GTRx Plus delivers cost control and clarity for specialty medications through an enforceable preferred-sourcing model. This program covers over 800 high-cost, high-complexity drugs focused on infusion therapies and specialty conditions. The list is continuously updated to reflect current pricing and plan design needs.
Product Name & Code
Abacavir
No J-code
Abilify
J0401
Abiraterone Acetate
No J-code
Abispak
J0130
Abraxane
J9264
Abrilada
No J-code
Actemra
J3262
Actemra Act
J3262
Acthar Gel
J0801
Actimmune
No J-code
Activase
J2997
Adakveo
J0791
Adbry
No J-code
Adcetris
J9042
Adcirca
No J-code
Adefovir Dipivoxil
No J-code
Adempas
No J-code
Adriamycin
J9000
Aduhelm
J0172
Advate
J7192
Adynovate
J7207
Afinitor
No J-code
Afinitor Disperz
No J-code
Afstyla
J7210
Aldurazyme
J1931
Alecensa
No J-code
Alferon N
J9215
Alimta
J9305
Alphanate
J7186
Alphanine Sd
J7193
Alprolix
J7201
Altuviiio
J7214
Alyglo
J1552
Alymsys
Q5126
Alyq
No J-code
Ambrisentan
No J-code
Amjevita
No J-code
Ampyra
No J-code
Amvuttra
J0225
Anktiva
J9028
Apokyn
J0364
Apretude
J0739
Aptivus
No J-code
Aralast Np
J0256
Aranesp
J0881
Arcalyst
No J-code
Arestin
No J-code
Aristada
J1943
Aristada Initio
J1943
Arixtra
J1652
Arranon
J9261
Arsenic Trioxide
J9017
Arzerra
J9302
Asceniv
J1554
Astagraf
J7508
Atazanavir
No J-code
Atripla
No J-code
Atropine Sulfate
J0461
Atropine Sulfate Ophthalmic
J0461
Aubagio
No J-code
Austedo
No J-code
Austedo Xr
No J-Code
Auviq
No J-Code
Avastin
J9035
Avonex
Q3027
Avsola
Q5121
Azacitidine
J9025
Azasan
J7500
Azathioprine
J7500
Bafiertam
No J-code
Baraclude
No J-code
Bebulin
J7190
Belrapzo
J9036
Bendamustine
J9033
Bendeka
J9034
Benefix
J7195
Benlysta
J0490
Beovu
J0179
Beqvez
No J-code
Berinert
J0597
Besponsa
J9229
Betaseron
No J-code
Bethkis
J7682
Bexarotene
No J-code
Bexarotene Gel
No J-Code
Bicalutamide
No J-code
Biktarvy
No J-code
Bimzelx
No J-code
Bivigam
J1556
Bleomycin Sulfate
J9040
Blincyto
J9039
Boniva
No J-code
Bortezomib
J9041
Bosentan
No J-code
Bosulif
No J-code
Botox
J0585
Braftovi
No J-code
Bravelle
S0126
Briumvi
J2329
Brixadi
J0577
Buphenyl
No J-code
Busulfan
J0594
Busulfex
J0594
Byooviz
Q5124
Cabenuva
J0741
Cabometyx
No J-code
Camptosar
J9206
Camzyos
No J-code
Capecitabine
J8520
Carbaglu
No J-code
Carboplatin
J9045
Carglumic Acid
No J-Code
Carmustine
J9050
Casodex
No J-code
Cayston
No J-code
Cellcept
J7517
Ceprotin
J2724
Cerdelga
No J-code
Cerezyme
J1786
Cetrorelix Acetate
J9167
Cetrotide
No J-code
Chorionic Gonadotropin
J0725
Cibinqo
No J-code
Cimduo
No J-code
Cimerli
Q5128
Cimzia
J0717
Cinacalcet Hcl
No J-Code
Cinryze
J0598
Cisplatin
