amylase 30250 UNT / lipase 8000 UNT / protease 28750 UNT Delayed Release Oral Capsule [Pertzye]

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amylase

RxCUI: 1294483

Important: Drug coverage and costs vary by plan and location. Verify coverage directly with your Medicare plan before filling a prescription. This is informational data only and should not replace advice from your healthcare provider or pharmacist.
0.1%
Plan Coverage
3
Plans Covering
T3
Avg Tier
50%
Prior Auth Required

What the CMS Formulary Data Shows for amylase 30250 UNT / lipase 8000 UNT / protease 28750 UNT Delayed Release Oral Capsule [Pertzye]

Per the CMS 2026 Part D formulary file, amylase 30250 UNT / lipase 8000 UNT / protease 28750 UNT Delayed Release Oral Capsule [Pertzye] (RxNorm concept RXCUI 1294483, generic name amylase) appears on 2 distinct formulary files spanning 3 Medicare Part D plan offerings - 0.1% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 2 to Tier 4, with a cross-plan average of Tier 3.

Real-world access to amylase 30250 UNT / lipase 8000 UNT / protease 28750 UNT Delayed Release Oral Capsule [Pertzye] depends on utilization management as much as tier placement: 50% 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 320 Part D beneficiaries filled amylase 30250 UNT / lipase 8000 UNT / protease 28750 UNT Delayed Release Oral Capsule [Pertzye] in 2023, with total plan-and-beneficiary spending of $6,564,873 and an average per-beneficiary annual cost of $20,515.23. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry amylase 30250 UNT / lipase 8000 UNT / protease 28750 UNT Delayed Release Oral Capsule [Pertzye] today.

Coverage Details

Formularies covering
2
Plans covering
3
Coverage rate
0.1%
Tier range
Tier 2 – Tier 4
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
50% of formularies
Step therapy required
0% of formularies
Quantity limits
0% of formularies

2023 Medicare Spending

Beneficiaries
320
Total spending
$6,564,873
Avg per beneficiary
$20,515.23

Tier Distribution Across Plans

1 plans
Tier 2, Generic
2 plans
Tier 4, Non-Preferred

Medicare Advantage Plans (MA-PD) Covering amylase 30250 UNT / lipase 8000 UNT / protease 28750 UNT Delayed Release Oral Capsule [Pertzye]

3 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. T4 No $0 FL
FHCP Medicare Rx Plus (HMO-POS) FLORIDA BLUE MEDICARE, INC. T4 No $49.00 FL

Frequently Asked Questions

Is amylase 30250 UNT / lipase 8000 UNT / protease 28750 UNT Delayed Release Oral Capsule [Pertzye] covered by Medicare Part D?

Yes, amylase 30250 UNT / lipase 8000 UNT / protease 28750 UNT Delayed Release Oral Capsule [Pertzye] is covered by 3 Medicare Part D plans (0.1% of all Part D formularies).

What tier is amylase 30250 UNT / lipase 8000 UNT / protease 28750 UNT Delayed Release Oral Capsule [Pertzye] on Medicare Part D plans?

amylase 30250 UNT / lipase 8000 UNT / protease 28750 UNT Delayed Release Oral Capsule [Pertzye] averages Tier 3 across Part D plans, ranging from Tier 2 to Tier 4.

Does amylase 30250 UNT / lipase 8000 UNT / protease 28750 UNT Delayed Release Oral Capsule [Pertzye] require prior authorization?

50% of Part D formularies require prior authorization for amylase 30250 UNT / lipase 8000 UNT / protease 28750 UNT Delayed Release Oral Capsule [Pertzye]. Step therapy: 0%. Quantity limits: 0%.

How much does Medicare spend on amylase 30250 UNT / lipase 8000 UNT / protease 28750 UNT Delayed Release Oral Capsule [Pertzye]?

In 2023, total Medicare Part D spending on amylase 30250 UNT / lipase 8000 UNT / protease 28750 UNT Delayed Release Oral Capsule [Pertzye] was $6,564,873, covering 320 beneficiaries. The average spend per beneficiary was $20,515.23.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial