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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 S 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
ALDACTAZIDE 25/25 TABLET
(Spironolactone & Hydrochlorothiazide)
100 BOT0002510113118
PDPs
55
MAPDs
ALDACTAZIDE 50/50 TABLET
(Spironolactone & Hydrochlorothiazide)
100 BOT0002510213126
PDPs
92
MAPDs
ALDACTONE 100MG TABLET
(Spironolactone)
100 BOT0002510313118
PDPs
55
MAPDs
ALDACTONE 25MG TABLET
(Spironolactone)
100 BOT0002510013118
PDPs
55
MAPDs
ALDACTONE 50MG TABLET
(Spironolactone)
100 BOT0002510413118
PDPs
55
MAPDs
AZULFIDINE 500MG TABLET
(Sulfasalazine)
6 X 300 BOTPL0001301012018
PDPs
55
MAPDs
AZULFIDINE EN TABLET S 500MG TABLET 6 X (300 CT)PL
(Sulfasalazine)
6 X 300 BOTPL0001301022018
PDPs
58
MAPDs
BACTRIM 400-80MG TABLET
(Sulfamethoxazole-Trimethoprim)
100 BOT1331001450118
PDPs
53
MAPDs
BACTRIM DS TABLET 800-160
(Sulfamethoxazole-Trimethoprim)
100 BOT1331001460117
PDPs
52
MAPDs
BETAPACE 120MG TABLET
(Sotalol HCl)
100 BOT5041901091017
PDPs
52
MAPDs
BETAPACE 160MG TABLET
(Sotalol HCl)
100 BOT5041901061017
PDPs
52
MAPDs
BETAPACE 240MG TABLET
(Sotalol HCl)
100 BOT5041901071017
PDPs
52
MAPDs
BETAPACE AF 80MG TABLET
(Sotalol HCl (AFIB/AFL))
60 TABS BOT5041901150618
PDPs
49
MAPDs
BLEPH-10 10% EYE DROPS
(Sulfacetamide Sodium Ophth)
5 ML BOT1198000110529
PDPs
100
MAPDs
BLEPHAMIDE 10-0.2% EYE OINT
(Sulfacetamide Sodium-Prednisolone Ophth)
3.5 GM TUBE0002303130452
PDPs
192
MAPDs
BLEPHAMIDE 0.2% EYE DROPS
(Sulfacetamide Sodium-Prednisolone Ophth)
10 ML BOT1198000221038
PDPs
152
MAPDs
BUPHENYL POWDER
(Sodium Phenylbutyrate Oral)
250 GM BOT6259201886455
PDPs
175
MAPDs
BUPHENYL 500MG TABLET
(Sodium Phenylbutyrate Oral)
250 BOT6259204960371
PDPs
245
MAPDs
CARAFATE SUCRALFATE 1G TABLET ORAL
(Sucralfate)
   5891401711019
PDPs
54
MAPDs
CARAFATE SUS 1GM/10ML
(Sucralfate)
14 BOT5891401701453
PDPs
196
MAPDs
CHEMET 100MG CAPSULE
(Succimer)
   6738602011145
PDPs
142
MAPDs
CLINORIL 200MG TABLET
(Sulindac)
100 BOT0000609426816
PDPs
52
MAPDs
COLLAGENASE SANTYL OINTMENT 250UNT 30GM TUBE
(Collagenase)
30 GM TUBE0006450103071
PDPs
245
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
ELDEPRYL 5 MG CAPSULE
(Selegiline HCl)
   4950204206015
PDPs
45
MAPDs
EMSAM TRANSDERMAL SYSTEM PATCHES 12MG/24H
(Selegiline TD)
30 PATCHES CRTN4950209023071
PDPs
244
MAPDs
EMSAM TRANSDERMAL SYSTEM PATCHES 6MG/24H
(Selegiline TD)
30 PATCHES CRTN4950209003071
PDPs
245
MAPDs
EMSAM TRANSDERMAL SYSTEM PATCHES 9MG/24H
(Selegiline TD)
30 PATCHES CRTN4950209013071
PDPs
245
MAPDs
ERTACZO 2% CREAM
(Sertaconazole Nitrate)
   0006216500221
PDPs
69
MAPDs
Exelderm 10mg/g 30 g in 1 TUBE
(Sulconazole Nitrate)
30 g in 1 TUBE  1063101013029
PDPs
118
MAPDs
Exelderm 10mg/mL 30 mL in 1 BOTTLE, PLASTIC
(Sulconazole Nitrate)
30 mL in 1 BOTTLE, PLASTI  1063101003026
PDPs
116
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
HUMATROPE 12MG CARTRIDGE
(Somatropin For)
1 PKGCOM0000281480137
PDPs
156
MAPDs
HUMATROPE 24MG CARTRIDGE
(Somatropin For)
1 CARTRIDGE VIAL0000281490137
PDPs
156
MAPDs
HUMATROPE FOR INJECTION 5MG 6 X 5ML VIAL
(Somatropin For)
6 X 5 ML VIAL0000273351636
PDPs
155
MAPDs
HUMATROPE 6MG CARTRIDGE
(Somatropin For)
1 CTG0000281470137
PDPs
150
MAPDs
IMITREX 100MG TABLET
(Sumatriptan Succinate)
9 BLPK0017307370117
PDPs
67
MAPDs
IMITREX 20MG NASAL SPRAY
(Sumatriptan Succinate)
6 X 1 UD NASAL SPRAY CTR0017305230015
PDPs
83
MAPDs
IMITREX 25MG TABLET
(Sumatriptan Succinate)
1 BLPK0017307350017
PDPs
67
MAPDs
IMITREX 4MG/0.5ML KIT REFILL
(Sumatriptan Succinate)
2 SYR0017307390218
PDPs
76
MAPDs
IMITREX 5MG NASAL SPRAY
(Sumatriptan Succinate)
6 X 1 UNIT DOSE SPRAY CTR0017305240015
PDPs
83
MAPDs
IMITREX 50MG TABLET
(Sumatriptan Succinate)
9 BLPK0017307360117
PDPs
67
MAPDs
IMITREX 6MG/0.5ML SYRNG KIT
(Sumatriptan Succinate)
2 (STATDOSE) SYR0017304780018
PDPs
77
MAPDs
IMITREX 6MG/0.5ML VIAL
(Sumatriptan Succinate)
5 X 0.5 ML VIAL0017304490219
PDPs
70
MAPDs
INSULIN, GLULISINE, HUMAN 100 UNT/ML PREFILLED SYRINGE [APIDRA] 3 ML
(Insulin Glulisine Subcutaneous)
   0008825020543
PDPs
146
MAPDs
Invega Sustenna 117 mg/0.75mL Prefilled Syringe
(Paliperidone Palmitate)
0.75 ML  5045805620171
PDPs
242
MAPDs
Invega Sustenna 156 mg/mL Prefilled Syringe
(Paliperidone Palmitate)
1 ML  5045805630171
PDPs
242
MAPDs
Invega Sustenna 234 mg/1.5mL Prefilled Syringe
(Paliperidone Palmitate)
1.5 ML  5045805640171
PDPs
242
MAPDs
Invega Sustenna 39 mg/0.25mL Prefilled Syringe
(Paliperidone Palmitate)
0.25 ML  5045805600171
PDPs
245
MAPDs
Invega Sustenna 78 mg/0.5mL Prefilled Syringe
(Paliperidone Palmitate)
0.5 ML  5045805610171
PDPs
243
MAPDs
INVIRASE 200MG CAPSULE
(Saquinavir Mesylate)
270 BOT0000402451571
PDPs
245
MAPDs
INVIRASE 500MG TABLET
(Saquinavir Mesylate)
120 BOT0000402445171
PDPs
245
MAPDs
JANUMET XR 100-1,000 MG TABLET
(Sitagliptin-Metformin HCl)
1000 EA  0000600818255
PDPs
183
MAPDs
JANUMET XR 50-1,000 MG TABLET
(Sitagliptin-Metformin HCl)
1000 EA  0000600808255
