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2017 Medicare Part D Formulary Search By Drug Letter

Select a Letter below:

Top Medicare Drugs (Short List) in Alphabetical Order

Drug Name
PackagingNDCOn This Nbr of 2017 Formularies
PDPsMAPDs
ABILIFY 10MG TABLET
(Aripiprazole)
30 BOT591480008135
PDPs
19
MAPDs
ABILIFY 15MG TABLET
(Aripiprazole)
30 BOT591480009135
PDPs
19
MAPDs
ABILIFY 2MG TABLET
(Aripiprazole)
30 BOX591480006135
PDPs
19
MAPDs
ABILIFY 20MG TABLET
(Aripiprazole)
30 BOT591480010135
PDPs
19
MAPDs
ABILIFY 30MG TABLET
(Aripiprazole)
30 BOT591480011135
PDPs
19
MAPDs
ABILIFY MAINTENA ER 300 MG SYR
(Aripiprazole)
   5914800458059
PDPs
332
MAPDs
ABILIFY MAINTENA ER 300 MG VL
(Aripiprazole)
1 EA  5914800187159
PDPs
338
MAPDs
ABILIFY MAINTENA ER 400 MG SYR
(Aripiprazole)
   5914800728059
PDPs
334
MAPDs
ABILIFY 5MG TABLET (OTSUKA)
(Aripiprazole)
30 BOT591480007135
PDPs
19
MAPDs
Actonel 150mg 36 DOSE PACK CASE / 1 TRAY DOSE PACK / 1 FILM COATED TABLETS in TRAY
(Risedronate Sodium)
36 DOSE PACK in 1 CASE /  004300478012
PDPs
10
MAPDs
Actonel 30mg 12 BOTTLE CASE / 30 FILM COATED TABLETS in BOTTLE
(Risedronate Sodium)
12 BOTTLE in 1 CASE / 30  004300470151
PDPs
16
MAPDs
Actonel 35mg 36 DOSE PACK CASE / 1 TRAY DOSE PACK / 4 FILM COATED TABLETS in TRAY
(Risedronate Sodium)
36 DOSE PACK in 1 CASE /  004300472031
PDPs
10
MAPDs
Actonel 5mg 12 BOTTLE CASE / 30 FILM COATED TABLETS in BOTTLE
(Risedronate Sodium)
12 BOTTLE in 1 CASE / 30  004300471151
PDPs
10
MAPDs
ACTOS 15 MG TABLET
(Pioglitazone HCL)
   647640151046
PDPs
11
MAPDs
ACTOS 30 MG TABLET
(Pioglitazone HCL)
   647640301146
PDPs
11
MAPDs
ACTOS 45 MG TABLET
(Pioglitazone HCL)
   647640451246
PDPs
11
MAPDs
ADVAIR DISKUS MIS 100/50
(Fluticasone-Salmeterol)
60 DOSE INHL0017306950052
PDPs
329
MAPDs
ADVAIR DISKUS MIS 250/50
(Fluticasone-Salmeterol)
60 DOSE BLPK0017306960052
PDPs
329
MAPDs
ADVAIR DISKUS MIS 500/50
(Fluticasone-Salmeterol)
60 BLPK0017306970052
PDPs
329
MAPDs
AMLODIPINE BESYLATE 10MG TABLET (90 CT)
(Amlodipine Besylate)
90 BOT6586201039059
PDPs
341
MAPDs
AMLODIPINE-BENAZEPRIL 10-40 MG
(Amlodipine Besylate-Benazepril HCl)
100 EA  6586205870151
PDPs
333
MAPDs
AMLODIPINE BESYLATE-BENAZEPRIL 10MG-20MG CAPSULE
(Amlodipine Besylate)
100 CAP BOT0009373730151
PDPs
333
MAPDs
AMLODIPINE BESYLATE 2.5MG TABLET (90 CT)
(Amlodipine Besylate)
90 BOT6586201019059
PDPs
341
MAPDs
AMLODIPINE BESYLATE-BENAZEPRIL 2.5MG-10MG CAPSULE
(Amlodipine Besylate)
100 CAP BOT0009373700151
PDPs
333
MAPDs
AMLODIPINE BESYLATE 5MG TABLET (90 CT)
(Amlodipine Besylate)
90 BOT6586201029059
PDPs
341
MAPDs
AMLODIPINE-BENAZEPRIL 5-40 MG
(Amlodipine Besylate-Benazepril HCl)
500 EA  6586205850551
PDPs
333
MAPDs
AMLODIPINE BESYLATE-BENAZEPRIL 5-10MG CAPSULE
(Amlodipine Besylate)
100 CAPS BOT0009373710151
PDPs
333
MAPDs
AMLODIPINE BESYLATE-BENAZEPRIL 5MG-20MG CAPSULE
(Amlodipine Besylate)
100 CAP BOT0009373720151
PDPs
333
MAPDs
ATORVASTATIN 10 MG TABLET [Lipitor]
(Atorvastatin Calcium)
   0037839500959
PDPs
341
MAPDs
ATORVASTATIN 20 MG TABLET [Lipitor]
(Atorvastatin Calcium)
   0037839510959
PDPs
341
MAPDs
ATORVASTATIN 40 MG TABLET [Lipitor]
(Atorvastatin Calcium)
   0037839520959
PDPs
341
MAPDs
ATORVASTATIN 80 MG TABLET [Lipitor]
(Atorvastatin Calcium)
   0037839530959
PDPs
341
MAPDs
CLOPIDOGREL 300 MG TABLET [Plavix]
(Clopidogrel)
   5511106713125
PDPs
205
MAPDs
CLOPIDOGREL 75 MG TABLET [Plavix]
(Clopidogrel)
30 EA  0009373145659
PDPs
341
MAPDs
CRESTOR 10MG TABLET
(Rosuvastatin Calcium)
90 BOT0031007519025
PDPs
79
MAPDs
CRESTOR 20MG TABLET
(Rosuvastatin Calcium)
90 BOT0031007529025
PDPs
79
MAPDs
CRESTOR 40mg/1 30 FILM COATED TABLETS in BOTTLE, PLASTIC
(Rosuvastatin Calcium)
30 TABLET, FILM COATED in  0031007543025
PDPs
79
MAPDs
CRESTOR 5MG TABLET
(Rosuvastatin Calcium)
90 BOT0031007559025
PDPs
80
MAPDs
CYMBALTA 20MG CAPSULE
(Duloxetine HCl Enteric Coated Pellets)
60 BOT000023235606
PDPs
12
MAPDs
CYMBALTA CAPSULES DELAYED RELEASE 30MG (30 CT)
(Duloxetine HCl Enteric Coated Pellets)
30 BOT000023240306
PDPs
12
MAPDs
Cymbalta 60mg/1 1000 CAPSULE, DELAYED RELEASE in 1 BOTTLE
(Duloxetine HCl Enteric Coated Pellets)
1000 CAPSULE, DELAYED REL  000023270046
PDPs
12
MAPDs
DIOVAN HCT 160/12.5MG TABLET
(Valsartan)
90 BOT000780315348
PDPs
14
MAPDs
DIOVAN HCT 320/12.5MG TABLET
(Valsartan)
90 BOT000780471348
PDPs
14
MAPDs
DIOVAN HCT 80/12.5MG TABLET
(Valsartan)
90 BOT000780314348
PDPs
14
MAPDs
DIOVAN 160MG TABLET
(Valsartan)
90 BOT000780359346
PDPs
12
MAPDs
DIOVAN HCT 160/25MG TABLET
(Valsartan)
90 BOT000780383348
PDPs
14
MAPDs
DIOVAN 320MG TABLET
(Valsartan)
90 BOT000780360346
PDPs
12
MAPDs
DIOVAN HCT 320/25MG TABLET
(Valsartan)
90 BOT000780472348
PDPs
14
MAPDs
DIOVAN 40MG TABLET
(Valsartan)
30 BOT000780423156
PDPs
12
MAPDs
DIOVAN 80MG TABLET
(Valsartan)
90 BOX000780358346
PDPs
12
MAPDs
