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2019 Medicare Part D Formulary Search By Drug Letter

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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
 Packaging NDC On This Nbr of 2019 Formularies
PDPs MAPDs
ACTIGALL 300 MG CAPSULE
(Ursodiol)		 60 capsules   00023614501 2
PDPs		 8
MAPDs
ANORO ELLIPTA 62.5-25 MCG INH
(umeclidinium and vilanterol inhalation powder)		     00173086910 58
PDPs		 320
MAPDs
CARISOPRODOL-ASPIRIN-CODEIN TB
(Carisoprodol w/ Aspirin & Codeine)		 100.000 EA   64980017601 1
PDPs		 45
MAPDs
INCRUSE ELLIPTA 62.5 MCG INH
(Umeclidinium)		     00173087310 49
PDPs		 272
MAPDs
STELARA 45 MG/0.5 ML SYRINGE
(Ustekinumab)		 0.5ML   57894006003 17
PDPs		 165
MAPDs
STELARA 45 MG/0.5 ML VIAL
(Ustekinumab)		     57894006002 17
PDPs		 152
MAPDs
STELARA 90 MG/ML SYRINGE
(Ustekinumab)		 1ML   57894006103 17
PDPs		 165
MAPDs
TRAMADOL HCL ER 300 MG Tablet ER 24H [Ultram ER]
(TRAMADOL)		 30 tablets   68180069906 20
PDPs		 154
MAPDs
UCERIS 2 MG RECTAL FOAM FOAM/APPL
(Budesonide)		 66.8 grams   65649065103 2
PDPs		 144
MAPDs
UCERIS 9 MG ER TABLET
(budesonide)		     68012030930 0
PDPs		 21
MAPDs
UDENYCA 6 MG/0.6 ML SYRINGE
(Pegfilgrastim (E. coli))		 ml   70114010101 5
PDPs		 137
MAPDs
ULORIC TABLETS 40MG 30 BOT
(Febuxostat)		 30 BOT 64764091830 56
PDPs		 328
MAPDs
ULORIC TABLETS 80MG 30 BOT
(Febuxostat)		 30 BOT 64764067730 56
PDPs		 328
MAPDs
ULTRACET TABLET
(Tramadol-Acetaminophen)		 100.000 EA   50458065060 2
PDPs		 7
MAPDs
ULTRAM 50MG TABLETS
(Tramadol HCl)		 100 BOT 50458065960 2
PDPs		 7
MAPDs
ULTRAVATE 0.05 % 60 ML
(Halobetasol Propionate)		     10631012204 1
PDPs		 20
MAPDs
Ultravate 0.5mg/g 50 g in 1 TUBE
(Halobetasol Propionate)		 50 g in 1 TUBE   10631010250 2
PDPs		 7
MAPDs
Ultravate 0.5mg/g 50 g in 1 TUBE
(Halobetasol Propionate)		 50 g in 1 TUBE   10631010350 2
PDPs		 7
MAPDs
UNASYN 15GM VIAL
(Ampicillin & Sulbactam Sodium For)		 15 GM BOT 00049002428 0
PDPs		 4
MAPDs
UNASYN 3 GM VIAL
(Ampicillin, Sulbactam)		 mls   00049001481 1
PDPs		 5
MAPDs
UNITHROID 100 MCG TABLET
(Levothyroxine Sodium)		 100 EA   60846080501 59
PDPs		 297
MAPDs
UNITHROID 112 MCG TABLET
(Levothyroxine Sodium)		 100 EA   60846080601 60
PDPs		 297
MAPDs
UNITHROID 125 MCG TABLET
(Levothyroxine Sodium)		 100 EA   60846080701 59
PDPs		 297
MAPDs
UNITHROID 150 MCG TABLET
(Levothyroxine Sodium)		 100 EA   60846080901 59