J9060
Cladribine
J9065
Clofarabine
J9027
Clolar
J9027
Coagadex
J7175
Columvi
J9286
Combivir
No J-code
Cometriq
No J-code
Complera
No J-code
Copaxone
J1595
Copegus
No J-Code
Copiktra
No J-code
Corifact
J7180
Cortrophin Gel
J0802
Cosentyx
J3247
Cosmegen
J9120
Cotellic
No J-code
Crinone
No J-code
Crixivan
No J-code
Crysvita
J0584
Cutaquig
J1551
Cuvitru
J1555
Cyclophosphamide
J8530
Cyclosporine
J7502
Cyklokapron
No J-code
Cyramza
J9308
Cytarabine Pf
J9100
Cytogam
J0850
Dacarbazine
J9130
Dacogen
J0894
Dactinomycin
J9120
Daklinza
No J-Code
Dalfampridine Er
No J-Code
Dalvance
J0875
Darzalex
J9144
Darzalex Faspro
J9144
Daunorubicin Hcl
J9150
Daurismo
No J-code
Daxxify
J0589
Ddavp
J2597
Decitabine
J0893
Deferasirox
No J-code
Deferasirox Granuleset
No J-Code
Deferiprone
No J-code
Deferoxamine Mesylate
J0895
Delstrigo
No J-code
Descovy
No J-code
Desmopressin Acetate
J2597
Dexrazoxane
J1190
Didanosine
No J-Code
Dimethyl Fumarate
No J-Code
Docetaxel
J9171
Dojolvi
No J-code
Doptelet
No J-code
Dovato
No J-code
Doxil
Q2050
DOXOrubicin HCL
J9000, Q2050
Droxidopa
No J-code
Duopa
J7340
Dupixent
No J-code
Durolane
J7318
Durysta
J7351
Durysta Intraocular
J7351
Dysport
J0586
Ebglyss
No J-code
Edurant
No J-code
Efavirenz
No J-code
Egrifta
No J-code
Elaprase
J1743
Elelyso
J3060
Elfabrio
J2508
Eligard
J9217
Elitek
J2783
Ellence
J9178
Eloctate
J7205
Elzonris
J9269
Emcyt
No J-code
Emflaza
No J-code
Empliciti
J9176
Emtriva
No J-code
Enbrel
J1438
Endometrin
No J-code
Enhertu
J9358
Enoxaparin Sodium
J1650
Enspryng
No J-code
Entecavir
No J-code
Entyvio
J3380
Envarsus XR
J7503
Epclusa
No J-code
Epclusa
No J-Code
Epidiolex
No J-code
Epivir
No J-code
Epogen
J0885
Epoprostenol Sodium
J1325
Epzicom
No J-code
Erbitux
J9055
Erivedge
No J-code
Erleada
No J-code
Erlotinib
No J-code
Esbriet
No J-code
Esperoct
J7204
Ethyol
No J-code
Etopophos
J9181
Etoposide
J8560
Euflexxa
J7323
Evenity
J3111
Everolimus
J7527
Evomela
J9246
Evotaz
No J-code
Exjade
No J-code
Extavia
No J-code
Eylea
J0178
Fabrazyme
J0180
Fareston
No J-code
Farydak
No J-code
Fasenra
J0517
Faslodex
J9395
Feiba
J7198
Fensolvi
J1951
Fingolimodhcl
No J-Code
Firazyr
J1744
Firmagon
J9155
Flebogamma
J1572
Flolan
J1325
Fludarabine Phosphate
J9185
Fluorouracil
J9190
Follistim Aq
S0126
Folotyn
J9307
Fondaparinux Sodium
J1652
Forteo
No J-code
Fosamprenavir Calcium
No J-Code
Fragmin
J1645
Fulphila
Q5108
Fulvestrant
J9393
Fuzeon
No J-code
Fyremadel
No J-code
Galafold
No J-code
Gamastan
J1460
Gammagard Liquid
J1569
Gammagard SD
J1566
Gammaked
J1561
Gammaplex
J1557
Gamunex-C
J1561
Ganirelix Acetate
J1560
Ganirelix Acetate
