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2017 Medicare Part D Formulary Search By Drug Letter

Select a Letter below:

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 2017 Formularies
PDPsMAPDs
AMARYL 1MG TABLET
(Glimepiride)
100 BOT000390221106
PDPs
11
MAPDs
AMARYL 2MG TABLET
(Glimepiride)
100 BOT000390222106
PDPs
11
MAPDs
AMARYL 4MG TABLET
(Glimepiride)
100 BOT000390223106
PDPs
11
MAPDs
COPAXONE 20MG/ML 30 BLISTER PACK IN 1 CRTN
(Glatiramer Acetate)
   6854603173040
PDPs
218
MAPDs
COPAXONE 40 MG/ML SYRINGE
(Glatiramer Acetate)
1 ML  6854603251255
PDPs
299
MAPDs
CUVPOSA 1 MG/5 ML SOLUTION
(Glycopyrrolate)
   0025905011611
PDPs
69
MAPDs
CYTOVENE IV INJECTION
(Ganciclovir Sodium For)
10ML X 1 X 25 VIALS CRTN 000046940035
PDPs
14
MAPDs
GABAPENTIN 100mg/1
(Gabapentin)
   6275601370257
PDPs
328
MAPDs
Gabapentin 250mg/5mL 470 mL in 1 BOTTLE
(Gabapentin)
470 mL in 1 BOTTLE  5038303114757
PDPs
328
MAPDs
GABAPENTIN CAPSULES 300MG
(Gabapentin)
   6050501130157
PDPs
328
MAPDs
GABAPENTIN 400 MG CAPSULE
(Gabapentin)
100 EA  5374601030157
PDPs
328
MAPDs
GABAPENTIN 600MG TABLET
(Gabapentin)
100 BOT0022826361157
PDPs
328
MAPDs
GABAPENTIN TABLET 800MG
(Gabapentin)
   6050525520557
PDPs
328
MAPDs
GABITRIL 12 MG TABLET
(Tiagabine HCl)
30 EA  6345904123042
PDPs
301
MAPDs
GABITRIL 16mg/1
(Tiagabine HCl)
   6345904163042
PDPs
302
MAPDs
GABITRIL 2mg/1
(Tiagabine HCl)
   634590402305
PDPs
22
MAPDs
GABITRIL 4mg/1
(Tiagabine HCl)
   634590404305
PDPs
22
MAPDs
Gablofen 2000ug/mL 20 mL in 1 VIAL, GLASS
(Baclofen)
20 mL in 1 VIAL, GLASS  4594501570210
PDPs
43
MAPDs
Gablofen 50ug/mL 1 mL in 1 SYRINGE, PLASTIC
(Baclofen)
1 mL in 1 SYRINGE, PLASTI  4594501510110
PDPs
43
MAPDs
Gablofen 500ug/mL 20 mL in 1 VIAL, GLASS
(Baclofen)
20 mL in 1 VIAL, GLASS  4594501550210
PDPs
43
MAPDs
Galantamine 12mg/1 60 FILM COATED TABLETS in BOTTLE
(Galantamine Hydrobromide)
60 TABLET, FILM COATED in  0055501400953
PDPs
312
MAPDs
GALANTAMINE HYDROBROMIDE CAPSULES EXTENDED RELEASE 16MG 30 BOT
(Galantamine Hydrobromide)
30 BOT0055510210153
PDPs
313
MAPDs
GALANTAMINE HYDROBROMIDE CAPSULES EXTENDED RELEASE 24MG 30 BOT
(Galantamine Hydrobromide)
30 BOT0055510220153
PDPs
313
MAPDs
Galantamine Hydrobromide Oral Solution 4mg/mL 100 mL in 1 BOTTLE
(Galantamine Hydrobromide)
100 mL in 1 BOTTLE  0005401374953
PDPs
305
MAPDs
Galantamine 4mg/1 60 FILM COATED TABLETS in BOTTLE
(Galantamine Hydrobromide)
60 TABLET, FILM COATED in  0055501380953
PDPs
312
MAPDs
GALANTAMINE HYDROBROMIDE CAPSULES EXTENDED RELEASE 8MG 30 BOT
(Galantamine Hydrobromide)
30 BOT0055510200153
PDPs
313
MAPDs
Galantamine 8mg/1 60 FILM COATED TABLETS in BOTTLE
(Galantamine Hydrobromide)
60 TABLET, FILM COATED in  0055501390953
PDPs
312
MAPDs
GamaSTAN S/D 0.165g/mL
(Immune Globulin (Human))
   1353306351242
PDPs
254
MAPDs
GAMMAGARD LIQUID 100mg/mL 1 BOTTLE, GLASS per CARTON / 25 mL in 1 BOTTLE, GLASS
(Immune Globulin (Human) IV)
1 BOTTLE, GLASS in 1 CART  0094427000333
PDPs
260
MAPDs
GAMMAKED 1 GRAM/10 ML VIAL
(Immune Globulin)
10 ML  7612509000128
PDPs
179
MAPDs
GAMMAPLEX INJECTION 5 GM/100 ML
(Immune Globulin)
   6420882340344
PDPs
245
MAPDs
Gamunex-C 10g/100mL 10 mL in 1 VIAL, GLASS
(Immune Globulin (Human) IV)
10 mL in 1 VIAL, GLASS  1353308001240
PDPs
278
MAPDs
GANCICLOVIR 500MG VIAL FOR INJECTION
(Ganciclovir)
25 X 10 TRAY 6332303151057
PDPs
328
MAPDs
GARDASIL SYRINGE
(Quadrivalent Human Papillomavirus (HPV) Recombinant Vac)
   0000641090257
PDPs
328
MAPDs
GARDASIL VIAL
(Quadrivalent Human Papillomavirus (HPV) Recombinant Vac)
1 X 0.5 ML VIAL0000640450057
PDPs
328
MAPDs
GARDASIL 9 VIAL
(Quadrivalent Human Papillomavirus (HPV) Recombinant Vac)
   0000641190357
PDPs
328
MAPDs
GARDASIL 9 SYRINGE
(Quadrivalent Human Papillomavirus (HPV) Recombinant Vac)
   0000641210257
PDPs
328
MAPDs
GASTROCROM 100 MG/5 ML CONC
(Cromolyn Sodium Oral)
   000370678961
PDPs
10
MAPDs
GATIFLOXACIN 0.5% EYE DROPS [Zymar, Zymaxid]
(gatifloxacin ophthalmic)
2.5 ML  6818004350126
PDPs
248
MAPDs
GATTEX 5 MG ONE-VIAL KIT
(teduglutide)
   6887501030157
PDPs
325
MAPDs
GAVILYTE-H AND BISACODYL KIT
(BISAC/NACL/NAHCO3/KCL/PEG 3350)
1 EA  4338600718338
PDPs
153
MAPDs
GAVILYTE-G SOLUTION
(Polyethylene Glycol 3350 Oral)
274.31 g in 1 BOTTLE  4338600901957
PDPs
300
MAPDs
GAVILYTE-C SOLUTION
(Polyethylene Glycol 3350 Oral)
278.26 g in 1 BOTTLE  4338600601957
PDPs
312
MAPDs
GAVILYTE-N SOLUTION
(Polyethylene Glycol 3350 Oral)
438.4 g in 1 BOTTLE  4338600501957
PDPs
307
MAPDs
GELNIQUE 100mg/g 30 PACKET per CARTON / 1 g in 1 PACKET
(Oxybutynin Chloride)
30 PACKET in 1 CARTON / 1  525440084305
PDPs
52
MAPDs
Gemcitabine Hydrochloride 1g/25mL 1 VIAL per CARTON / 25 mL in 1 VIAL
()
1 VIAL in 1 CARTON / 25 m  1672901171148
PDPs
285
MAPDs
GEMFIBROZIL TABLET 600MG (500 CT)
(Gemfibrozil)
500 BOT0014391300557
PDPs
328
MAPDs
GEMZAR 1GRAM VIAL
(Gemcitabine HCl For)
1 X 50 ML VIAL000027502011
PDPs
14
MAPDs
GENERESS FE CHEWABLE TABLET
(norethindrone and ethinyl estradiol and ferrous fumarate)
28 EA  525440204311
PDPs
13
MAPDs
GENERLAC 10 GM/15 ML SOLUTION
(Lactulose (Encephalopathy))
1892 ML  6043200386457
PDPs
316
MAPDs
GENGRAF 100 MG CAPSULE
(Cyclosporine Modified)
30 EA  0007431093257
PDPs
312
MAPDs
GENGRAF 100MG/ML SOLUTION
(Cyclosporine Modified)
50 ML BOTGL0007472695057
PDPs
310
MAPDs
GENGRAF 25 MG CAPSULE
(Cyclosporine Modified)
30 EA  0007431083257
PDPs
314
MAPDs
GENOTROPIN 13.8MG CARTRIDGE
(Somatropin For)
1 X 13.8 MG CTG0001326468118
PDPs
149
MAPDs
GENOTROPIN 5 MG CARTRIDGE
(Somatropin For)
1 PKGCOM0001326268118
PDPs
147
MAPDs
GENOTROPIN MINIQUICK 0.2MG
(Somatropin For)
7 X 0.2 MG VIALPAT0001326490218
PDPs
150
MAPDs
GENOTROPIN MINIQUICK 0.4MG
(Somatropin For)
7 X 0.4 MG VIALPAT0001326500218
PDPs
148
MAPDs
GENOTROPIN MINIQUICK 0.6MG
(Somatropin For)
7 X 0.6 MG VIALPAT0001326510218
PDPs
146
MAPDs
GENOTROPIN MINIQUICK 0.8MG
(Somatropin For)
7 X 0.8 MG VIALPAT0001326520218
PDPs
146
MAPDs
GENOTROPIN MINIQUICK 1MG
(Somatropin For)
7 X 1.0 MG VIALPAT0001326530218
PDPs
146
MAPDs
GENOTROPIN MINIQUICK 1.2MG
(Somatropin For)
7 VIALPAT0001326540218
PDPs
146
MAPDs
GENOTROPIN MINIQUICK 1.4MG
(Somatropin For)
7 VIALPAT0001326550218
PDPs
146
MAPDs
GENOTROPIN MINIQUICK 1.6MG
(Somatropin For)
7 VIALPAT0001326560218
PDPs
146
MAPDs
GENOTROPIN MINIQUICK 1.8MG
(Somatropin For)
7 VIALPAT0001326570218
PDPs
146
MAPDs
GENOTROPIN MINIQUICK 2MG
(Somatropin For)
7 X 2.0 MG VIALPAT0001326580218
PDPs
146
MAPDs
GENTAK 3MG/GM EYE OINTMENT
(Gentamicin Sulfate Ophth)
3.5 GM TUBE1747802843557
PDPs
299
MAPDs
GENTAMICIN 10MG/ML VIAL
(Gentamicin)
25 X 8 ML VIAL0040934010155
PDPs
304
MAPDs
GENTAMICIN SULFATE OINTMENT USP 0.1% 15GM TUBE
(Gentamicin Sulfate)
15 GM TUBE4580200463557
PDPs
324
MAPDs
GENTAMICIN SULFATE CREAM USP 0.1% 15GM TUBE
(Gentamicin Sulfate)
15 GM TUBE4580200563557
PDPs
326
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  0040912070357
PDPs
313
MAPDs
Gentamicin Sulfate in Sodium Chloride 60mg/50mL 50 mL in 1 BAG
(Gentamicin Sulfate)
50 mL in 1 BAG  0033805074151
PDPs
276
MAPDs
GENTAMICIN SULFATE OPHTHALMIC SOLUTION 0.3% 5ML BOT
(Gentamicin Sulfate Ophth)
5 ML BOT2420805806057
PDPs
322
MAPDs
Gentamicin 3 mg/gm eye oint
(Gentamicin Sulfate Ophth)
   0057441023557
PDPs
320
MAPDs
GENVOYA TABLET
(Elvitegravir, Cobicistat, Emtricitabine, and Tenofovir Alafenamide Fumarate)
   6195819010157
PDPs
327
MAPDs
GEODON 20MG VIAL
(Ziprasidone HCl)
1 VIAL VIALSD0004939208357
PDPs
328
MAPDs
GEODON 20MG CAPSULE
(Ziprasidone HCl)
60 BOT000493960604
PDPs
10
MAPDs
GEODON 40MG CAPSULE
(Ziprasidone HCl)
60 BOT000493970604
PDPs
10
MAPDs
GEODON 60MG CAPSULE
(Ziprasidone HCl)
60 BOT000493980604
PDPs
10
MAPDs
GEODON 80MG CAPSULE
(Ziprasidone HCl)
60 BOT000493990604
PDPs
10
MAPDs
