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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 K 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
ACULAR 0.5% EYE DROPS
(Ketorolac Tromethamine Ophth)
5 ML BOT0002321810519
PDPs
65
MAPDs
ACULAR LS 0.4% OPHTH SOL
(Ketorolac Tromethamine Ophth)
5 ML BOTDR0002392770519
PDPs
64
MAPDs
ACUVAIL 0.45% OPHTH SOLUTION #30X0.4 EA
(Ketorolac Tromethamine Ophth)
#30X0.4  0002335073027
PDPs
86
MAPDs
EXTINA 2% FOAM
(Ketoconazole)
   6303200510018
PDPs
60
MAPDs
K-TAB 10MEQ TABLET SA
(Potassium Chloride)
1000 BOT0007478041932
PDPs
94
MAPDs
KADIAN ER 10 MG CAPSULE
(Morphine Sulfate)
100 EA  4698704101143
PDPs
157
MAPDs
KADIAN ER 100 MG CAPSULE
(Morphine Sulfate)
100 EA  4698703241142
PDPs
130
MAPDs
KADIAN ER 20 MG CAPSULE
(Morphine Sulfate)
100 EA  4698703221142
PDPs
130
MAPDs
KADIAN ER 200 MG CAPSULE
(Morphine Sulfate)
100 EA  4698703771142
PDPs
157
MAPDs
KADIAN ER 30 MG CAPSULE
(Morphine Sulfate)
100 EA  4698703251142
PDPs
130
MAPDs
KADIAN ER 50 MG CAPSULE
(Morphine Sulfate)
100 EA  4698703231142
PDPs
130
MAPDs
KADIAN ER 60 MG CAPSULE
(Morphine Sulfate)
100 EA  4698703261142
PDPs
130
MAPDs
KADIAN ER 80 MG CAPSULE
(Morphine Sulfate)
100 EA  4698704121141
PDPs
130
MAPDs
Kaletra 100; 25mg/1; mg/1 60 TABLET, FILM COATED in 1 BOTTLE
(Lopinavir-Ritonavir)
60 TABLET, FILM COATED in  0007405226071
PDPs
244
MAPDs
KALETRA 50-200MG TABLET
(Lopinavir-Ritonavir)
120 BOT0007467992271
PDPs
245
MAPDs
KALETRA ORAL SOLUTION
(Lopinavir-Ritonavir)
160 ML BOT0007439564671
PDPs
245
MAPDs
KALYDECO 150 MG TABLET
(ivacaftor)
60 EA  5116702000247
PDPs
150
MAPDs
KANAMYCIN 1GM/3ML VIAL
(Kanamycin Sulfate)
10 X 3 ML VIAL6332303590339
PDPs
151
MAPDs
Kapvay 0.2mg/1
(CLONIDINE HYDROCHLORIDE)
   5963006586016
PDPs
58
MAPDs
KARIVA 21-5 TABLET
(Desogestrel & Ethinyl Estradiol)
21ACTIVE,5ETHINYL,2PLACEB BLPK0055590505865
PDPs
228
MAPDs
KAYEXALATE POWDER
(Sodium Polystyrene Sulfonate Oral)
16 OZ JAR0002410750120
PDPs
72
MAPDs
Keflex 250mg/1
(Cephalexin)
   6845301121018
PDPs
64
MAPDs
Keflex 500mg/1
(Cephalexin)
   6845301131018
PDPs
64
MAPDs
Keflex 750mg/1
(Cephalexin)
   6845301150521
PDPs
84
MAPDs
KELNOR 1-35 1-0.035MG TABLET
(Ethynodiol Diacetate & Ethinyl Estradiol)
28 (21+7) BLPK0055590645865
PDPs
218
MAPDs
Kenalog 0.147mg/g 63 g in 1 CAN
(Triamcinolone Acetonide)
63 g in 1 CAN  1063100936233
PDPs
120
MAPDs
KEPIVANCE INJECTION
(Palifermin For IV)
1.2ML X 6 VIALSD CRTN 6665801120640
PDPs
148
MAPDs
KEPPRA 100MG/ML ORAL SOLUTION
(Levetiracetam)
16 FLO BOT5047400014819
PDPs
76
MAPDs
Keppra 1000mg/1 60 TABLET, FILM COATED in 1 BOTTLE, PLASTIC
(Levetiracetam)
60 TABLET, FILM COATED in  5047405976622
PDPs
78
MAPDs
KEPPRA 250MG TABLET
(Levetiracetam)
120 TABS BOT5047405944021
PDPs
79
MAPDs
