Does Sapphire Edge, INC. require prior authorization for Procrit?
Sapphire Edge, INC. requires prior authorization for Procrit 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 | Step therapy | Qty limit | Status |
|---|---|---|---|---|---|
| 1 ML epoetin alfa 10000 UNT/ML Injection [Procrit]1721690 | 5 / 5 | 5 | 0 | 0 | Prior authorization required |
| 1 ML epoetin alfa 2000 UNT/ML Injection [Procrit]205918 | 5 / 5 | 5 | 0 | 0 | Prior authorization required |
| 1 ML epoetin alfa 3000 UNT/ML Injection [Procrit]205922 | 5 / 5 | 5 | 0 | 0 | Prior authorization required |
| 1 ML epoetin alfa 4000 UNT/ML Injection [Procrit]205924 | 5 / 5 | 5 | 0 | 0 | Prior authorization required |
| epoetin alfa 20000 UNT/ML Injectable Solution [Procrit]212219 | 5 / 5 | 5 | 0 | 0 | Prior authorization required |
| 1 ML epoetin alfa 40000 UNT/ML Injection [Procrit]213475 | 5 / 5 | 5 | 0 | 0 | Prior authorization required |
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.
| Plan | Contract | Tier | Prior auth | Step therapy | Qty limit |
|---|---|---|---|---|---|
| Blue Cross and Blue Shield of Nebraska MA Access (PPO) | H8181-001 | 4 | Yes | No | No |
| Blue Cross and Blue Shield of Nebraska MA Connect (PPO) | H8181-002 | 4 | Yes | No | No |
| Blue Cross and Blue Shield of Nebraska MA Core (HMO) | H3170-003 | 4 | Yes | No | No |
| Blue Cross and Blue Shield of Nebraska MA Core (HMO) | H3170-003 | 4 | Yes | No | No |
| Blue Cross and Blue Shield of Nebraska MA Secure (PPO) | H8181-003 | 4 | Yes | No | No |
- 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
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.