Prior authorization required

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

Blue Cross Blue Shield (affiliate) requires prior authorization for Pyzchiva 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 product	Plans covering	Require prior auth	Qty limit	Status
0.5 ML ustekinumab-ttwe 90 MG/ML Prefilled Syringe [Pyzchiva]2705573	90 / 269	90	90	Prior authorization required
1 ML ustekinumab-ttwe 90 MG/ML Prefilled Syringe [Pyzchiva]2705576	90 / 269	90	90	Prior authorization required
0.5 ML ustekinumab-ttwe 90 MG/ML Injection [Pyzchiva]2713887	90 / 269	90	90	Prior authorization required
0.5 ML ustekinumab-ttwe 90 MG/ML Auto-Injector [Pyzchiva]2720516	16 / 269	16	16	Prior authorization required
1 ML ustekinumab-ttwe 90 MG/ML Auto-Injector [Pyzchiva]2721431	16 / 269	16	16	Prior authorization required

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

Plan-by-plan detail — 0.5 ML ustekinumab-ttwe 90 MG/ML Prefilled Syringe [Pyzchiva]

Pyzchiva has 5 products in the corpus; this table is for 0.5 ML ustekinumab-ttwe 90 MG/ML Prefilled Syringe [Pyzchiva], the one carried on the most plans. The product table above covers every strength.

