J9358, Injection, fam-trastuzumab deruxtecan-nxki, 1 mgHCPCS/CPT
Prior Auth Required
At least one active policy explicitly requires prior authorization (high confidence)
ARKBLUE-FAM-TRASTUZUMAB-DERUXTECAN-NXKI-E-G-ENHERTU-E2B88EF30F, Fam-trastuzumab deruxtecan-nxki (e.g., Enhertu)
AR
BCBSM-2119714-1A7604A947, ENHERTU (FAM-TRASTUZUMAB DERUXTECAN-NXKI)
MI
HEALTHPARTNERS-CC-ENTRY-226852, Oncology - fam-trastuzumab deruxtecan-nxki (Enhertu) – Minnesota Health Care Programs
MULTI
HEALTHPARTNERS-CC-ENTRY-203715, Oncology - ado-trastuzumab emtansine (Kadcyla), fam-trastuzumab deruxtecan-nxki (Enhertu), pertuzumab (Perjeta)
MULTI
BCBSND-FAM-TRASTUZUMAB-DERUXTECAN-NXKI-ENHERTU-860D9E0AA8, FAM Trastuzumab Deruxtecan Nxki Enhertu
ND
BCBSNJ-DRUGS-011-749DD9CCDF, Trastuzumab (Herceptin), Trastuzumab-dkst (Ogivri), Ado-trastuzumab emtansine (Kadcyla), Trastuzumab-pkrb (Herzuma), Trastuzumab-dttb (Ontruzant), Trastuzumab and Hyaluronidase-oysk (Herceptin Hylecta), Trastuzumab-qyyp (Trazimera), Trastuzumab-anns (Kanjinti), Fam-trastuzumab deruxtecan-nxki (Enhertu), Pertuzumab (Perjeta), and Pertuzumab, Trastuzumab, and hyaluronidase-zzxf (Phesgo)
NJ
MODA-ENHERTU-38B937864F, Enhertu (fam-trastuzumab deruxtecan-nxki)
OR
HEALTHNET_OR-HNOR-FAM-TRASTUZUMB-DERUXTECAN-NXKI-ENHERTU-CP-PHAR-456-07118E27D4, Fam-trastuzumb deruxtecan-nxki (Enhertu); CP.PHAR.456
OR
IBX-MEDICARE-ADVANTAGE-MA08-114I-4154F135EF, Fam-trastuzumab deruxtecan-nxki (Enhertu)
PA
IBX-COMMERCIAL-08-00-12I-4E0E918465, Fam-trastuzumab deruxtecan-nxki (Enhertu)
PA
BCBSOK-RX502.061, Oncology Medications
EVICORE-HPLAN-HEALTH_PARTNERS_PLANS-4BC80209CCC5, Q3 - 2026 Jefferson Health Plans MedOnc Master Drug List
AETNA-fam-trastuzumab-deruxtecan-nxki-enhertu-medical-clinical, Fam-trastuzumab Deruxtecan-nxki (Enhertu)
AMERIHEALTH-COMMERCIAL-08-00-12I-84A865246D, Fam-trastuzumab deruxtecan-nxki (Enhertu)
AMERIHEALTH-MEDICARE-ADVANTAGE-MA08-114I-ADE5F21669, Fam-trastuzumab deruxtecan-nxki (Enhertu)
BCBSTN-f2dbd9bd44, Fam-trastuzumab Deruxtecan-nxki (Enhertu)
BCBSIL-RX502.061, Oncology Medications
BCBSMT-RX502.061, Oncology Medications
BCBSNM-RX502.061, Oncology Medications
EVICORE-HPLAN-CIGNA-729A536F50C8, Q3 - 2026 Cigna MedOnc Master Drug List.pdf
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