Benefily
Varies by plan

Does Devoted Health require prior authorization for Procrit?

Prior authorization for Procrit differs across Devoted Health's Medicare Part D plans and product strengths — 5 of 6 Procrit products in the corpus appear on their formularies, and the requirement is not uniform. Check the member's specific plan.

Some plans require authorization and others do not. The member's specific plan decides.

  • This drug does not appear on any of this payer's Medicare Part D formularies. That means it is NOT COVERED under those plans — which is a different and generally worse outcome than requiring prior authorization. An exception or formulary-exception request may still be possible.

By product strength

RxNorm productPlans coveringRequire prior authStep therapyQty limitStatus
1 ML epoetin alfa 10000 UNT/ML Injection [Procrit]1721690415 / 41541500Prior authorization required
1 ML epoetin alfa 2000 UNT/ML Injection [Procrit]205918415 / 41541500Prior authorization required
1 ML epoetin alfa 3000 UNT/ML Injection [Procrit]205922415 / 41541500Prior authorization required
1 ML epoetin alfa 4000 UNT/ML Injection [Procrit]205924415 / 41541500Prior authorization required
epoetin alfa 20000 UNT/ML Injectable Solution [Procrit]212219415 / 41541500Prior authorization required
1 ML epoetin alfa 40000 UNT/ML Injection [Procrit]2134750 / 415000Not on formulary

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

Plan-by-plan detail — 1 ML epoetin alfa 10000 UNT/ML Injection [Procrit]

