Xyntha

Generic: antihemophil fact rcmb(bdd-rfviii,mor) for

250UNIT, 500UNIT, 1000UNIT, 2000UNIT — Kit

Also known as: XYNTHA KIT 250UNIT, 500UNIT, 1000UNIT, 2000UNIT XYNTHA KIT 250UNIT, 500UNIT, 1000UNIT,

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: 22 hours, 16 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBS Federal Standard Option 2026	Tier 4 - Preferred Specialty	—	—	—	None
BCBS Federal Basic Option 2026	Tier 4 - Preferred Specialty	—	—	—	None

5 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 22 hours, 16 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBSNC Blue Local 2026	Tier 5 - Specialty	✓	—	✓ Restricted Access	PA \| QL
BCBSNC Blue Care 2026	Tier 5 - Specialty	✓	—	✓ Restricted Access	PA \| QL
BCBSNC Blue Value 2026	Tier 5 - Specialty	✓	—	✓ Restricted Access	PA \| QL
BCBSNC Blue Advantage 2026	Tier 5 - Specialty	✓	—	✓ Restricted Access	PA \| QL
BCBSNC Blue Home with UNC Health Alliance 2026	Tier 5 - Specialty	✓	—	✓ Restricted Access	PA \| QL

3 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 22 hours, 16 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC State Health Plan - 80/20 Plus PPO 2026	Tier 5 - Preferred Brand Specialty	✓	—	—	PA
NC State Health Plan - 70/30 Standard PPO 2026	Tier 5 - Preferred Brand Specialty	✓	—	—	PA
NC State Health Plan - HDHP 2026	Tier 5 - Preferred Brand Specialty	✓	—	—	PA