PDPs
183
MAPDs
JANUMET XR 50-500 MG TABLET
(Sitagliptin-Metformin HCl)
1000 EA  0000600788255
PDPs
182
MAPDs
JANUMET 50-1000MG TABLET
(Sitagliptin-Metformin HCl)
180 BOT0000605776271
PDPs
241
MAPDs
JANUMET 50MG-500MG TABLET
(Sitagliptin-Metformin HCl)
180 BOT0000605756271
PDPs
241
MAPDs
JANUVIA TABLET 100MG (30 CT)
(Sitagliptin Phosphate)
30 BOT0000602773171
PDPs
244
MAPDs
JANUVIA 25MG TABLET
(Sitagliptin Phosphate)
30 BOT0000602213171
PDPs
244
MAPDs
JANUVIA 50MG TABLET
(Sitagliptin Phosphate)
90 BOT0000601125471
PDPs
244
MAPDs
JUVISYNC 100-10 MG TABLET
(sitagliptin and simvastatin)
1000 EA  0000607538250
PDPs
155
MAPDs
JUVISYNC 100-20 MG TABLET
(sitagliptin and simvastatin)
1000 EA  0000607578250
PDPs
155
MAPDs
JUVISYNC 100-40 MG TABLET
(sitagliptin and simvastatin)
1000 EA  0000607738250
PDPs
155
MAPDs
KAYEXALATE POWDER
(Sodium Polystyrene Sulfonate Oral)
16 OZ JAR0002410750120
PDPs
72
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
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
KUVAN 100MG TABLET SOLUBLE
(Sapropterin DiHCL Soluble)
   6813503000271
PDPs
245
MAPDs
LANREOTIDE 240 MG/ML PREFILLED SYRINGE [SOMATULINE]
(Lanreotide Acetate Extended Release)
0.5 ML  1505401200167
PDPs
234
MAPDs
LEUKINE INJECTION 250 MCG/ML
(Sargramostim)
   5846801800271
PDPs
245
MAPDs
LEUKINE 500 MCG/ML
(Sargramostim)
   5846801810266
PDPs
234
MAPDs
LIDOCAINE 70 MG / TETRACAINE 70 MG TRANSDERMAL PATCH [SYNERA]
(Lidocaine-Tetracaine Topical)
   4346908641019
PDPs
73
MAPDs
NEXAVAR TABLETS 200MG 120 BOT
(Sorafenib Tosylate)
120 BOT5041904885871
PDPs
245
MAPDs
Norditropin 10mg/1.5mL 1 SYRINGE, PLASTIC in 1 CARTON / 1.5 mL in 1 SYRINGE, PLASTIC
(Somatropin For)
1 SYRINGE, PLASTIC in 1 C  0016977052146
PDPs
167
MAPDs
Norditropin 15mg/1.5mL 1 SYRINGE, PLASTIC in 1 CARTON / 1.5 mL in 1 SYRINGE, PLASTIC
(Somatropin For)
1 SYRINGE, PLASTIC in 1 C  0016977082147
PDPs
189
MAPDs
Norditropin 5mg/1.5mL 1 SYRINGE, PLASTIC in 1 CARTON / 1.5 mL in 1 SYRINGE, PLASTIC
(Somatropin For)
1 SYRINGE, PLASTIC in 1 C  0016977042147
PDPs
180
MAPDs
NORDITROPIN NORDIFLEX INJECTION
(Somatropin For)
3 ML X 1 SYR CRTN 0016977031146
PDPs
162
MAPDs
NUTROPIN 10 MG VIAL
(Somatropin For)
1 EA  5024200182132
PDPs
154
MAPDs
NUTROPIN AQ PEN CARTRIDGE 10MG/2 ML
(Somatropin For)
1 X 10 MG PER 2 ML CTG5024200431432
PDPs
144
MAPDs
NUTROPIN AQ NUSPIN SOLUTION
(Somatropin For)
2 ML X 1 CTG CRTN 5024200750127
PDPs
112
MAPDs
NUTROPIN AQ 20MG/2ML PEN CART SOMATROPIN
(Somatropin For)
1X 20 MG PER 2 ML CTG CTG5024200730131
PDPs
140
MAPDs
OLANZAPINE-FLUOXETINE 12-25MG CAPSULE
(Olanzapine-Fluoxetine HCl)
30 EA  0009355065644
PDPs
139
MAPDs
OLANZAPINE-FLUOXETINE 12-50MG CAPSULE
(Olanzapine-Fluoxetine HCl)
30 EA  0009355075645
PDPs
140
MAPDs
OLANZAPINE-FLUOXETINE 6/25MG CAP 3
(Olanzapine-Fluoxetine HCl)
30 EA 0009355045645
PDPs
140
MAPDs
OLANZAPINE-FLUOXETINE 6-50MG CAPSULE
(Olanzapine-Fluoxetine HCl)
30 EA  0009355055645
PDPs
140
MAPDs
OMNITROPE FOR INJECTION KIT 5.8MG 1 BOX PKGCOM
(Somatropin For)
1 BOX PKGCOM0078140043641
PDPs
140
MAPDs
ONGLYZA 2.5mg/1 30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC
(Saxagliptin HCl)
30 TABLET, FILM COATED in  0000342141164
PDPs
214
MAPDs
ONGLYZA 5mg/1 30 TABLET, FILM COATED in 1 BOTTLE, PLASTIC
(Saxagliptin HCl)
30 TABLET, FILM COATED in  0000342151164
PDPs
218
MAPDs
OSMOPREP TABLET 1.5GM
(Sod Phos Mono-Sod Phos Di)
100 BOT6564907014132
PDPs
122
MAPDs
QUETIAPINE FUMARATE 100 MG TAB
(Quetiapine Fumarate)
100 EA  4733509048868
PDPs
240
MAPDs
QUETIAPINE FUMARATE 200 MG TAB
(Quetiapine Fumarate)
100 EA  4733509058868
PDPs
240
MAPDs
QUETIAPINE FUMARATE 25 MG TAB
(Quetiapine Fumarate)
100 EA  4733509028868
PDPs
235
MAPDs
QUETIAPINE FUMARATE 300 MG TAB
(Quetiapine Fumarate)
100 EA  4733509068868
PDPs
240
MAPDs
QUETIAPINE FUMARATE 400 MG TAB
(Quetiapine Fumarate)
100 EA  4733509078868
PDPs
240
MAPDs
QUETIAPINE FUMARATE 50 MG TAB
(Quetiapine Fumarate)
100 EA  4733509038868
PDPs
235
MAPDs
RAPAFLO CAPSULES 4MG 30 BOT
(Silodosin)
30 BOT5254401513049
PDPs
99
MAPDs
RAPAFLO CAPSULES 8MG 90 BOT
(Silodosin)
90 BOT5254401521949
PDPs
99
MAPDs
RAPAMUNE TABLETS
(Sirolimus)
100 BOT 0000810400571
PDPs
243
MAPDs
RAPAMUNE 1MG TABLET
(Sirolimus)
100 BOT0000810410571
PDPs
245
MAPDs
RAPAMUNE 1MG/ML ORAL TUBEX
(Sirolimus)
60 ML BOT0000810300671
PDPs
245
MAPDs
RAPAMUNE 2MG TABLET
(Sirolimus)
100 BOT0000810420571
PDPs
245
MAPDs
RENAGEL 400MG TABLET
(Sevelamer HCl)
   5846800200142
PDPs
165
MAPDs
RENAGEL 800MG TABLET
(Sevelamer HCl)
   5846800210142
PDPs
166
MAPDs
RENVELA 800MG TABLET
(Sevelamer Carbonate)
   5846801300171
PDPs
238
MAPDs
Revatio 0.8mg/mL 12.5 mL in 1 VIAL, SINGLE-USE
(Sildenafil Citrate)
12.5 mL in 1 VIAL, SINGLE  0006903380134
PDPs
110
MAPDs
REVATIO 20MG TABLET
(Sildenafil Citrate)
90 BOT0006941906868
PDPs
242
MAPDs
Safyral 3 BLISTER PACK in 1 PACKAGE / 1 KIT in 1 BLISTER PACK
(DROSPIRENONE/ETHINYL ESTRADIOL/LEVOMEFOLATE CALCIUM AND LEVOMEFOLATE CALCIUM)
