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2010 Medicare Part D Formulary Search By Drug Letter

This is archive material for research purposes. Please see PDPFinder.com or MAFinder.com for current plans.
Select a Letter below:

Letter I

Drug Name
PackagingNDCOn This Nbr
of 2010
PDP
Formularies
ACCUTANE 10MG CAPSULE
(Isotretinoin)
100 (10X10) BLPK0000401554923
ACCUTANE 20MG CAPSULE
(Isotretinoin)
100 (10X10) BLPK0000401694923
ACCUTANE 40MG CAPSULE
(Isotretinoin)
100 (10 X 10) BLPK0000401564923
ACTIMMUNE SOLUTION FOR INJECTION 100MCG
(Interferon Gamma-1B)
12 X 0.5 ML CRTN6411600111287
IPRATROPIUM BROMIDE/ALBUTEROL SULFATE INHALATION SOLUTION 0.5MG/3ML 33 CRTN
(Albuterol-Ipratropium Nebu)
33 CRTN1625205473361
ALDARA IMIQUIMOD CREAM 5% 24 PKT X 250 MG CRTN
(Imiquimod)
24 PKT X 250 MG CRTN2933606102487
ALFERON N INJ 5MU/ML
(Interferon Alfa-n3)
1 ML VIALGL5474600010151
AMNESTEEM 10MG CAPSULE
(Isotretinoin)
   0037866119375
AMNESTEEM 20MG CAPSULE
(Isotretinoin)
   0037866129375
AMNESTEEM 40MG CAPSULE
(Isotretinoin)
   0037866149375
APIDRA 100UNITS/ML VIAL
(Insulin Glulisine Subcutaneous)
10 ML VIAL0008825003355
ATROVENT NASAL SPRAY 0.03%
(Ipratropium Bromide Nasal)
30 ML BOT0059700813025
ATROVENT NASAL SPRAY 0.06%
(Ipratropium Bromide Nasal)
15 ML BOT0059700867626
ATROVENT HFA AER 17MCG
(Ipratropium Bromide HFA)
12.9 GRAMS PER 200 ACT CAN0059700871787
AVALIDE 300-12.5MG TABLET
(Irbesartan-Hydrochlorothiazide)
30 BOT0008727763150
AVALIDE 150-12.5MG TABLET
(Irbesartan-Hydrochlorothiazide)
90 BOT0008727753250
AVALIDE 300-25MG TABLET
(Irbesartan-Hydrochlorothiazide)
90 BOT0008727883250
AVAPRO 150MG TABLET
(Irbesartan)
500 BOT0008727721551
AVAPRO 300MG TABLET
(Irbesartan)
90 BOT0008727733251
AVAPRO 75MG TABLET (30 CT)
(Irbesartan)
30 BOT0008727713151
AVONEX ADMIN PACK 30MCG VL
(Interferon Beta-1a)
1 X 4 KITS PKGCOM5962700010375
AVONEX ADMIN PACK 30MCG SYR
(Interferon Beta-1a)
1 X 4 PKGCOM5962700020577
BETASERON KIT 0.3MG/VIAL 14 TRAY BOX PKGCOM
(Interferon Beta-1b For)
14 TRAY BOX PKGCOM5041905233587
BIDIL TABLET 20MG/37.5MG
(Isosorbide Dinitrate-Hydralazine HCl)
180 BOT1294800011246
BONIVA 150MG TABLET
(Ibandronate Sodium)
3 CRTN0000401868269
BONIVA 2.5MG TABLET
(Ibandronate Sodium)
30 BOT0000401852368
BONIVA 3MG/3ML SYRINGE
(Ibandronate Sodium)
1 PREFIILED SYR SYRGL0000401880958
CAMPTOSAR 20MG/ML VIAL
(Irinotecan HCl)
5 ML VIALGL0000975290134
CARIMUNE NF 3GM VIAL
(Immune Globulin (Human) IV)
3 GM PKGCOM4420604160356
CEREZYME INJ 200UNIT
