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2012 Medicare Part D Formulary Search By Drug Letter

Select a Letter below:
Links to Summaries by State for LTC Drugs on LIS/SNP Plans:
AK  AL  AR  AZ  CA  CO  CT  DC  DE  FL  GA  HI  IA  ID  IL  IN  KS  KY  LA  MA  MD  ME  MI  MN  MO  MS  MT  NC  ND  NE  NH  NJ  NM  NV  NY  OH  OK  OR  PA  PR  RI  SC  SD  TN  TX  UT  VA  VT  WA  WI  WV  WY

Drug Names Containing the Letter G in Alphabetical Order.
Example: Lipitor® is found on letter page "L" as well as letter page "A" for Atorvastatin.

Drug Name
PackagingNDCOn This Nbr of 2012 Formularies
PDPsMAPDs
AMARYL 1MG TABLET
(Glimepiride)
100 BOT0003902211016
PDPs
51
MAPDs
AMARYL 2MG TABLET
(Glimepiride)
100 BOT0003902221016
PDPs
51
MAPDs
AMARYL 4MG TABLET
(Glimepiride)
100 BOT0003902231016
PDPs
51
MAPDs
COPAXONE 20MG/ML 30 BLISTER PACK IN 1 CRTN
(Glatiramer Acetate)
   6854603173071
PDPs
245
MAPDs
Cuvposa 1mg/5mL
(Glycopyrrolate)
   5963002061628
PDPs
97
MAPDs
CYTOVENE IV INJECTION
(Ganciclovir Sodium For)
10ML X 1 X 25 VIALS CRTN 0000469400326
PDPs
62
MAPDs
DIABETA 1.25MG TABLET
(Glyburide)
50 BOT0003900530517
PDPs
58
MAPDs
DIABETA TABLETS 2.5MG 100 BOT
(Glyburide)
100 BOT0003900511017
PDPs
58
MAPDs
DiaBeta 5mg/1 100 TABLET in 1 BOTTLE
(Glyburide)
100 TABLET BOTTLE  0003900521017
PDPs
58
MAPDs
EGG YOLK PHOSPHOLIPIDS 12 MG/ML / GLYCERIN 25 MG/ML / SAFFLOWER OIL 100 MG/ML / SOYBEAN OIL 100 MG/M
(fat emulsion)
   0040997890242
PDPs
151
MAPDs
FACTIVE 320mg/1 7 TABLET in 1 BLISTER PACK
(Gemifloxacin Mesylate)
7 TABLET in 1 BLISTER PAC  1012203210727
PDPs
93
MAPDs
GABAPENTIN 100mg/1
(Gabapentin)
   6275601370271
PDPs
245
MAPDs
Gabapentin 250mg/5mL 470 mL in 1 BOTTLE
(Gabapentin)
470 mL in 1 BOTTLE  5038303114771
PDPs
238
MAPDs
GABAPENTIN CAPSULES 300MG
(Gabapentin)
   6050501130171
PDPs
245
MAPDs
GABAPENTIN 400 MG CAPSULE
(Gabapentin)
100 EA  5374601030171
PDPs
245
MAPDs
GABAPENTIN 600MG TABLET
(Gabapentin)
100 BOT0022826361171
PDPs
245
MAPDs
GABAPENTIN TABLET 800MG
(Gabapentin)
   6050525520571
PDPs
245
MAPDs
GABITRIL 12MG FILMTAB
(Tiagabine HCl)
100 BOTPL6345904120171
PDPs
244
MAPDs
GABITRIL 16mg/1
(Tiagabine HCl)
   6345904163071
PDPs
245
MAPDs
GABITRIL 2mg/1
(Tiagabine HCl)
   6345904023071
PDPs
245
MAPDs
GABITRIL 4mg/1
(Tiagabine HCl)
   6345904043071
