PA
Source: CMS QHP JSON  ·  Formulary date: Sep 16, 2026  ·  Checked: 21 hours, 49 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
DEVOTED CHOICE GIVEBACK 004 NC (PPO) Tier 4 - Non-Preferred — — ✓ 1 per 180 days QL
Aetna Medicare Signature (HMO) Tier 4 - Non-Preferred — — ✓ 1 per 180 days QL
Aetna Medicare Dual (HMO D-SNP) Tier 4 - Non-Preferred — — ✓ 1 per 180 days QL
Aetna Medicare Signature (HMO) Tier 4 - Non-Preferred — — ✓ 1 per 180 days QL
Aetna Medicare Value Plus (HMO) Tier 4 - Non-Preferred — — ✓ 1 per 180 days QL
Aetna Medicare Prime (HMO) Tier 4 - Non-Preferred — — ✓ 1 per 180 days QL
Aetna Medicare Signature Care (HMO) Tier 4 - Non-Preferred — — ✓ 1 per 180 days QL
Aetna Medicare Full Dual Care (HMO D-SNP) Tier 4 - Non-Preferred — — ✓ 1 per 180 days QL
Aetna Medicare Chronic Care (HMO C-SNP) Tier 4 - Non-Preferred — — ✓ 1 per 180 days QL
Aetna Medicare Enhanced (HMO) Tier 4 - Non-Preferred — — ✓ 1 per 180 days QL
Aetna Medicare Chronic Care Value (HMO C-SNP) Tier 4 - Non-Preferred — — ✓ 1 per 180 days QL
DEVOTED CORE 001 NC (HMO) Tier 4 - Non-Preferred — — ✓ 1 per 180 days QL
DEVOTED GIVEBACK 002 NC (HMO) Tier 4 - Non-Preferred — — ✓ 1 per 180 days QL
DEVOTED DUAL PLUS 006 NC (HMO D-SNP) Tier 4 - Non-Preferred — — ✓ 1 per 180 days QL
DEVOTED DUAL 009 NC (HMO D-SNP) Tier 4 - Non-Preferred — — ✓ 1 per 180 days QL
DEVOTED GIVEBACK 012 NC (HMO) Tier 4 - Non-Preferred — — ✓ 1 per 180 days QL
DEVOTED DUAL FULL 013 NC (HMO D-SNP) Tier 4 - Non-Preferred — — ✓ 1 per 180 days QL
DEVOTED C-SNP PREMIUM 014 NC (HMO C-SNP) Tier 4 - Non-Preferred — — ✓ 1 per 180 days QL
DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) Tier 4 - Non-Preferred — — ✓ 1 per 180 days QL
DEVOTED C-SNP PREMIUM 016 NC (HMO C-SNP) Tier 4 - Non-Preferred — — ✓ 1 per 180 days QL
DEVOTED C-SNP PREMIUM 017 NC (HMO C-SNP) Tier 4 - Non-Preferred — — ✓ 1 per 180 days QL
DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) Tier 4 - Non-Preferred — — ✓ 1 per 180 days QL
Aetna Medicare Signature (PPO) Tier 4 - Non-Preferred — — ✓ 1 per 180 days QL
Aetna Medicare Enhanced (PPO) Tier 4 - Non-Preferred — — ✓ 1 per 180 days QL
Aetna Medicare Enhanced (PPO) Tier 4 - Non-Preferred — — ✓ 1 per 180 days QL
Aetna Medicare Signature Extra (PPO) Tier 4 - Non-Preferred — — ✓ 1 per 180 days QL
Aetna Medicare Signature (PPO) Tier 4 - Non-Preferred — — ✓ 1 per 180 days QL
Aetna Medicare Signature (PPO) Tier 4 - Non-Preferred — — ✓ 1 per 180 days QL
Aetna Medicare Signature Giveback (PPO) Tier 4 - Non-Preferred — — ✓ 1 per 180 days QL
Aetna Medicare Signature (PPO) Tier 4 - Non-Preferred — — ✓ 1 per 180 days QL
DEVOTED CHOICE 001 NC (PPO) Tier 4 - Non-Preferred — — ✓ 1 per 180 days QL
DEVOTED CHOICE GIVEBACK 002 NC (PPO) Tier 4 - Non-Preferred — — ✓ 1 per 180 days QL
DEVOTED CHOICE 003 NC (PPO) Tier 4 - Non-Preferred — — ✓ 1 per 180 days QL
DEVOTED CHOICE 005 NC (PPO) Tier 4 - Non-Preferred — — ✓ 1 per 180 days QL
DEVOTED CHOICE GIVEBACK 006 NC (PPO) Tier 4 - Non-Preferred — — ✓ 1 per 180 days QL
DEVOTED CHOICE 008 NC (PPO) Tier 4 - Non-Preferred — — ✓ 1 per 180 days QL
DEVOTED CHOICE GIVEBACK 009 NC (PPO) Tier 4 - Non-Preferred — — ✓ 1 per 180 days QL
Aetna Medicare Signature (PPO)
via Bilprevda 		Tier 5 - Specialty ✓ — — PA
Aetna Medicare Signature (HMO)
via Bilprevda 		Tier 5 - Specialty ✓ — — PA
Aetna Medicare Dual (HMO D-SNP)
via Bilprevda 		Tier 5 - Specialty ✓ — — PA
Aetna Medicare Signature (HMO)
via Bilprevda 		Tier 5 - Specialty ✓ — — PA
Aetna Medicare Value Plus (HMO)
via Bilprevda 		Tier 5 - Specialty ✓ — — PA
Aetna Medicare Prime (HMO)
via Bilprevda 		Tier 5 - Specialty ✓ — — PA
Aetna Medicare Signature Care (HMO)
via Bilprevda 		Tier 5 - Specialty ✓ — — PA
Aetna Medicare Full Dual Care (HMO D-SNP)
via Bilprevda 		Tier 5 - Specialty ✓ — — PA
Aetna Medicare Chronic Care (HMO C-SNP)
via Bilprevda 		Tier 5 - Specialty ✓ — — PA
Aetna Medicare Enhanced (HMO)
via Bilprevda 		Tier 5 - Specialty ✓ — — PA
Aetna Medicare Chronic Care Value (HMO C-SNP)
via Bilprevda 		Tier 5 - Specialty ✓ — — PA
Aetna Medicare Signature (PPO)
via Bilprevda 		Tier 5 - Specialty ✓ — — PA
Aetna Medicare Enhanced (PPO)
via Bilprevda 		Tier 5 - Specialty ✓ — — PA
Aetna Medicare Enhanced (PPO)
via Bilprevda 		Tier 5 - Specialty ✓ — — PA
Aetna Medicare Signature Extra (PPO)
via Bilprevda 		Tier 5 - Specialty ✓ — — PA
Aetna Medicare Signature (PPO)
via Bilprevda 		Tier 5 - Specialty ✓ — — PA
Aetna Medicare Signature (PPO)
via Bilprevda 		Tier 5 - Specialty ✓ — — PA
Aetna Medicare Signature Giveback (PPO)
via Bilprevda 		Tier 5 - Specialty ✓ — — PA
Source: PDF  ·  Formulary date: Oct 1, 2026  ·  Checked: 21 hours, 49 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC Medicaid Preferred Drug List 2026 Non-Preferred — — — None
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