(Imiglucerase For)
   5846819830187
CLARAVIS 30MG CAPSULE
(Isotretinoin)
   0055510568666
CLARAVIS 10MG CAPSULE
(Isotretinoin)
100 BLPK0055510545670
CLARAVIS 20MG CAPSULE
(Isotretinoin)
100 BLPK0055510555671
CLARAVIS 40MG CAPSULE
(Isotretinoin)
100 BLPK0055510575670
CRIXIVAN 100MG CAPSULE
(Indinavir Sulfate)
180 BOT0000605706287
CRIXIVAN 200MG CAPSULE
(Indinavir Sulfate)
360 BOT0000605714387
CRIXIVAN 333MG CAPSULE
(Indinavir Sulfate)
135 BOT0000605746587
CRIXIVAN 400MG CAPSULE (120 CT)
(Indinavir Sulfate)
120 BOT0000605734087
DILATRATE-SR 40MG CAPSULE
(Isosorbide Dinitrate)
100 BOT0009109200131
DYNACIRC CR 10MG TABLET SA
(Isradipine)
30 BOT6572602361039
DYNACIRC CR 5MG TABLET SA
(Isradipine)
30 BOT6572602351038
ELAPRASE 6MG/3ML VIAL
(Idursulfase)
   5409207000173
FLEBOGAMMA INJECTION 50MG
(Immune Globulin (Human) IV)
   6195300030451
GAMASTAN S/D INJECTION 16.5GM/2ML VIALGL
(Immune Globulin (Human))
2 ML VIALGL1353306350465
GAMMAGARD LIQUID 10% VIAL
(Immune Globulin (Human) IV)
   0094427000370
GAMUNEX FOR SOLUTION 10GM/25ML VIALGL
(Immune Globulin (Human) IV)
25 ML VIALGL1353306451567
GLEEVEC 100MG TABLET (90 CT)
(Imatinib Mesylate)
90 BOT0007804013487
GLEEVEC 400MG TABLET
(Imatinib Mesylate)
30 BOT0007804381587
HUMALOG 100UNITS/ML PEN
(Insulin Lispro (Human))
1 PEN VIAL0000287250172
HUMALOG 100U/ML VIAL
(Insulin Lispro (Human))
1 X 10 ML VIAL0000275100180
HUMALOG MIX 50/50 VIAL
(Insulin Lispro Prot & Lispro (Human))
1 X 10 ML VIAL0000275120179
HUMALOG MIX 50/50 PEN
(Insulin Lispro Prot & Lispro (Human))
5 X 3 ML AP0000287935974
HUMALOG MIX 75/25 VIAL
(Insulin Lispro Prot & Lispro (Human))
1 X 10ML VIAL0000275110180
HUMALOG MIX 75/25 PEN
(Insulin Lispro Prot & Lispro (Human))
5 X 3 ML CTG0000287945974
HUMULIN 50/50 VIAL
(Insulin Isophane & Regular (Human))
10 ML VIAL0000295150179
HUMULIN 70/30 VIAL
(Insulin Isophane & Regular (Human))
1 X 10 ML VIAL0000287150180
HUMULIN 70/30 PEN INJECTION 100UNT 1 X 3.0ML(PEN) CTG
(Insulin Isophane & Regular (Human))
1 X 3.0 ML(PEN) CTG0000287700174
HUMULIN N PEN INJECTION 100UNT 1 X 3.0ML (PEN) CTG
(Insulin Isophane (Human))
1 X 3.0 ML (PEN) CTG0000287300174
HUMULIN N 100U/ML VIAL
(Insulin Isophane (Human))
10 ML VIAL0000283150180
HUMULIN R 100U/ML VIAL
(Insulin Regular (Human))
1 X 10 ML VIAL0000282150180
HUMULIN R 500U/ML VIAL
(Insulin Regular (Human))
1 X 20 ML VIAL0000285010174
IBUPROFEN 100MG/5ML SUSP
(Ibuprofen)
1 PINT BOTPL0047212701680
IBUPROFEN TABLET 400MG 1 BLPK
(Ibuprofen)
1 BLPK0018218090087
