Fylnetra

Generic: pegfilgrastim-pbbk

6MG/0.6ML — Prefilled Syringe

Also known as: pegfilgrastim-pbbk FYLNETRA SOSY 6MG/0.6ML

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.

2 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 17 hours, 36 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBS Federal Basic Option 2026	Tier 5 - Non-Preferred Specialty	✓	—	—	PA
BCBS Federal Standard Option 2026	Tier 5 - Non-Preferred Specialty	✓	—	—	PA

5 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 17 hours, 36 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBSNC Blue Local 2026	Tier 5 - Specialty	—	—	—	None
BCBSNC Blue Value 2026	Tier 5 - Specialty	—	—	—	None
BCBSNC Blue Advantage 2026	Tier 5 - Specialty	—	—	—	None
BCBSNC Blue Care 2026	Tier 5 - Specialty	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026	Tier 5 - Specialty	—	—	—	None

3 plans

Source: CMS QHP JSON · Formulary date: Mar 18, 2026 · Checked: 17 hours, 36 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
AmeriHealth Caritas VIP Care (HMO D-SNP)	Tier 5 - Specialty	✓	—	—	PA
Troy Medicare (HMO)	Tier 5 - Specialty	✓	—	—	PA
Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP)	Tier 5 - Specialty	✓	—	—	PA

1 plan

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 17 hours, 36 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC Medicaid Preferred Drug List 2026	Preferred	—	—	—	None