Benefily
Prior authorization required

Does California Physicians' Service require prior authorization for Recombivax?

California Physicians' Service requires prior authorization for Recombivax 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
1 ML hepatitis B surface antigen vaccine 0.01 MG/ML Injection [Recombivax]165815017 / 171700Prior authorization required
0.5 ML hepatitis B surface antigen vaccine 0.01 MG/ML Injection [Recombivax]165815517 / 171700Prior authorization required
1 ML hepatitis B surface antigen vaccine 0.01 MG/ML Prefilled Syringe [Recombivax]83024517 / 171700Prior authorization required
0.5 ML hepatitis B surface antigen vaccine 0.01 MG/ML Prefilled Syringe [Recombivax]83025317 / 171700Prior authorization required
1 ML hepatitis B surface antigen vaccine 0.04 MG/ML Injection [Recombivax]83026317 / 171700Prior authorization required

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

Plan-by-plan detail — 1 ML hepatitis B surface antigen vaccine 0.01 MG/ML Injection [Recombivax]

Recombivax has 5 products in the corpus; this table is for 1 ML hepatitis B surface antigen vaccine 0.01 MG/ML Injection [Recombivax], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
Blue Shield 65 Plus (HMO)H0504-0153YesNoNo
Blue Shield 65 Plus (HMO)H0504-0173YesNoNo
Blue Shield 65 Plus (HMO)H0504-0263YesNoNo
Blue Shield 65 Plus (HMO)H0504-0283YesNoNo
Blue Shield 65 Plus (HMO)H0504-0383YesNoNo
Blue Shield 65 Plus (HMO)H0504-0393YesNoNo
Blue Shield 65 Plus Choice Plan (HMO)H0504-0403YesNoNo
Blue Shield 65 Plus Plan 2 (HMO)H0504-0213YesNoNo
Blue Shield Advantage (HMO)H0504-0503YesNoNo
Blue Shield AdvantageOptimum Plan (HMO)H5928-0043YesNoNo
Blue Shield AdvantageOptimum Plan 1 (HMO)H5928-0103YesNoNo
Blue Shield Inspire (HMO)H0504-0413YesNoNo
Blue Shield Inspire (HMO)H0504-0433YesNoNo
Blue Shield Inspire (HMO)H0504-0473YesNoNo
Blue Shield Rx Enhanced (PDP)S2468-0043YesNoNo
Blue Shield Rx Plus (PDP)S2468-0033YesNoNo
Blue Shield TotalDual Plan (HMO D-SNP)H2819-0013YesNoNo
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.

Recombivax at other payers

Or see Recombivax 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.