PDPs
245
MAPDs
Gablofen 2000ug/mL 20 mL in 1 VIAL, GLASS
(Baclofen)
20 mL in 1 VIAL, GLASS  4594501570213
PDPs
36
MAPDs
Gablofen 50ug/mL 1 mL in 1 SYRINGE, PLASTIC
(Baclofen)
1 mL in 1 SYRINGE, PLASTI  4594501510113
PDPs
36
MAPDs
Gablofen 500ug/mL 20 mL in 1 VIAL, GLASS
(Baclofen)
20 mL in 1 VIAL, GLASS  4594501550213
PDPs
36
MAPDs
Galantamine 12mg/1 60 TABLET, FILM COATED in 1 BOTTLE
(Galantamine Hydrobromide)
60 TABLET, FILM COATED in  0055501400971
PDPs
239
MAPDs
GALANTAMINE HYDROBROMIDE CAPSULES EXTENDED RELEASE 16MG 30 BOT
(Galantamine Hydrobromide)
30 BOT0055510210171
PDPs
234
MAPDs
GALANTAMINE HYDROBROMIDE CAPSULES EXTENDED RELEASE 24MG 30 BOT
(Galantamine Hydrobromide)
30 BOT0055510220171
PDPs
234
MAPDs
Galantamine Hydrobromide Oral Solution 4mg/mL 100 mL in 1 BOTTLE
(Galantamine Hydrobromide)
100 mL in 1 BOTTLE  0005401374969
PDPs
211
MAPDs
Galantamine 4mg/1 60 TABLET, FILM COATED in 1 BOTTLE
(Galantamine Hydrobromide)
60 TABLET, FILM COATED in  0055501380971
PDPs
240
MAPDs
GALANTAMINE HYDROBROMIDE CAPSULES EXTENDED RELEASE 8MG 30 BOT
(Galantamine Hydrobromide)
30 BOT0055510200171
PDPs
234
MAPDs
Galantamine 8mg/1 60 TABLET, FILM COATED in 1 BOTTLE
(Galantamine Hydrobromide)
60 TABLET, FILM COATED in  0055501390971
PDPs
240
MAPDs
GAMASTAN S/D INJECTION 16.5GM/2ML VIALGL
(Immune Globulin (Human))
2 ML VIALGL1353306350448
PDPs
190
MAPDs
GAMMAGARD LIQUID 100mg/mL 1 BOTTLE, GLASS in 1 CARTON / 25 mL in 1 BOTTLE, GLASS
(Immune Globulin (Human) IV)
1 BOTTLE, GLASS in 1 CART  0094427000358
PDPs
216
MAPDs
GAMMAPLEX INJECTION 5 GM/100 ML
(Immune Globulin)
   6420882340337
PDPs
131
MAPDs
Gamunex-C 10g/100mL 10 mL in 1 VIAL, GLASS
(Immune Globulin (Human) IV)
10 mL in 1 VIAL, GLASS  1353308001251
PDPs
190
MAPDs
GANCICLOVIR 250MG CAPSULE
(Ganciclovir)
180 BOT6330406362871
PDPs
244
MAPDs
GANCICLOVIR 500MG CAPSULE
(Ganciclovir)
180 BOT6330406372871
PDPs
245
MAPDs
GANCICLOVIR FOR INJECTION
(Ganciclovir)
25 X 10 TRAY 6332303151056
PDPs
186
MAPDs
GARDASIL VIAL
(Quadrivalent Human Papillomavirus (HPV) Recombinant Vac)
1 X 0.5 ML VIAL0000640450071
PDPs
245
MAPDs
GASTROCROM 100MG/5ML CONC
(Cromolyn Sodium Oral)
96 X 5 ML AMP1886006787052
PDPs
152
MAPDs
GaviLyte G TM 236; 2.97; 6.74; 5.86; 22.74g/274.31g; g/274.31g; g/274.31g; g/274.31g; g/274.31g 274.
(Polyethylene Glycol 3350 Oral)
274.31 g in 1 BOTTLE  4338600901960
PDPs
202
MAPDs
GaviLyte - C TM 240; 2.98; 6.72; 5.84; 22.72g/278.26g; g/278.26g; g/278.26g; g/278.26g; g/278.26g 27
(Polyethylene Glycol 3350 Oral)
278.26 g in 1 BOTTLE  4338600601960
PDPs
209
MAPDs
GaviLyte - N 420; 1.48; 5.72; 11.2g/438.4g; g/438.4g; g/438.4g; g/438.4g 438.4 g in 1 BOTTLE
(Polyethylene Glycol 3350 Oral)
438.4 g in 1 BOTTLE  4338600501956
PDPs
201
MAPDs
GELNIQUE 100mg/g 30 PACKET in 1 CARTON / 1 g in 1 PACKET
(Oxybutynin Chloride)
30 PACKET in 1 CARTON / 1  5254400843041
PDPs
125
MAPDs
Gemcitabine 38mg/mL 1 VIAL, SINGLE-USE in 1 CARTON / 26.3 mL in 1 VIAL, SINGLE-USE
(Gemcitabine Hydrochloride)
1 VIAL, SINGLE-USE in 1 C  0040901810163
PDPs
201
MAPDs
Gemcitabine Hydrochloride 1g/25mL
()
   6332301255058
PDPs
185
MAPDs
GEMFIBROZIL TABLET 600MG (500 CT)
(Gemfibrozil)
500 BOT0014391300571
PDPs
245
MAPDs
GEMZAR 1GRAM VIAL
(Gemcitabine HCl For)
1 X 50 ML VIAL0000275020126
PDPs
82
MAPDs
GENGRAF 100MG CAPSULE U.D.
(Cyclosporine Modified)
30 BOXUD0007464793269
PDPs
229
MAPDs
GENGRAF 100MG/ML SOLUTION
(Cyclosporine Modified)
50 ML BOTGL0007472695069
PDPs
228
MAPDs
GENGRAF 25MG CAPSULE U.D.
(Cyclosporine Modified)
30 BOXUD0007464633271
PDPs
235
MAPDs
GENOTROPIN 13.8MG CARTRIDGE
(Somatropin For)
1 X 13.8 MG CTG0001326468133
PDPs
137
MAPDs
GENOTROPIN 5 MG CARTRIDGE
(Somatropin For)
1 PKGCOM0001326268133
PDPs
131
MAPDs
GENOTROPIN MINIQUICK 0.2MG
(Somatropin For)
7 X 0.2 MG VIALPAT0001326490230
PDPs
133
MAPDs
GENOTROPIN MINIQUICK 0.4MG
(Somatropin For)
7 X 0.4 MG VIALPAT0001326500230
PDPs
128
MAPDs
GENOTROPIN MINIQUICK 0.6MG
(Somatropin For)
7 X 0.6 MG VIALPAT0001326510230
PDPs
128
MAPDs
GENOTROPIN MINIQUICK 0.8MG
(Somatropin For)
7 X 0.8 MG VIALPAT0001326520229
PDPs
129
MAPDs
GENOTROPIN MINIQUICK 1MG
(Somatropin For)
7 X 1.0 MG VIALPAT0001326530230
PDPs
129
MAPDs
GENOTROPIN MINIQUICK 1.2MG
(Somatropin For)
7 VIALPAT0001326540230
PDPs
129
MAPDs
GENOTROPIN MINIQUICK 1.4MG
(Somatropin For)
7 VIALPAT0001326550230
PDPs
128
MAPDs
GENOTROPIN MINIQUICK 1.6MG
(Somatropin For)
7 VIALPAT0001326560230
PDPs
129
MAPDs
GENOTROPIN MINIQUICK 1.8MG
(Somatropin For)
7 VIALPAT0001326570230
PDPs
128
MAPDs
GENOTROPIN MINIQUICK 2MG
(Somatropin For)
7 X 2.0 MG VIALPAT0001326580230
PDPs
128
MAPDs
GENTAK 3MG/GM EYE OINTMENT
(Gentamicin Sulfate Ophth)
3.5 GM TUBE1747802843566
PDPs
233
MAPDs
GENTAMICIN 90MG/NS 100ML PB
(Gentamicin)
24 X 100 ML CTR0040978862355
PDPs
174
MAPDs
GENTAMICIN 100MG/NS 100ML
(Gentamicin)
24 X 100 ML CTR0040978892363
PDPs
210
MAPDs
GENTAMICIN 60MG/NS 50ML PB
(Gentamicin)
50 ML PLASTIC BAG X 24 CASE0026458123861