Gianvi 3 BLISTER PACK in 1 PACKAGE / 1 KIT per BLISTER PACK
(Drospirenone-Ethinyl Estradiol)
3 BLISTER PACK in 1 PACKA  0009354235847
PDPs
259
MAPDs
GIAZO 180 GM
(balsalazide disodium)
   656490102022
PDPs
28
MAPDs
gildagia 0.4 mg-0.035 mg tab
(ethinyl estradiol / norethindrone)
   0060335901752
PDPs
276
MAPDs
Gildess 1.5 mg-30 mcg tablet
(Ethinyl Estradiol and Norethindrone)
   0060376060253
PDPs
272
MAPDs
Gildess 24 fe 1-20 Tablet
(Ethinyl Estradiol and Norethindrone)
   0060376101734
PDPs
199
MAPDs
GILENYA 0.5 MG CAPSULE
(FINGOLIMOD HCL)
30 EA  0007806071545
PDPs
299
MAPDs
GILOTRIF 20 MG TABLET
(afatinib)
30 EA  0059701413057
PDPs
328
MAPDs
GILOTRIF 30 MG TABLET
(afatinib)
30 EA  0059701373057
PDPs
328
MAPDs
GILOTRIF 40 MG TABLET
(afatinib)
30 EA  0059701383057
PDPs
328
MAPDs
GLASSIA 1g/50mL 1 VIAL, GLASS per CARTON / 50 mL in 1 VIAL, GLASS
(ALPHA-1-PROTEINASE INHIBITOR (HUMAN))
1 VIAL, GLASS in 1 CARTON  0094428840111
PDPs
132
MAPDs
Glatopa 20 mg/ml syringe
(Glatiramer Acetate)
   0078132343445
PDPs
212
MAPDs
GLEEVEC 100MG TABLET (90 CT)
(Imatinib Mesylate)
90 BOT0007804013412
PDPs
111
MAPDs
GLEEVEC 400 MG TABLET
(Imatinib Mesylate)
30 EA  0007806493012
PDPs
111
MAPDs
GLEOSTINE 10 MG CAPSULE
(Lomustine)
   5818130400550
PDPs
276
MAPDs
GLEOSTINE 100 MG CAPSULE
(Lomustine)
   5818130420550
PDPs
276
MAPDs
GLEOSTINE 40 MG CAPSULE
(Lomustine)
   5818130410550
PDPs
284
MAPDs
GLEOSTINE 5 MG CAPSULE
(Lomustine)
   5818130430557
PDPs
319
MAPDs
GLIMEPIRIDE 1MG TABLET (100 CT)
(Glimepiride)
100 BOT5511103200157
PDPs
328
MAPDs
GLIMEPIRIDE 2MG TABLET (100 CT)
(Glimepiride)
100 BOT5511103210157
PDPs
328
MAPDs
GLIMEPIRIDE 4MG TABLET (100 CT)
(Glimepiride)
100 BOT5511103220157
PDPs
328
MAPDs
GLIPIZIDE 10MG TABLET (100 CT)
(Glipizide)
100 BOT0037811100157
PDPs
328
MAPDs
GLIPIZIDE 10MG TABLETS EXTENDED RELEASE
(Glipizide)
100 BOT 0059108450157
PDPs
327
MAPDs
GLIPIZIDE ER 2.5MG TABLET SR OSMOTIC PUSH 24HR
(Glipizide)
30 BOTPL0059109003057
PDPs
327
MAPDs
GLIPIZIDE-METFORMIN 2.5-500MG TABLET
(Glipizide)
100 BOT0009374560155
PDPs
311
MAPDs
GLIPIZIDE 5MG TABLETS EXTENDED RELEASE
(Glipizide)
100 BOT 0059108440157
PDPs
327
MAPDs
Glipizide 5mg/1 500 TABLET BOTTLE
(Glipizide)
500 TABLET in 1 BOTTLE  1672901391657
PDPs
328
MAPDs
GLIPIZIDE-METFORMIN 5-500 MG
(Glipizide)
100 EA  0009374570155
PDPs
311
MAPDs
Glipizide and Metformin Hydrochloride 2.5; 250mg/1; mg/1 100 BOTTLE, PLASTIC in 1 BOTTLE, PLASTIC /
(Glipizide-Metformin HCl)
100 BOTTLE, PLASTIC in 1  0037831310155
PDPs
311
MAPDs
GLUCAGEN 1MG HYPOKIT
(Glucagon HCl (rDNA) For)