3 BLISTER PACK in 1 PACKA  5041904030314
PDPs
45
MAPDs
Saizen 1 KIT in 1 CARTON
(Somatropin (Non-Refrigerated) For Subcutaneous)
1 KIT in 1 CARTON  4408710050235
PDPs
153
MAPDs
SAIZEN CLICKEASY 1 KIT in 1 CARTON
(Somatropin (Non-Refrigerated) For Subcutaneous)
1 KIT in 1 CARTON  4408710800135
PDPs
154
MAPDs
Salagen 5mg/1
(Pilocarpine HCl)
   6285607051016
PDPs
50
MAPDs
Salagen 7.5mg/1
(Pilocarpine HCl)
   6285607751016
PDPs
50
MAPDs
SANCTURA TABLETS
(Trospium Chloride)
60 BOTPL 0002335136014
PDPs
50
MAPDs
SANCTURA XR 60MG CAPSULE SR 24 HR
(Trospium Chloride)
30 X 60 BOT0002393503043
PDPs
136
MAPDs
SANCUSO TRANSDERMAL SYSTEM 3.1MG/24HRS 1 PATCH CRTN
(Granisetron Transdermal)
1 PATCH CRTN4274707260146
PDPs
140
MAPDs
SANDIMMUNE 100MG CAPSULE
(Cyclosporine)
30 PKG0007802411546
PDPs
142
MAPDs
SANDIMMUNE 100MG/ML TUBEX
(Cyclosporine)
50 ML BOT0007801102252
PDPs
153
MAPDs
SANDIMMUNE 25MG CAPSULE
(Cyclosporine)
30 PKG0007802401546
PDPs
144
MAPDs
SANDIMMUNE 50MG/ML AMPUL
(Cyclosporine)
10 BOX0007801090137
PDPs
103
MAPDs
SANDOSTATIN 0.05MG/ML AMPUL
(Octreotide Acetate)
10 AMP0007801800124
PDPs
82
MAPDs
SANDOSTATIN 0.2MG/ML VIAL
(Octreotide Acetate)
6 X 5ML VIAL0007801832526
PDPs
81
MAPDs
SANDOSTATIN 1MG/ML VIAL
(Octreotide Acetate)
6 X 5ML VIAL0007801842526
PDPs
81
MAPDs
SANDOSTATIN LAR 10MG KIT
(Octreotide Acetate)
1 PKGCOM0007803406158
PDPs
208
MAPDs
Sandostatin 100ug/mL 10 AMPULE in 1 PACKAGE / 1 mL in 1 AMPULE
(Octreotide Acetate)
10 AMPULE in 1 PACKAGE /  0007801810126
PDPs
83
MAPDs
SANDOSTATIN LAR 20MG KIT
(Octreotide Acetate)
1 PKGCOM0007803416158
PDPs
208
MAPDs
SANDOSTATIN LAR 30MG KIT
(Octreotide Acetate)
1 KIT PKGCOM0007803426158
PDPs
214
MAPDs
Sandostatin 500ug/mL 10 AMPULE in 1 PACKAGE / 1 mL in 1 AMPULE
(Octreotide Acetate)
10 AMPULE in 1 PACKAGE /  0007801820126
PDPs
83
MAPDs
SAPHRIS 10mg/1 6 CASE in 1 CARTON / 1 BLISTER PACK in 1 CASE / 10 TABLET in 1 BLISTER PACK
(Asenapine)
6 CASE in 1 CARTON / 1 BL  0005201190671
PDPs
245
MAPDs
SAPHRIS 5mg/1 6 CASE in 1 CARTON / 1 BLISTER PACK in 1 CASE / 10 TABLET in 1 BLISTER PACK
(Asenapine)
6 CASE in 1 CARTON / 1 BL  0005201180671
PDPs
245
MAPDs
SARAFEM 10mg/1 72 CARTON in 1 CASE / 4 BLISTER PACK in 1 CARTON / 7 TABLET in 1 BLISTER PACK
(Fluoxetine HCl (PMDD))
72 CARTON in 1 CASE / 4 B  0043002101413
PDPs
52
MAPDs
SARAFEM 20mg/1 72 CARTON in 1 CASE / 4 BLISTER PACK in 1 CARTON / 7 TABLET in 1 BLISTER PACK
(Fluoxetine HCl (PMDD))
72 CARTON in 1 CASE / 4 B  0043002201413
PDPs
63
MAPDs
SAVELLA TABLETS 100MG 60 COUNT BOT
(Milnacipran HCl)
60 COUNT BOT0045615106052
PDPs
193
MAPDs
SAVELLA TABLETS 12.5MG 60 COUNT BOT
(Milnacipran HCl)
60 COUNT BOT0045615126052
PDPs
193
MAPDs
SAVELLA TABLETS TITRATION PACK KIT 12.5;25;50MG;MG;MG 55 COUNT PKGCOM
(Milnacipran HCl)
55 COUNT PKGCOM0045615005552
PDPs
186
MAPDs
SAVELLA TABLETS 25MG 60 COUNT BOT
(Milnacipran HCl)
60 COUNT BOT0045615256052
PDPs
192
MAPDs
SAVELLA TALBETS 50MG 60 COUNT BOT
(Milnacipran HCl)
60 COUNT BOT0045615506052
PDPs
193
MAPDs
SEASONALE 0.15-0.03 TABLET DOSE PACK 3 MONTHS
(Levonorgestrel & Ethinyl Estradiol (91-Day))
91 84 ACTIVE+7 PLACEBO BLPK5128500586620
PDPs
58
MAPDs
SEASONIQUE 150-30(84) TABLET DOSE PACK 3 MONTHS
(Levonorgestrel & Ethinyl Estradiol (91-Day))
91 TABLETS BLPK5128500878723
PDPs
83
MAPDs
SECTRAL 200MG CAPSULE
(Acebutolol HCl)
100 CAPS BOT6785707000117
PDPs
50
MAPDs
SECTRAL 400MG CAPSULE
(Acebutolol HCl)
100 CAPS BOT6785707010117
PDPs
50
MAPDs
SELEGILINE HCL 5MG CAPSULE
(Selegiline HCl)
   6050500550170
PDPs
243
MAPDs
Selegiline Hydrochloride 5mg/1 60 TABLET in 1 BOTTLE, PLASTIC
(Selegiline HCl)
60 TABLET in 1 BOTTLE, PL  0037892909170
PDPs
236
MAPDs
SELENIUM SULFIDE 2.5mg/100mL 118 mL in 1 BOTTLE
(Selenium Sulfide)
118 mL in 1 BOTTLE  4580200406467
PDPs
237
MAPDs
SELFEMRA CAPSULES 10MG 28 CAPSULE BLPK
(Fluoxetine HCl (PMDD))
28 CAPSULE BLPK0009372252831
PDPs
112
MAPDs
SELFEMRA CAPSULES 20MG 28 CAPSULE 4X7 BLPK
(Fluoxetine HCl (PMDD))
28 CAPSULE 4X7 BLPK0009372262831
PDPs
102
MAPDs
SELZENTRY 150mg/1 60 TABLET, FILM COATED in 1 BOTTLE
(Maraviroc)
60 TABLET, FILM COATED in  4970202231871
PDPs
245
MAPDs
SELZENTRY 300mg/1 60 TABLET, FILM COATED in 1 BOTTLE
(Maraviroc)
60 TABLET, FILM COATED in  4970202241871
PDPs
244
MAPDs
SEMPREX-D 60/8 CAPSULE
(Acrivastine & Pseudoephedrine)
100 BOTPL5301404041024
PDPs
89
MAPDs
SENSIPAR 30MG TABLET
(Cinacalcet HCl)
30 BOT5551300733071
PDPs
245
MAPDs
SENSIPAR 60MG TABLET
(Cinacalcet HCl)
60 BOT5551300743071
PDPs
245
MAPDs
SENSIPAR 90MG TABLET
(Cinacalcet HCl)
90 BOT5551300753071
PDPs
245
MAPDs
SEPTRA 80/400 TABLET
(Sulfamethoxazole-Trimethoprim)
100 BOTPL6157000520116
PDPs
50
MAPDs
SEPTRA DS TABLET 800-160
(Sulfamethoxazole-Trimethoprim)
100 BOT6157000530118
PDPs
52
MAPDs
SEREVENT DIS AER 50MCG
(Salmeterol Xinafoate)
60 BLPK0017305210071
PDPs
245
MAPDs
SEROMYCIN 250mg/250mg 40 CAPSULE in 1 BOTTLE / 250 mg in 1 CAPSULE
(Cycloserine)
40 CAPSULE in 1 BOTTLE /  1384512000368
PDPs
238
MAPDs