IBUPROFEN TABLETS 600MG 90 BOT
(Ibuprofen)
90 BOT0059136641981
IBUPROFEN TABLETS USP 800MG 10 X 10 BOXUD
(Ibuprofen)
10 X 10 BOXUD0018212978983
IDAMYCIN PFS 1MG/ML VIAL
(Idarubicin HCl IV)
20 ML VIALPL0001325969127
IDARUBICIN HCL 1MG/ML VIAL
(Idarubicin HCl IV)
1 X 10 ML PKG0070341551159
IFEX INJECTION 3GM/ML 3GM VIALSD
(Ifosfamide For)
3GM VIALSD0033839930147
IFOSFAMIDE 1GM VIAL
(Ifosfamide For)
1 GRAM VIAL1001909250163
IFOSFAMIDE/MESNA KIT 1G/20ML / 1MG/
(Ifosfamide & Mesna)
2X60ML IFOSF+6X10ML MESNA PKGCOM0070341006857
IFOSFAMIDE/MESNA KIT 1G/20ML / 1MG/
(Ifosfamide & Mesna)
5X20ML IFOSF+3X10ML MESNA PKGCOM0070341004857
IMDUR 120MG TABLET SA
(Isosorbide Mononitrate)
   0008500910129
IMDUR 30MG TABLET SA
(Isosorbide Mononitrate)
   0008513740129
IMDUR 60MG TABLET SA
(Isosorbide Mononitrate)
   0008520280123
IMIPRAMINE HCL 10MG TABLET (100 CT)
(Imipramine HCl)
100 BOT4988400540187
IMIPRAMINE HCL 25MG TABLET (100 CT)
(Imipramine HCl)
100 BOT4988400550187
IMIPRAMINE HCL 50MG TABLET (100 CT)
(Imipramine HCl)
100 BOT5348903320187
IMIPRAMINE PAMOATE 100MG CAPSULE
(Imipramine Pamoate)
30 BOT0040699320356
IMIPRAMINE PAMOATE 125MG CAPSULE
(Imipramine Pamoate)
30 BOT0040699330356
IMIPRAMINE PAMOATE 150MG CAPSULE
(Imipramine Pamoate)
30 BOT0040699340356
IMIPRAMINE PAMOATE 75MG CAPSULE
(Imipramine Pamoate)
30 BOT0040699310356
IMITREX 100MG TABLET
(Sumatriptan Succinate)
9 BLPK0017307370124
IMITREX 20MG NASAL SPRAY
(Sumatriptan Succinate)
6 X 1 UD NASAL SPRAY CTR0017305230028
IMITREX 25MG TABLET
(Sumatriptan Succinate)
1 BLPK0017307350023
IMITREX 4MG/0.5ML KIT REFILL
(Sumatriptan Succinate)
2 SYR0017307390230
IMITREX 5MG NASAL SPRAY
(Sumatriptan Succinate)
6 X 1 UNIT DOSE SPRAY CTR0017305240028
IMITREX 50MG TABLET
(Sumatriptan Succinate)
9 BLPK0017307360123
IMITREX 6MG/0.5ML SYRNG KIT
(Sumatriptan Succinate)
2 (STATDOSE) SYR0017304780029
IMITREX 6MG/0.5ML VIAL
(Sumatriptan Succinate)
5 X 0.5 ML VIAL0017304490226
IMOVAX RABIES VACCINE 2.5UNT/ML
(Rabies Virus Vaccine, HDC)
1 ML VIAL4928102505187
IMURAN 50MG TABLET
(Azathioprine)
100 BOT6548305901023
INCRELEX 40MG/4ML VIAL
(Mecasermin)
   1505410400575
INDAPAMIDE 1.25MG TABLET USP (1000 CT)
(Indapamide)
1000 BOTPL0022825979687
INDAPAMIDE 2.5MG TABLET USP (1000 CT)
(Indapamide)
1000 BOT0037800801087
INDERAL LA LONG ACTING CAPSULES 120MG 100 BOT
(Propranolol HCl)
100 BOT2409004738820
INDERAL LA LONG ACTING CAPSULES 160MG 100 BOT
(Propranolol HCl)
100 BOT2409004798820
INDERAL LA LONG ACTING CAPSULES 60MG 100 BOT