PDPs
213
MAPDs
GENTAMICIN 70MG/NS 50ML PB
(Gentamicin)
24 X 50 ML CTR0040978811354
PDPs
178
MAPDs
GENTAMICIN 80MG/NS 50ML PB
(Gentamicin)
24 X 50 ML CTR0040978831362
PDPs
213
MAPDs
GENTAMICIN 10MG/ML VIAL
(Gentamicin)
25 X 8 ML VIAL0040934010168
PDPs
226
MAPDs
GENTAMICIN SULFATE OINTMENT USP 0.1% 15GM TUBE
(Gentamicin Sulfate)
15 GM TUBE4580200463571
PDPs
243
MAPDs
GENTAMICIN SULFATE CREAM USP 0.1% 15GM TUBE
(Gentamicin Sulfate)
15 GM TUBE4580200563571
PDPs
243
MAPDs
Gentamicin Sulfate 40mg/mL 25 VIAL, SINGLE-DOSE in 1 TRAY / 2 mL in 1 VIAL, SINGLE-DOSE
(Gentamicin Sulfate)
25 VIAL, SINGLE-DOSE in 1  0040912070371
PDPs
225
MAPDs
GENTAMICIN SULFATE OPHTHALMIC SOLUTION 0.3% 5ML BOT
(Gentamicin Sulfate Ophth)
5 ML BOT2420805806071
PDPs
243
MAPDs
GENTASOL 3MG/ML EYE DROPS
(Gentamicin Sulfate Ophth)
5 ML BOT5479905100565
PDPs
220
MAPDs
GEODON 20MG VIAL
(Ziprasidone HCl)
1 VIAL VIALSD0004939208371
PDPs
245
MAPDs
GEODON 20MG CAPSULE
(Ziprasidone HCl)
60 BOT0004939606055
PDPs
169
MAPDs
GEODON 40MG CAPSULE
(Ziprasidone HCl)
60 BOT0004939706055
PDPs
169
MAPDs
GEODON 60MG CAPSULE
(Ziprasidone HCl)
60 BOT0004939806055
PDPs
169
MAPDs
GEODON 80MG CAPSULE
(Ziprasidone HCl)
60 BOT0004939906055
PDPs
169
MAPDs
GIANVI 3 MG-0.02 MG TABLET
(Drospirenone-Ethinyl Estradiol)
   0009356612854
PDPs
160
MAPDs
Gilenya 0.5mg/1 28 CAPSULE in 1 CARTON
(FINGOLIMOD HCL)
28 CAPSULE in 1 CARTON  0007806075152
PDPs
189
MAPDs
GLASSIA 1g/50mL 1 VIAL, GLASS in 1 CARTON / 50 mL in 1 VIAL, GLASS
(ALPHA-1-PROTEINASE INHIBITOR (HUMAN))
1 VIAL, GLASS in 1 CARTON  0094428840129
PDPs
80
MAPDs
GLEEVEC 100MG TABLET (90 CT)
(Imatinib Mesylate)
90 BOT0007804013471
PDPs
245
MAPDs
GLEEVEC 400MG TABLET
(Imatinib Mesylate)
30 BOT0007804381571
PDPs
245
MAPDs
GLIMEPIRIDE 1MG TABLET (100 CT)
(Glimepiride)
100 BOT5511103200171
PDPs
245
MAPDs
GLIMEPIRIDE 2MG TABLET (100 CT)
(Glimepiride)
100 BOT5511103210171
PDPs
245
MAPDs
GLIMEPIRIDE 4MG TABLET (100 CT)
(Glimepiride)
100 BOT5511103220171
PDPs
245
MAPDs
GLIPIZIDE 10MG TABLET (100 CT)
(Glipizide)
100 BOT0037811100171
PDPs
245
MAPDs
GLIPIZIDE TABLETS EXTENDED RELEASE
(Glipizide)
100 BOT 0059108450171
PDPs
244
MAPDs
GLIPIZIDE ER 2.5MG TABLET SR OSMOTIC PUSH 24HR
(Glipizide)
30 BOTPL0059109003071
PDPs
244
MAPDs
GLIPIZIDE-METFORMIN 2.5-500MG TABLET
(Glipizide)
100 BOT0009374560169
PDPs
240
MAPDs
GLIPIZIDE 5MG TABLET
(Glipizide)
100 BOT0017236496071
PDPs
245
MAPDs
GLIPIZIDE TABLETS EXTENDED RELEASE
(Glipizide)
100 BOT 0059108440171
PDPs
244
MAPDs
Glipizide and Metformin Hydrochloride 2.5; 250mg/1; mg/1 100 TABLET, FILM COATED in 1 BOTTLE
(Glipizide-Metformin HCl)
100 TABLET, FILM COATED  0059139710169