1 X 1 MG PKGCOM0016970651557
PDPs
314
MAPDs
GLUCAGON 1MG EMERGENCY KIT
(Glucagon (rDNA) For)
1 KIT PKGCOM0000280310153
PDPs
323
MAPDs
GLUCOPHAGE 1000MG TABLET
(Metformin HCl)
100 BOT000876071116
PDPs
11
MAPDs
GLUCOPHAGE 500MG TABLET
(Metformin HCl)
500 BOT000876060106
PDPs
11
MAPDs
GLUCOPHAGE 850MG TABLET
(Metformin HCl)
100 BOT000876070056
PDPs
11
MAPDs
GLUCOPHAGE XR 500MG TABLET SA
(Metformin HCl)
100 BOT000876063136
PDPs
11
MAPDs
GLUCOPHAGE XR 750MG TABLET SA
(Metformin HCl)
100 BOT000876064136
PDPs
11
MAPDs
GLUCOTROL 10MG TABLET
(Glipizide)
100 BOT000494120667
PDPs
13
MAPDs
GLUCOTROL 5MG TABLET
(Glipizide)
100 BOT000494110667
PDPs
13
MAPDs
GLUCOTROL XL 10 MG TABLET
(Glipizide)
500 EA  000490178086
PDPs
11
MAPDs
GLUCOTROL XL 2.5 MG TABLET
(Glipizide)
30 EA 000490170016
PDPs
11
MAPDs
GLUCOTROL XL 5 MG TABLET
(Glipizide)
   000490174036
PDPs
11
MAPDs
GLUCOVANCE 2.5/500MG TABLET
(Glyburide-Metformin)
100 BOT000876073112
PDPs
7
MAPDs
GLUCOVANCE 5/500MG TABLET
(Glyburide-Metformin)
100 BOT000876074112
PDPs
7
MAPDs
GLUMETZA ER 1,000 MG TABLET
(Metformin HCl)
   680120003162
PDPs
23
MAPDs
GLUMETZA ER 500 MG TABLET
(Metformin HCl)
   680120002133
PDPs
24
MAPDs
GLYBURIDE 1.25MG TABLETS
(Glyburide)
100 TABLETS BOT 0009383420120
PDPs
157
MAPDs
GLYBURIDE AND METFORMIN HCL 1.25-250MG TABLET (100 CT)
(Glyburide)
100 BOT0009357100120
PDPs
136
MAPDs
GLYBURIDE 2.5MG TABLET (100 CT)
(Glyburide)
100 TABLETS BOT0009383430120
PDPs
157
MAPDs
GLYBURIDE 5MG TABLETS
(Glyburide)
500 TABLETS BOT 0009383440520
PDPs
157
MAPDs
Glyburide 6mg/1 500 TABLET BOTTLE, PLASTIC
(Glyburide)
500 TABLET BOTTLE  0014399200520
PDPs
151
MAPDs
GLYBURIDE MICRONIZED 1.5MG TABLET (100 CT)
(Glyburide Micronized)
100 BOT0037811130120
PDPs
151
MAPDs
GLYBURIDE MICRO 3MG TABLET (100 CT)
(Glyburide Micronized)
100 TABLETS BOT0009380350120
PDPs
152
MAPDs
GLYBURIDE-METFORMIN HCL 2.5-500MG TABLET
(Glyburide-Metformin)
500 BOT0022827525020
PDPs
136
MAPDs
GLYBURIDE-METFORMIN HCL 5MG-500MG TABLET
(Glyburide-Metformin)
500 BOT0022827535020
PDPs
136
MAPDs
GLYCOPYRROLATE 0.2MG/ML VL
(Glycopyrrolate)
25 X 20 ML VIALMD0051746202540
PDPs
238
MAPDs
GLYCOPYRROLATE TABLET 1MG (100 CT)
(Glycopyrrolate)
100 BOT4988400650149
PDPs
315
MAPDs
GLYCOPYRROLATE TABLET 2MG (100 CT)
(Glycopyrrolate)
100 BOT4988400660149
PDPs
313
MAPDs
GLYNASE 1.5MG PRESTAB
(Glyburide Micronized)
100 BOT000090341010
PDPs
5
MAPDs
Glynase 3mg/1 1000 TABLET BOTTLE, PLASTIC
(Glyburide Micronized)
1000 TABLET in 1 BOTTLE,  000090352040
PDPs
5
MAPDs
GLYNASE 6 MG PRESTAB
(Glyburide Micronized)
100 EA  000093449010
PDPs
5
MAPDs