SEROQUEL 100MG TABLET
(Quetiapine Fumarate)
100 BOT0031002711054
PDPs
175
MAPDs
SEROQUEL 200MG TABLET
(Quetiapine Fumarate)
100 BOT0031002721054
PDPs
175
MAPDs
SEROQUEL 25MG TABLET
(Quetiapine Fumarate)
100 BOT0031002751054
PDPs
170
MAPDs
SEROQUEL 300MG TABLET
(Quetiapine Fumarate)
60 BOT0031002746054
PDPs
175
MAPDs
SEROQUEL 400MG TABLET
(Quetiapine Fumarate)
100 BOT0031002791054
PDPs
175
MAPDs
SEROQUEL 50MG TABLET (100 CT)
(Quetiapine Fumarate)
100 BOT0031002781054
PDPs
170
MAPDs
SEROQUEL TABLETS EXTENDED RELEASE 150MG 100 CRTN
(Quetiapine Fumarate)
100 CRTN0031002813967
PDPs
228
MAPDs
SEROQUEL TABLETS EXTENDED RELEASE 200MG 100 X 200 MG CRTN
(Quetiapine Fumarate)
100 X 200 MG CRTN0031002823967
PDPs
229
MAPDs
SEROQUEL XR 300MG TABLET 60X300MG BOT
(Quetiapine Fumarate)
60 X 300 MG BOT0031002836067
PDPs
229
MAPDs
SEROQUEL TABLETS EXTENDED RELEASE 400MG 100 X 400 MG CRTN
(Quetiapine Fumarate)
100 X 400 MG CRTN0031002843967
PDPs
229
MAPDs
SEROQUEL TABLETS EXTENDED RELEASE 50MG 100 TABS CRTN
(Quetiapine Fumarate)
100 TABS CRTN0031002803967
PDPs
228
MAPDs
Serostim 4mg/mL 1 INJECTION, POWDER, FOR SOLUTION in 1 CARTON
(Somatropin (Non-Refrigerated) For Subcutaneous)
1 INJECTION, POWDER, FOR  4408700040737
PDPs
140
MAPDs
Serostim 5mg/mL 1 INJECTION, POWDER, FOR SOLUTION in 1 CARTON
(Somatropin (Non-Refrigerated) For Subcutaneous)
1 INJECTION, POWDER, FOR  4408700050737
PDPs
139
MAPDs
Sterile Water 6mg/mL 1 INJECTION, SOLUTION in 1 CARTON
(Somatropin (Non-Refrigerated) For Subcutaneous)
1 INJECTION, SOLUTION in  4408700060737
PDPs
141
MAPDs
SERTRALINE HCL 100MG TABLET (30 CT)
(Sertraline HCl)
30 BOT3172202143071
PDPs
245
MAPDs
SERTRALINE HCL 25 MG TABLET
(Sertraline HCl)
30 EA  3172202123071
PDPs
245
MAPDs
SERTRALINE HCL 50MG TABLET (30 CT)
(Sertraline HCl)
30 BOT3172202133071
PDPs
244
MAPDs
SERTRALINE HYDROCHLORIDE ORAL CONCENTRATE
(Sertraline HCl)
60 ML BOTGL 1671406010171
PDPs
245
MAPDs
SEVELAMER CARBONATE 40 MG/ML ORAL SUSPENSION [RENVELA]
(Sevelamer Carbonate)
   5846801310268
PDPs
211
MAPDs
SEVELAMER CARBONATE 26.7 MG/ML ORAL SUSPENSION [RENVELA]
(Sevelamer Carbonate)
   5846801320265
PDPs
189
MAPDs
Silenor 3mg/1 30 TABLET in 1 BLISTER PACK
(DOXEPIN HYDROCHLORIDE)
30 TABLET in 1 BLISTER PA  4284701030335
PDPs
102
MAPDs
Silenor 6mg/1 30 TABLET in 1 BLISTER PACK
(DOXEPIN HYDROCHLORIDE)
30 TABLET in 1 BLISTER PA  4284701060335
PDPs
102
MAPDs
SILVADENE 1% CREAM
(Silver Sulfadiazine)
50 GM JAR6157001315020
PDPs
68
MAPDs
SILVER SULFADIAZINE 1% CRM
(Silver Sulfadiazine)
50 GM BOT0059108105571
PDPs
245
MAPDs
SIMCOR 500MG-20MG TABLET MULTIPHASIC RELEASE 24HR
(Niacin-Simvastatin)
90 TABLETS BOTPL0007433129038
PDPs
147
MAPDs
SIMCOR 750MG-20MG TABLET MULTIPHASIC RELEASE 24HR
(Niacin-Simvastatin)
90 BOTPL0007433159038
PDPs
147
MAPDs
SIMCOR TABLETS EXTENDED RELEASE
(Niacin-Simvastatin)
90 BOT 0007434579037
PDPs
147
MAPDs
SIMCOR TABLETS EXTENDED RELEASE
(Niacin-Simvastatin)
90 BOT 0007434599037
PDPs
136
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
SIMULECT 20MG VIAL
(Basiliximab For IV)
1 VIALSD0007803318445
PDPs
168
MAPDs
Simvastatin 10mg/1 30 TABLET, FILM COATED in 1 BOTTLE
(Simvastatin)
30 TABLET, FILM COATED  0009371535671
PDPs
244
MAPDs
SIMVASTATIN 20MG TABLET 10000 BOT
(Simvastatin)
10000 BOT6838200672471
PDPs
244
MAPDs
SIMVASTATIN 40MG TABLET (500 CT)
(Simvastatin)
500 BOT6838200680571
PDPs
244
MAPDs
Simvastatin 5mg/1
(Simvastatin)
   6838200651071
PDPs
243
MAPDs
SIMVASTATIN 80MG TABLET (1000 CT)
(Simvastatin)
1000 BOT6838200691071
PDPs
244
MAPDs
SINEMET 10; 100mg/1; mg/1 100 TABLET in 1 BOTTLE
(Carbidopa & Levodopa)
100 TABLET BOTTLE  0000639156818
PDPs
62
MAPDs
SINEMET 25; 100mg/1; mg/1 100 TABLET in 1 BOTTLE
(Carbidopa & Levodopa)
100 TABLET BOTTLE  0000639166818
PDPs
61
MAPDs
SINEMET CR 25; 100mg/1; mg/1 100 TABLET, EXTENDED RELEASE in 1 BOTTLE
(Carbidopa & Levodopa)
100 TABLET, EXTENDED RELE  0000639186818
PDPs
62
MAPDs
SINEMET 25; 250mg/1; mg/1 100 TABLET in 1 BOTTLE
(Carbidopa & Levodopa)
100 TABLET BOTTLE  0000639176818
PDPs
61
MAPDs
SINEMET CR 50; 200mg/1; mg/1 100 TABLET, EXTENDED RELEASE in 1 BOTTLE
(Carbidopa & Levodopa)
100 TABLET, EXTENDED RELE  0000639196818
PDPs
62
MAPDs
SINGULAIR 10MG TABLET
(Montelukast Sodium)
90 BOT0000601175471
PDPs
244
MAPDs
SINGULAIR 4MG GRANULES
(Montelukast Sodium)
30 PKT0000638413071
PDPs
242
MAPDs
SINGULAIR 4MG TABLET CHEW
(Montelukast Sodium)
90 BOT0000607115471
PDPs
243
MAPDs
SINGULAIR 5MG TABLET CHEW
(Montelukast Sodium)
90 BOT0000602755471
PDPs
243
MAPDs
SKELAXIN 800MG TABLET
(Metaxalone)
500 BOTPL6079301360513
PDPs
62
MAPDs
SKELID 200MG TABLET
(Tiludronate Disodium)
   0002418001629
PDPs
104
MAPDs
SOD POLY SUL SUS 15GM/60
()
   0057420030271
PDPs
243
MAPDs
SODIUM BICARB INJ 7.5%
(Sodium Bicarbonate)
10 X 50 ML SYR0040934861646
PDPs
175
MAPDs
SODIUM BICARB INJ 8.4%
(Sodium Bicarbonate)
10 X 50 ML SYR0040934951639
PDPs
147
MAPDs
SODIUM CHLORIDE 0.45% TUBEX
(Sodium Chloride)
1000 ML BAG0033800430469