PDPs
240
MAPDs
Glipizide and Metformin Hydrochloride 5; 500mg/1; mg/1 100 TABLET, FILM COATED in 1 BOTTLE
(Glipizide-Metformin HCl)
100 TABLET, FILM COATED  0059139730169
PDPs
240
MAPDs
GLUCAGEN 1MG HYPOKIT
(Glucagon HCl (rDNA) For)
1 X 1 MG PKGCOM0016970651564
PDPs
226
MAPDs
GLUCAGON 1MG EMERGENCY KIT
(Glucagon (rDNA) For)
1 KIT PKGCOM0000280310168
PDPs
240
MAPDs
GLUCOPHAGE 1000MG TABLET
(Metformin HCl)
100 BOT0008760711117
PDPs
62
MAPDs
GLUCOPHAGE 500MG TABLET
(Metformin HCl)
500 BOT0008760601017
PDPs
51
MAPDs
GLUCOPHAGE 850MG TABLET
(Metformin HCl)
100 BOT0008760700517
PDPs
62
MAPDs
GLUCOPHAGE XR 500MG TABLET SA
(Metformin HCl)
100 BOT0008760631317
PDPs
62
MAPDs
GLUCOPHAGE XR 750MG TABLET SA
(Metformin HCl)
100 BOT0008760641317
PDPs
62
MAPDs
GLUCOTROL 10MG TABLET
(Glipizide)
100 BOT0004941206617
PDPs
65
MAPDs
GLUCOTROL 5MG TABLET
(Glipizide)
100 BOT0004941106617
PDPs
65
MAPDs
GLUCOTROL XL 10MG TABLET SA
(Glipizide)
500 BOT0004915607317
PDPs
65
MAPDs
GLUCOTROL XL 2.5MG TABLET SA
(Glipizide)
30 BOT0004916203017
PDPs
54
MAPDs
GLUCOTROL XL 5MG TABLET SA
(Glipizide)
500 BOT0004915507317
PDPs
65
MAPDs
GLUCOVANCE 1.25/250MG TABLET
(Glyburide-Metformin)
100 BOT0008760721114
PDPs
54
MAPDs
GLUCOVANCE 2.5/500MG TABLET
(Glyburide-Metformin)
100 BOT0008760731116
PDPs
59
MAPDs
GLUCOVANCE 5/500MG TABLET
(Glyburide-Metformin)
100 BOT0008760741116
PDPs
59
MAPDs
GLUMETZA ER 500 MG TABLET
(Metformin HCl)
   6801200021319
PDPs
81
MAPDs
GLYBURIDE TABLETS
(Glyburide)
100 TABLETS BOT 0009383420171
PDPs
245
MAPDs
GLYBURIDE AND METFORMIN HCL 1.25-250MG TABLET (100 CT)
(Glyburide)
100 BOT0009357100169
PDPs
242
MAPDs
GLYBURIDE 2.5MG TABLET (100 CT)
(Glyburide)
100 TABLETS BOT0009383430171
PDPs
245
MAPDs
GLYBURIDE TABLETS
(Glyburide)
500 TABLETS BOT 0009383440571
PDPs
245
MAPDs
Glyburide 6mg/1 500 TABLET in 1 BOTTLE, PLASTIC
(Glyburide)
500 TABLET BOTTLE  0014399200571
PDPs
243
MAPDs
GLYBURIDE MICRONIZED 1.5MG TABLET (100 CT)
(Glyburide Micronized)
100 BOT0037811130169
PDPs
242
MAPDs
GLYBURIDE MICRO 3MG TABLET (100 CT)
(Glyburide Micronized)
100 TABLETS BOT0009380350169
PDPs
242
MAPDs
GLYBURIDE-METFORMIN HCL 2.5-500MG TABLET
(Glyburide-Metformin)
500 BOT0022827525069
PDPs
243
MAPDs
GLYBURIDE-METFORMIN HCL 5MG-500MG TABLET
(Glyburide-Metformin)
500 BOT0022827535069
PDPs
243
MAPDs
GLYCOPYRROLATE 0.2MG/ML VL
(Glycopyrrolate)
25 X 20 ML VIALMD0051746202558
PDPs
203
MAPDs
GLYCOPYRROLATE TABLET 1MG (100 CT)
(Glycopyrrolate)
100 BOT4988400650169
PDPs
237
MAPDs
GLYCOPYRROLATE TABLET 2MG (100 CT)
(Glycopyrrolate)
100 BOT4988400660169
PDPs
226
MAPDs
GLYCRON 1.5MG TABLET
(Glyburide Micronized)
