Benefily
Prior authorization required

Does Blue Cross Blue Shield (affiliate) require prior authorization for Phyrago?

Blue Cross Blue Shield (affiliate) requires prior authorization for Phyrago on every Medicare Part D plan of theirs that covers it.

Every plan from this payer that covers the drug requires authorization before it is dispensed.

By product strength

RxNorm productPlans coveringRequire prior authStep therapyQty limitStatus
dasatinib 100 MG Oral Tablet [Phyrago]269183751 / 26951051Prior authorization required
dasatinib 140 MG Oral Tablet [Phyrago]269183951 / 26951051Prior authorization required
dasatinib 20 MG Oral Tablet [Phyrago]269184151 / 26951051Prior authorization required
dasatinib 50 MG Oral Tablet [Phyrago]269184351 / 26951051Prior authorization required
dasatinib 70 MG Oral Tablet [Phyrago]269184551 / 26951051Prior authorization required
dasatinib 80 MG Oral Tablet [Phyrago]269184751 / 26951051Prior authorization required

Product names come from RxNorm (U.S. National Library of Medicine).

Plan-by-plan detail — dasatinib 100 MG Oral Tablet [Phyrago]

Phyrago has 6 products in the corpus; this table is for dasatinib 100 MG Oral Tablet [Phyrago], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Anthem Dual Advantage (HMO D-SNP)H5422-0185YesNoYes
Anthem Extra Help (HMO-POS)H5422-0135YesNoYes
Anthem Full Dual Advantage (HMO D-SNP)H5422-0195YesNoYes
Anthem Full Dual Advantage Aligned (HMO D-SNP)H4471-0105YesNoYes
Anthem Full Dual Advantage Aligned (HMO D-SNP)H4471-0105YesNoYes
Anthem Full Dual Advantage Aligned (HMO D-SNP)H4471-0115YesNoYes
Anthem I CareMore Chronic Care (HMO-POS C-SNP)H0544-0045YesNoYes
Anthem I CareMore Chronic Care (HMO-POS C-SNP)H0544-0105YesNoYes
Anthem I CareMore Chronic Care 2 (HMO-POS C-SNP)H4161-0145YesNoYes
Anthem I CareMore Chronic Care 2 (HMO-POS C-SNP)H4161-0155YesNoYes
Anthem I CareMore Home Care (HMO I-SNP)H0544-0055YesNoYes
Anthem I CareMore Kidney Care (HMO-POS C-SNP)H0544-0155YesNoYes
Anthem I CareMore Kidney Care (HMO-POS C-SNP)H0544-0205YesNoYes
Anthem I CareMore Lung Care (HMO-POS C-SNP)H0544-0145YesNoYes
Anthem I CareMore Lung Care (HMO-POS C-SNP)H0544-0195YesNoYes
Anthem I CareMore Lung Care 2 (HMO-POS C-SNP)H4161-0165YesNoYes
Anthem I CareMore Lung Care 2 (HMO-POS C-SNP)H4161-0175YesNoYes
Anthem I CareMore Medicare Advantage (HMO-POS)H4161-0115YesNoYes
Anthem I CareMore Medicare Advantage (HMO-POS)H4161-0135YesNoYes
Anthem I CareMore Medicare Advantage 2 (HMO-POS)H0544-0025YesNoYes
Anthem I CareMore Premium Savings (HMO-POS)H4161-0125YesNoYes
Anthem Kidney Care (HMO-POS C-SNP)H5422-0155YesNoYes
Anthem Medicare Advantage (HMO-POS)H0544-0565YesNoYes
Anthem Medicare Advantage (HMO-POS)H0544-0615YesNoYes
Anthem Medicare Advantage (HMO-POS)H0544-0625YesNoYes
Anthem Medicare Advantage (HMO-POS)H0544-0635YesNoYes
Anthem Medicare Advantage (HMO-POS)H0544-0645YesNoYes
Anthem Medicare Advantage (HMO-POS)H0544-0655YesNoYes
Anthem Medicare Advantage (HMO-POS)H0544-0955YesNoYes
Anthem Medicare Advantage (HMO-POS)H0544-0965YesNoYes
Anthem Medicare Advantage (HMO-POS)H0544-1085YesNoYes
Anthem Medicare Advantage (HMO-POS)H5422-0115YesNoYes
Anthem Prime (HMO-POS)H4161-0025YesNoYes
Anthem Prime (HMO-POS)H4161-0035YesNoYes
Anthem Prime (HMO-POS)H4161-0045YesNoYes
Anthem Prime (HMO-POS)H4161-0055YesNoYes
Anthem Prime (HMO-POS)H4161-0065YesNoYes
Anthem Prime (HMO-POS)H4161-0075YesNoYes
Anthem Prime (HMO-POS)H4161-0095YesNoYes
Anthem Prime (HMO-POS)H4161-0105YesNoYes
Anthem Select (HMO-POS)H0544-0585YesNoYes
Anthem Select (HMO-POS)H0544-0665YesNoYes
Anthem Select (HMO-POS)H0544-0695YesNoYes
Anthem Select (HMO-POS)H0544-0915YesNoYes
Anthem Select (HMO-POS)H0544-0985YesNoYes
True Blue Rx 32PSP (HMO)H1350-0325YesNoYes
True Blue Rx 33 (HMO)H1350-0335YesNoYes
True Blue Rx 34 (HMO)H1350-0345YesNoYes
True Blue Rx 35PSP (HMO)H1350-0355YesNoYes
True Blue Rx 36 (HMO)H1350-0365YesNoYes
True Blue Rx 37 (HMO)H1350-0375YesNoYes
Source
Monthly Prescription Drug Plan Formulary and Pharmacy Network Information — Basic Drugs Formulary File
Effective
2026-06-30
Retrieved
2026-07-19
SHA-256
e626e6bcda1aa6a0071e6f0df6bafe686ae41842cdf0a9feffdc649b6d3ff3ae

We publish the hash of the exact file we ingested so any answer can be audited against the bytes CMS served that day.

Phyrago at other payers

Or see Phyrago across every payer at once.

Administrative information only. Benefily reports what a payer has published in its own prior-authorization policy as of the effective date shown. It is not medical advice, not a coverage or payment guarantee, and not an authorization. Requirements vary by plan, place of service and member benefits — always verify with the payer before rendering service.