Medicare Part D coverage · amylase · RxCUI 1806931
amylase 83900 UNT / lipase 21000 UNT / protease 54700 UNT Delayed Release Oral Capsule [Pancreaze]
Per the CMS 2026 Part D formulary file, amylase 83900 UNT / lipase 21000 UNT / protease 54700 UNT Delayed Release Oral Capsule [Pancreaze] is covered by 28 Medicare Part D plans (0.6% of enrollable products), averaging Tier 4.2, with prior authorization required on 16.7% of covering formularies.
- 0.6%
- Plan coverage
- 28
- Plans covering
- T4.2
- Avg tier
- 16.7%
- Prior auth required
What the CMS Formulary Data Shows for amylase 83900 UNT / lipase 21000 UNT / protease 54700 UNT Delayed Release Oral Capsule [Pancreaze]
Per the CMS 2026 Part D formulary file, amylase 83900 UNT / lipase 21000 UNT / protease 54700 UNT Delayed Release Oral Capsule [Pancreaze] (RxNorm concept RXCUI 1806931, generic name amylase) appears on 6 distinct formulary files spanning 28 Medicare Part D plan offerings - 0.6% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 2 to Tier 5, with a cross-plan average of Tier 4.2.
Real-world access to amylase 83900 UNT / lipase 21000 UNT / protease 54700 UNT Delayed Release Oral Capsule [Pancreaze] depends on utilization management as much as tier placement: 16.7% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 2,095 Part D beneficiaries filled amylase 83900 UNT / lipase 21000 UNT / protease 54700 UNT Delayed Release Oral Capsule [Pancreaze] in 2023, with total plan-and-beneficiary spending of $10,310,701 and an average per-beneficiary annual cost of $4,921.58. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry amylase 83900 UNT / lipase 21000 UNT / protease 54700 UNT Delayed Release Oral Capsule [Pancreaze] today.
Coverage Details
- Formularies covering
- 6
- Plans covering
- 28
- Coverage rate
- 0.6%
- Tier range
- Tier 2 – Tier 5
- Average tier
- Tier 4, Non-Preferred
Restrictions
- Prior authorization required
- 16.7% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 2,095
- Total spending
- $10,310,701
- Avg per beneficiary
- $4,921.58
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering amylase 83900 UNT / lipase 21000 UNT / protease 54700 UNT Delayed Release Oral Capsule [Pancreaze]
28 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| CalOptima Health OneCare Complete (HMO D-SNP) | Orange County Health Authority | T2 | Yes | $0 | CA |
| FHCP Medicare Classic (HMO) | Florida Blue Medicare, Inc. | T3 | No | $0 | FL |
| FHCP Medicare Rx Plus (HMO-POS) | Florida Blue Medicare, Inc. | T3 | No | $49.00 | FL |
| UPMC for Life HMO Premier Rx (HMO) | Upmc Health Plan, Inc. | T5 | No | $0 | PA |
| UPMC for Life Complete Care (HMO D-SNP) | Upmc FOR YOU, Inc | T5 | No | $0 | PA |
| UPMC for Life Complete Care (HMO D-SNP) | Upmc FOR YOU, Inc | T5 | No | $0 | PA |
| UPMC for Life PPO Premier Rx (PPO) | Upmc Health Network, Inc. | T5 | No | $0 | PA |
| UPMC for Life PPO Premier Rx (PPO) | Upmc Health Network, Inc. | T5 | No | $0 | PA |
| UPMC for Life PPO Essential Care Rx (PPO) | Upmc Health Network, Inc. | T5 | No | $0 | PA |
| UPMC for Life Complete Care (HMO D-SNP) | Upmc Health Coverage, Inc. | T5 | No | $0 | PA |
| Presbyterian Senior Care Plan 2 with Rx (HMO) | Presbyterian Health Plan | T5 | No | $0 | NM |
| Presbyterian Dual Plus (HMO D-SNP) | Presbyterian Health Plan | T5 | No | $0 | NM |
| Presbyterian Senior Care Extra Health Plan with Rx (HMO) | Presbyterian Health Plan | T5 | No | $0 | NM |
| UPMC for Life HMO Rx Choice (HMO) | Upmc Health Plan, Inc. | T5 | No | $3.90 | OH, PA |
| UPMC for Life HMO Deductible Rx (HMO) | Upmc Health Plan, Inc. | T5 | No | $18.10 | OH, PA |