DULOXETINE HCL DR 20 MG CAPSULE [Cymbalta]
()
   0009375420659
PDPs
341
MAPDs
DULOXETINE HCL DR 30 MG CAPSULE [Cymbalta]
()
90 EA  6818002950959
PDPs
341
MAPDs
DULOXETINE HCL DR 40 MG CAPSULE [Cymbalta]
()
   6818002970625
PDPs
225
MAPDs
DULOXETINE HCL DR 60 MG CAPSULE [Cymbalta]
()
1000 EA  6818002960359
PDPs
341
MAPDs
ESCITALOPRAM 10 MG TABLET [Lexapro]
(Escitalopram)
   0009358510159
PDPs
341
MAPDs
ESCITALOPRAM 20 MG TABLET [Lexapro]
(Escitalopram)
   0009358520159
PDPs
341
MAPDs
ESCITALOPRAM 5 MG TABLET [Lexapro]
(Escitalopram)
   0009358500159
PDPs
341
MAPDs
ESCITALOPRAM OXALATE 5 MG/5 ML [Lexapro]
(Escitalopram)
   6516207058859
PDPs
341
MAPDs
ESOMEPRAZOLE MAG DR 20 MG CAPSULE [Nexium]
()
   0009364509841
PDPs
211
MAPDs
ESOMEPRAZOLE SODIUM 20 MG VIAL [Nexium]
()
1 EA  6275605084447
PDPs
269
MAPDs
ESOMEPRAZOLE SODIUM 40 MG VIAL [Nexium]
()
1 EA  6275605094449
PDPs
267
MAPDs
ESOMEPRAZOLE DR 49.3 MG CAPSULE [Nexium]
()
   0009364519840
PDPs
210
MAPDs
Furosemide 10 ML 10 MG/ML Injection
(Furosemide)
   2315505214459
PDPs
337
MAPDs
Furosemide 10mg/mL 10 CARTON in 1 CONTAINER / 1 SYRINGE, PLASTIC in 1 CARTON / 4 mL in 1 SYRINGE, P
(Furosemide)
10 CARTON in 1 CONTAINER  0040996310456
PDPs
305
MAPDs
FUROSEMIDE 10MG/ML SOLUTION
(Furosemide)
120 ML BOT0005432945059
PDPs
329
MAPDs
FUROSEMIDE 20 MG TABLET
(Furosemide)
100 EA  6330406240159
PDPs
341
MAPDs
FUROSEMIDE 40 MG TABLET
(Furosemide)
1000 EA  6330406251059
PDPs
341
MAPDs
FUROSEMIDE 40MG/5ML TUBEX
(Furosemide)
500 ML BOT0005432986349
PDPs
291
MAPDs
FUROSEMIDE 80 MG TABLET
(Furosemide)
100 EA  0037802320159
PDPs
341
MAPDs
Hydrocodone Acetaminophen 2.5-325
(Hydrocodone-Acetaminophen)
   1381106571025
PDPs
231
MAPDs
Hydrocodone Bitartrate and Acetaminophen 300; 10mg/1; mg/1
(Hydrocodone-Acetaminophen)
   6437606430126
PDPs
201
MAPDs
Hydrocodone Bitartrate and Acetaminophen 300; 5mg/1; mg/1
(Hydrocodone-Acetaminophen)
   6437606480126
PDPs
204
MAPDs
Hydrocodone Bitartrate and Acetaminophen 300; 7.5mg/1; mg/1
(Hydrocodone-Acetaminophen)
   6437606490126
PDPs
209
MAPDs
Hydrocodone Acetaminophen 325; 10mg/1; mg/1 500 TABLET BOTTLE
(Hydrocodone-Acetaminophen)
500 TABLET in 1 BOTTLE  5374601100559
PDPs
341
MAPDs
Hydrocodone Bitartrate and Acetaminophen 325; 7.5mg/15mL; mg/15mL
(Hydrocodone-Acetaminophen)
   6437606401656
PDPs
290
MAPDs
JANUVIA TABLET 100MG (30 CT)
(Sitagliptin Phosphate)
30 BOT0000602773155