100 TABLETS BOTPL6490901010757
PDPs
172
MAPDs
GLYCRON 3MG TABLET
(Glyburide Micronized)
500 BOT6490901020848
PDPs
162
MAPDs
GLYCRON 4.5MG TABLET
(Glyburide Micronized)
100 BOT6490901040738
PDPs
113
MAPDs
GLYCRON 6MG TABLET
(Glyburide Micronized)
500 BOT6490901050848
PDPs
154
MAPDs
GLYNASE 1.5MG PRESTAB
(Glyburide Micronized)
100 BOT0000903410118
PDPs
66
MAPDs
GLYNASE PRESTAB TABLET 3MG (100 CT)
(Glyburide Micronized)
100 BOT0000903520118
PDPs
66
MAPDs
GLYNASE PRESTAB TABLET 6MG (100 CT)
(Glyburide Micronized)
100 BOT0000934490118
PDPs
66
MAPDs
GLYSET 100MG TABLET
(Miglitol)
100 BOTPL0000950140139
PDPs
150
MAPDs
GLYSET 25MG TABLET
(Miglitol)
100 BOT0000950120139
PDPs
150
MAPDs
GLYSET 50MG TABLET
(Miglitol)
100 BOTPL0000950130139
PDPs
150
MAPDs
GOLYTELY PACKET 227.1 GM/2.82 GM
(PEG 3350-KCl-Na Bicarb-NaCl-Na Sulfate For)
263 GM PKT5226807000127
PDPs
98
MAPDs
GOLYTELY SOLUTION 236 GM/2.97 GM/6 GM
(PEG 3350-KCl-Na Bicarb-NaCl-Na Sulfate For)
4 L BOT5226801000129
PDPs
96
MAPDs
Gralise Starter Pack 1 KIT in 1 BLISTER PACK
(Gabapentin)
1 KIT in 1 BLISTER PACK  1391300061620
PDPs
67
MAPDs
Gralise 300mg/1 30 TABLET, FILM COATED in 1 BOTTLE
(Gabapentin)
30 TABLET, FILM COATED in  1391300041320
PDPs
68
MAPDs
Gralise 600mg/1 90 TABLET, FILM COATED in 1 BOTTLE
(Gabapentin)
90 TABLET, FILM COATED in  1391300051920
PDPs
68
MAPDs
Granisetron Hydrochloride 0.1mg/mL 10 VIAL, GLASS in 1 CARTON / 1 mL in 1 VIAL, GLASS
(Granisetron HCl)
10 VIAL, GLASS in 1 CARTO  1747805470155
PDPs
202
MAPDs
Granisetron Hydrochloride 1mg/mL 10 VIAL, SINGLE-USE in 1 PACKAGE / 1 mL in 1 VIAL, SINGLE-USE
(Granisetron HCl)
10 VIAL, SINGLE-USE in 1  0014397441055
PDPs
201
MAPDs
GRANISETRON HCL 1MG TABLET (20 CT)
(Granisetron HCl)
20 BOT6472001980266
PDPs
231
MAPDs
Granisol 2mg/10mL 1 BOTTLE, GLASS in 1 CARTON / 30 mL in 1 BOTTLE, GLASS
(Granisetron HCl)
1 BOTTLE, GLASS in 1 CART  5254708013031
PDPs
142
MAPDs
GRIFULVIN V 500MG TABLET
(Griseofulvin Microsize)
100 BOT0006202146045
PDPs
147
MAPDs
GRIS-PEG 125MG TABLET
(Griseofulvin Ultramicrosize)
100 BOT0088407630461
PDPs
208
MAPDs
GRIS-PEG 250 MG TABLET
(Griseofulvin Ultramicrosize)
100 EA  0088407730461
PDPs
207
MAPDs
GRISEOFULVIN ORAL SUSPENSION 125MG/5ML 4 FLOZ CTR
(Griseofulvin Microsize)
4 FLOZ CTR0047200130469
PDPs
237
MAPDs
GUANABENZ ACETATE 4MG TABLET
(Guanabenz Acetate)
100 BOT0017242266046
PDPs
164
MAPDs
GUANFACINE 1MG TABLET
(Guanfacine HCl)
100 BOT0059104440169
PDPs
238
MAPDs
GUANFACINE 2MG TABLET (100 CT)
(Guanfacine HCl)
100 BOT0037811900169
PDPs
238
MAPDs
GUANIDINE HCL 125MG TABLET
(Guanidine HCl)
100 BOT0008504920161
PDPs
220
MAPDs
HORIZANT 600mg/1 30 TABLET in 1 BOTTLE