No J-Code
Gattex
No J-code
Gazyva
J9301
Gefitinib
No J-code
Gel-One
No J-code
Gelsyn
J7328
Gemcitabine Hcl
J9296, J9201
Gengraf
J7502
Genotropin
J2941
Genvisc
No J-code
Genvoya
No J-code
Geodon
J3486
Gilenya
No J-code
Gilotrif
No J-code
Givlaari
J0223
Glassia
J0257
Glatiramer
No J-code
Glatopa
No J-code
Gleevec
No J-code
Gleostine
No J-code
Gliadel Wafer Implant Wafer
C9281
Gonalf
S0126
Granix
J1447
Haegarda
No J-code
Halaven
J9179
Harvoni
No J-code
Harvoni
No J-Code
Healon Pro
J7317
Hecoria
J7505
Helixate Fs
J7189
Hemlibra
J7170
Hemofil M
J7190
Herceptin
J9355
Herceptin Hylecta
J9356
Herzuma
Q5113
Hetlioz
No J-code
Hizentra
J1559
Humate-P
J7187
Humatrope
No J-code
Humira
J0135
Hyalgan
J7321
Hycamtin
J8705
HYDROXYprogesterone Caproate
J1726
Hymovis
J7322
Hympavzi
J7172
Hyperrhosd
J2792
Hyqvia
J1575
Ibandronate Sodium
J1740
Ibrance
No J-code
Icatibant
J1744
Idamycin PFS
J9211
IDArubicin HCL
J9211
Idelvion
J7202
Idhifa
No J-code
Ifex GM
J9208
Ifosfamide GM
J9208
Ilaris
J0638
Ilumya
J3245
Iluvien
J7313
Imaavy
No J-code
Imatinib Mesylate
J9000
Imbruvica
No J-code
Imfinzi
J9173
Imjudo
J9347
Imuran
J7500
Inbrija
No J-code
Incivek
No J-Code
Increlex
No J-code
Infergen
J9212
Inflectra
Q5103
Inlyta
No J-code
Inqovi
No J-code
Inrebic
No J-code
Intelence
No J-code
Intron A
J9214
Invega Hafyera
J2427
Invega Sustenna
J2426
Invega Trinza
J2427
Invirase
No J-code
Iprivask
No J-Code
Iressa
No J-code
Irinotecan HCL
J9206
Isentress
No J-code
Istodax
J9319
Ixempra
J9207
Ixinity
J7213
Jadenu
No J-code
Jadenu
No J-Code
Jakafi
No J-code
Jaypirca
No J-code
Jelmyto
J9281
Jemperli
J9272
Jevtana
J9043
Jivi
J7208
Juluca
No J-code
Jynarque
No J-code
Kadcyla
J9354
Kalbitor
J1290
Kaletra
No J-code
Kalydeco
No J-code
Kalydeco
No J-Code
Kanjinti
Q5117
Kanuma
No J-code
Kesimpta
No J-code
Kevzara
No J-code
Keytruda
J9271
Kisqali
No J-code
Kisunla
J0175
Kitabis Pak
No J-Code
Koate
J7190
Kogenate Fs
J7192
Kovaltry
J7211
Krystexxa
J2507
Kuvan
No J-code
Kynamro
No J-Code
Kyprolis
J9047
Lamivudine
No J-code
Lanreotide Acetate
J1930, J1932
Lapatinib Ditosylate
No J-Code
Lartruvo
J9285
Ledipasvir-Sofosbuvir
No J-code
Lemtrada
J0202
Lenmeldy
No J-code
Lenvima
No J-code
Lenvima
No J-Code
Letairis
No J-code
Leukine
J2820
Leuprolide Acetate
J1950, J9217
Lexiva
No J-code
Liletta
No J-code
Liqrev
No J-Code
Lonsurf
No J-code
Lopinavir/Ritonavir
No J-Code
Lorbrena
No J-code
Lovenox
J1650
Lucentis
J2778
Lumakras
No J-code
Lumizyme
J0221
Lunsumio
J9350
Lupaneta Pack
No J-Code
Lupron Depot
J1950, J9217
Luxturna
No J-code
Lyfgenia
No J-code
Lynparza
No J-code
Macrilen
No J-code