GLYSET 100MG TABLET
(Miglitol)
100 BOTPL000095014016
PDPs
72
MAPDs
GLYSET 25MG TABLET
(Miglitol)
100 BOT000095012016
PDPs
72
MAPDs
GLYSET 50MG TABLET
(Miglitol)
100 BOTPL000095013016
PDPs
72
MAPDs
GLYXAMBI 10 MG-5 MG TABLET
(Empagliflozin and Linagliptin)
   005970182307
PDPs
97
MAPDs
GLYXAMBI 25 MG-5 MG TABLET
(Empagliflozin and Linagliptin)
   005970164307
PDPs
97
MAPDs
GOLYTELY PACKET 227.1 GM/2.82 GM
(PEG 3350-KCl-Na Bicarb-NaCl-Na Sulfate For)
263 GM PKT5226807000128
PDPs
123
MAPDs
GOLYTELY SOLUTION 236 GM/2.97 GM/6 GM
(PEG 3350-KCl-Na Bicarb-NaCl-Na Sulfate For)
4 L BOT5226801000124
PDPs
83
MAPDs
Gralise Starter Pack 1 KIT per BLISTER PACK
(Gabapentin)
1 KIT in 1 BLISTER PACK  139130006166
PDPs
67
MAPDs
GRALISE ER 300 MG TABLET
(Gabapentin)
   139130004196
PDPs
67
MAPDs
Gralise 600 MG 90 FILM COATED TABLETS in BOTTLE
(Gabapentin)
90 TABLET, FILM COATED in  139130005196
PDPs
67
MAPDs
Granisetron HCl 0.1 mg/ml vial
(Granisetron HCl)
   6332303170144
PDPs
266
MAPDs
Granisetron hcl 1 mg/ml vial
(Granisetron HCl)
   6332303190444
PDPs
220
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  0014397441044
PDPs
260
MAPDs
Granisetron Hydrochloride 1mg/1 2 TABLET BOTTLE
(Granisetron HCl)
2 TABLET in 1 BOTTLE  0005401438755
PDPs
305
MAPDs
GRANIX 300 MCG/0.5 ML SYRINGE
(tbo-filgrastim)
   6345909101135
PDPs
243
MAPDs
GRANIX 480 MCG/0.8 ML SYRINGE
(tbo-filgrastim)
   6345909121135
PDPs
243
MAPDs
GRASTEK 2;800 BAU SL TABLET
(timothy grass pollen allergen extract)
   0000642293017
PDPs
92
MAPDs
GRIS-PEG 125MG TABLET
(Griseofulvin Ultramicrosize)
100 BOT008840763044
PDPs
15
MAPDs
GRIS-PEG 250 MG TABLET
(Griseofulvin Ultramicrosize)
100 EA  008840773046
PDPs
17
MAPDs
Griseofulvin 125mg/5mL 120 mL in 1 BOTTLE
(Griseofulvin Microsize)
120 mL in 1 BOTTLE  0009371021252
PDPs
301
MAPDs
griseofulvin micro 500 mg tab
(Griseofulvin Microsize)
   6498001860139
PDPs
267
MAPDs
griseofulvin ultra 125 mg tab
(Griseofulvin Ultra)
   6498001840152
PDPs
268
MAPDs
griseofulvin ultra 250 mg tab
(Griseofulvin Ultra)
   6498001850152
PDPs
268
MAPDs
Guanfacine hcl er 1 mg tablet
(Guanfacine HCl)
   0022828501136
PDPs
229
MAPDs
GUANFACINE 1MG TABLET
(Guanfacine HCl)
100 BOT0059104440123
PDPs
161
MAPDs
Guanfacine hcl er 2 mg tablet
(Guanfacine HCl)
   0022828511136
PDPs
229
MAPDs
GUANFACINE 2MG TABLET (100 CT)
(Guanfacine HCl)
100 BOT0037811900123
PDPs
161
MAPDs
Guanfacine hcl er 3 mg tablet
(Guanfacine HCl)
   0022828531136
PDPs
229
MAPDs
Guanfacine hcl er 4 mg tablet
(Guanfacine HCl)
   0022828551136
PDPs
229
MAPDs
guanidine hcl 125 mg tablet