KEPPRA 500MG/5ML VIAL
(Levetiracetam)
10 X 5 ML VIAL5047400026331
PDPs
102
MAPDs
KEPPRA 500MG TABLET
(Levetiracetam)
120 TABS BOT5047405954021
PDPs
79
MAPDs
KEPPRA TABLETS EXTENDED RELEASE 500MG 60 BOT
(Levetiracetam)
60 BOT5047405986620
PDPs
89
MAPDs
KEPPRA 750MG TABLET
(Levetiracetam)
120 TABS BOT5047405964021
PDPs
79
MAPDs
KEPPRA XR TABLET
(Levetiracetam)
60 BOT5047405996620
PDPs
89
MAPDs
Ketek 300mg/1 20 TABLET, FILM COATED in 1 BOTTLE
(Telithromycin)
20 TABLET, FILM COATED in  0008822232042
PDPs
148
MAPDs
KETEK 400MG TABLET
(Telithromycin)
60 CT BOT0008822254142
PDPs
153
MAPDs
KETOCONAZOLE SHAMPOO
(Ketoconazole)
118.28ML BOTPL 0078170900471
PDPs
244
MAPDs
KETOCONAZOLE 2% CREAM
(Ketoconazole)
30 GRAMS TUBE0009308403071
PDPs
245
MAPDs
KETOCONAZOLE 2% FOAM
(Ketoconazole)
   4580205323335
PDPs
123
MAPDs
Ketoconazole 200mg 100 TABLET BOTTLE
(Ketoconazole)
100 TABLET BOTTLE  0037802610171
PDPs
245
MAPDs
KETOPROFEN 200MG CAPSULE 24HR SR PELLETS
(Ketoprofen)
100 BOT0037882000158
PDPs
220
MAPDs
KETOPROFEN 50MG CAPSULE
(Ketoprofen)
100 BOT0037840700166
PDPs
236
MAPDs
KETOPROFEN 75MG CAPSULE
(Ketoprofen)
100 CAPSULES BOT0009331950166
PDPs
236
MAPDs
KETOROLAC 10MG TABLET
(Ketorolac)
100 TABLETS BOT0009303140143
PDPs
151
MAPDs
KETOROLAC INJECTION 60MG/2ML 25X1ML ON 2ML VIALSD
(Ketorolac)
25X1ML ON 2ML VIALSD1001900300335
PDPs
132
MAPDs
KETOROLAC TROMETHAMINE INJECTION 15MG BOX OF 10 VIALGL
(Ketorolac Tromethamine)
BOX OF 10 VIALGL6467907570239
PDPs
143
MAPDs
Ketorolac Tromethamine 4mg/mL 1 BOTTLE, DROPPER in 1 CARTON / 5 mL in 1 BOTTLE, DROPPER
(Ketorolac Tromethamine)
1 BOTTLE, DROPPER in 1 CA  1747802081071
PDPs
243
MAPDs
Ketorolac Tromethamine 5mg/mL 10 mL in 1 BOTTLE
(Ketorolac Tromethamine)
10 mL in 1 BOTTLE  4161602219071
PDPs
243
MAPDs
Kineret 100mg/0.67mL
(Anakinra Subcutaneous)
   6665802342834
PDPs
168
MAPDs
KIONEX POW USP
(Sodium Polystyrene Sulfonate Oral)
454 GM BOTPL0057420041659
PDPs
201
MAPDs
KLARON 10% LOTION
(Sulfacetamide Sodium)
118 ML CTR0006675000417
PDPs
61
MAPDs
KLOR-CON 10MEQ TABLET SA
(Potassium Chloride)
500 BOTPL0024500411569
PDPs
239
MAPDs
KLOR-CON 8MEQ TABLET SA
(Potassium Chloride)
500 BOTPL0024500401569
PDPs
238
MAPDs
KLOR-CON M15 15MEQ TABLET SR PARTICLES/CRYSTALS
(Potassium Chloride Microencapsulated Crys CR)
100 BOT0024501501158
PDPs
211
MAPDs
KLOR-CON M20 TABLET 20MEQ ER
(Potassium Chloride Microencapsulated Crys CR)
500 BOT0024500581567
PDPs
235
MAPDs
KOMBIGLYZE XR 1000; 2.5mg/1; mg/1 60 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC
(SAXAGLIPTIN AND METFORMIN HYDROCHLORIDE)
60 TABLET, FILM COATED, E  0000342221663
PDPs
186
MAPDs
KOMBIGLYZE XR 1000; 5mg/1; mg/1 30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC
(SAXAGLIPTIN AND METFORMIN HYDROCHLORIDE)
30 TABLET, FILM COATED, E  0000342231163