Procrit has 6 products in the corpus; this table is for 1 ML epoetin alfa 10000 UNT/ML Injection [Procrit], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
DEVOTED C-SNP 003 NM (HMO C-SNP)H9977-0033YesNoNo
DEVOTED C-SNP 007 NM (HMO C-SNP)H9977-0073YesNoNo
DEVOTED C-SNP 011 AZ (HMO C-SNP)H8173-0113YesNoNo
DEVOTED C-SNP 023 AZ (HMO C-SNP)H8173-0233YesNoNo
DEVOTED C-SNP 027 TX (HMO C-SNP)H7993-0273YesNoNo
DEVOTED C-SNP 046 TX (HMO C-SNP)H7993-0463YesNoNo
DEVOTED C-SNP CHOICE 004 SC (PPO C-SNP)H7028-0043YesNoNo
DEVOTED C-SNP CHOICE 006 AR (PPO C-SNP)H7397-0063YesNoNo
DEVOTED C-SNP CHOICE 006 MS (PPO C-SNP)H7355-0063YesNoNo
DEVOTED C-SNP CHOICE 008 AL (PPO C-SNP)H9888-0083YesNoNo
DEVOTED C-SNP CHOICE 010 AL (PPO C-SNP)H9888-0103YesNoNo
DEVOTED C-SNP CHOICE PLUS 003 DE (PPO C-SNP)H0413-0033YesNoNo
DEVOTED C-SNP CHOICE PLUS 004 KS (PPO C-SNP)H4348-0043YesNoNo
DEVOTED C-SNP CHOICE PLUS 004 KY (PPO C-SNP)H5718-0043YesNoNo
DEVOTED C-SNP CHOICE PLUS 006 NE (PPO C-SNP)H9802-0063YesNoNo
DEVOTED C-SNP CHOICE PLUS 006 SC (PPO C-SNP)H7028-0063YesNoNo
DEVOTED C-SNP CHOICE PLUS 006 WA (PPO C-SNP)H8917-0063YesNoNo
DEVOTED C-SNP CHOICE PLUS 007 UT (PPO C-SNP)H4473-0073YesNoNo
DEVOTED C-SNP CHOICE PLUS 008 OK (PPO C-SNP)H2845-0083YesNoNo
DEVOTED C-SNP CHOICE PLUS 010 AR (PPO C-SNP)H7397-0103YesNoNo
DEVOTED C-SNP CHOICE PLUS 010 MS (PPO C-SNP)H7355-0103YesNoNo
DEVOTED C-SNP CHOICE PLUS 012 AL (PPO C-SNP)H9888-0123YesNoNo
DEVOTED C-SNP CHOICE PLUS 012 IL (PPO C-SNP)H8320-0123YesNoNo
DEVOTED C-SNP CHOICE PLUS 013 IN (PPO C-SNP)H7471-0133YesNoNo
DEVOTED C-SNP CHOICE PLUS 014 LA (PPO C-SNP)H7766-0143YesNoNo
DEVOTED C-SNP CHOICE PLUS 015 AL (PPO C-SNP)H9888-0153YesNoNo
DEVOTED C-SNP CHOICE PLUS 016 GA (PPO C-SNP)H5453-0163YesNoNo
DEVOTED C-SNP CHOICE PLUS 020 TN (PPO C-SNP)H9231-0203YesNoNo
DEVOTED C-SNP CHOICE PREMIUM 003 KS (PPO C-SNP)H4348-0033YesNoNo
DEVOTED C-SNP CHOICE PREMIUM 003 UT (PPO C-SNP)H4473-0033YesNoNo
DEVOTED C-SNP CHOICE PREMIUM 005 KY (PPO C-SNP)H5718-0053YesNoNo
DEVOTED C-SNP CHOICE PREMIUM 005 SC (PPO C-SNP)H7028-0053YesNoNo
DEVOTED C-SNP CHOICE PREMIUM 005 WA (PPO C-SNP)H8917-0053YesNoNo
DEVOTED C-SNP CHOICE PREMIUM 006 KY (PPO C-SNP)H5718-0063YesNoNo
DEVOTED C-SNP CHOICE PREMIUM 007 AR (PPO C-SNP)H7397-0073YesNoNo
DEVOTED C-SNP CHOICE PREMIUM 007 KS (PPO C-SNP)H4348-0073YesNoNo
DEVOTED C-SNP CHOICE PREMIUM 007 MS (PPO C-SNP)H7355-0073YesNoNo
DEVOTED C-SNP CHOICE PREMIUM 009 AL (PPO C-SNP)H9888-0093YesNoNo
DEVOTED C-SNP CHOICE PREMIUM 009 NE (PPO C-SNP)H9802-0093YesNoNo
DEVOTED C-SNP CHOICE PREMIUM 009 OK (PPO C-SNP)H2845-0093YesNoNo
DEVOTED C-SNP CHOICE PREMIUM 010 OK (PPO C-SNP)H2845-0103YesNoNo
DEVOTED C-SNP CHOICE PREMIUM 011 AL (PPO C-SNP)H9888-0113YesNoNo
DEVOTED C-SNP CHOICE PREMIUM 011 IL (PPO C-SNP)H8320-0113YesNoNo
DEVOTED C-SNP CHOICE PREMIUM 012 LA (PPO C-SNP)H7766-0123YesNoNo
DEVOTED C-SNP CHOICE PREMIUM 013 IL (PPO C-SNP)H8320-0133YesNoNo
DEVOTED C-SNP CHOICE PREMIUM 013 LA (PPO C-SNP)H7766-0133YesNoNo
DEVOTED C-SNP CHOICE PREMIUM 014 IL (PPO C-SNP)H8320-0143YesNoNo
DEVOTED C-SNP CHOICE PREMIUM 014 IN (PPO C-SNP)H7471-0143YesNoNo
DEVOTED C-SNP CHOICE PREMIUM 015 GA (PPO C-SNP)H5453-0153YesNoNo
