pantoprazole 20 MG Delayed Release Oral Tablet
pantoprazole
RxCUI: 251872
What the CMS Formulary Data Shows for pantoprazole 20 MG Delayed Release Oral Tablet
Per the CMS 2026 Part D formulary file, pantoprazole 20 MG Delayed Release Oral Tablet (RxNorm concept RXCUI 251872, generic name pantoprazole) appears on 330 distinct formulary files spanning 5,067 Medicare Part D plan offerings - 100% of enrollable Part D products, near-universal placement. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 1.2.
Real-world access to pantoprazole 20 MG Delayed Release Oral Tablet depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 60.6% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 6,191,845 Part D beneficiaries filled pantoprazole 20 MG Delayed Release Oral Tablet in 2023, with total plan-and-beneficiary spending of $384,047,698 and an average per-beneficiary annual cost of $62.02. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry pantoprazole 20 MG Delayed Release Oral Tablet today.
Coverage Details
- Formularies covering
- 330
- Plans covering
- 5,067
- Coverage rate
- 100%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 1, Preferred Generic
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 60.6% of formularies
2023 Medicare Spending
- Beneficiaries
- 6,191,845
- Total spending
- $384,047,698
- Avg per beneficiary
- $62.02
Tier Distribution Across Plans
Standalone Drug Plans (PDP) Covering pantoprazole 20 MG Delayed Release Oral Tablet
2 standalone prescription drug plans include this drug.
| Plan | Insurer | Tier | PA | ST | Premium | States |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Preferred from UHC (PDP) | UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY | T1 | No | No | $0 | - |
| AARP Medicare Rx Preferred from UHC (PDP) | UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY | T1 | No | No | $0 | - |
Medicare Advantage Plans (MA-PD) Covering pantoprazole 20 MG Delayed Release Oral Tablet
98 Medicare Advantage plans with Part D drug coverage include this drug.
Frequently Asked Questions
Is pantoprazole 20 MG Delayed Release Oral Tablet covered by Medicare Part D?
Yes, pantoprazole 20 MG Delayed Release Oral Tablet is covered by 5,067 Medicare Part D plans (100% of all Part D formularies).
What tier is pantoprazole 20 MG Delayed Release Oral Tablet on Medicare Part D plans?
pantoprazole 20 MG Delayed Release Oral Tablet averages Tier 1.2 across Part D plans, ranging from Tier 1 to Tier 4.
Does pantoprazole 20 MG Delayed Release Oral Tablet require prior authorization?
0% of Part D formularies require prior authorization for pantoprazole 20 MG Delayed Release Oral Tablet. Step therapy: 0%. Quantity limits: 60.6%.
How much does Medicare spend on pantoprazole 20 MG Delayed Release Oral Tablet?
In 2023, total Medicare Part D spending on pantoprazole 20 MG Delayed Release Oral Tablet was $384,047,698, covering 6,191,845 beneficiaries. The average spend per beneficiary was $62.02.
Read our methodology - how this data is sourced, computed, and verified.