PDPs
334
MAPDs
JANUVIA 25MG TABLET
(Sitagliptin Phosphate)
30 BOT0000602213155
PDPs
334
MAPDs
JANUVIA 50MG TABLET
(Sitagliptin Phosphate)
90 BOT0000601125455
PDPs
334
MAPDs
LANTUS 100U/ML VIAL
(Insulin Glargine)
10 ML VIAL0008822203356
PDPs
337
MAPDs
LANTUS SOLOSTAR INJECTION
(Insulin Glargine)
3 ML X 5 CRTG CRTN 0008822190556
PDPs
334
MAPDs
Levothyroxine 100 mcg tablet
(Levothyroxine Sodium)
   0037818097759
PDPs
341
MAPDs
LEVOTHYROXINE 100 MCG VIAL
(Levothyroxine Sodium)
   6332306490712
PDPs
94
MAPDs
LEVOTHYROXINE 112 MCG TABLET
(Levothyroxine Sodium)
90.000 EA  0037818117759
PDPs
341
MAPDs
LEVOTHYROXINE 125 MCG TABLET
(Levothyroxine Sodium)
1000 EA  0037818131059
PDPs
341
MAPDs
LEVOTHYROXINE 137 MCG TABLET
(Levothyroxine Sodium)
1000 EA  0037818231059
PDPs
341
MAPDs
LEVOTHYROXINE 150 MCG TABLET
(Levothyroxine Sodium)
1000.000 EA  0037818151059
PDPs
341
MAPDs
LEVOTHYROXINE 175 MCG TABLET
(Levothyroxine Sodium)
1000 EA  0037818171059
PDPs
341
MAPDs
LEVOTHYROXINE 200 MCG TABLET
(Levothyroxine Sodium)
1000.000 EA  0037818191059
PDPs
341
MAPDs
Levothyroxine 25 mcg tablet
(Levothyroxine Sodium)
   0037818007759
PDPs
341
MAPDs
LEVOTHYROXINE 300 MCG TABLET
(Levothyroxine Sodium)
90 EA  0037818217759
PDPs
341
MAPDs
LEVOTHYROXINE 50 MCG TABLET
(Levothyroxine Sodium)
1000.000 EA  0037818031059
PDPs
341
MAPDs
LEVOTHYROXINE 75 MCG TABLET
(Levothyroxine Sodium)
1000 EA  0037818051059
PDPs
341
MAPDs
LEVOTHYROXINE 88 MCG TABLET
(Levothyroxine Sodium)
90.000 EA  0037818077759
PDPs
341
MAPDs
LEXAPRO 10MG TABLET
(Escitalopram Oxalate)
10 BOT004562010014
PDPs
9
MAPDs
LEXAPRO 20MG TABLET
(Escitalopram Oxalate)
100 TABLETS BOT004562020014
PDPs
9
MAPDs
LEXAPRO 5MG TABLET
(Escitalopram Oxalate)
100 BOT004562005014
PDPs
9
MAPDs
LIPITOR 10MG TABLET
(Atorvastatin Calcium)
90 BOT000710155237
PDPs
14
MAPDs
LIPITOR 20 MG TABLET
(Atorvastatin Calcium)
   000710156235
PDPs
12
MAPDs
LIPITOR 40MG TABLET (500 CT)
(Atorvastatin Calcium)
500 BOT000710157735
PDPs
12
MAPDs
LIPITOR 80MG TABLET
(Atorvastatin Calcium)
500 BOT000710158735
PDPs
12
MAPDs
LISINOPRIL 10MG TABLET (100 CT)
(Lisinopril)
100 BOT0017237596059
PDPs
341
MAPDs
Lisinopril with Hydrochlorothiazide 12.5; 10mg/1; mg/1 100 TABLET BOTTLE, PLASTIC
(Lisinopril)
100 TABLET in 1 BOTTLE, P  0014312620159
PDPs
341
MAPDs
Lisinopril with Hydrochlorothiazide 12.5; 20mg/1; mg/1 100 TABLET BOTTLE, PLASTIC
(Lisinopril)