Macugen
J2503
Makena
No J-code
Mavenclad
No J-code
Mavyret
No J-code
Mayzent
No J-code
Mekinist
No J-code
Mektovi
No J-code
Melphalan
J9245
Menopur
No J-code
Mepsevii
No J-code
Mesna
J9209
Mesnex
J9209
Miacalcin
J0630
MICHRhoGAM Ultra
J2788
Miglustat
No J-code
Mitomycin
J9280
Mitoxantrone
J9293
Moderiba
No J-Code
Monoclate-P
No J-Code
Mononine
J7193
Monovisc
J7327
Mozobil
J2562
Mulpleta
No J-code
Mutamycin
J9280
Mvasi
Q5107
Myalept
No J-code
Mycophenolate Mofetil
J7519, J7517
Myfortic
J7518
Mylotarg
J9203
Myobloc
J0587
Nabihb
J1580
Naglazyme
J1458
Natpara
No J-code
Nemluvio
No J-code
Neoral
J7502
Nerlynx
No J-code
Neulasta
J2506
Neumega
J2355
Neupogen
J1442
Nevirapine
No J-code
Nexavar
No J-code
Nexplanon
No J-code
Nexviazyme
J0219
Nilutamide
No J-code
Ninlaro
No J-code
Nipent
J9268
Nitisinone
No J-code
Nityr
No J-code
Nivestym
Q5110
Norditropin
No J-code
Northera
No J-code
Norvir
No J-code
Novarel
J0725
Novoeight
J7182
Novoseven Rt
J7189
Nplate
J2802
Nubeqa
No J-code
Nucala
J2182
Nulojix
J0485
Nuplazid
No J-code
Nutropin Aq
S0142
Nuwiq
J7209
Nyvepria
Q5122
Ocaliva
No J-code
Ocrevus
J2350
Ocrevus Zunovo
J2351
Octagam
J1568
Octreotide Acetate
J2353
Odefsey
No J-code
Odomzo
No J-code
Ofev
No J-code
Ogivri
Q5114
Olumiant
No J-code
Olysio
No J-Code
Omnitrope
No J-code
Omvoh
J2267
Onivyde
J9205
Onpattro
J0222
Ontruzant
Q5112
Onureg
No J-code
Opdivo
J9299
Opdualag
J9298
Opsumit
No J-code
Orencia
J0129
Orenitram
No J-code
Orilissa
No J-code
Orkambi
No J-code
Orkambi
No J-Code
Orthovisc
J7324
Otezla
No J-code
Ovidrel
No J-code
Oxaliplatin
J9263
Oxervate
No J-code
Ozurdex
J7312
Paclitaxel
J9264
PACLitaxel Protein-Bound
J9264
Padcev
J9177
Palynziq
No J-code
Pamidronate Disodium
J2430
Panhematin
J1640
Panretin Gel
No J-Code
Panzyga
J1576
Paraplatin
J9045
Peg-Intron
J9214
Pegasys
No J-code
Pemetrexed
J9294
PEMEtrexed Disodium
J9294, J9296, J9297, J9305
PEMEtrexed Ditromethamine
J9323
Penicillamine
No J-code
Perjeta
J9306
Perseris
J2798
Phentolamine Mesylate
J2760
Phesgo
J9316
Piasky
No J-code
Pifeltro
No J-code
Piqray
No J-code
Piqray
No J-Code
Pirfenidone
No J-code
Plegridy
No J-code
Plerixafor
J2562
Polivy
J9309
Pomalyst
No J-code
Pombiliti
J1203
Ponvory
No J-code
Portrazza
J9295
Pralatrexate
J9307
Praluent
No J-code
Pregnyl
J0725
Prevymis
No J-code
Prezcobix
No J-code
Prezista
No J-code
Prialt
J2278
Privigen
J1459
Probuphine
J0570
Procrit
J0885
Procysbi
No J-code
Profilnine
J7194
Progesterone
J2675
Prograf
J7507
Prolastin-C
J0256
Proleukin
No J-code
Prolia
J0897
Promacta
No J-code
Prothelial
No J-code
Pulmozyme
J7639
Purified Cortrophin Gel
