Benefily
No prior authorization

Does Mmm Healthcare, LLC require prior authorization for Farxiga?

Mmm Healthcare, LLC does not require prior authorization for Farxiga 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
dapagliflozin 10 MG Oral Tablet [Farxiga]148697720 / 200020No prior authorization
dapagliflozin 5 MG Oral Tablet [Farxiga]148698120 / 200020No prior authorization

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

Plan-by-plan detail — dapagliflozin 10 MG Oral Tablet [Farxiga]

Farxiga has 2 products in the corpus; this table is for dapagliflozin 10 MG Oral Tablet [Farxiga], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
MMM Balance (HMO-POS)H4004-0733NoNoYes
MMM Balance (HMO-POS)H4004-0733NoNoYes
MMM Balance (HMO-POS)H4004-0733NoNoYes
MMM Combo Platino (HMO D-SNP)H4004-0683NoNoYes
MMM Deluxe (HMO-POS)H4003-0553NoNoYes
MMM Diamante Platino (HMO D-SNP)H4003-0173NoNoYes
MMM Dorado Platino (HMO D-SNP)H4003-0583NoNoYes
MMM Elite (HMO-POS)H4003-0343NoNoYes
MMM Flexi Platino (HMO D-SNP)H4004-0693NoNoYes
MMM Grandioso (HMO-POS)H4004-0703NoNoYes
MMM Mega Flex (HMO-POS)H4004-0713NoNoYes
MMM Plenitud (HMO-POS)H4004-0653NoNoYes
MMM Relax Platino (HMO D-SNP)H4004-0723NoNoYes
MMM Relax Platino (HMO D-SNP)H4004-0723NoNoYes
MMM Relax Platino (HMO D-SNP)H4004-0723NoNoYes
MMM Supremo (HMO C-SNP)H4003-0093NoNoYes
MMM Unico (HMO-POS)H4003-0193NoNoYes
MMM Valioso (HMO-POS)H4004-0663NoNoYes
PMC Max (HMO-POS)H4004-0563NoNoYes
PMC Premier Platino (HMO D-SNP)H4004-0483NoNoYes
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.

Farxiga at other payers

Or see Farxiga 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.