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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:
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Drug Names Containing the Letter U 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
ACTIGALL 300MG CAPSULE
(Ursodiol)
100 BOT5254409300116
PDPs
52
MAPDs
BENZYL ALCOHOL 50 ML/ML TOPICAL LOTION [ULESFIA]
()
   5963007800836
PDPs
92
MAPDs
CARMOL HC 1%-10% CREAM
(Urea-HC Acetate)
85 GM TUBE1033705501925
PDPs
67
MAPDs
Ella 30mg/1 1 BLISTER PACK in 1 CARTON / 1 TABLET in 1 BLISTER PACK
(ULIPRISTAL ACETATE)
BLISTER PACK  5254402385435
PDPs
90
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
U-CORT 1%-10% CREAM
(Urea-HC Acetate)
   5167230090241
PDPs
146
MAPDs
ULORIC TABLETS 40MG 30 BOT
(Febuxostat)
30 BOT6476409183059
PDPs
199
MAPDs
ULORIC TABLETS 80MG 30 BOT
(Febuxostat)
30 BOT6476406773059
PDPs
197
MAPDs
ULTRACET TABLETS
(Tramadol-Acetaminophen)
10 TAB X 1 BLPK X 10 BOXUD 5045806501017
PDPs
52
MAPDs
ULTRAM TABLETS
(Tramadol HCl)
100 BOT 5045806596015
PDPs
48
MAPDs
Ultram ER 100mg/1 30 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC
(Tramadol HCl)
30 TABLET, EXTENDED RELEA  5045806533013
PDPs
44
MAPDs
Ultram ER 200mg/1 30 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC
(Tramadol HCl)
30 TABLET, EXTENDED RELEA  5045806553013
PDPs
44
MAPDs
Ultram ER 300mg/1 30 TABLET, EXTENDED RELEASE in 1 BOTTLE, PLASTIC
(Tramadol HCl)
30 TABLET, EXTENDED RELEA  5045806573016
PDPs
59
MAPDs
Ultravate 0.5mg/g 50 g in 1 TUBE
(Halobetasol Propionate)
50 g in 1 TUBE  1063101025017
PDPs
52
MAPDs
Ultravate 0.5mg/g 50 g in 1 TUBE
(Halobetasol Propionate)
50 g in 1 TUBE  1063101035017
PDPs
52
MAPDs
UNASYN 15GM VIAL
(Ampicillin & Sulbactam Sodium For)
15 GM BOT0004900242816
PDPs
56
MAPDs
UNASYN 3GM VIAL
(Ampicillin & Sulbactam Sodium For)
3 GM X 10 VIAL0004900148317
PDPs
58
MAPDs
UNIRETIC 15/12.5 TABLET
(Moexipril-Hydrochlorothiazide)
100 BOT0009137200116
PDPs
54
MAPDs
UNIRETIC 7.5/12.5 TABLET
(Moexipril-Hydrochlorothiazide)
100 BOT0009137120116
PDPs
54
MAPDs
UNIRETIC 15/25 TABLET
(Moexipril-Hydrochlorothiazide)
100 BOT0009137250116
PDPs
54
MAPDs
UNITHROID 100MCG TABLET
(Levothyroxine Sodium)
100 BOT0052713740167
PDPs
185
MAPDs
UNITHROID 112MCG TABLET
(Levothyroxine Sodium)
100 BOT0052713750167
PDPs
185
MAPDs
UNITHROID 125MCG TABLET
(Levothyroxine Sodium)
100 BOT0052713760168
PDPs
186
MAPDs
UNITHROID 150MCG TABLET
(Levothyroxine Sodium)
100 BOT0052713770167
PDPs
185
MAPDs
UNITHROID 175MCG TABLET
(Levothyroxine Sodium)
100 BOT0052713780167
PDPs
185
MAPDs
UNITHROID 200MCG TABLET
(Levothyroxine Sodium)
100 BOT0052713790167
PDPs
186
MAPDs
UNITHROID 25MCG TABLET
(Levothyroxine Sodium)
100 BOT0052713700170
PDPs
203
MAPDs
UNITHROID 300MCG TABLET
(Levothyroxine Sodium)
100 BOT0052713800167
PDPs
185
MAPDs
UNITHROID 50MCG TABLET
(Levothyroxine Sodium)
100 BOT0052713710167
PDPs
185
MAPDs
UNITHROID 75MCG TABLET
(Levothyroxine Sodium)
100 BOT0052713720167
PDPs
185
MAPDs
UNITHROID 88MCG TABLET
(Levothyroxine Sodium)
100 BOT0052713730167
PDPs
185
MAPDs
UNIVASC 15MG TABLET
(Moexipril HCl)
100 BOT0009137150116
PDPs
54
MAPDs
UNIVASC 7.5MG TABLET
(Moexipril HCl)
100 BOT0009137070116
PDPs
54
MAPDs
Urecholine 10mg/1 100 TABLET in 1 BOTTLE
(Bethanechol Chloride)
100 TABLET BOTTLE  5128506900215
PDPs
51
MAPDs
Urecholine 25mg/1 100 TABLET in 1 BOTTLE
(Bethanechol Chloride)
100 TABLET BOTTLE  5128506910215
PDPs
51
MAPDs
Urecholine 5mg/1 100 TABLET in 1 BOTTLE
(Bethanechol Chloride)
100 TABLET BOTTLE  5128506970215
PDPs
51
MAPDs
Urecholine 50mg/1 100 TABLET in 1 BOTTLE
(Bethanechol Chloride)
100 TABLET BOTTLE  5128506920215
PDPs
51
MAPDs
UROXATRAL 10MG TABLET
(Alfuzosin HCl)
100 BOT0002442001026
PDPs
82
MAPDs
URSO 250MG TABLET
(Ursodiol)
500 BOTPL5891407855014
PDPs
59
MAPDs
URSO FORTE TABLETS 500MG 100 BOT
(Ursodiol)
100 BOT5891407901014
PDPs
57
MAPDs
URSODIOL TABLETS 250MG 100 BOT
(Ursodiol)
100 BOT0009353600159
PDPs
213
MAPDs
URSODIOL CAPSULES
(Ursodiol)
100 BLPK BOXUD 5107903832069
PDPs
233
MAPDs
URSODIOL TABLETS 500MG 100 BOT
(Ursodiol)
100 BOT0009353610158
PDPs
211
MAPDs
UVADEX SOLUTION STERILE 20MCG/ML
(Methoxsalen (Photopheresis))
12 X 10 ML VIAL6406702160142
PDPs
132
MAPDs



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


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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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  • 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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  • 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.