(GABAPENTIN ENACARBIL)
30 TABLET in 1 BOTTLE  0017308060129
PDPs
69
MAPDs
IRESSA 250MG TABLET
(Gefitinib)
30 BOT0031004823057
PDPs
198
MAPDs
ISOTON GENTAMICIN 80MG/100ML
(Gentamicin in Saline)
100 ML BAG0033805034856
PDPs
196
MAPDs
ISOTON GENTAMICIN 60MG/100ML
(Gentamicin in Saline)
100 BAG0033805014857
PDPs
194
MAPDs
LOPID 600MG TABLET (500 CT)
(Gemfibrozil)
500 BOT0007107373015
PDPs
58
MAPDs
METAGLIP 2.5/250MG TABLET
(Glipizide-Metformin HCl)
   0008760813114
PDPs
56
MAPDs
NAGLAZYME 5MG/5ML VIAL
(Galsulfase)
5ML VIALSU6813500200171
PDPs
245
MAPDs
NEOMYCIN/POLYMY/GRAM EYE DROPS 0.025MG/ML 1.75MG/M
(Neomycin-Polymyxin B-Gramicidin Ophth)
10 ML BOT2420807906266
PDPs
231
MAPDs
NEURONTIN 100MG CAPSULE
(Gabapentin)
100 BOT0007108032418
PDPs
67
MAPDs
NEURONTIN 250MG/5ML TUBEX
(Gabapentin)
470 ML BOT0007120122325
PDPs
104
MAPDs
NEURONTIN 300MG CAPSULE
(Gabapentin)
100 BOT0007108052418
PDPs
67
MAPDs
NEURONTIN 400MG CAPSULE
(Gabapentin)
100 BOT0007108062418
PDPs
67
MAPDs
NEURONTIN 600MG TABLET
(Gabapentin)
100 BOT0007105132418
PDPs
67
MAPDs
NEURONTIN 800MG TABLET
(Gabapentin)
100 BOT0007104012418
PDPs
67
MAPDs
POLYETHYLENE GLYCOL 3350 105 MG/ML / POTASSIUM CHLORIDE 0.00497 MEQ/ML / SODIUM BICARBONATE 1.43 MG/
(Polyethylene Glycol 3350 Oral)
   6822001310459
PDPs
217
MAPDs
POLYETH GLYC NF POWDER FOR ORAL SOLUTION 17GM (527 CT)
(Polyethylene Glycol 3350 Powder)
527 BOT0057404120568
PDPs
232
MAPDs
PRED G OPHTHALMIC SUSPENSION 1;0.3%;% 5 ML BOTDR
(Gentamicin-Prednisolone Ace Ophth)
5 ML BOTDR0002301060531
PDPs
119
MAPDs
PRED-G S.O.P. EYE OINTMENT
(Gentamicin-Prednisolone Ace Ophth)
3.5 GM TUBE0002300660430
PDPs
117
MAPDs
RAZADYNE 12MG TABLET
(Galantamine Hydrobromide)
TABLETS BOT5045803986017
PDPs
49
MAPDs
RAZADYNE SOL 4MG/ML
(Galantamine Hydrobromide)
100 ML BOT5045804901021
PDPs
72
MAPDs
RAZADYNE 4MG TABLET
(Galantamine Hydrobromide)
60 TABLETS BOT5045803966017
PDPs
48
MAPDs
RAZADYNE 8MG TABLET
(Galantamine Hydrobromide)
60 TABLETS BOT5045803976017
PDPs
48
MAPDs
RAZADYNE ER 16MG CAPSULE
(Galantamine Hydrobromide)
30 CAPSULES BOT5045803883017
PDPs
53
MAPDs
RAZADYNE ER 24MG CAPSULE
(Galantamine Hydrobromide)
30 CAPSULES BOT5045803893017
PDPs
53
MAPDs
RAZADYNE ER 8MG CAPSULE
(Galantamine Hydrobromide)
30 CAPSULES BOT5045803873017
PDPs
53
MAPDs
ROBINUL 0.2MG/ML VIAL
(Glycopyrrolate)
25 X 5ML VIALMD6097701550318
PDPs
62
MAPDs
ROBINUL 1MG TABLET
(Glycopyrrolate)
100 TABS BOTPL5963002001018
PDPs
67
MAPDs
ROBINUL FORTE 2MG TABLET
(Glycopyrrolate)
100 TABS BOTPL5963002051018
PDPs
67
MAPDs
SANCUSO TRANSDERMAL SYSTEM 3.1MG/24HRS 1 PATCH CRTN
(Granisetron Transdermal)
1 PATCH CRTN4274707260146