J0802
Purixan
No J-code
Radicava ORS
J1301
Rapamune
J7520
Ravicti
No J-code
Rebetol
No J-Code
Rebif
No J-code
Rebinyn
J7203
Reblozyl
J0896
Rebyota
J1440
Reclast
J3489
Recombinate
J7192
Releuko
Q5125
Remicade
J1745
Remodulin
J3285
Renflexis
Q5104
Repatha
No J-code
Rescriptor
No J-Code
Retacrit
Q5105
Retevmo
No J-code
Retisert
J7311
Retrovir
J3485
Revatio
No J-code
Revlimid
No J-code
Reyataz
No J-code
RhoGAM Ultrafiltered Plus
J2790
Rhophylac
J2791
Riabni
Q5123
Riastap
J7178
Ribapak
No J-Code
Ribasphere
No J-Code
Ribavirin
No J-code
Rilutek
No J-code
Riluzole
No J-code
Rinvoq
No J-code
Ritonavir
No J-code
Rituxan
J9312
Rituxan Hycela
J9311
Rixubis
J7200
Rolvedon
J1449
Romidepsin
J9318
Rozlytrek
No J-code
Rubraca
No J-code
Ruconest
J0596
Ruxience
Q5119
Rybrevant
J9061
Rydapt
No J-code
Sabril
No J-code
Saizen
J2941
Sajazir
No J-code
Samsca
No J-code
Sandimmune
J7502
SandosSTATIN LAR
J2353
SandoSTATIN
J2354
Saphnelo
J0491
Sapropterin Dihydrochloride
No J-code
Scemblix
No J-code
Selzentry
No J-code
Serostim
J2941
Sevenfact
J7212
Signifor
J2502
Sildenafil Citrate
No J-Code
Siliq
No J-code
Simponi
J1602
Simponi Aria
J1602
Simulect
J0480
Sinibmalate
No J-Code
Sirolimus
J7520
Skyrizi
J2327
Skytrofa
No J-code
Sodium Chloride
No J-Code
Sodium Citrate Crystals
No J-Code
Sodium Citrate In Vitro
No J-Code
Sodium Citrate Lock Flush
No J-Code
Sodium Hyaluronate
J7329
Sodium Phenylbutyrate
No J-code
Sodium Thiosulfate
J3490
Sofosbuvir Velpatasvir
No J-Code
Solesta
No J-code
Soliris
J1299
Somatuline Depot
J1930
Somavert
No J-code
Sorafenibtosylate
No J-Code
Sotyktu
No J-code
Sovaldi
No J-code
Sovaldi
No J-Code
Spevigo
J1747
Spinraza
No J-code
Sprycel
No J-code
Stavudine
No J-code
Stelara
J3357
Steqeyma
No J-Code
Stimate
No J-code
Stimufend
Q5127
Stivarga
No J-code
Stribild
No J-code
Sublocade
Q9991
Sucraid
No J-code
Supartz
J7321
Supprelin LA
J9226
Sustiva
No J-code
Sutent
No J-code
Syfovre
J2781
Sylatron
J9212
Sylvant
J2860
Symdeko
No J-code
Symfi
No J-code
Symtuza
No J-code
Synagis
No J-code
Synvisc
J7325
Syprine
No J-code
Tabrecta
No J-code
Tacrolimus
J7507
Tadalafil
No J-code
Tadliq
No J-code
Tafinlar
No J-code
Tagrisso
No J-code
Takhzyro
J0593
Taltz
No J-code
Talzenna
No J-code
Tarceva
No J-code
Targretin
No J-code
Tasigna
No J-code
Tasimelteon
No J-code
Tavalisse
No J-code
Tecentriq
J9022
Tecfidera
No J-code
Technivie
No J-Code
Tegsedi
No J-code
Temodar
J8700
Temozolomide
J8700
Temsirolimus
J9330
Tenofovir Disoproxil Fumarate
No J-Code
Tepadina
J9342
Tepezza
J3241
Teriflunomide
No J-code
Teriparatide
No J-code
Tetrabenazine
No J-code