100 TABLET in 1 BOTTLE, P  0014312630159
PDPs
341
MAPDs
LISINOPRIL 2.5 MG TABLET
(Lisinopril)
100 EA  0037820720159
PDPs
341
MAPDs
LISINOPRIL 20 MG TABLET
(Lisinopril)
1000 EA  0037820751059
PDPs
341
MAPDs
LISINOPRIL-HCTZ 20-25MG TABLET (100 CT)
(Lisinopril)
100 BOT6586200450159
PDPs
341
MAPDs
LISINOPRIL 30MG TABLET (100 CT)
(Lisinopril)
100 BOT0059108850159
PDPs
341
MAPDs
LISINOPRIL 40MG TABLET (500 CT)
(Lisinopril)
500 BOT0059104090559
PDPs
341
MAPDs
Lisinopril 5mg/1 1000 TABLET BOTTLE
(Lisinopril)
1000 TABLET in 1 BOTTLE  0060342103259
PDPs
341
MAPDs
MEMANTINE HCL 10 MG TABLET [Namenda]
(Memantine HCl)
500 EA  5511105970559
PDPs
341
MAPDs
MEMANTINE HCL 2 MG/ML SOLUTION [Namenda]
(Memantine HCl)
   0052719431358
PDPs
324
MAPDs
MEMANTINE HCL 5 MG TABLET [Namenda]
(Memantine HCl)
   5511105966059
PDPs
341
MAPDs
Metformin HCL ER tab 1000mg
(Metformin HCl)
   681800339095
PDPs
42
MAPDs
METFORMIN HCL 1,000 MG TABLET
(Metformin HCl)
500 EA  4354703595059
PDPs
341
MAPDs
METFORMIN ER 1,000 MG OSM-TAB
(Metformin HCl)
60 EA  0037860019117
PDPs
128
MAPDs
24 HR Metformin hydrochloride 500 MG Extended Release Oral Tablet
(Metformin HCl)
   0037860029121
PDPs
129
MAPDs
Metformin hcl 500 mg tablet
(Metformin HCl)
   2315501020559
PDPs
341
MAPDs
Metformin HCL ER tab 500mg
(Metformin HCl)
   681800338019
PDPs
51
MAPDs
METFORMIN HCL ER 500 MG TABLET
(Metformin HCl)
100 EA  6050502600159
PDPs
341
MAPDs
Metformin Hydrochloride 750mg/1
(Metformin HCl)
   6050513290159
PDPs
341
MAPDs
METFORMIN HYDROCHLORIDE 850mg/1 100 TABLET BOTTLE
(Metformin HCl)
100 TABLET in 1 BOTTLE  5766404355159
PDPs
341
MAPDs
Metoprolol Tartrate 1mg/mL 3 AMPULE in 1 CARTON / 5 mL in 1 AMPULE
(Metoprolol Tartrate)
3 AMPULE in 1 CARTON / 5  0040922850548
PDPs
281
MAPDs
METOPROLOL TARTRATE 100 MG TAB
(Metoprolol Tartrate)
1000 EA  0037800471059
PDPs
341
MAPDs
METOPROLOL TARTRATE 25MG TABLET (100 CT)
(Metoprolol Tartrate)
100 BOT6586200620159
PDPs
341
MAPDs
METOPROLOL TARTRATE INJ.USP 5MG/5ML CARPUJECT
(Metoprolol Tartrate)
   0040917783545
PDPs
245
MAPDs
METOPROLOL TARTRATE TABLET FILM COATED 50MG (1000 CT)
(Metoprolol Tartrate)
1000 BOT0037800321059
PDPs
341
MAPDs
NAMENDA XR TITRATION PACK
(Memantine HCl)
   0045634002947
PDPs
275
MAPDs
NAMENDA 10MG TABLET
(Memantine HCl)
60 BOT0045632106010
PDPs
65
MAPDs
NAMENDA XR 14 MG CAPSULE
(Memantine HCl)
30 EA  0045634143347
PDPs
273
MAPDs
NAMENDA XR 21 MG CAPSULE