PDPs
237
MAPDs
SODIUM CL 2.5 MEQ/ML VIAL
(Sodium Chloride)
4 X 25 X 20ML CRTN0040966577359
PDPs
218
MAPDs
Sodium Chloride 3g/100mL
(Sodium Chloride)
   0033800540359
PDPs
218
MAPDs
Sodium Chloride 9g/1000mL 4 BAG in 1 PACKAGE / 100 mL in 1 BAG
(Sodium Chloride)
4 BAG in 1 PACKAGE / 100  0033800491869
PDPs
242
MAPDs
Sodium Chloride 900mg/100mL 9 BOTTLE, PLASTIC in 1 CASE / 1500 mL in 1 BOTTLE, PLASTIC
(Sodium Chloride)
9 BOTTLE, PLASTIC in 1 CA  0040971383671
PDPs
244
MAPDs
SODIUM CHLORIDE INJECTION USP 5%
(Sodium Chloride)
500 ML BAG0033800560359
PDPs
219
MAPDs
SODIUM EDECRIN FOR INJECTION 50MG 1 X 50 MG VIAL
(Ethacrynate Sodium For)
1 X 50 MG VIAL2501002102730
PDPs
98
MAPDs
SODIUM LACTATE 1/6MOLAR INJ
(Sodium Lactate IV)
1000 ML BAG0033801290436
PDPs
124
MAPDs
SODIUM LACTATE 5 MEQ/ML VIAL
(Sodium Lactate IV)
25 X 10 ML VIAL0040966640238
PDPs
147
MAPDs
SOLARAZE 3% GEL
(Diclofenac Sodium (Actinic Keratoses))
100 TUBE1033708030168
PDPs
222
MAPDs
SOLIA 0.15-0.03 TABLET
(Desogestrel & Ethinyl Estradiol)
28 CRTN6699306112865
PDPs
220
MAPDs
Solodyn 105mg/1
(Minocycline HCl)
   9920704673013
PDPs
57
MAPDs
SOLODYN 135MG TABLET
(Minocycline HCl)
100 BOT9920704621014
PDPs
52
MAPDs
SOLODYN 45MG TABLET SR 24HR (100 CT)
(Minocycline HCl)
100 BOT9920704601014
PDPs
52
MAPDs
Solodyn 55mg/1
(Minocycline HCl)
   9920704653013
PDPs
47
MAPDs
Solodyn 80mg/1
(Minocycline HCl)
   9920704663013
PDPs
47
MAPDs
SOLODYN 90MG TABLET
(Minocycline HCl)
100 COUNT BOT9920704611014
PDPs
52
MAPDs
SOLODYN ER 115 MG TABLET
(Minocycline HCl)
30 EA  9920704643013
PDPs
59
MAPDs
SOLODYN ER 65 MG TABLET
(Minocycline HCl)
30 EA  9920704633013
PDPs
59
MAPDs
SOLU MEDROL FOR INJECTION 40 MG/ML
(Methylprednisolone Sodium Succinate For)
25 VIAL X 1 ML PKG0000900392833
PDPs
95
MAPDs
SOLU MEDROL FOR INJECTION 500 MG/ML
(Methylprednisolone Sodium Succinate For)
4ML VIAL0000900030233
PDPs
96
MAPDs
SOLU CORTEF INJECTION 100 MG/VIAL
(Hydrocortisone Sodium Succinate For)
2 ML X 1 VIALSD0000900110332
PDPs
103
MAPDs
SOLU CORTEF INJECTION
(Hydrocortisone Sodium Succinate For)
2ML X 1 VIALSD 0000900130543
PDPs
154
MAPDs
SOLU-MEDROL 2000MG VIAL
(Methylprednisolone Sodium Succinate For)
30 ML VIAL0000907960134
PDPs
133
MAPDs
Solu-Medrol 125mg/mL 25 VIAL, PATENT DELIVERY SYSTEM in 1 PACKAGE / 2 mL in 1 VIAL, PATENT DELIVERY
(Methylprednisolone Sodium Succinate For)
25 VIAL, PATENT DELIVERY  0000900472233
PDPs
91
MAPDs
Soma 250mg 100 TABLET BOTTLE
(Carisoprodol)
100 TABLET BOTTLE  0003722501015
PDPs
56
MAPDs
SOMA TABLETS
(Carisoprodol)
100 BOTPL 0003720010112
PDPs
51
MAPDs
Somatuline Depot 90mg/0.3mL 1 POUCH in 1 CARTON / 1 SYRINGE in 1 POUCH / 0.3 mL in 1 SYRINGE
(Lanreotide Acetate Extended Release)
1 POUCH in 1 CARTON / 1 S  1505400900167
PDPs
221
MAPDs
SOMATULINE 60 MG/0.2 ML SYRING
(Lanreotide Acetate Extended Release)
0.2ML  1505400600166
PDPs
220
MAPDs
SOMAVERT 10MG VIAL
(Pegvisomant For)
1 PKGCOM0000951760171
PDPs
245
MAPDs
SOMAVERT 15MG VIAL
(Pegvisomant For)
1 PKGCOM0000951780171
PDPs
244
MAPDs
SOMAVERT 20MG VIAL
(Pegvisomant For)
1 PKGCOM0000951800171
PDPs
244
MAPDs
SONATA 10MG CAPSULE
(Zaleplon)
100 BOTPL6079301460116
PDPs
57
MAPDs
SONATA 5MG CAPSULE
(Zaleplon)
100 BOTPL6079301450116
PDPs
57
MAPDs
SORIATANE CAPSULES
(Acitretin)
30 BOT 0014500902555
PDPs
164
MAPDs
SORIATANE 17.5 MG CAPSULE
(Acitretin)
30 EA  0014538170355
PDPs
166
MAPDs
SORIATANE CAPSULES
(Acitretin)
30 BOT 0014500912555
PDPs
164
MAPDs
SORILUX 50ug/g 60 g in 1 CAN
(calcipotriene topical)
60 g in 1 CAN  0014521300611
PDPs
41
MAPDs
SORINE SOTALOL HCL TABLETS 120MG 100 BOXUD
(Sotalol HCl)
100 BOXUD0024500130166
PDPs
222
MAPDs
SORINE SOTALOL HCL TABLETS 160MG 100 BOXUD
(Sotalol HCl)
100 BOXUD0024500140166
PDPs
222
MAPDs
SORINE SOLTALOL HCL TABLETS 240MG 100 BOXUD
(Sotalol HCl)
100 BOXUD0024500150166
PDPs
222
MAPDs
SORINE SOTALOL HCL TABLETS 80MG 100 BOXUD
(Sotalol HCl)
100 BOXUD0024500120166
PDPs
222
MAPDs
SOTALOL HCL 120MG TABLET 100 BOT
(Sotalol HCl)
100 BOT0037803100171
PDPs
245
MAPDs
SOTALOL HCL 160MG TABLET (100 CT)
(Sotalol HCl)
100 BOT0037803140171
PDPs
245
MAPDs
SOTALOL HCL TABLET 240MG
(Sotalol HCl)
100 BOT0009310630171
PDPs
245
MAPDs
SOTALOL HCL 80MG TABLET
(Sotalol HCl)
100 BOT0037803050171
PDPs
245
MAPDs
SOTALOL HYDROCHLORIDE INJECTION 15MG/ML
(Sotalol HCl)
10 ML X 1 VIAL CRTN6745701761021
PDPs
87
MAPDs
SOTRET 10MG CAPSULE
(Isotretinoin)
100 BOXUD1063105847759
PDPs
187
MAPDs
SOTRET 20MG CAPSULE
(Isotretinoin)
100 BOXUD1063105857763
PDPs
213
MAPDs
SOTRET 30MG CAPSULE
(Isotretinoin)
30 BOXUD1063104473159
PDPs
186
MAPDs
SOTRET 40MG CAPSULE
(Isotretinoin)
100 BOXUD1063105867759
PDPs
187
MAPDs
SPECTRACEF TABLETS 200 MG
(Cefditoren Pivoxil)
20 BLPK1012208012020
PDPs
70
MAPDs
SPECTRACEF 400 MG DOSE PACK TB
(Cefditoren Pivoxil)
20 BLPK1012208022018
PDPs
67
MAPDs
SPIRIVA 18MCG CP-HANDIHALER 90 (9 X 10) BLPK
(Tiotropium Bromide Monohydrate)
90 (9 X 10) BLPK0059700754771
PDPs
245
MAPDs
SPIRONOLACTONE 100MG TABLET
(Spironolactone)