Tezspire
J2356
Thalomid
No J-code
Thiotepa
J9340
Thrombate III
J7197
Thymoglobulin
J7511
Thyrogen
J3240
Tice Bcg Intravesical
J9030
Tiopronin
No J-code
Tivdak
J9273
Tivicay
No J-code
Tobi
J7682
Tobi Podhaler
No J-Code
Tobramycin
J3260
Tobramycin Ophthalmic
No J-Code
Tobramycin Sulfate
J3260
Tolvaptan
No J-code
Topotecan Hcl
J9351
Torisel
J9330
Tracleer
No J-code
Trazimera
Q5116
Treanda
J9033
Trelstar Mixject
J3315
Tremfya
J1628
Treprostinil Sodium
J3285
Tretinoin
No J-code
Tretinoin Gel
No J-Code
Tretinoin Microsphere
No J-Code
Tretten
J7181
Trientine Hcl
No J-Code
Trikafta
No J-code
Triluron
J7332
Trisenox
J9017
Triumeq
No J-code
Trivisc
No J-code
Trizivir
No J-code
Trogarzo
J1746
Truvada
No J-code
Truxima
Q5115
Tybost
No J-code
Tykerb
No J-code
Tymlos
No J-code
Tyos
No J-Code
Tysabri
J2323
Tyvaso
J7686
Udenyca
Q5111
Ultomiris
J1303
Uplizna
J1823
Uptravi
No J-code
Ustekinumab-Ttwe (Qualllent)
J3358
Vabysmo
J2777
Valchlor Gel
No J-Code
Valrubicin
J9357
Valstar
J9357
Vantas
J9225
Vectibix
J9303
Veidy
No J-Code
Velcade
J9041
Veletri
J1325
Velsipity
No J-Code
Venclexta
No J-code
Ventavis
Q4074
Verzenio
No J-code
Vidaza
J9025
Videx
No J-Code
Viekira
No J-code
Vigabatrin
No J-code
Vijoice
No J-code
Vimizim
J1322
VinBLAStine Sulfate
J9360
VinCRIStine Sulfate
J9370
Vinorelbine Tartrate
J9390
Viracept
No J-code
Viramune
No J-code
Viramune XR
No J-Code
Virazole GM
No J-Code
Viread
No J-code
Visco-3
No J-code
Visudyne
J3396
Vitekta
No J-Code
Vitrakvi
No J-code
Vivimusta
J9056
Vivitrol
J2315
Vizimpro
No J-code
Vonvendi
J7179
Voraxaze
No J-code
Vosevi
No J-code
Votrient
No J-code
Voxzogo
No J-code
Vpriv
J3385
Vumerity
No J-code
Vyalev
No J-code
Vyndamax
No J-code
Vyndaqel
No J-code
Vyvgart
J9332
Vyvgart Hytrulo
J9334
Wakix
No J-code
Wilate
J7183
Winrevair
No J-code
WinRho SDF
J2792
Xalkori
No J-code
Xatmep
J8612
Xeljanz
No J-code
Xeljanz XR
No J-Code
Xeloda
J8522
Xembify
J1558
Xenazine
No J-code
Xenpozyme
J0218
Xeomin
J0588
Xgeva
J0897
Xipere
J3299
Xolair
J2357
Xtandi
No J-code
Xyntha
J7185
Xyrem
No J-code
Yervoy
J9228
Yesintek
No J-Code
Yondelis
J9352
Yonsa
No J-code
Yutiq
J7314
Zaltrap
J9400
Zanosar GM
J9320
Zarxio
Q5101
Zavesca
No J-code
Zejula
No J-code
Zelboraf
No J-code
Zemaira
J0256
Zepatier
No J-code
Zeposia
No J-code
Zerit
No J-Code
Ziagen
No J-code
Zidovudine
No J-code
Ziextenzo
Q5120
Zinbryta
No J-Code
Zirabev
Q5118
Zoladex
J9202
Zoledronic Acid
J3489
Zolgensma
No J-Code
Zolinza
No J-code
Zomacton
No J-code
Zometa
J3489
Zorbtive
J2941
Zortress
J7527
Zydelig
No J-code
Zykadia
No J-code
Zymfentra
J1748
Zyprexa
J2358
Zytiga
No J-code