(Propranolol HCl)
100 BOT2409004708820
INDERAL LA LONG ACTING CAPSULES 80MG 100 BOT
(Propranolol HCl)
100 BOT2409004718820
INDOCIN ORAL SUSPENSION 25MG/5ML 237 ML BOT
(Indomethacin)
237 ML BOT4221101011140
INDOCIN SR 75MG CAPSULE SA
(Indomethacin)
   6481406956018
INDOMETHACIN 25MG CAPSULE
(Indomethacin)
1000 BOT0037801431083
INDOMETHACIN 50MG CAPSULE
(Indomethacin)
100 BOT0037801470183
INDOMETHACIN 75MG CAPSULE SA
(Indomethacin)
60 BOTPL0018507206081
INFANRIX VACCINE VIAL 25-10UNT/.5ML
(Diph, Acellular Pert & Tet Tox)
10 X 0.5 ML VIALSD5816008401187
INFERGEN SOLUTION FOR INJECTION 15MCG/0.5ML
(Interferon alfacon-1)
   6643502019567
INFUMORPH 10MG/ML AMPUL P/F
(Morphine Sulfate For Microinfusion)
1 X 20 ML AMP6097701140141
INFUMORPH 25MG/ML AMPUL P/F
(Morphine Sulfate For Microinfusion)
20 ML AMP6097701150136
INNOHEP 20000UNIT/ML VIAL
(Tinzaparin Sodium)
10 X 2 ML VIALMD6721103425341
INNOPRAN XL (PROPRANOLOL HCL) 80MG CAPSULE SR 24 HR
(Propranolol HCl Sustained-Release Beads)
   6572602502537
INNOPRAN XL (PROPRANOLOL HCL) 120MG CAPSULE SR 24 HR
(Propranolol HCl Sustained-Release Beads)
   6572602512537
INSPRA 50MG TABLET
(Eplerenone)
   0002517200323
INSPRA 25MG TABLET
(Eplerenone)
90 TABLETS BOT0002517100223
INTAL INH AER 800MCG
(Cromolyn Sodium)
1 14.2G INHL6079300111487
INTELENCE 100MG TABLET
(Etravirine)
120 TABLETS BOT5967605700187
INTRALIPID PHARMACY BULK PACKAGE FAT EMULSION 1.7-1.2-30GM 500ML BAG
(Fat)
500 ML BAG0033805200365
INTRALIPID 20% IV FAT EMUL
(Fat)
250 ML BAG0033805190287
INTRON A 5MMU MULTIDOSE PEN
(Interferon Alfa-2B)
   0008512350187
INTRON A 3MMU INJECTION PEN
(Interferon Alfa-2B)
   0008512420186
INTRON A 10MMU INJ PEN
(Interferon Alfa-2B)
   0008512540184
INTRON A 10MMU VIAL
(Interferon Alfa-2B)
2 ML KIT0008505710286
INTRON A 6MMU/ML VIAL
(Interferon Alfa-2B)
3 ML VIAL0008511680186
INVANZ 1GM VIAL
(Ertapenem Sodium For)
10X 1 GM VIAL0000638437168
INVEGA 3MG TABLET SR OSMOTIC PUSH 24HR
(Paliperidone)
30 BOT5045805500187
INVEGA 6MG TABLET SR OSMOTIC PUSH 24HR
(Paliperidone)
30 BOT5045805510187
INVEGA 9MG TABLET SR OSMOTIC PUSH 24HR
(Paliperidone)
30 BOT5045805520187
INVERSINE 2.5MG TABLET
(Mecamylamine HCl)
   1720506260132
INVIRASE 200MG CAPSULE
(Saquinavir Mesylate)
270 BOT0000402451587
INVIRASE 500MG TABLET
(Saquinavir Mesylate)
120 BOT0000402445187
IONOSOL B-D5W IV SOLUTION
(Electrolyte-B in D5W)
12 X 1000 ML BAG0040973710953
IONOSOL MB-D5W IV SOLUTION
(Electrolyte-MB in D5W)
24 X 500 ML CTR0040973720353
IONOSOL T-D5W IV SOLUTION
