Benefily
Prior authorization required

Does Uhc Of California require prior authorization for Revuforj?

Uhc Of California requires prior authorization for Revuforj 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
revumenib 110 MG Oral Tablet [Revuforj]269833740 / 4040040Prior authorization required
revumenib 160 MG Oral Tablet [Revuforj]269834140 / 4040040Prior authorization required
revumenib 25 MG Oral Tablet [Revuforj]269834540 / 4040040Prior authorization required

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

Plan-by-plan detail — revumenib 110 MG Oral Tablet [Revuforj]

Revuforj has 3 products in the corpus; this table is for revumenib 110 MG Oral Tablet [Revuforj], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
AARP Medicare Advantage from UHC CA-0001 (HMO-POS)H0543-0135YesNoYes
AARP Medicare Advantage from UHC CA-0002 (HMO-POS)H0543-0195YesNoYes
AARP Medicare Advantage from UHC CA-0005 (HMO-POS)H0543-0355YesNoYes
AARP Medicare Advantage from UHC CA-0007 (HMO-POS)H0543-0605YesNoYes
AARP Medicare Advantage from UHC CA-0008 (HMO-POS)H0543-0865YesNoYes
AARP Medicare Advantage from UHC CA-0010 (HMO-POS)H0543-1405YesNoYes
AARP Medicare Advantage from UHC CA-0012 (HMO-POS)H0543-1525YesNoYes
AARP Medicare Advantage from UHC CA-0015 (HMO-POS)H0543-1665YesNoYes
AARP Medicare Advantage from UHC CA-003P (HMO-POS)H0543-1515YesNoYes
AARP Medicare Advantage from UHC CA-004P (HMO-POS)H0543-1685YesNoYes
AARP Medicare Advantage from UHC CA-005P (HMO-POS)H0543-1695YesNoYes
AARP Medicare Advantage from UHC CA-006P (HMO-POS)H0543-1705YesNoYes
AARP Medicare Advantage from UHC CA-021P (HMO-POS)H0543-2205YesNoYes
AARP Medicare Advantage from UHC CA-022P (HMO-POS)H0543-2215YesNoYes
AARP Medicare Advantage from UHC CA-023P (HMO-POS)H0543-2225YesNoYes
AARP Medicare Advantage from UHC CA-026P (HMO-POS)H0543-2255YesNoYes
AARP Medicare Advantage from UHC CA-10 (HMO-POS)H0543-1935YesNoYes
AARP Medicare Advantage from UHC CA-33 (HMO-POS)H0543-2325YesNoYes
AARP Medicare Advantage from UHC CA-37 (HMO-POS)H0543-2515YesNoYes
AARP Medicare Advantage from UHC CA-43 (HMO-POS)H0543-2545YesNoYes
AARP Medicare Advantage from UHC CA-44 (HMO-POS)H0543-2555YesNoYes
AARP Medicare Advantage from UHC CA-7 (HMO-POS)H0543-1885YesNoYes
AARP Medicare Advantage from UHC CA-8 (HMO-POS)H0543-1895YesNoYes
AARP Medicare Advantage from UHC CA-9 (HMO-POS)H0543-1915YesNoYes
AARP Medicare Advantage Giveback from UHC CA-19 (HMO-POS)H0543-2365YesNoYes
AARP Medicare Advantage Giveback from UHC CA-20 (HMO-POS)H0543-2375YesNoYes
AARP Medicare Advantage Giveback from UHC CA-21 (HMO-POS)H0543-2385YesNoYes
UHC Complete Care CA-15P (HMO-POS C-SNP)H0543-2145YesNoYes
UHC Complete Care CA-18P (HMO-POS C-SNP)H0543-2175YesNoYes
UHC Complete Care CA-19P (HMO-POS C-SNP)H0543-2185YesNoYes
UHC Complete Care CA-20P (HMO-POS C-SNP)H0543-2195YesNoYes
UHC Complete Care CA-27P (HMO-POS C-SNP)H0543-2265YesNoYes
UHC Complete Care Support CA-1AP (HMO C-SNP)H0543-2395YesNoYes
UHC Complete Care Support CA-2AP (HMO C-SNP)H0543-2405YesNoYes
UHC Complete Care Support CA-3AP (HMO C-SNP)H0543-2415YesNoYes
UHC Complete Care Support CA-4AP (HMO C-SNP)H0543-2425YesNoYes
UHC Complete Care Support CA-6AP (HMO C-SNP)H0543-2465YesNoYes
UHC Complete Care Support CA-8AP (HMO-POS C-SNP)H0543-2495YesNoYes
UHC Sharp Medicare Advantage CA-001P (HMO-POS)H0543-1455YesNoYes
UHC Sharp Medicare Advantage ValueRx CA-12P (HMO-POS)H0543-2045YesNoYes
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.

Revuforj at other payers

Or see Revuforj 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.