All *DIGESTIVE AIDS*

Creon CAPSULE DELAYED RELEASE PARTICLES 12000 UNIT ORAL
Creon CAPSULE DELAYED RELEASE PARTICLES 12000 UNIT ORAL

Pancrelipase (Lip-Prot-Amyl)

Tier: 2
PA Type: No Prior Authorization
ST: N
Creon CAPSULE DELAYED RELEASE PARTICLES 12000 UNIT ORAL
Creon CAPSULE DELAYED RELEASE PARTICLES 12000 UNIT ORAL

Pancrelipase (Lip-Prot-Amyl)

Tier: 2
PA Type: No Prior Authorization
ST: N
Creon CAPSULE DELAYED RELEASE PARTICLES 24000-76000 UNIT Oral
Creon CAPSULE DELAYED RELEASE PARTICLES 24000-76000 UNIT Oral

Pancrelipase (Lip-Prot-Amyl)

Tier: 2
PA Type: No Prior Authorization
ST: N
Creon CAPSULE DELAYED RELEASE PARTICLES 24000-76000 UNIT Oral
Creon CAPSULE DELAYED RELEASE PARTICLES 24000-76000 UNIT Oral

Pancrelipase (Lip-Prot-Amyl)

Tier: 2
PA Type: No Prior Authorization
ST: N
Creon CAPSULE DELAYED RELEASE PARTICLES 3000-9500 UNIT ORAL
Creon CAPSULE DELAYED RELEASE PARTICLES 3000-9500 UNIT ORAL

Pancrelipase (Lip-Prot-Amyl)

Tier: 2
PA Type: No Prior Authorization
ST: N
Creon CAPSULE DELAYED RELEASE PARTICLES 36000 UNIT ORAL
Creon CAPSULE DELAYED RELEASE PARTICLES 36000 UNIT ORAL

Pancrelipase (Lip-Prot-Amyl)

Tier: 2
PA Type: No Prior Authorization
ST: N
Creon CAPSULE DELAYED RELEASE PARTICLES 36000 UNIT ORAL
Creon CAPSULE DELAYED RELEASE PARTICLES 36000 UNIT ORAL

Pancrelipase (Lip-Prot-Amyl)

Tier: 2
PA Type: No Prior Authorization
ST: N
Creon CAPSULE DELAYED RELEASE PARTICLES 6000 UNIT ORAL
Creon CAPSULE DELAYED RELEASE PARTICLES 6000 UNIT ORAL

Pancrelipase (Lip-Prot-Amyl)

Tier: 2
PA Type: No Prior Authorization
ST: N
Creon CAPSULE DELAYED RELEASE PARTICLES 6000 UNIT ORAL
Creon CAPSULE DELAYED RELEASE PARTICLES 6000 UNIT ORAL

Pancrelipase (Lip-Prot-Amyl)

Tier: 2
PA Type: No Prior Authorization
ST: N
Enzadyne Capsule Oral
Enzadyne Capsule Oral

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Pancreaze Capsule Delayed Release Particles 10500 UNIT Oral
Pancreaze Capsule Delayed Release Particles 10500 UNIT Oral

Pancrelipase (Lip-Prot-Amyl)

Tier: 3
PA Type: No Prior Authorization
ST: N
Pancreaze Capsule Delayed Release Particles 10500 UNIT Oral
Pancreaze Capsule Delayed Release Particles 10500 UNIT Oral

Pancrelipase (Lip-Prot-Amyl)

Tier: 3
PA Type: No Prior Authorization
ST: N