(Electrolyte-T in D5W)
12 X 1000 ML CTR0040973730953
IOPIDINE 0.5% EYE DROPS
(Apraclonidine HCl Ophth)
10 ML BOTDR0006506651048
IOPIDINE 1% EYE DROPS
(Apraclonidine HCl Ophth)
0.1 ML CTR0006506601048
IPOL VIAL 40;8;32; UNT
(Poliovirus Vaccine, IPV)
10 DOSE VIAL4928108601087
IPRATROPIUM BROMIDE INHALATION SOLUTION 0.02% 60 X 2.5ML VIALSD
(Ipratropium Bromide)
60 X 2.5ML VIALSD1625200986673
IPRATROPIUM BROMIDE 21MCG AEROSOL SPRAY
(Ipratropium Bromide)
   6050508260185
IPRATROPIUM BROMIDE 42MCG AEROSOL SPRAY
(Ipratropium Bromide)
   6050508270185
IQUIX 1.5% DROPS
(Levofloxacin Ophth)
5 ML BOT6866901450529
IRESSA 250MG TABLET
(Gefitinib)
30 BOT0031004823066
IRINOTECAN HCL INJECTION 20MG
(Irinotecan HCl)
1 X 5 ML VIAL6170303490962
ISENTRESS 400MG TABLET
(Raltegravir Potassium)
60 BOT0000602276187
ISMO 20MG TABLET
(Isosorbide Mononitrate)
100 TABS BOT6785707020121
ISOCHRON 40MG TABLET SA
(Isosorbide Dinitrate)
100 BOT0045606370147
ISOLYTE H IN 5% DEXTROSE
(Electrolyte-H in D5W)
12 X 1000 ML BAG0026477190065
ISOLYTE M IN 5% DEXTROSE INJECTION
(Electrolyte-M in D5W)
12 X 1000 ML BAG0026477200056
ISOLYTE P IN 5% DEXTROSE INJECTION
(Electrolyte-P in D5W)
24 X 500 ML BAG0026477301061
ISOLYTE S SOLUTION FOR INJECTION
(Electrolyte-S)
1000 ML X 12 CASE0026477030062
ISOLYTE S IN 5% DEXTROSE INJECTION
(Electrolyte-S in D5W)
12 X 1000 ML BAG0026477040061
ISONARIF 300-150MG CAPSULE
(Isoniazid & Rifampin)
60 CAPS BOT6174800176072
ISONIAZID 50MG/5ML SYRUP
(Isoniazid)
16 FLO BOT4628700090178
ISONIAZID INJ 100MG/ML
(Isoniazid)
10 ML VIALMD0078130567061
ISONIAZID 100MG TABLET
(Isoniazid)
1000 BOT0014312601087
ISONIAZID 300MG TABLET
(Isoniazid)
100 BOTPL0018543500187
ISOPTIN SR 120MG
(Verapamil HCl)
   1063104880121
ISOPTIN SR 180MG
(Verapamil HCl)
   1063104890121
ISOPTIN SR 240MG (500 Count)
(Verapamil HCl)
   1063104900521
ISORDIL 40MG TABLET
(Isosorbide Dinitrate)
100 BOT6445501920139
ISORDIL TABLETS 5MG 100 BOT
(Isosorbide Dinitrate)
   6445501520122
ISOSORBIDE DN 10MG TABLET
(Isosorbide Dinitrate)
1000 BOT0014317711087
ISOSORBIDE DN 2.5MG TABLET SL
(Isosorbide Dinitrate)
100 BOT0060341222185
ISOSORBIDE DN 20MG TABLET
(Isosorbide Dinitrate)
100 BOT0014317720187
ISOSORBIDE DN 30MG TABLET
(Isosorbide Dinitrate)
1000 BOT4988400091087
ISOSORBIDE DN 40MG TABLET SA
(Isosorbide Dinitrate)
100 BOT0025836130186
ISOSORBIDE DN 5MG TABLET
(Isosorbide Dinitrate)
1000 BOT0060341163287
ISOSORBIDE DN 5MG TABLET SL
(Isosorbide Dinitrate)
100 BOT0060341232185
ISOSORBIDE MN 10MG TABLET