Plan	Contract	Tier	Prior auth	Step therapy	Qty limit
Blue Advantage Choice (PPO)	H0104-016	4	Yes	No	Yes
Blue Advantage Complete (PPO)	H0104-012	4	Yes	No	Yes
Blue Advantage Complete (PPO)	H0104-014	4	Yes	No	Yes
Blue Advantage Premier (PPO)	H0104-015	4	Yes	No	Yes
Blue Cross Medicare Advantage Choice (PPO)	H5959-009	4	Yes	No	Yes
Blue Cross Medicare Advantage Choice (PPO)	H5959-014	4	Yes	No	Yes
Blue Cross Medicare Advantage Choice (PPO)	H5959-014	4	Yes	No	Yes
Blue Cross Medicare Advantage Comfort (PPO)	H5959-015	4	Yes	No	Yes
Blue Cross Medicare Advantage Comfort (PPO)	H5959-016	4	Yes	No	Yes
Blue Cross Medicare Advantage Complete (PPO)	H5959-010	4	Yes	No	Yes
Blue Cross Medicare Advantage Complete (PPO)	H5959-010	4	Yes	No	Yes
Blue Cross Medicare Advantage Complete (PPO)	H5959-011	4	Yes	No	Yes
Blue Cross Medicare Advantage Core (PPO)	H5959-012	4	Yes	No	Yes
Blue Cross Medicare Advantage Core (PPO)	H5959-013	4	Yes	No	Yes
Blue Cross Medicare Advantage Core (PPO)	H5959-013	4	Yes	No	Yes
Blue Cross Medicare Advantage Secure (HMO)	H8547-001	4	Yes	No	Yes
Blue Medicare Advantage Classic PPO (PPO)	H5900-008	3	Yes	No	Yes
Blue Medicare Advantage Enhanced PPO (PPO)	H5900-004	3	Yes	No	Yes
Blue Medicare Advantage PPO (PPO)	H5900-001	3	Yes	No	Yes
Blue Medicare Choice (HMO)	H3449-026	4	Yes	No	Yes
Blue Medicare Enhanced (HMO-POS)	H3449-024	4	Yes	No	Yes
Blue Medicare Enhanced (HMO-POS)	H3449-024	4	Yes	No	Yes
Blue Medicare Enhanced (HMO-POS)	H3449-024	4	Yes	No	Yes
Blue Medicare Essential (HMO)	H3449-027	4	Yes	No	Yes
Blue Medicare Essential (HMO)	H3449-027	4	Yes	No	Yes
Blue Medicare Essential Plus (HMO-POS)	H3449-023	4	Yes	No	Yes
Blue Medicare Essential Plus (HMO-POS)	H3449-023	4	Yes	No	Yes
Blue Medicare Essential Plus (HMO-POS)	H3449-023	4	Yes	No	Yes
Blue Medicare Essential Plus (HMO-POS)	H3449-023	4	Yes	No	Yes
Blue Medicare PPO Enhanced (PPO)	H3404-003	4	Yes	No	Yes
Blue Medicare PPO Enhanced (PPO)	H3404-003	4	Yes	No	Yes
Blue Medicare Rx Enhanced (PDP)	S5540-004	4	Yes	No	Yes
Blue Medicare Rx Standard (PDP)	S5540-002	4	Yes	No	Yes
Blue MedicareRx Essentials (PDP)	S5726-020	4	Yes	No	Yes
Blue MedicareRx Plus (PDP)	S5726-014	4	Yes	No	Yes
Blue MedicareRx Value (PDP)	S5726-013	4	Yes	No	Yes
BlueCHiP for Medicare Access (HMO-POS)	H4152-022	4	Yes	No	Yes
BlueCHiP for Medicare Enhanced (HMO-POS)	H4152-013	4	Yes	No	Yes
BlueCHiP for Medicare Essential (HMO-POS)	H4152-023	4	Yes	No	Yes
BlueCHiP for Medicare Extra (HMO-POS)	H4152-018	4	Yes	No	Yes
BlueMedicare Complete Rx (PDP)	S5904-002	4	Yes	No	Yes
BlueMedicare Premier Rx (PDP)	S5904-001	4	Yes	No	Yes
BlueMedicare Select (PPO)	H5434-002	4	Yes	No	Yes
BlueMedicare Select (PPO)	H5434-045	4	Yes	No	Yes
BlueMedicare Value (PPO)	H5434-023	4	Yes	No	Yes
BlueMedicare Value (PPO)	H5434-024	4	Yes	No	Yes
BlueMedicare Value (PPO)	H5434-025	4	Yes	No	Yes
BlueMedicare Value (PPO)	H5434-026	4	Yes	No	Yes
BlueMedicare Value (PPO)	H5434-030	4	Yes	No	Yes
BlueMedicare Value (PPO)	H5434-031	4	Yes	No	Yes
BlueMedicare Value (PPO)	H5434-034	4	Yes	No	Yes
BlueMedicare Value (PPO)	H5434-035	4	Yes	No	Yes
BlueMedicare Value (PPO)	H5434-036	4	Yes	No	Yes
BlueRI for Duals (HMO D-SNP)	H4152-021	4	Yes	No	Yes
BlueRx Enhanced Plus (PDP)	S1030-001	4	Yes	No	Yes
BlueRx Essential (PDP)	S1030-006	4	Yes	No	Yes
CareFirst BlueCross BlueShield Advantage Complete (PPO)	H7379-002	3	Yes	No	Yes
CareFirst BlueCross BlueShield Advantage DualPrime (HMO D-SNP)	H8854-002	3	Yes	No	Yes
CareFirst BlueCross BlueShield Advantage Essential (PPO)	H7379-001	3	Yes	No	Yes
Experience Health Medicare Advantage (HMO)	H3777-002	4	Yes	No	Yes
Healthy Blue + Medicare (HMO-POS D-SNP)	H9147-001	4	Yes	No	Yes
Medicare HMO Blue FlexRx (HMO-POS)	H2261-023	3	Yes	No	Yes
Medicare HMO Blue FlexRx (HMO-POS)	H2261-023	3	Yes	No	Yes
Medicare HMO Blue PlusRx (HMO)	H2261-005	3	Yes	No	Yes
Medicare HMO Blue SaverRx (HMO-POS)	H2261-024	3	Yes	No	Yes
Medicare HMO Blue ValueRx (HMO)	H2261-022	3	Yes	No	Yes
Medicare HMO Blue ValueRx (HMO)	H2261-022	3	Yes	No	Yes
Medicare PPO Blue EssentialRx (PPO)	H2230-019	3	Yes	No	Yes
Medicare PPO Blue PlusRx (PPO)	H2230-002	3	Yes	No	Yes
Medicare PPO Blue ValueRx (PPO)	H2230-018	3	Yes	No	Yes
Medicare PPO Blue ValueRx (PPO)	H2230-018	3	Yes	No	Yes
MedicareBlue Rx Standard (PDP)	S5743-001	4	Yes	No	Yes
Platinum Blue Choice Plan with Rx (Cost)	H2461-009	4	Yes	No	Yes
Platinum Blue Complete Plan with Rx (Cost)	H2461-010	4	Yes	No	Yes
Platinum Blue Core Plan with Rx (Cost)	H2461-008	4	Yes	No	Yes
Regence BlueAdvantage HMO (HMO)	H1997-013	4	Yes	No	Yes
Regence BlueAdvantage HMO (HMO)	H6237-009	4	Yes	No	Yes
Regence MedAdvantage + Rx Classic (PPO)	H3817-008	4	Yes	No	Yes
Regence MedAdvantage + Rx Classic (PPO)	H3817-008	4	Yes	No	Yes
Regence MedAdvantage + Rx Classic (PPO)	H3817-008	4	Yes	No	Yes
Regence MedAdvantage + Rx Classic (PPO)	H4605-002	4	Yes	No	Yes
Regence MedAdvantage + Rx Enhanced (PPO)	H3817-009	4	Yes	No	Yes
Regence MedAdvantage + Rx Enhanced (PPO)	H3817-009	4	Yes	No	Yes
Regence MedAdvantage + Rx Enhanced (PPO)	H4605-004	4	Yes	No	Yes
Regence MedAdvantage + Rx Enhanced (PPO)	H5009-002	4	Yes	No	Yes
Regence MedAdvantage + Rx Primary (PPO)	H3817-011	4	Yes	No	Yes
Regence MedAdvantage + Rx Primary (PPO)	H3817-011	4	Yes	No	Yes
Regence MedAdvantage + Rx Primary (PPO)	H3817-011	4	Yes	No	Yes
Regence MedAdvantage + Rx Primary (PPO)	H5009-011	4	Yes	No	Yes
Regence MedAdvantage + Rx Primary (PPO)	H5009-011	4	Yes	No	Yes

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.

Pyzchiva at other payers

Or see Pyzchiva 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.