Nyvepria

Generic: pegfilgrastim-apgf

6MG/0.6ML — Prefilled Syringe

Colony Stimulating Factors

Also known as: pegfilgrastim-apgf Nyvepria 6 Mg/0.6 Ml Syringe NYVEPRIA SOSY 6MG/0.6ML

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: 15 hours, 17 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Standard Expanded Bronze with Atrium Health Tier 5 - Specialty PA
Standard Gold with Atrium Health Tier 5 - Specialty PA
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental Tier 5 - Specialty PA
Complete Gold + Vision + Adult Dental Tier 5 - Specialty PA
Standard Expanded Bronze Tier 5 - Specialty PA
Standard Silver Tier 5 - Specialty PA
Standard Gold Tier 5 - Specialty PA
Everyday Bronze with Atrium Health Tier 5 - Specialty PA
Elite Bronze with Atrium Health Tier 5 - Specialty PA
Focused Silver with Atrium Health Tier 5 - Specialty PA
Complete Gold with Atrium Health Tier 5 - Specialty PA
Standard Silver with Atrium Health Tier 5 - Specialty PA
Complete Gold Tier 5 - Specialty PA
Everyday Bronze + Vision + Adult Dental Tier 5 - Specialty PA
Elite Bronze + Vision + Adult Dental Tier 5 - Specialty PA
Everyday Bronze with Atrium Health + Vision + Adult Dental Tier 5 - Specialty PA
Elite Bronze with Atrium Health + Vision + Adult Dental Tier 5 - Specialty PA
Focused Silver with Atrium Health + Vision + Adult Dental Tier 5 - Specialty PA
Complete Gold with Atrium Health + Vision + Adult Dental Tier 5 - Specialty PA
Standard Expanded Bronze + Vision + Adult Dental Tier 5 - Specialty PA
Standard Silver + Vision + Adult Dental Tier 5 - Specialty PA
Standard Gold + Vision + Adult Dental Tier 5 - Specialty PA
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental Tier 5 - Specialty PA
Standard Silver with Atrium Health + Vision + Adult Dental Tier 5 - Specialty PA
Standard Gold with Atrium Health + Vision + Adult Dental Tier 5 - Specialty PA
Enhanced Asthma/COPD Care Silver with $0 Drug Options Tier 5 - Specialty PA
Everyday Bronze Tier 5 - Specialty PA
Elite Bronze Tier 5 - Specialty PA
Clear Silver with $0 Insulin Options Tier 5 - Specialty PA
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 15 hours, 17 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBS Federal Standard Option 2026 Tier 5 - Non-Preferred Specialty PA
BCBS Federal Basic Option 2026 Tier 5 - Non-Preferred Specialty PA
Source: PDF  ·  Formulary date: Jan 1, 2026  ·  Checked: 15 hours, 17 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Cigna Plus NC 4-Tier Formulary 2026 Tier 4 - Specialty Specialty Pharmacy Required PA
Source: CMS QHP JSON  ·  Formulary date: Mar 18, 2026  ·  Checked: 15 hours, 17 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Liberty Medicare Dual Plan (HMO D-SNP) Tier 1 - Preferred Generic None
NHC Advantage (HMO I-SNP) Tier 1 - Preferred Generic None
Longevity Health Plan (HMO I-SNP) Tier 1 - Preferred Generic PA
PruittHealth Premier (HMO I-SNP) Tier 1 - Preferred Generic None
Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) Tier 1 - Preferred Generic None
Senior Care (HMO I-SNP) Tier 5 - Specialty None
HealthSpring True Choice (PPO) Tier 5 - Specialty PA
HealthSpring TotalCare (HMO D-SNP) Tier 5 - Specialty PA
HealthSpring TotalCare Plus (HMO D-SNP) Tier 5 - Specialty PA
HealthSpring Preferred (HMO) Tier 5 - Specialty PA
HealthSpring Preferred Select (HMO) Tier 5 - Specialty PA
HealthSpring Preferred Savings (HMO) Tier 5 - Specialty PA
HealthSpring Preferred Plus (HMO) Tier 5 - Specialty PA
Liberty Medicare Advantage (HMO C-SNP) Tier 5 - Specialty None
Wellcare Simple Open (PPO) Tier 5 - Specialty PA
Wellcare Simple (HMO-POS) Tier 5 - Specialty PA
Wellcare Giveback Open (PPO) Tier 5 - Specialty PA
Wellcare Dual Liberty Open (PPO D-SNP) Tier 5 - Specialty PA
Wellcare Assist Open (PPO) Tier 5 - Specialty PA
Wellcare Dual Access (HMO-POS D-SNP) Tier 5 - Specialty PA
Wellcare Dual Liberty (HMO-POS D-SNP) Tier 5 - Specialty PA
Wellcare Dual Reserve (HMO-POS D-SNP) Tier 5 - Specialty PA
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 15 hours, 17 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC Medicaid Preferred Drug List 2026 Non-Preferred None
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