Nyvepria

Generic: pegfilgrastim-apgf

6 MG/0.6 ML — 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: 6 hours, 40 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Signature Expanded Bronze + Vision + Adult Dental Tier 5 - Specialty ✓ — — PA
Signature Silver + Vision + Adult Dental Tier 5 - Specialty ✓ — — PA
Signature Gold + Vision + Adult Dental Tier 5 - Specialty ✓ — — PA
Signature Expanded Bronze with Atrium Health + Vision + Adult Dental Tier 5 - Specialty ✓ — — PA
Signature Silver with Atrium Health + Vision + Adult Dental Tier 5 - Specialty ✓ — — PA
Signature Gold with Atrium Health + Vision + Adult Dental Tier 5 - Specialty ✓ — — PA
Signature Expanded Bronze Tier 5 - Specialty ✓ — — PA
Signature Silver Tier 5 - Specialty ✓ — — PA
Signature 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
Signature Expanded Bronze with Atrium Health Tier 5 - Specialty ✓ — — PA
Signature Silver with Atrium Health Tier 5 - Specialty ✓ — — PA
Signature Gold with Atrium Health Tier 5 - Specialty ✓ — — PA
Enhanced Asthma/COPD Care Silver $0 Rx Options + Vision + Adult Dental Tier 5 - Specialty ✓ — — PA
Complete Gold + Vision + Adult Dental 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
Complete Gold Tier 5 - Specialty ✓ — — PA
Enhanced Asthma/COPD Care Silver $0 Rx 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: Oct 1, 2026  ·  Checked: 6 hours, 39 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: Oct 7, 2026  ·  Checked: 6 hours, 39 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Connect myDiabetesCare Bronze Tier 5 - Specialty ✓ — — PA
Connect Silver 5000 Indiv Med Deductible Tier 5 - Specialty ✓ — — PA
Connect Silver 3000 Indiv Med Deductible Tier 5 - Specialty ✓ — — PA
Connect Silver CMS Standard Tier 5 - Specialty ✓ — — PA
Connect Bronze RD 5000 Indiv Med Deductible Tier 5 - Specialty ✓ — — PA
Connect Gold CMS Standard Tier 5 - Specialty ✓ — — PA
Connect Gold 1500 Indiv Med Deductible Tier 5 - Specialty ✓ — — PA
Connect Bronze RD 6000 Indiv Med Deductible Tier 5 - Specialty ✓ — — PA
Connect Bronze RD CMS Standard Tier 5 - Specialty ✓ — — PA
Connect Silver RD 3500 Indiv Med Deductible Tier 5 - Specialty ✓ — — PA
Connect Silver RD 5000 Indiv Med Deductible Tier 5 - Specialty ✓ — — PA
Connect Silver RD CMS Standard Tier 5 - Specialty ✓ — — PA
Connect Silver RD 2200 Indiv Med Deductible Tier 5 - Specialty ✓ — — PA
Connect Gold RD CMS Standard Tier 5 - Specialty ✓ — — PA
Connect Bronze 7000 HSA Indiv Med Deductible Tier 5 - Specialty ✓ — — PA
Connect Bronze 5500 Indiv Med Deductible Tier 5 - Specialty ✓ — — PA
Connect myDiabetesCare Silver Tier 5 - Specialty ✓ — — PA
Connect Silver 3600 Indiv Med Deductible Tier 5 - Specialty ✓ — — PA
Connect Bronze 6500 Indiv Med Deductible Tier 5 - Specialty ✓ — — PA
Connect Bronze CMS Standard Tier 5 - Specialty ✓ — — PA
Source: CMS QHP JSON  ·  Formulary date: Sep 16, 2026  ·  Checked: 6 hours, 39 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
HealthSpring Preferred Select (HMO) Tier 5 - Specialty ✓ — — PA
HealthSpring Preferred Plus (HMO) Tier 5 - Specialty ✓ — — PA