(Memantine HCl)
   0045634213347
PDPs
273
MAPDs
NAMENDA XR 28 MG CAPSULE
(Memantine HCl)
   0045634289047
PDPs
273
MAPDs
NAMENDA 5MG TABLET
(Memantine HCl)
60 BOT0045632056010
PDPs
65
MAPDs
NAMENDA 5-10MG TITRATION PK
(Memantine HCl)
49 COUNT 0045632001410
PDPs
70
MAPDs
NAMENDA XR 7 MG CAPSULE
(Memantine HCl)
   0045634073347
PDPs
273
MAPDs
NEXIUM 10mg/1 30 GRANULE, DELAYED RELEASE per CARTON
(Esomeprazole Magnesium)
30 GRANULE, DELAYED RELEA  0018640100131
PDPs
118
MAPDs
NEXIUM 20MG SUSP FOR RECON DELAYED REL. IN A PACKET
(Esomeprazole Magnesium)
20 MG PKT X 30 PKT0018640200131
PDPs
120
MAPDs
NEXIUM 20MG CAPSULE
(Esomeprazole Magnesium)
90 BOT0018650205418
PDPs
15
MAPDs
NEXIUM DR 2.5 MG PACKET
(Esomeprazole Magnesium)
   0018640250132
PDPs
120
MAPDs
NEXIUM IV 40MG VIAL
(Esomeprazole Magnesium)
10 VIALSD001866040015
PDPs
18
MAPDs
NEXIUM 40MG SUSP FOR RECON DELAYED REL. IN A PACKET
(Esomeprazole Magnesium)
40 MG PKT X 30 PKT0018640400131
PDPs
120
MAPDs
NEXIUM 40MG CAPSULE
(Esomeprazole Magnesium)
90 BOT0018650405418
PDPs
15
MAPDs
NEXIUM DR 5 MG PACKET
(Esomeprazole Magnesium)
   0018640500132
PDPs
120
MAPDs
OMEPRAZOLE 10MG CAPSULE DELAYED RELEASE (30 CT)
(Omeprazole)
30 BOT0037852119359
PDPs
340
MAPDs
Omeprazole 20mg DELAYED RELEASE 100 CAPSULE BOTTLE
(Omeprazole)
100 CAPSULE BOTTLE  0037861500159
PDPs
341
MAPDs
OMEPRAZOLE-BICARB 20-1,100 CAP
(Omeprazole)
30 EA  167140508018
PDPs
62
MAPDs
Omeprazole-bicarb 20-1,680 pkt
(Omeprazole)
   272410029627
PDPs
64
MAPDs
OMEPRAZOLE CAPSULES DELAYED RELEASE 40 MG
(Omeprazole)
30 BOT6217501363259
PDPs
339
MAPDs
OMEPRAZOLE-BICARB 40-1,100 CAP
(Omeprazole)
30 EA  131070116308
PDPs
62
MAPDs
Omeprazole-bicarb 40-1,680 pkt
(Omeprazole)
   272410030627
PDPs
63
MAPDs
pioglitazone hcl 15 mg tablet [Actos]
(Pioglitazone HCL)
   0037800487759
PDPs
341
MAPDs
pioglitazone hcl 30 mg tablet [Actos]
(Pioglitazone HCL)
   0037802289359
PDPs
341
MAPDs
pioglitazone hcl 45 mg tablet [Actos]
(Pioglitazone HCL)
   0037803187759
PDPs
341
MAPDs
PLAVIX TABLETS 300MG
(Clopidogrel Bisulfate)
   636531332022
PDPs
6
MAPDs
PLAVIX 75 MG TABLET
(Clopidogrel Bisulfate)
90.000 EA  636531171015
PDPs
9
MAPDs
QUETIAPINE FUMARATE 100 MG TABLET [Seroquel]
(Quetiapine Fumarate)
100 EA  4733509048859
PDPs
341
MAPDs
24 HR Quetiapine 150 MG Extended Release Oral Tablet [Seroquel]
(Quetiapine Fumarate)
   0040611816044
PDPs
307
MAPDs