(Isosorbide Mononitrate)
100 BOTPL0022826311187
ISOSORBIDE MONONITRATE ER TABLET 120MG (100 CT)
(Isosorbide Mononitrate)
100 TABLETS BOT6217501293787
ISOSORBIDE MONONITRATE TABLETS 20MG 100 TABLETS BOT
(Isosorbide Mononitrate)
100 TABLETS BOT0009300760187
ISOSORBIDE MONONITRATE ER TABLET 30MG (100 CT)
(Isosorbide Mononitrate)
100 BOT0014322300186
ISOSORBIDE MONONITRATE TABLETS EXTENDED RELEASE 60MG 100 TABLETS BOT
(Isosorbide Mononitrate)
100 TABLETS BOT6217501193786
ISOTON GENTAMICIN 80MG/100ML
(Gentamicin in Saline)
100 ML BAG0033805034866
ISOTON GENTAMICIN 60MG/100ML
(Gentamicin in Saline)
100 BAG0033805014865
ISRADIPINE CAPSULES 2.5MG (100 CT)
(Isradipine)
100 BOT1625205390177
ISRADIPINE CAPSULES 5MG (100 CT)
(Isradipine)
100 BOT1625205400177
ISTALOL 0.5% EYE DROPS
(Timolol Maleate Ophth)
5 ML BOTDR6742500035051
ITRACONAZOLE 100MG CAPSULE
(Itraconazole)
30 CAPS BOT0018505503083
IXEMPRA KIT 45MG
(IXABEPILONE)
   0001519111349
LANTUS 100U/ML VIAL
(Insulin Glargine)
10 ML VIAL0008822203385
LANTUS INJECTION
(Insulin Glargine)
5 X 3ML SYR0008822206075
LEVEMIR FLEXPEN 100UNITS/ML
(Insulin Detemir)
   0016964391078
LEVEMIR 100UNITS/ML VIAL
(Insulin Detemir)
1 X 10 ML VIAL0016936871286
MARPLAN 10MG TABLET (100 CT)
(Isocarboxazid)
100 BOT3069800320187
MONOKET 10MG TABLET
(Isosorbide Mononitrate)
100 BOT0009136100131
MONOKET 20MG TABLET
(Isosorbide Mononitrate)
180 BOT0009136201825
NOVOLIN 70/30 100U/ML VIAL
(Insulin Isophane & Regular (Human))
   0016918371184
NOVOLIN 70/INJ 30 INNLT
(Insulin Isophane & Regular (Human))
   0016923172173
NOVOLIN N 100U/ML VIAL
(Insulin Isophane (Human))
   0016918341184
NOVOLIN N INJ INNOLET
(Insulin Isophane (Human))
   0016923142173
NOVOLIN R 100U/ML VIAL
(Insulin Regular (Human))
   0016918331184
NOVOLIN R 100UNIT/ML INNOLET
(Insulin Regular (Human))
   0016923132172
NOVOLOG 100U/ML VIAL
(Insulin Aspart)
1 X 10ML VIALGL0016975011186
NOVOLOG FLEXPEN SYRINGE
(Insulin Aspart)
5 X 3ML SYR0016963391079
NOVOLOG MIX 70/30 VIAL
(Insulin Aspart Prot & Aspart (Human))
1 VIAL0016936851286
NOVOLOG MIX 70/30 SYRINGE 70-30U/ML
(Insulin Aspart Prot & Aspart (Human))
5 X 3 ML SYR0016936961979
OCTAGAM IMMUNE GLOBULIN INTRAVENOUS HUMAN 5% S/D 50MG
(Immune Globulin (Human) IV)
100 ML BOTGL6746708430357
PHYSIOLYTE SOLUTION FOR IRRIGATION
(Irrigation Solution, Physiological)
1000 ML X 16 CASE0026422050045
PHYSIOSOL IRRIGATION SOL
(Irrigation Solution, Physiological)
24 X 500 ML CTR0040961410344
POLYGAM S/D 10GM VL W/DILUENT