| UPMC for Life PPO Rx Choice (PPO) | Upmc Health Network, Inc. | T5 | No | $25.00 | PA |
| UPMC for Life PPO High Deductible Rx (PPO) | Upmc Health Network, Inc. | T5 | No | $33.00 | PA |
| UPMC for Life HMO Rx (HMO) | Upmc Health Plan, Inc. | T5 | No | $33.70 | OH, PA |
| UPMC for Life PPO Rx Enhanced (PPO) | Upmc Health Network, Inc. | T5 | No | $42.70 | PA |
| Keystone 65 Select Rx (HMO) | Keystone Health Plan East, Inc. | T5 | No | $47.00 | PA |
Show the next 8 plans
| Keystone 65 Preferred Rx (HMO) | Keystone Health Plan East, Inc. | T5 | No | $59.70 | PA |
| Keystone 65 Select Rx (HMO) | Keystone Health Plan East, Inc. | T5 | No | $63.50 | PA |
| Presbyterian Senior Care Plan 3 with Rx (HMO) | Presbyterian Health Plan | T5 | No | $65.80 | NM |
| Keystone 65 Preferred Rx (HMO) | Keystone Health Plan East, Inc. | T5 | No | $79.70 | PA |
| UPMC for Life HMO Rx Enhanced (HMO) | Upmc Health Plan, Inc. | T5 | No | $93.40 | OH, PA |
| Personal Choice 65 Rx (PPO) | QCC Insurance Company | T5 | No | $102.20 | PA |
| Personal Choice 65 Rx (PPO) | QCC Insurance Company | T5 | No | $112.70 | PA |
| UPMC for Life PPO Rx Enhanced (PPO) | Upmc Health Network, Inc. | T5 | No | $140.00 | PA |
Frequently Asked Questions
Is amylase 83900 UNT / lipase 21000 UNT / protease 54700 UNT Delayed Release Oral Capsule [Pancreaze] covered by Medicare Part D?
Yes, amylase 83900 UNT / lipase 21000 UNT / protease 54700 UNT Delayed Release Oral Capsule [Pancreaze] is covered by 28 Medicare Part D plans (0.6% of all Part D formularies).
What tier is amylase 83900 UNT / lipase 21000 UNT / protease 54700 UNT Delayed Release Oral Capsule [Pancreaze] on Medicare Part D plans?
amylase 83900 UNT / lipase 21000 UNT / protease 54700 UNT Delayed Release Oral Capsule [Pancreaze] averages Tier 4.2 across Part D plans, ranging from Tier 2 to Tier 5.
Does amylase 83900 UNT / lipase 21000 UNT / protease 54700 UNT Delayed Release Oral Capsule [Pancreaze] require prior authorization?
16.7% of Part D formularies require prior authorization for amylase 83900 UNT / lipase 21000 UNT / protease 54700 UNT Delayed Release Oral Capsule [Pancreaze]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on amylase 83900 UNT / lipase 21000 UNT / protease 54700 UNT Delayed Release Oral Capsule [Pancreaze]?
In 2023, total Medicare Part D spending on amylase 83900 UNT / lipase 21000 UNT / protease 54700 UNT Delayed Release Oral Capsule [Pancreaze] was $10,310,701, covering 2,095 beneficiaries. The average spend per beneficiary was $4,921.58.
Read our methodology - how this data is sourced, computed, and verified.
Nationwide similar Part D drugs
Data-derived peers across the CMS Part D formulary extract: nearest average tier placement and nearest prior-authorization rate. Not therapeutic alternatives or same-generic strengths.
Closest average formulary tier
- 1.5 ML aripiprazole 200 MG/ML Prefilled Syringe [Abilify] T4.2
- 2 ML aripiprazole 200 MG/ML Prefilled Syringe [Abilify] T4.2
- 24 HR asenapine 0.158 MG/HR Transdermal System [Secuado] T4.2
- aripiprazole 400 MG Injection [Abilify] T4.2
- 10 ML immunoglobulin G, human 100 MG/ML Injection [Gamunex] T4.2
- naltrexone 380 MG Injection [Vivitrol] T4.2
Similar prior-authorization rate
- quetiapine 150 MG Oral Tablet 16.7% PA
- naldemedine 0.2 MG Oral Tablet [Symproic] 16.7% PA
- ziprasidone 20 MG Injection 16.8% PA
- morphine sulfate 20 MG/ML Oral Solution 16.9% PA
- 1000 ML glucose 100 MG/ML / sodium chloride 4.5 MG/ML Injection 16.5% PA
- chlorpromazine hydrochloride 50 MG Oral Tablet 16.5% PA