(Guanidine HCl)
   0008504920141
PDPs
267
MAPDs
GYNAZOLE-1 2% CREAM
(Butoconazole Nitrate (One Dose) Vaginal)
5 GM  458020396014
PDPs
45
MAPDs
HORIZANT ER 300 MG TABLET
(GABAPENTIN ENACARBIL)
   534510103013
PDPs
53
MAPDs
HORIZANT ER 600 MG TABLET
(GABAPENTIN ENACARBIL)
   534510101013
PDPs
52
MAPDs
IMATINIB MESYLATE 100 MG TABLET [Gleevec]
(Imatinib Mesylate)
90 EA  4733504728154
PDPs
283
MAPDs
IMATINIB MESYLATE 400 MG TABLET [Gleevec]
(Imatinib Mesylate)
30 EA  4733504758354
PDPs
283
MAPDs
IRESSA 250 MG TABLET
(Gefitinib)
30 EA  0031004823057
PDPs
328
MAPDs
ISOTONIC GENTAMICIN 100 MG/100 ML
(Gentamicin in Saline)
100 ML  0033805054851
PDPs
283
MAPDs
ISOTON GENTAMICIN 80MG/100ML
(Gentamicin in Saline)
100 ML BAG0033805034851
PDPs
272
MAPDs
ISOTONIC GENTAMICIN 80 MG/50 ML
(Gentamicin in Saline)
50 ML  0033805094151
PDPs
277
MAPDs
LOPID 600 MG TABLET
(Gemfibrozil)
60 EA  000710737206
PDPs
11
MAPDs
Miglitol 100 MG TABLET [Glyset]
(Miglitol)
   5766406868816
PDPs
199
MAPDs
Miglitol 25 MG TABLET [Glyset]
(Miglitol)
   5766406848816
PDPs
199
MAPDs
Miglitol 50 MG TABLET [Glyset]
(Miglitol)
   5766406858816
PDPs
199
MAPDs
NAGLAZYME 5MG/5ML VIAL
(Galsulfase)
5ML VIALSU6813500200157
PDPs
328
MAPDs
NEOMYCIN/POLYMY/GRAM EYE DROPS 0.025MG/ML 1.75MG/M
(Neomycin-Polymyxin B-Gramicidin Ophth)
10 ML BOT2420807906257
PDPs
322
MAPDs
NEURONTIN 100MG CAPSULE
(Gabapentin)
100 BOT000710803245
PDPs
13
MAPDs
NEURONTIN 250MG/5ML TUBEX
(Gabapentin)
470 ML BOT000712012235
PDPs
14
MAPDs
NEURONTIN 300MG CAPSULE
(Gabapentin)
100 BOT000710805245
PDPs
13
MAPDs
NEURONTIN 400MG CAPSULE
(Gabapentin)
100 BOT000710806245
PDPs
13
MAPDs
NEURONTIN 600MG TABLET
(Gabapentin)
100 BOT000710513245
PDPs
13
MAPDs
NEURONTIN 800MG TABLET
(Gabapentin)
100 BOT000710401245
PDPs
13
MAPDs
NutreStore 5g/1 84 PACKET in 1 BOX / 1 POWDER, FOR SOLUTION in 1 PACKET
(Glutamine)
84 PACKET in 1 BOX / 1 PO  424570001844
PDPs
40
MAPDs
ORALAIR 300 IR SUBLINGUAL TAB
(Grass Pollen Allergen Extract)
30 EA  5961700150213
PDPs
63
MAPDs
POLYETH GLYC NF POWDER FOR ORAL SOLUTION 17GM (527 CT)
(Polyethylene Glycol 3350 Powder)
527 BOT0057404120557
PDPs
328
MAPDs
PRED G OPHTHALMIC SUSPENSION 1;0.3%;% 5 ML BOTDR
(Gentamicin-Prednisolone Ace Ophth)
5 ML BOTDR0002301060516
PDPs
123
MAPDs
PRED-G S.O.P. EYE OINTMENT
(Gentamicin-Prednisolone Ace Ophth)
3.5 GM TUBE0002300660416
PDPs
108
MAPDs
RAVICTI 1.1 GRAM/ML LIQUID
(Glycerol Phenylbutyrate)
25 ML  7598700500644
PDPs
284
MAPDs
RAZADYNE 12MG TABLET
(Galantamine Hydrobromide)
TABLETS BOT504580398604
PDPs
9
MAPDs
RAZADYNE 4MG TABLET