DEVOTED C-SNP CHOICE PREMIUM 015 IN (PPO C-SNP)H7471-0153YesNoNo
DEVOTED C-SNP CHOICE PREMIUM 016 IN (PPO C-SNP)H7471-0163YesNoNo
DEVOTED C-SNP CHOICE PREMIUM 016 TN (PPO C-SNP)H9231-0163YesNoNo
DEVOTED C-SNP CHOICE PREMIUM 017 GA (PPO C-SNP)H5453-0173YesNoNo
DEVOTED C-SNP CHOICE PREMIUM 017 IN (PPO C-SNP)H7471-0173YesNoNo
DEVOTED C-SNP CHOICE PREMIUM 017 TN (PPO C-SNP)H9231-0173YesNoNo
DEVOTED C-SNP CHOICE PREMIUM 018 GA (PPO C-SNP)H5453-0183YesNoNo
DEVOTED C-SNP CHOICE PREMIUM 018 TN (PPO C-SNP)H9231-0183YesNoNo
DEVOTED C-SNP CHOICE PREMIUM 019 TN (PPO C-SNP)H9231-0193YesNoNo
DEVOTED C-SNP PLUS 003 HI (HMO C-SNP)H5397-0033YesNoNo
DEVOTED C-SNP PLUS 004 NM (HMO C-SNP)H9977-0043YesNoNo
DEVOTED C-SNP PLUS 004 VA (HMO C-SNP)H6994-0043YesNoNo
DEVOTED C-SNP PLUS 006 IL (HMO C-SNP)H7151-0063YesNoNo
DEVOTED C-SNP PLUS 009 OR (HMO C-SNP)H2923-0093YesNoNo
DEVOTED C-SNP PLUS 013 CO (HMO C-SNP)H7147-0133YesNoNo
DEVOTED C-SNP PLUS 015 NC (HMO C-SNP)H5299-0153YesNoNo
DEVOTED C-SNP PLUS 016 MO (HMO C-SNP)H2041-0163YesNoNo
DEVOTED C-SNP PLUS 016 OH (HMO C-SNP)H2697-0163YesNoNo
DEVOTED C-SNP PLUS 021 PA (HMO C-SNP)H6852-0213YesNoNo
DEVOTED C-SNP PLUS 022 AZ (HMO C-SNP)H8173-0223YesNoNo
DEVOTED C-SNP PLUS 022 PA (HMO C-SNP)H6852-0223YesNoNo
DEVOTED C-SNP PLUS 024 TX (HMO C-SNP)H7993-0243YesNoNo
DEVOTED C-SNP PLUS 025 AZ (HMO C-SNP)H8173-0253YesNoNo
DEVOTED C-SNP PLUS 027 AZ (HMO C-SNP)H8173-0273YesNoNo
DEVOTED C-SNP PLUS 029 TX (HMO C-SNP)H7993-0293YesNoNo
DEVOTED C-SNP PLUS 031 TX (HMO C-SNP)H7993-0313YesNoNo
DEVOTED C-SNP PLUS 033 TX (HMO C-SNP)H7993-0333YesNoNo
DEVOTED C-SNP PLUS 036 IA (HMO C-SNP)H7993-0363YesNoNo
DEVOTED C-SNP PLUS 084 FL (HMO C-SNP)H1290-0843YesNoNo
DEVOTED C-SNP PLUS 085 FL (HMO C-SNP)H1290-0853YesNoNo
DEVOTED C-SNP PLUS 086 FL (HMO C-SNP)H1290-0863YesNoNo
DEVOTED C-SNP PLUS 087 FL (HMO C-SNP)H1290-0873YesNoNo
DEVOTED C-SNP PLUS 088 FL (HMO C-SNP)H1290-0883YesNoNo
DEVOTED C-SNP PLUS 089 FL (HMO C-SNP)H1290-0893YesNoNo
DEVOTED C-SNP PLUS 090 FL (HMO C-SNP)H1290-0903YesNoNo
DEVOTED C-SNP PLUS 091 FL (HMO C-SNP)H1290-0913YesNoNo
DEVOTED C-SNP PREMIUM 003 VA (HMO C-SNP)H6994-0033YesNoNo
DEVOTED C-SNP PREMIUM 005 IL (HMO C-SNP)H7151-0053YesNoNo
DEVOTED C-SNP PREMIUM 009 CO (HMO C-SNP)H7147-0093YesNoNo
DEVOTED C-SNP PREMIUM 010 CO (HMO C-SNP)H7147-0103YesNoNo
DEVOTED C-SNP PREMIUM 010 VA (HMO C-SNP)H6994-0103YesNoNo
DEVOTED C-SNP PREMIUM 011 CO (HMO C-SNP)H7147-0113YesNoNo
DEVOTED C-SNP PREMIUM 012 MO (HMO C-SNP)H2041-0123YesNoNo
DEVOTED C-SNP PREMIUM 013 MO (HMO C-SNP)H2041-0133YesNoNo
DEVOTED C-SNP PREMIUM 013 VA (HMO C-SNP)H6994-0133YesNoNo
DEVOTED C-SNP PREMIUM 014 AZ (HMO C-SNP)H8173-0143YesNoNo
DEVOTED C-SNP PREMIUM 014 MO (HMO C-SNP)H2041-0143YesNoNo
DEVOTED C-SNP PREMIUM 014 NC (HMO C-SNP)H5299-0143YesNoNo
DEVOTED C-SNP PREMIUM 015 MO (HMO C-SNP)H2041-0153YesNoNo
DEVOTED C-SNP PREMIUM 016 NC (HMO C-SNP)H5299-0163YesNoNo
DEVOTED C-SNP PREMIUM 016 PA (HMO C-SNP)H6852-0163YesNoNo
Showing 100 of 415 covering plans.
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.

Procrit at other payers

Or see Procrit 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.