Viokace
Generic: lipase
300 UNIT — Tablet
Also known as:
VIOKACE TAB 10440
VIOKACE TAB 20880
amylase
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Coverage by Insurer
Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Blue Cross Blue Shield Federal
4 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| BCBS Federal Focus 2026 | Tier 2 - Preferred Brand | — | — | — | None |
| BCBS Federal Standard Option 2026 | Tier 2 - Preferred Brand | — | — | — | None |
| BCBS Federal Basic Option 2026 | Tier 2 - Preferred Brand | — | — | — | None |
|
BCBS Federal Standard Option 2026
via Pertzye |
Tier 3 - Non-Preferred Brand | — | — | — | None |
Cigna
20 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Connect Bronze CMS Standard | Tier 4 - Non-Preferred | — | — | — | None |
| Connect Silver RD CMS Standard | Tier 4 - Non-Preferred | — | — | — | None |
| Connect Silver CMS Standard | Tier 4 - Non-Preferred | — | — | — | None |
| Connect Bronze 6500 Indiv Med Deductible | Tier 4 - Non-Preferred | — | — | — | None |
| Connect Silver 3000 Indiv Med Deductible | Tier 4 - Non-Preferred | — | — | — | None |
| Connect Silver RD 5000 Indiv Med Deductible | Tier 4 - Non-Preferred | — | — | — | None |
| Connect Silver 4400 Indiv Med Deductible | Tier 4 - Non-Preferred | — | — | — | None |
| Connect Bronze 7000 HSA Indiv Med Deductible | Tier 4 - Non-Preferred | — | — | — | None |
| Connect Silver RD 3500 Indiv Med Deductible | Tier 4 - Non-Preferred | — | — | — | None |
| Connect Bronze RD 5000 Indiv Med Deductible | Tier 4 - Non-Preferred | — | — | — | None |
| Connect Silver 3500 Indiv Med Deductible | Tier 4 - Non-Preferred | — | — | — | None |
| Connect Bronze RD 6000 Indiv Med Deductible | Tier 4 - Non-Preferred | — | — | — | None |
| Connect Bronze 5500 Indiv Med Deductible | Tier 4 - Non-Preferred | — | — | — | None |
| Connect myDiabetesCare Bronze | Tier 4 - Non-Preferred | — | — | — | None |
| Connect Gold 1500 Indiv Med Deductible | Tier 4 - Non-Preferred | — | — | — | None |
| Connect Silver RD 2200 Indiv Med Deductible | Tier 4 - Non-Preferred | — | — | — | None |
| Connect myDiabetesCare Silver | Tier 4 - Non-Preferred | — | — | — | None |
| Connect Gold CMS Standard | Tier 4 - Non-Preferred | — | — | — | None |
| Connect Bronze RD CMS Standard | Tier 4 - Non-Preferred | — | — | — | None |
| Connect Gold RD CMS Standard | Tier 4 - Non-Preferred | — | — | — | None |
NC Medicaid PDL
1 planNC State Health Plan
6 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| NC State Health Plan - 80/20 Plus PPO 2026 | Tier 2 - Non-Preferred Generic | — | — | — | None |
| NC State Health Plan - 70/30 Standard PPO 2026 | Tier 2 - Non-Preferred Generic | — | — | — | None |
| NC State Health Plan - HDHP 2026 | Tier 2 - Non-Preferred Generic | — | — | — | None |
|
NC State Health Plan - HDHP 2026
via Pertzye |
Tier 3 - Non-Preferred Brand | — | — | — | None |
|
NC State Health Plan - 80/20 Plus PPO 2026
via Pertzye |
Tier 3 - Non-Preferred Brand | — | — | — | None |
|
NC State Health Plan - 70/30 Standard PPO 2026
via Pertzye |
Tier 3 - Non-Preferred Brand | — | — | — | None |
Oscar Health
28 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
| Bronze Simple Diabetes | with Atrium Health | Tier 3 - Preferred Brand | ✓ | — | — | PA |
| Bronze Simple Chronic Care CKM | with Atrium Health | Tier 3 - Preferred Brand | ✓ | — | — | PA |
| Bronze Classic Standard | Tier 3 - Preferred Brand | ✓ | — | — | PA |
| Gold Classic Standard | Tier 3 - Preferred Brand | ✓ | — | — | PA |
| Silver Classic Standard | Tier 3 - Preferred Brand | ✓ | — | — | PA |
| Bronze Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health | Tier 3 - Preferred Brand | ✓ | — | — | PA |
| Gold Elite Saver Plus | with Atrium Health | Tier 3 - Preferred Brand | ✓ | — | — | PA |
| Silver Simple PCP Saver | with Atrium Health | Tier 3 - Preferred Brand | ✓ | — | — | PA |
| Silver Simple Diabetes | with Atrium Health | Tier 3 - Preferred Brand | ✓ | — | — | PA |
| Silver Classic | with Atrium Health | Tier 3 - Preferred Brand | ✓ | — | — | PA |
| Bronze Elite + PCP Saver Plus | with Atrium Health | Tier 3 - Preferred Brand | ✓ | — | — | PA |
| Bronze Classic 4700 | with Atrium Health | Tier 3 - Preferred Brand | ✓ | — | — | PA |
| Secure | with Atrium Health | Tier 3 - Preferred Brand | ✓ | — | — | PA |
| Silver Simple Diabetes | Tier 3 - Preferred Brand | ✓ | — | — | PA |
| Gold Elite Saver Plus | Tier 3 - Preferred Brand | ✓ | — | — | PA |
| Silver Simple PCP Saver | Tier 3 - Preferred Brand | ✓ | — | — | PA |
| Bronze Classic 4700 | Tier 3 - Preferred Brand | ✓ | — | — | PA |
| Secure | Tier 3 - Preferred Brand | ✓ | — | — | PA |
| Silver Classic | Tier 3 - Preferred Brand | ✓ | — | — | PA |
| Bronze Elite + PCP Saver Plus | Tier 3 - Preferred Brand | ✓ | — | — | PA |
| Gold Classic Standard | with Atrium Health | Tier 3 - Preferred Brand | ✓ | — | — | PA |
| Silver Classic Standard | with Atrium Health | Tier 3 - Preferred Brand | ✓ | — | — | PA |
| Bronze Classic Standard | with Atrium Health | Tier 3 - Preferred Brand | ✓ | — | — | PA |
| AIAN Cost Share | Tier 3 - Preferred Brand | ✓ | — | — | PA |
| Silver Simple Women's Health with Menopause Benefits | with Atrium Health | Tier 3 - Preferred Brand | ✓ | — | — | PA |
| AIAN Cost Share | with Atrium Health | Tier 3 - Preferred Brand | ✓ | — | — | PA |
| Silver Simple Chronic Care CKM | with Atrium Health | Tier 3 - Preferred Brand | ✓ | — | — | PA |
| Silver Simple Breathe Easy with Enhanced COPD Benefits | with Atrium Health | Tier 3 - Preferred Brand | ✓ | — | — | PA |