(Galantamine Hydrobromide)
60 TABLETS BOT504580396606
PDPs
11
MAPDs
RAZADYNE 8MG TABLET
(Galantamine Hydrobromide)
60 TABLETS BOT504580397604
PDPs
9
MAPDs
RAZADYNE ER 16MG CAPSULE
(Galantamine Hydrobromide)
30 CAPSULES BOT504580388304
PDPs
9
MAPDs
RAZADYNE ER 24MG CAPSULE
(Galantamine Hydrobromide)
30 CAPSULES BOT504580389304
PDPs
9
MAPDs
RAZADYNE ER 8MG CAPSULE
(Galantamine Hydrobromide)
30 CAPSULES BOT504580387304
PDPs
9
MAPDs
ROBINUL 0.4 MG/2 ML VIAL
(Glycopyrrolate)
   006416105251
PDPs
13
MAPDs
ROBINUL 1MG TABLET
(Glycopyrrolate)
100 TABS BOTPL596300200104
PDPs
9
MAPDs
ROBINUL FORTE 2MG TABLET
(Glycopyrrolate)
100 TABS BOTPL596300205104
PDPs
15
MAPDs
SANCUSO TRANSDERMAL SYSTEM 3.1MG/24HRS 1 PATCH CRTN
(Granisetron Transdermal)
1 PATCH CRTN4274707260112
PDPs
115
MAPDs
SIMPONI 100 MG/ML SYRINGE
(Golimumab Subcutaneous)
1 ML  5789400710115
PDPs
174
MAPDs
SIMPONI 100 MG/ML PEN INJECTOR
(Golimumab Subcutaneous)
1 ML  5789400710215
PDPs
166
MAPDs
SIMPONI 50 MG/0.5 ML PEN INJEC
(Golimumab Subcutaneous)
0.5 ML  5789400700212
PDPs
149
MAPDs
SIMPONI GOLIMUMAB INJECTION 50MG/0.5ML 1 50 MG SINGLE DOSE SYR SYR
(Golimumab Subcutaneous)
1 50 MG SINGLE DOSE SYR SYR5789400700112
PDPs
160
MAPDs
SIMPONI ARIA 50 MG/4 ML VIAL
(golimumab)
4 ML  578940350016
PDPs
146
MAPDs
TENEX 1MG TABLET
(Guanfacine HCl)
500 TABS BOTPL678570705050
PDPs
6
MAPDs
TENEX 2MG TABLET
(Guanfacine HCl)
100 TABS BOTPL678570706010
PDPs
6
MAPDs
tiagabine hcl 2 mg tablet [Gabitril]
(Tiagabine HCl)
   6275602008357
PDPs
327
MAPDs
tiagabine hcl 4 mg tablet [Gabitril]
(Tiagabine HCl)
   6275602248357
PDPs
327
MAPDs
ZIPRASIDONE HCL 20 MG CAPSULE [Geodon]
(Ziprasidone HCl)
   6818003310757
PDPs
328
MAPDs
ZIPRASIDONE HCL 40 MG CAPSULE [Geodon]
(Ziprasidone HCl)
   6818003320757
PDPs
328
MAPDs
ZIPRASIDONE HCL 60 MG CAPSULE [Geodon]
(Ziprasidone HCl)
   5511102586057
PDPs
328
MAPDs
ZIPRASIDONE HCL 80 MG CAPSULE [Geodon]
(Ziprasidone HCl)
   0090462720857
PDPs
328
MAPDs
ZIRGAN 1.5mg/g 1 TUBE, WITH APPLICATOR per CARTON / 5 g in 1 TUBE, WITH APPLICATOR
(Ganciclovir Ophth)
1 TUBE, WITH APPLICATOR i  2420805353547
PDPs
302
MAPDs
ZYMAXID 5mg/mL 1 BOTTLE, DROPPER per CARTON / 2.5 mL in 1 BOTTLE, DROPPER
(Gatifloxacin Ophth)
1 BOTTLE, DROPPER in 1 CA  000233615251
PDPs
9
MAPDs



(Chart Source: Centers for Medicare and Medicaid files: CMS Data January 2017)


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  • 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
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  • 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.