PDPs
140
MAPDs
SIMPONI GOLIMUMAB INJECTION 50MG/0.5ML 1 50 MG SINGLE DOSE SYR SYR
(Golimumab Subcutaneous)
1 50 MG SINGLE DOSE SYR SYR5789400700133
PDPs
133
MAPDs
TENEX 1MG TABLET
(Guanfacine HCl)
500 TABS BOTPL6785707050516
PDPs
49
MAPDs
TENEX 2MG TABLET
(Guanfacine HCl)
100 TABS BOTPL6785707060116
PDPs
49
MAPDs
ZIPRASIDONE HCL 20 MG CAPSULE
(Ziprasidone HCl)
   6818003310769
PDPs
240
MAPDs
ZIPRASIDONE HCL 40 MG CAPSULE
(Ziprasidone HCl)
   6818003320769
PDPs
240
MAPDs
ZIPRASIDONE HCL 60 MG CAPSULE
(Ziprasidone HCl)
   5511102586069
PDPs
240
MAPDs
ZIPRASIDONE HCL 80 MG CAPSULE
(Ziprasidone HCl)
   0090462720869
PDPs
240
MAPDs
ZIRGAN 1.5mg/g 1 TUBE, WITH APPLICATOR in 1 CARTON / 5 g in 1 TUBE, WITH APPLICATOR
(Ganciclovir Ophth)
1 TUBE, WITH APPLICATOR i  2420805353546
PDPs
148
MAPDs
ZYMAR 3mg/mL 1 BOTTLE, DROPPER in 1 CARTON / 5 mL in 1 BOTTLE, DROPPER
(Gatifloxacin Ophth)
1 BOTTLE, DROPPER in 1 CA  0002392180546
PDPs
179
MAPDs
ZYMAXID 5mg/mL 1 BOTTLE, DROPPER in 1 CARTON / 2.5 mL in 1 BOTTLE, DROPPER
(Gatifloxacin Ophth)
1 BOTTLE, DROPPER in 1 CA  0002336152544
PDPs
159
MAPDs



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




Tips & Disclaimers
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  • Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Our PDP-Compare.com and MA-Compare.com provide highlights of annual plan benefit changes.
  • The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
  • Limitations, copayments, and restrictions may apply.
  • We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
  • When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium.
  • Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Read more on IRMAA.
  • Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
  • You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Members may enroll in a Medicare Advantage plan only during specific times of the year. Contact the Medicare plan for more information.
  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
  • Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.
  • A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Providers who do not contract with the plan are not required to see you except in an emergency.
  • Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home.
  • Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
  • 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.
  • Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.
  • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
  • 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.
  • Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.