Ziextenzo

Generic: pegfilgrastim-bmez

6MG/0.6ML — Prefilled Syringe

Colony Stimulating Factors

Also known as: pegfilgrastim-bmez ZIEXTENZO 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: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 3 hours, 18 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
Source: CMS QHP JSON  ·  Formulary date: Mar 18, 2026  ·  Checked: 3 hours, 18 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
Blue Medicare Essential Plus (HMO-POS) Tier 5 - Specialty PA
Blue Medicare Enhanced (HMO-POS) Tier 5 - Specialty PA
Blue Medicare Choice (HMO) Tier 5 - Specialty PA
Blue Medicare Essential (HMO) Tier 5 - Specialty PA
Experience Health Medicare Advantage (HMO) Tier 5 - Specialty PA
Healthy Blue + Medicare (HMO-POS D-SNP) Tier 5 - Specialty PA
Alignment Health Platinum (HMO) Tier 5 - Specialty PA
Alignment Health NC Duals (HMO-POS D-SNP) Tier 5 - Specialty PA
Alignment Health smartHMO (HMO) Tier 5 - Specialty PA
Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP) Tier 5 - Specialty PA
Alignment Health Platinum Select (HMO) Tier 5 - Specialty PA
Alignment Health Heart & Diabetes Care (HMO C-SNP) Tier 5 - Specialty PA
Alignment Health AVA (PPO) Tier 5 - Specialty PA
Blue Medicare PPO Enhanced (PPO) Tier 5 - Specialty PA
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 3 hours, 18 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC Medicaid Preferred Drug List 2026 Non-Preferred None
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