24 HR Quetiapine 200 MG Extended Release Oral Tablet [Seroquel]
(Quetiapine Fumarate)
   0040611826044
PDPs
307
MAPDs
QUETIAPINE FUMARATE 200 MG TABLET [Seroquel]
(Quetiapine Fumarate)
100 EA  4733509058859
PDPs
341
MAPDs
QUETIAPINE FUMARATE 25 MG TABLET [Seroquel]
(Quetiapine Fumarate)
100 EA  4733509028859
PDPs
341
MAPDs
24 HR Quetiapine 300 MG Extended Release Oral Tablet [Seroquel]
(Quetiapine Fumarate)
   5281701636044
PDPs
307
MAPDs
QUETIAPINE FUMARATE 300 MG TABLET [Seroquel]
(Quetiapine Fumarate)
100 EA  4733509068859
PDPs
341
MAPDs
QUETIAPINE FUMARATE 400 MG TABLET [Seroquel]
(Quetiapine Fumarate)
100 EA  4733509078859
PDPs
341
MAPDs
QUETIAPINE ER 400 MG TABLET [Seroquel]
(Quetiapine Fumarate)
60.000 EA  1672900971245
PDPs
307
MAPDs
24 HR Quetiapine 50 MG Extended Release Oral Tablet [Seroquel]
(Quetiapine Fumarate)
   0040611806044
PDPs
307
MAPDs
QUETIAPINE FUMARATE 50 MG TABLET [Seroquel]
(Quetiapine Fumarate)
100 EA  4733509038859
PDPs
341
MAPDs
REVLIMID 10MG CAPSULE (100 CT)
(Lenalidomide)
100 BOT5957204100059
PDPs
341
MAPDs
REVLIMID 15MG CAPSULE 21 BOT
(Lenalidomide)
21 BOT5957204152159
PDPs
341
MAPDs
REVLIMID 2.5 MG CAPSULE
(Lenalidomide)
100 EA  5957204020059
PDPs
341
MAPDs
REVLIMID 20 MG CAPSULE
(Lenalidomide)
100 EA  5957204200059
PDPs
341
MAPDs
REVLIMID 25MG CAPSULE (100 CT)
(Lenalidomide)
100 BOT5957204250059
PDPs
341
MAPDs
REVLIMID 5MG CAPSULE
(Lenalidomide)
100 BOT5957204050059
PDPs
341
MAPDs
RISEDRONATE SODIUM 35 MG TABLET [Actonel]
(Risedronate Sodium)
4 EA  4733506686826
PDPs
233
MAPDs
RISEDRONATE SODIUM 150 MG TABLET [Actonel]
(Risedronate Sodium)
   0037841503228
PDPs
257
MAPDs
RISEDRONATE SODIUM 30 MG TABLET [Actonel]
(Risedronate Sodium)
30 EA  0009331005629
PDPs
235
MAPDs
RISEDRONATE SODIUM 35 MG TABLET [Actonel]
(Risedronate Sodium)
   0009330984427
PDPs
219
MAPDs
RISEDRONATE SODIUM 35 MG TABLET [Actonel]
(Risedronate Sodium)
12 EA  0009330982927
PDPs
220
MAPDs
RISEDRONATE SODIUM DR 35 MG TABLET [Actonel]
(Risedronate Sodium)
4 EA  0009355094426
PDPs
165
MAPDs
RISEDRONATE SODIUM 5 MG TABLET [Actonel]
(Risedronate Sodium)
30 EA  0009330995628
PDPs
235
MAPDs
ROSUVASTATIN CALCIUM 10 MG TABLET [Crestor]
(Rosuvastatin Calcium)
90 EA  1625206169054
PDPs
331
MAPDs
ROSUVASTATIN CALCIUM 20 MG TABLET [Crestor]
(Rosuvastatin Calcium)
90 EA  1625206179054
PDPs
331
MAPDs
Rosuvastatin calcium 40 MG TABLET [Crestor]
(Rosuvastatin Calcium)
   1625206183054
PDPs