100 BOT0037804370171
PDPs
244
MAPDs
SPIRONOLACTONE 25MG TABLET (100 CT)
(Spironolactone)
100 BOT0037821460171
PDPs
245
MAPDs
SPIRONOLACTONE 50MG TABLET (100 CT)
(Spironolactone)
100 TABS BOT0060357642171
PDPs
245
MAPDs
SPIRONOLACTONE/HCTZ TABLET 25-25MG (500 CT)
(Spironolactone & Hydrochlorothiazide)
500 BOT5348901440569
PDPs
232
MAPDs
SPORANOX 10MG/ML SOLUTION
(Itraconazole)
150 ML BOT5045802951544
PDPs
164
MAPDs
SPORANOX 100MG CAPSULE
(Itraconazole)
28 (PULSE PACK) BLPK5045802902816
PDPs
53
MAPDs
SPORANOX 100MG CAPSULE
(Itraconazole)
30 BOT5045802900421
PDPs
62
MAPDs
SPRINTEC 0.25-0.035 TABLET
(Norgestimate & Ethinyl Estradiol)
28 (21 ACTIVE/7 PLACEBO) BLPK0055590165865
PDPs
221
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
SPRYCEL 140mg/1 1 BOTTLE in 1 CARTON / 30 TABLET in 1 BOTTLE
(Dasatinib)
1 BOTTLE in 1 CARTON / 30  0000308572270
PDPs
231
MAPDs
SPRYCEL 20MG TABLET
(Dasatinib)
60 TABLETS BOT0000305271171
PDPs
244
MAPDs
SPRYCEL 50MG TABLET
(Dasatinib)
60 BOT0000305281171
PDPs
244
MAPDs
SPRYCEL 70MG TABLET
(Dasatinib)
60 BOT0000305241171
PDPs
245
MAPDs
SPRYCEL 80mg/1 1 BOTTLE in 1 CARTON / 30 TABLET in 1 BOTTLE
(Dasatinib)
1 BOTTLE in 1 CARTON / 30  0000308552270
PDPs
231
MAPDs
SPRYCEL 100mg/1 1 BOTTLE in 1 CARTON / 30 TABLET in 1 BOTTLE
(Dasatinib)
1 BOTTLE in 1 CARTON / 30  0000308522271
PDPs
241
MAPDs
SRONYX 0.1-0.02 TABLET
(Levonorgestrel & Ethinyl Estradiol)
6 X 28 BLPK5254409672859
PDPs
210
MAPDs
SSD Cream 10g/1000g 85 g in 1 TUBE
(Silver Sulfadiazine)
85 g in 1 TUBE  4359802108563
PDPs
222
MAPDs
STADOL 2MG/ML VIAL
(Butorphanol Tartrate)
2 ML VIAL0001556442013
PDPs
39
MAPDs
STAGESIC 5MG-500MG CAPSULE
(Hydrocodone-Acetaminophen)
100 BOT5840700910162
PDPs
205
MAPDs
STALEVO 50 TABLET
(Carbidopa-Levodopa-Entacapone)
100 BOT0007804070565
PDPs
229
MAPDs
STALEVO 125/200 MG/MG TABLETS
(Carbidopa-Levodopa-Entacapone )
100 BOT0007805450564
PDPs
224
MAPDs
STALEVO 18.75/75 MG/MG TABLETS
(Carbidopa-Levodopa-Entacapone )
100 BOT0007805440564
PDPs
225
MAPDs
STALEVO 200 50-200-200 TABLET
(Carbidopa-Levodopa-Entacapone)
100 BOT0007805270564
PDPs
227
MAPDs
STALEVO 100 TABLET
(Carbidopa-Levodopa-Entacapone)
100 BOT0007804080565
PDPs
229
MAPDs
STALEVO 150 TABLET
(Carbidopa-Levodopa-Entacapone)
100 BOT0007804090565
PDPs
229
MAPDs
STARLIX 120MG TABLET
(Nateglinide)
100 BOT0007803520518
PDPs
69
MAPDs
STARLIX 60MG TABLET
(Nateglinide)
100 BOT0007803510518
PDPs
69
MAPDs
STAVUDINE SOL 1MG/ML
(Stavudine)
   4279901130171
PDPs
245
MAPDs
STAVUDINE CAPSULES 15MG 60 BOT
(Stavudine)
60 BOT0037850409171
PDPs
244
MAPDs
STAVUDINE CAPSULES 20MG 60 BOT
(Stavudine)
60 BOT0037850419171
PDPs
245
MAPDs
STAVUDINE CAPSULES 30MG 60 BOT
(Stavudine)
60 BOT3172205176071
PDPs
245
MAPDs
STAVUDINE CAPSULES 40MG 60 BOT
(Stavudine)
60 BOT3172205186071
PDPs
245
MAPDs
STAVZOR 125MG CPDR
(STAVZOR)
   6896831250128
PDPs
105
MAPDs
STAVZOR 250MG CPDR
(STAVZOR)
   6896832500128
PDPs
107
MAPDs
STAVZOR 500MG CPDR
(STAVZOR)
   6896835000128
PDPs
107
MAPDs
STELARA 45 MG/0.5 ML SYRINGE
(Ustekinumab)
0.5ML  5789400600328
PDPs
107
MAPDs
STELARA 90 MG/ML SYRINGE
(Ustekinumab)
1ML  5789400610328
PDPs
107
MAPDs
STERILE WATER FOR IRRIGATION
(Water For Irrigation, Sterile Irrigation)
1000ML BOTGL 0026421010040
PDPs
129
MAPDs
Stimate 1.5mg/mL 1 BOTTLE, SPRAY in 1 CARTON / 2.5 mL in 1 BOTTLE, SPRAY
(Desmopressin Acetate)
1 BOTTLE, SPRAY in 1 CART  0005368710045
PDPs
135
MAPDs
STRATTERA 10MG CAPSULE
(Atomoxetine HCl)
30 BOT0000232273059
PDPs
226
MAPDs
STRATTERA 100MG CAPSULE
(Atomoxetine HCl)
30 BOT0000232513059
PDPs
224
MAPDs
STRATTERA 18MG CAPSULE
(Atomoxetine HCl)
30 BOT0000232383059
PDPs
225
MAPDs
STRATTERA 25MG CAPSULE
(Atomoxetine HCl)
30 BOT0000232283059
PDPs
226
MAPDs
STRATTERA 40MG CAPSULE
(Atomoxetine HCl)
30 BOT0000232293059
PDPs
226
MAPDs
STRATTERA 60MG CAPSULE
(Atomoxetine HCl)
30 BOT0000232393059
PDPs
225
MAPDs
STRATTERA 80MG CAPSULE
(Atomoxetine HCl)
30 BOT0000232503059
PDPs
224
MAPDs
STREPTOMYCIN FOR INJECTION 1GM/VIL
(Streptomycin Sulfate)
   3982207060257
PDPs
181
MAPDs
Striant 30mg/1 6 BLISTER PACK in 1 CARTON / 10 TABLET in 1 BLISTER PACK
(Testosterone)
6 BLISTER PACK in 1 CARTO  5505630600121
PDPs
86
MAPDs
STROMECTOL 3MG TABLET
(Ivermectin)
20 X 1 TABLET BOXUD0000600322056
PDPs
195
MAPDs
Suboxone 2; 0.5mg/1; mg/1 30 POUCH in 1 CARTON / 1 FILM, SOLUBLE in 1 POUCH
(Buprenorphine HCl-Naloxone HCl SL)
30 POUCH in 1 CARTON / 1  1249612020358
PDPs
187
MAPDs
SUBOXONE 2MG-0.5MG TABLET
(Buprenorphine HCl-Naloxone HCl SL)
   1249612830252
PDPs
183
MAPDs
Suboxone 8; 2mg/1; mg/1 30 POUCH in 1 CARTON / 1 FILM, SOLUBLE in 1 POUCH
(Buprenorphine HCl-Naloxone HCl SL)
30 POUCH in 1 CARTON / 1  1249612080358
PDPs
187
MAPDs
SUBOXONE 8MG-2MG TABLET
(Buprenorphine HCl-Naloxone HCl SL)
   1249613060252
PDPs
183
MAPDs
SUBSYS SPR 100MCG
(fentanyl)
   2048200013016
PDPs
49
MAPDs
SUBSYS SPR 1200MCG
(fentanyl)
   2048200123016
PDPs
49
MAPDs
SUBSYS SPR 200MCG
(fentanyl)
   2048200023016
PDPs