PDPs
186
MAPDs
KOMBIGLYZE XR 500; 5mg/1; mg/1 30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE, PLASTIC
(SAXAGLIPTIN AND METFORMIN HYDROCHLORIDE)
30 TABLET, FILM COATED, E  0000342211163
PDPs
185
MAPDs
KRISTALOSE 10G PACKET
(Lactulose)
10 GM (1X10GMX30POU) CRTN6622007193032
PDPs
118
MAPDs
KRISTALOSE 20G PACKET
(Lactulose)
20 GM (1X20GMX30POU) CRTN6622007293032
PDPs
118
MAPDs
KUVAN 100MG TABLET SOLUBLE
(Sapropterin DiHCL Soluble)
   6813503000271
PDPs
245
MAPDs
Nizoral 20mg/mL 120 mL in 1 BOTTLE
(Ketoconazole)
120 mL in 1 BOTTLE  5045806800817
PDPs
65
MAPDs
POTASSIUM CHLORIDE 0.075%/D5W/SODIUM CHLORIDE 0.2%
(DEXTROSE (ANHYDROUS)/POTASSIUM CHLORIDE/SODIUM CHLORIDE)
12 X 1000 ML CTR0040979970965
PDPs
223
MAPDs
POTASSIUM CHLORIDE IN 10% DEXTROSE AND NACL SOLUTION FOR INJECTION
(DEXTROSE (ANHYDROUS)/POTASSIUM CHLORIDE/SODIUM CHLORIDE)
250 ML X 24 CASE0026476632050
PDPs
189
MAPDs
POTASSIUM CHLORIDE 0.15%/D5W/SODIUM CHLORIDE 0.3%
(DEXTROSE (ANHYDROUS)/POTASSIUM CHLORIDE/SODIUM CHLORIDE)
1000 ML BAG0033806030464
PDPs
220
MAPDs
POTASSIUM CHLORIDE 20MEQ IN D5W/NACL 0.225%
(DEXTROSE (ANHYDROUS)/POTASSIUM CHLORIDE/SODIUM CHLORIDE)
12 X 1000 ML CTR0040979010950
PDPs
174
MAPDs
POTASSIUM CHLORIDE 0.15%/D5W/SODIUM CHLORIDE 0.45%
(DEXTROSE (ANHYDROUS)/POTASSIUM CHLORIDE/SODIUM CHLORIDE)
1000 ML BAG0033806710464
PDPs
223
MAPDs
POTASSIUM CHLORIDE 0.15%/D5W/SODIUM CHLORIDE 0.9% 1000ML
(DEXTROSE (ANHYDROUS)/POTASSIUM CHLORIDE/SODIUM CHLORIDE)
1000 ML BAG0026476520054
PDPs
189
MAPDs
POTASSIUM CHLORIDE 40MEQ IN D5W/NACL 0.9%
(DEXTROSE (ANHYDROUS)/POTASSIUM CHLORIDE/SODIUM CHLORIDE)
12 X 1000 ML CTR0040971090952
PDPs
192
MAPDs
POTASSIUM CHLORIDE 0.3%/D5W/SODIUM CHLORIDE 0.2%
(DEXTROSE (ANHYDROUS)/POTASSIUM CHLORIDE/SODIUM CHLORIDE)
1000 ML BAG0033806670462
PDPs
206
MAPDs
POTASSIUM CHLORIDE 0.3%/D5W/SODIUM CHLORIDE 0.45% 1000ML BAG
(DEXTROSE (ANHYDROUS)/POTASSIUM CHLORIDE/SODIUM CHLORIDE)
1000ML BAG0026476380062
PDPs
209
MAPDs
SPRIX 15.75mg/1 5 BOTTLE, SPRAY in 1 CARTON / 8 SPRAY, METERED in 1 BOTTLE, SPRAY
(Ketorolac Tromethamine)
5 BOTTLE, SPRAY in 1 CART  0051788800514
PDPs
38
MAPDs



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


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Tips & Disclaimers
  • The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change.
  • Medicare has neither reviewed nor endorsed the information on our site.
  • We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227.
  • We are an independent education, research, and technology company. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. We are not compensated for Medicare plan enrollments. We do not sell leads or share your personal information.
  • 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.