331
MAPDs
ROSUVASTATIN CALCIUM 5 MG TABLET [Crestor]
(Rosuvastatin Calcium)
90 EA  1625206159054
PDPs
331
MAPDs
SEROQUEL 100MG TABLET
(Quetiapine Fumarate)
100 BOT003100271104
PDPs
9
MAPDs
SEROQUEL 200MG TABLET
(Quetiapine Fumarate)
100 BOT003100272104
PDPs
9
MAPDs
SEROQUEL 25MG TABLET
(Quetiapine Fumarate)
100 BOT003100275104
PDPs
9
MAPDs
SEROQUEL 300MG TABLET
(Quetiapine Fumarate)
60 BOT003100274604
PDPs
9
MAPDs
SEROQUEL 400MG TABLET
(Quetiapine Fumarate)
100 BOT003100279104
PDPs
9
MAPDs
SEROQUEL 50MG TABLET (100 CT)
(Quetiapine Fumarate)
100 BOT003100278104
PDPs
9
MAPDs
SEROQUEL TABLETS EXTENDED RELEASE 150MG 100 CRTN
(Quetiapine Fumarate)
100 CRTN0031002813929
PDPs
151
MAPDs
SEROQUEL TABLETS EXTENDED RELEASE 200MG 100 X 200 MG CRTN
(Quetiapine Fumarate)
100 X 200 MG CRTN0031002823929
PDPs
152
MAPDs
SEROQUEL XR 300MG TABLET 60X300MG BOT
(Quetiapine Fumarate)
60 X 300 MG BOT0031002836029
PDPs
152
MAPDs
SEROQUEL TABLETS EXTENDED RELEASE 400MG 100 X 400 MG CRTN
(Quetiapine Fumarate)
100 X 400 MG CRTN0031002843929
PDPs
149
MAPDs
SEROQUEL TABLETS EXTENDED RELEASE 50MG 100 TABS CRTN
(Quetiapine Fumarate)
100 TABS CRTN0031002803929
PDPs
151
MAPDs
SPIRIVA RESPIMAT INHAL SPRAY
(Tiotropium Bromide Monohydrate)
4 GM  0059701006142
PDPs
279
MAPDs
VALSARTAN 160 MG TABLET [Diovan]
(Valsartan-Hydrochlorothiazide)
90 EA  5166001429059
PDPs
340
MAPDs
VALSARTAN 320 MG TABLET [Diovan]
(Valsartan-Hydrochlorothiazide)
90 EA  5166001439059
PDPs
340
MAPDs
VALSARTAN 40 MG TABLET [Diovan]
(Valsartan-Hydrochlorothiazide)
30 EA  5166001403059
PDPs
340
MAPDs
VALSARTAN 80 MG TABLET [Diovan]
(Valsartan-Hydrochlorothiazide)
90 EA  5166001419059
PDPs
340
MAPDs
VALSARTAN-HCTZ 160-12.5 MG TABLET [Diovan HCT]
(Valsartan-Hydrochlorothiazide)
500 EA  0037863220557
PDPs
335
MAPDs
VALSARTAN-HCTZ 160-25 MG TABLET [Diovan HCT]
(Valsartan-Hydrochlorothiazide)
90 EA  0037863237757
PDPs
335
MAPDs
VALSARTAN-HCTZ 320-12.5 MG TABLET [Diovan HCT]
(Valsartan-Hydrochlorothiazide)
500 EA  0037863240557
PDPs
335
MAPDs
VALSARTAN-HCTZ 320-25 MG TABLET [Diovan HCT]
(Valsartan-Hydrochlorothiazide)
500 EA  0037863250557
PDPs
335
MAPDs
VALSARTAN-HCTZ 80-12.5 MG TABLET [Diovan HCT]
(Valsartan-Hydrochlorothiazide)
90 EA  0037863217757
PDPs
335
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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  • 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.