49
MAPDs
SUBSYS SPR 400MCG
(fentanyl)
   2048200043016
PDPs
49
MAPDs
SUBSYS SPR 800MCG
(fentanyl)
   2048200083016
PDPs
49
MAPDs
SUBUTEX 2MG TABLET
(Buprenorphine HCl)
   1249612780219
PDPs
65
MAPDs
SUBUTEX 8MG TABLET
(Buprenorphine HCl)
   1249613100219
PDPs
65
MAPDs
SUCRAID 8500[iU]/mL
(Sacrosidase)
   6787101110449
PDPs
158
MAPDs
SUCRALFATE 1GM TABLET
(Sucralfate)
500 BOT0009322100571
PDPs
245
MAPDs
SULAR 17MG TABLET SR 24HR
(Nisoldipine)
   5963005011015
PDPs
44
MAPDs
SULAR 34MG TABLET SR 24HR
(Nisoldipine)
   5963005031015
PDPs
46
MAPDs
SULAR 25.5MG TABLET SR 24HR
(Nisoldipine)
100 BOT5963005021015
PDPs
46
MAPDs
SULAR 8.5MG TABLET SR 24HR
(Nisoldipine)
100 BOT5963005001015
PDPs
46
MAPDs
SULFACETAMIDE 10% EYE OINTMENT
(Sulfacetamide)
   4810201033555
PDPs
186
MAPDs
Sulfacetamide Sodium 100mg/mL 118 mL in 1 BOTTLE
(Sulfacetamide Sodium)
118 mL in 1 BOTTLE  0016803820463
PDPs
214
MAPDs
SULFACETAMIDE SODIUM OPHTHALMIC SOLUTION USP 10% 15 ML BOT
(Sulfacetamide Sodium Ophth)
15 ML BOT2420806700471
PDPs
233
MAPDs
SULFACETAMIDE-PREDNISOLONE 10-0.25% DROPS
(Sulfacetamide Sodium-Prednisolone Ophth)
10 ML BOTPL6131402971069
PDPs
242
MAPDs
SULFADIAZINE 500MG TABLET
(Sulfadiazine)
1000 BOTPL0018507571071
PDPs
245
MAPDs
Sulfamethoxazole and Trimethoprim 200; 40mg/5mL; mg/5mL 473 mL in 1 BOTTLE
(Sulfamethoxazole-Trimethoprim)
473 mL in 1 BOTTLE  5038308231671
PDPs
244
MAPDs
SULFAMETHOXAZOLE-TRIMETHOPRIM TABLET 400-80MG (500 CT)
(Sulfamethoxazole-Trimethoprim)
500 BOT0060357802871
PDPs
245
MAPDs
SULFAMETHOXAZOLE W/TMP VIAL 80MG-16ML 10 X 10ML VIAL
(Sulfamethoxazole-Trimethoprim)
10 X 10 ML VIALMD0070395140371
PDPs
245
MAPDs
SULFAMETHOXAZOLE W/TMP 800-160MG TABLET (100 CT)
(Sulfamethoxazole-Trimethoprim)
100 BOT0090427256071
PDPs
245
MAPDs
SULFAMYLON 50G PACKET
(Mafenide Acetate)
   5107906248536
PDPs
126
MAPDs
SULFAMYLON CREAM 85GM 4 OZ TUBE
(Mafenide Acetate)
4 OZ TUBE5107906238237
PDPs
128
MAPDs
SULFASALAZINE 500MG TABLET
(Sulfasalazine)
500 BOTPL0059107960571
PDPs
245
MAPDs
SULFAZINE EC 500MG TABLET DELAYED RELEASE
(Sulfasalazine)
300 BOT0060358032570
PDPs
242
MAPDs
SULINDAC 150MG TABLET (100 CT)
(Sulindac)
100 BOT0037804270171
PDPs
243
MAPDs
SULINDAC 200MG TABLET
(Sulindac)
500 BOT0059156600571
PDPs
243
MAPDs
SUMATRIPTAN SUCCINATE TABLETS 100MG 9 BOXUD
(Sumatriptan Succinate)
9 BOXUD6330400991971
PDPs
245
MAPDs
SUMATRIPTAN SUCCINATE TABLETS 25MG 9 BOX
(Sumatriptan Succinate)
9 BOX0009302229071
PDPs
245
MAPDs
SUMATRIPTAN SUCCINATE TABLETS 50MG 9 (3 CARDS OF 3) BOX
(Sumatriptan Succinate)
9 (3 CARDS OF 3) BOX0009302239071
PDPs
245
MAPDs
Sumatriptan Succinate 6mg/0.5mL 2 SYRINGE in 1 PACKAGE / 0.5 mL in 1 SYRINGE
(Sumatriptan Succinate)
2 SYRINGE in 1 PACKAGE /  4733502764163
PDPs
210
MAPDs
SUMATRIPTAN SUCCINATE INJECTION 4MG/0.5ML 0.5 ML VIALSD
(Sumatriptan Succinate)
0.5 ML VIALSD0078132314762
PDPs
218
MAPDs
SUMATRIPTAN
(Sumatriptan Succinate)
0.5ML VIAL0070373510271
PDPs
238
MAPDs
SUPRAX 100MG/5ML SUSPENSION RECONSTITUTED ORAL 50ML BOT
(Cefixime For)
50 ML BOT6818002020358
PDPs
190
MAPDs
SUPRAX 200MG/5ML SUSPENSION RECONSTITUTED ORAL
(Cefixime For)
75 ML BOT2743702060260
PDPs
203
MAPDs
SUPRAX 400 MG TABLET
(Cefixime For)
50 EA  2743702010861
PDPs
182
MAPDs
SUPREP bowel prep 1.6; 3.13; 17.5g/mL; g/mL; g/mL 2 BOTTLE, PLASTIC in 1 CARTON / 177.4 mL in 1 BOT
(SODIUM SULFATE, POTASSIUM SULFATE, MAGNESIUM SULFATE, UNSPECIFIED)
2 BOTTLE, PLASTIC in 1 CA  5226800120127
PDPs
79
MAPDs
SURMONTIL 100MG CAPSULE
(Trimipramine Maleate)
100 BOT5128505540258
PDPs
176
MAPDs
SURMONTIL 25MG CAPSULE
(Trimipramine Maleate)
100 BOT5128505380257
PDPs
168
MAPDs
Surmontil 50mg/1 100 CAPSULE in 1 BOTTLE
(Trimipramine Maleate)
100 CAPSULE BOTTLE  5128505390257
PDPs
167
MAPDs
SUSTIVA 200MG CAPSULE
(Efavirenz)
90 BOT0005604749271
PDPs
245
MAPDs
SUSTIVA 50MG CAPSULE
(Efavirenz)
30 BOT0005604703071
PDPs
245
MAPDs
SUSTIVA 600MG TABLET
(Efavirenz)
30 BOT0005605103071
PDPs
245
MAPDs
SUTENT 12.5MG CAPSULE
(Sunitinib Malate)
28 BOT0006905503871
PDPs
245
MAPDs
SUTENT 25mg/1 28 CAPSULE in 1 BOTTLE
(Sunitinib Malate)
28 CAPSULE in 1 BOTTLE  0006907703871
PDPs
245
MAPDs
SUTENT 50MG CAPSULE
(Sunitinib Malate)
28 BOT0006909803871
PDPs
245
MAPDs
SYLATRON 296 MCG KIT 1 KIT in 1 CARTON
(PEGINTERFERON ALFA-2B)
1 KIT in 1 CARTON  0008513880171
PDPs
245
MAPDs
SYLATRON 444 MCG KIT 1 KIT in 1 CARTON
(PEGINTERFERON ALFA-2B)
1 KIT in 1 CARTON  0008512870271
PDPs
244
MAPDs
SYLATRON 888 MCG KIT 1 KIT in 1 CARTON
(PEGINTERFERON ALFA-2B)
1 KIT in 1 CARTON  0008513120168
PDPs
239
MAPDs
SYMBICORT 160-4.5MCG HFA AEROSOL WITH ADAPTER
(Budesonide-Formoterol Fumarate Dihyd)
120 INHL0018603702068
PDPs
227
MAPDs
SYMBICORT 80-4.5MCG HFA AEROSOL WITH ADAPTER 60 INHL
(Budesonide-Formoterol Fumarate Dihyd)
60 INHL0018603722868
PDPs
227
MAPDs
Symbyax 25; 3mg/1; mg/1 30 CAPSULE in 1 BOTTLE
(Olanzapine-Fluoxetine HCl)
30 CAPSULE in 1 BOTTLE  0000232303041
PDPs
132
MAPDs
SYMBYAX 12-25MG CAPSULE
(Olanzapine-Fluoxetine HCl)
