Benefily
No prior authorization

Does Bravo Health Pennsylvania, INC. require prior authorization for Claravis?

Bravo Health Pennsylvania, INC. does not require prior authorization for Claravis on the Medicare Part D plans that cover it.

No covering plan from this payer files a prior-authorization requirement for this drug.

By product strength

RxNorm productPlans coveringRequire prior authStep therapyQty limitStatus
isotretinoin 10 MG Oral Capsule [Claravis]40405935 / 35000No prior authorization
isotretinoin 20 MG Oral Capsule [Claravis]40406235 / 35000No prior authorization
isotretinoin 40 MG Oral Capsule [Claravis]40406535 / 35000No prior authorization
isotretinoin 30 MG Oral Capsule [Claravis]64348835 / 35000No prior authorization

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

Plan-by-plan detail — isotretinoin 10 MG Oral Capsule [Claravis]

Claravis has 4 products in the corpus; this table is for isotretinoin 10 MG Oral Capsule [Claravis], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
HealthSpring Achieve (HMO C-SNP)H0354-0274NoNoNo
HealthSpring Achieve (HMO C-SNP)H3949-0244NoNoNo
HealthSpring Alliance (HMO)H0354-0284NoNoNo
HealthSpring Preferred (HMO)H0354-0014NoNoNo
HealthSpring Preferred (HMO)H3949-0354NoNoNo
HealthSpring Preferred (HMO)H3949-0454NoNoNo
HealthSpring Preferred (HMO)H3949-0474NoNoNo
HealthSpring Preferred (HMO)H3949-0494NoNoNo
HealthSpring Preferred (HMO)H3949-0524NoNoNo
HealthSpring Preferred (HMO)H3949-0544NoNoNo
HealthSpring Preferred (HMO)H9725-0094NoNoNo
HealthSpring Preferred (HMO)H9725-0094NoNoNo
HealthSpring Preferred (HMO)H9725-0094NoNoNo
HealthSpring Preferred (HMO)H9725-0094NoNoNo
HealthSpring Preferred Full Savings (HMO)H0354-0304NoNoNo
HealthSpring Preferred PA (HMO)H3949-0314NoNoNo
HealthSpring Preferred Plus (HMO)H3949-0304NoNoNo
HealthSpring Preferred Plus (HMO)H3949-0484NoNoNo
HealthSpring Preferred Plus (HMO)H9725-0174NoNoNo
HealthSpring Preferred Plus (HMO)H9725-0174NoNoNo
HealthSpring Preferred Plus (HMO)H9725-0174NoNoNo
HealthSpring Preferred Plus (HMO)H9725-0174NoNoNo
HealthSpring Preferred Savings (HMO)H0354-0294NoNoNo
HealthSpring Preferred Savings (HMO)H3949-0534NoNoNo
HealthSpring Preferred Savings (HMO)H9725-0154NoNoNo
HealthSpring Preferred Savings (HMO)H9725-0154NoNoNo
HealthSpring Preferred Savings (HMO)H9725-0154NoNoNo
HealthSpring Preferred Savings (HMO)H9725-0154NoNoNo
HealthSpring Preferred Savings (HMO)H9725-0164NoNoNo
HealthSpring Preferred Select (HMO)H9725-0144NoNoNo
HealthSpring Premier (HMO-POS)H9725-0184NoNoNo
HealthSpring TotalCare (HMO D-SNP)H9725-0034NoNoNo
HealthSpring TotalCare Plus (HMO D-SNP)H2752-0034NoNoNo
HealthSpring TotalCare Plus (HMO D-SNP)H3949-0094NoNoNo
HealthSpring TotalCare Plus (HMO D-SNP)H9725-0134NoNoNo
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.

Claravis at other payers

Or see Claravis 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.