(Immune Globulin (Human) IV)
10 GM VIAL CRTN0094404718060
PRIMAXIN I.M. 500MG VIAL
(Imipenem-Cilastatin Intravenous For)
1 X 10 VIALS VIAL0000635827578
PRIMAXIN IV 250MG VIAL
(Imipenem-Cilastatin Intravenous For)
25 X 10 ML VIAL0000635145880
PRIMAXIN IV INJ 500MG
(Imipenem-Cilastatin Intravenous For)
10 X 100 ML VIAL0000635177580
REBIF 22MCG/0.5ML SYRINGE
(Interferon Beta-1a)
   4408700220370
REBIF 44MCG/0.5ML SYRINGE
(Interferon Beta-1a)
   4408700440370
REBIF TITRTN SOL PACK 8.8MCG/22 VIAL
(Interferon Beta-1a)
   4408788220169
RELION 70/30 INJ 100/ML
(Insulin Isophane & Regular (Human))
   5906018370258
RELION N INJ 100/ML
(Insulin Isophane (Human))
   5906018340259
RELION R INJ 100/ML
(Insulin Regular (Human))
   5906018330258
REMICADE 100MG VIAL
(Infliximab For IV)
20 ML VIALSU5789400300187
RIFAMATE CAPSULE
(Isoniazid & Rifampin)
60 BOT0006805096026
RIFATER TABLET
(Isoniazid-Rifampin w/ Pyrazinamide)
60 BOT0008805764144
SOTRET 10MG CAPSULE
(Isotretinoin)
100 BOXUD1063105847776
SOTRET 20MG CAPSULE
(Isotretinoin)
100 BOXUD1063105857776
SOTRET 30MG CAPSULE
(Isotretinoin)
30 BOXUD1063104473172
SOTRET 40MG CAPSULE
(Isotretinoin)
100 BOXUD1063105867776
SPORANOX 10MG/ML SOLUTION
(Itraconazole)
150 ML BOT5045802951555
SPORANOX 100MG CAPSULE
(Itraconazole)
28 (PULSE PACK) BLPK5045802902819
SPORANOX 100MG CAPSULE
(Itraconazole)
30 BOT5045802900420
STROMECTOL 6MG TABLET
(Ivermectin)
   0000601391056
STROMECTOL 3MG TABLET
(Ivermectin)
20 X 1 TABLET BOXUD0000600322064
TOFRANIL TABLETS 10MG 30 BOT
(Imipramine HCl)
30 BOT0040699200319
TOFRANIL TABLETS 25MG 30 BOT
(Imipramine HCl)
30 BOT0040699210319
TOFRANIL 50MG TABLET (30 CT)
(Imipramine HCl)
30 BOT0040699220319
TOFRANIL-PM 100MG CAPSULE
(Imipramine Pamoate)
30 BOT0040699240321
TOFRANIL-PM 125MG CAPSULE
(Imipramine Pamoate)
30 BOT0040699250321
TOFRANIL-PM 150MG CAPSULE
(Imipramine Pamoate)
30 BOT0040699260321
TOFRANIL-PM 75MG CAPSULE
(Imipramine Pamoate)
30 BOT0040699230321
VENTAVIS ILOPROST INHALATION SOLUTION 10MCG/ML 1 ML AMP
(Iloprost)
1 ML AMP6621503020047
VIVAGLOBIN SOL 160MG/ML 10ML VIAL
(Immune Globulin (Human) Subcutaneous)
10 ML VIAL0005375961054



(Chart Source: Centers for Medicare and Medicaid files: CMS Data )





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  • Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition.
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  • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
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