HealthSpring TotalCare (HMO D-SNP) Tier 5 - Specialty ✓ — — PA
Wellcare Dual Reserve (HMO-POS D-SNP) Tier 5 - Specialty ✓ — — PA
Wellcare Dual Liberty (HMO-POS D-SNP) Tier 5 - Specialty ✓ — — PA
Wellcare Simple Open (PPO) Tier 5 - Specialty ✓ — — PA
Senior Care (HMO I-SNP) Tier 5 - Specialty — — — None
HealthSpring Preferred Savings (HMO) Tier 5 - Specialty ✓ — — PA
Wellcare Dual Liberty Open (PPO D-SNP) Tier 5 - Specialty ✓ — — PA
Wellcare Assist Open (PPO) Tier 5 - Specialty ✓ — — PA
Liberty Medicare Advantage (HMO C-SNP) Tier 5 - Specialty — — — None
Wellcare Giveback Open (PPO) Tier 5 - Specialty ✓ — — PA
HealthSpring True Choice (PPO) Tier 5 - Specialty ✓ — — PA
Wellcare Simple (HMO-POS) Tier 5 - Specialty ✓ — — PA
Wellcare Dual Access (HMO-POS D-SNP) Tier 5 - Specialty ✓ — — PA
HealthSpring Preferred (HMO) Tier 5 - Specialty ✓ — — PA
HealthSpring TotalCare Plus (HMO D-SNP) Tier 5 - Specialty ✓ — — PA
Source: PDF  ·  Formulary date: Oct 1, 2026  ·  Checked: 6 hours, 39 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC Medicaid Preferred Drug List 2026 Non-Preferred — — — None
Source: CMS QHP JSON  ·  Checked: 6 hours, 39 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Silver Simple PCP Saver | with Atrium Health Tier 5 - Specialty ✓ — — PA
Gold Elite Saver Plus | with Atrium Health Tier 5 - Specialty ✓ — — PA
Bronze Simple Diabetes | with Atrium Health Tier 5 - Specialty ✓ — — PA
Silver Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health Tier 5 - Specialty ✓ — — PA
Silver Simple Chronic Care CKM | with Atrium Health Tier 5 - Specialty ✓ — — PA
Silver Simple Women's Health with Menopause Benefits | with Atrium Health Tier 5 - Specialty ✓ — — PA
Gold Elite Saver Plus Tier 5 - Specialty ✓ — — PA
Silver Simple Diabetes Tier 5 - Specialty ✓ — — PA
Bronze Classic Standard Tier 5 - Specialty ✓ — — PA
Gold Classic Standard Tier 5 - Specialty ✓ — — PA
Silver Classic Standard Tier 5 - Specialty ✓ — — PA
Bronze Classic Standard | with Atrium Health Tier 5 - Specialty ✓ — — PA
Silver Classic Standard | with Atrium Health Tier 5 - Specialty ✓ — — PA
Gold Classic Standard | with Atrium Health Tier 5 - Specialty ✓ — — PA
Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health Tier 5 - Specialty ✓ — — PA
Bronze Simple Chronic Care CKM | with Atrium Health Tier 5 - Specialty ✓ — — PA
Secure | with Atrium Health Tier 5 - Specialty ✓ — — PA
AIAN Cost Share Tier 5 - Specialty ✓ — — PA
AIAN Cost Share | with Atrium Health Tier 5 - Specialty ✓ — — PA
Silver Classic Tier 5 - Specialty ✓ — — PA
Silver Simple PCP Saver Tier 5 - Specialty ✓ — — PA
Bronze Classic 4700 Tier 5 - Specialty ✓ — — PA
Bronze Elite + PCP Saver Plus Tier 5 - Specialty ✓ — — PA
Secure Tier 5 - Specialty ✓ — — PA
Bronze Classic 4700 | with Atrium Health Tier 5 - Specialty ✓ — — PA
Bronze Elite + PCP Saver Plus | with Atrium Health Tier 5 - Specialty ✓ — — PA
Silver Classic | with Atrium Health Tier 5 - Specialty ✓ — — PA
Silver Simple Diabetes | with Atrium Health Tier 5 - Specialty ✓ — — PA
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