30 BOT0000232323041
PDPs
132
MAPDs
SYMBYAX 6-25MG CAPSULE
(Olanzapine-Fluoxetine HCl)
30 BOT0000232313041
PDPs
132
MAPDs
SYMBYAX 12-50MG CAPSULE
(Olanzapine-Fluoxetine HCl)
30 BOT0000232343041
PDPs
131
MAPDs
SYMBYAX 6-50MG CAPSULE
(Olanzapine-Fluoxetine HCl)
30 BOT0000232333041
PDPs
131
MAPDs
SYMLIN 0.6MG/ML VIAL
(Pramlintide Acetate)
5 ML VIAL6678001100171
PDPs
244
MAPDs
SYMLINPEN 120 1000MCG/ML PEN INJECTOR
(Pramlintide Acetate)
   6678001210266
PDPs
219
MAPDs
SYMLINPEN 60 1000MCG/ML PEN INJECTOR
(Pramlintide Acetate)
   6678001150268
PDPs
224
MAPDs
SYNAGIS 50MG/0.5ML VIAL
(Palivizumab For)
   6057441140131
PDPs
107
MAPDs
SYNALGOS DC CAPSULES 16;356.4;MG;MG;MG;
(Dihydrocodeine Compound)
100 BOT4970804198821
PDPs
71
MAPDs
SYNAREL 2MG/ML NASAL SPRAY
(Nafarelin Acetate Nasal)
8 ML BOT0002501660871
PDPs
245
MAPDs
SYNERCID 500MG VIAL
(Quinupristin-Dalfopristin for)
10 ML VIALGL6157002601035
PDPs
122
MAPDs
SYNTHROID 100MCG TABLET
(Levothyroxine Sodium)
1000 BOT0007466241963
PDPs
205
MAPDs
SYNTHROID 112 MCG TABLET
(Levothyroxine Sodium)
1000 BOT0007492961963
PDPs
205
MAPDs
SYNTHROID 125MCG TABLET
(Levothyroxine Sodium)
1000 BOT0007470681963
PDPs
205
MAPDs
Synthroid 137ug/1 90 TABLET in 1 BOTTLE
(Levothyroxine Sodium)
90 TABLET in 1 BOTTLE  0007437279063
PDPs
205
MAPDs
SYNTHROID 150MCG TABLET
(Levothyroxine Sodium)
1000 BOT0007470691963
PDPs
205
MAPDs
SYNTHROID 175MCG TABLET
(Levothyroxine Sodium)
1000 BOT0007470701963
PDPs
205
MAPDs
SYNTHROID 200MCG TABLET
(Levothyroxine Sodium)
1000 BOT0007471481963
PDPs
205
MAPDs
SYNTHROID 25MCG TABLET
(Levothyroxine Sodium)
1000 BOT0007443411963
PDPs
205
MAPDs
SYNTHROID 300MCG TABLET
(Levothyroxine Sodium)
1000 BOT0007471491963
PDPs
205
MAPDs
SYNTHROID 50MCG TABLET
(Levothyroxine Sodium)
1000 BOT0007445521963
PDPs
205
MAPDs
SYNTHROID 75MCG TABLET
(Levothyroxine Sodium)
1000 BOT0007451821963
PDPs
205
MAPDs
SYNTHROID 88 MCG TABLET
(Levothyroxine Sodium)
1000 BOT0007465941963
PDPs
205
MAPDs
SYPRINE 250MG CAPSULE (100 CT)
(Trientine HCl)
100 BOT2501007101568
PDPs
214
MAPDs
Thermazene 10mg/g
(Silver Sulfadiazine)
   6787701248564
PDPs
202
MAPDs
TOLVAPTAN 15 MG ORAL TABLET [SAMSCA]
(Tolvaptan)
   5914800205046
PDPs
149
MAPDs
TOLVAPTAN 30 MG ORAL TABLET [SAMSCA]
(Tolvaptan)
   5914800215046
PDPs
149
MAPDs
TRANSDERM-SCOP 1.5MG 24 PKG
(Scopolamine TD)
24 PKG1001905530244
PDPs
145
MAPDs
TREXIMET 500; 85mg/1; mg/1 9 TABLET, FILM COATED in 1 CONTAINER
(Sumatriptan-Naproxen Sodium)
9 TABLET, FILM COATED in  0017307500024
PDPs
61
MAPDs
VEREGEN 15% OINTMENT
(Sinecatechins)
15 GM TUBE1033704501534
PDPs
100
MAPDs
VESICARE 10MG TABLET
(Solifenacin Succinate)
90 BOT5124801510363
PDPs
207
MAPDs
VESICARE 5MG TABLET (90 CT)
(Solifenacin Succinate)
90 BOT5124801500363
PDPs
207
MAPDs
VIGABATRIN 500 MG ORAL TABLET [SABRIL]
(Vigabatrin)
   6738601110171
PDPs
245
MAPDs
VIGABATRIN 50 MG/ML ORAL SOLUTION [SABRIL]
(Vigabatrin)
   6738602116571
PDPs
245
MAPDs
VISICOL 1.5GM TABLET
(Sod Phos Mono-Sod Phos Di)
100 BOT6564906014139
PDPs
126
MAPDs
XYREM 500MG/ML ORAL SOLUTION
(Sodium Oxybate Oral)
180 ML BOT6872701000171
PDPs
245
MAPDs
ZANOSAR 1GM VIAL
(Streptozocin For)
1 X 20 ML VIAL0070346360148
PDPs
157
MAPDs
ZELAPAR 1.25MG ODT TABLET
(Selegiline HCl)
6 X 10 UNIT BLPK0018704530233
PDPs
108
MAPDs
ZERIT 1MG/ML SOLUTION
(Stavudine)
200 ML BOT0000319680144
PDPs
135
MAPDs
ZERIT 15MG CAPSULE
(Stavudine)
60 BOT0000319640123
PDPs
73
MAPDs
ZERIT 20MG CAPSULE
(Stavudine)
60 BOT0000319650123
PDPs
73
MAPDs
ZERIT 30MG CAPSULE
(Stavudine)
60 BOT0000319660123
PDPs
73
MAPDs
ZERIT 40MG CAPSULE
(Stavudine)
60 BOT0000319670123
PDPs
73
MAPDs
ZOCOR 10MG TABLET
(Simvastatin)
90 BOT0000607355414
PDPs
44
MAPDs
ZOCOR 20MG TABLET (90 CT)
(Simvastatin)
90 BOT0000607405414
PDPs
44
MAPDs
ZOCOR 40MG TABLET
(Simvastatin)
90 BOT0000607495414
PDPs
44
MAPDs
ZOCOR TABLETS 5 MG
(Simvastatin)
30 BOT0000607263114
PDPs
44
MAPDs
ZOCOR 80MG TABLET
(Simvastatin)
90 BOT0000605435415
PDPs
44
MAPDs
ZOLOFT 100MG TABLET (30 CT)
(Sertraline HCl)
30 BOT0004949103016
PDPs
60
MAPDs
ZOLOFT 20MG/ML ORAL CONC
(Sertraline HCl)
60 ML BOT0004949402316
PDPs
60
MAPDs
ZOLOFT 25MG TABLET
(Sertraline HCl)
30 BOT0004949603016
PDPs
60
MAPDs
ZOLOFT 50MG TABLET
(Sertraline HCl)
30 BOT0004949003016
PDPs
60
MAPDs
Zorbtive 8.8mg/mL 1 INJECTION, POWDER, FOR SOLUTION in 1 CARTON
(Somatropin (Non-Refrigerated) For Subcutaneous)
1 INJECTION, POWDER, FOR  4408733880730
PDPs
132
MAPDs



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




Tips & Disclaimers
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  • The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
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  • 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.
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  • 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.
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  • 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.