PDPs		 292
MAPDs
UNITHROID 175 MCG TABLET
(Levothyroxine Sodium)		 100 EA   60846081001 59
PDPs		 297
MAPDs
UNITHROID 200 MCG TABLET
(Levothyroxine Sodium)		 100 EA   60846081101 59
PDPs		 297
MAPDs
UNITHROID 25 MCG TABLET
(Levothyroxine Sodium)		 100 EA   60846080101 59
PDPs		 297
MAPDs
UNITHROID 300 MCG TABLET
(Levothyroxine Sodium)		 100 EA   60846081201 59
PDPs		 297
MAPDs
UNITHROID 50 MCG TABLET
(Levothyroxine Sodium)		 100 EA   60846080201 59
PDPs		 297
MAPDs
UNITHROID 75 MCG TABLET
(Levothyroxine Sodium)		 100 EA   60846080301 59
PDPs		 297
MAPDs
UNITHROID 88 MCG TABLET
(Levothyroxine Sodium)		 100 EA   60846080401 59
PDPs		 292
MAPDs
UPTRAVI 1,000 MCG TABLET
(Selexipag)		     66215061006 33
PDPs		 247
MAPDs
UPTRAVI 1,200 MCG TABLET
(Selexipag)		     66215061206 33
PDPs		 247
MAPDs
UPTRAVI 1,400 MCG TABLET
(Selexipag)		     66215061406 33
PDPs		 247
MAPDs
UPTRAVI 1,600 MCG TABLET
(Selexipag)		     66215061606 33
PDPs		 247
MAPDs
UPTRAVI 200 MCG TABLET
(Selexipag)		     66215060214 33
PDPs		 247
MAPDs
UPTRAVI 200-800 TITRATION PACK
(Selexipag)		     66215062820 33
PDPs		 241
MAPDs
UPTRAVI 400 MCG TABLET
(Selexipag)		     66215060406 33
PDPs		 247
MAPDs
UPTRAVI 600 MCG TABLET
(Selexipag)		     66215060606 33
PDPs		 247
MAPDs
UPTRAVI 800 MCG TABLET
(Selexipag)		     66215060806 33
PDPs		 247
MAPDs
Urecholine 10mg/1 100 TABLET BOTTLE
(Bethanechol Chloride)		 100 TABLET BOTTLE   51285069002 0
PDPs		 4
MAPDs
Urecholine 25mg/1 100 TABLET BOTTLE
(Bethanechol Chloride)		 100 TABLET BOTTLE   51285069102 0
PDPs		 4
MAPDs
Urecholine 50mg/1 100 TABLET BOTTLE
(Bethanechol Chloride)		 100 TABLET BOTTLE   51285069202 0
PDPs		 4
MAPDs
Urecholine 5mg/1 100 TABLET BOTTLE
(Bethanechol Chloride)		 100 TABLET BOTTLE   51285069702 0
PDPs		 4
MAPDs
Urocit-K 10.000000meq/1 100 TABLET, EXTENDED RELEASE in 1 BOTTLE
(Potassium Citrate)		 100 TABLET, EXTENDED RELE   00178061001 0
PDPs		 7
MAPDs
Urocit-k 15.000000meq/1 100 TABLET, EXTENDED RELEASE in 1 BOTTLE
(Potassium Citrate)		 100 TABLET, EXTENDED RELE   00178061501 0
PDPs		 7
MAPDs
Urocit-K 5.0000000meq/1 100 TABLET, EXTENDED RELEASE in 1 BOTTLE
(Potassium Citrate)		 100 TABLET, EXTENDED RELE   00178060001 0
PDPs		 7
MAPDs
UROXATRAL 10 MG TABLET
(Alfuzosin HCl)		     59212020010 0
PDPs		 4
MAPDs
Urso 250 250mg/1
(Ursodiol)		     58914078510 0
PDPs		 5
MAPDs
URSO FORTE TABLETS 500MG 100 BOT
(Ursodiol)		 100 BOT 58914079010 0
PDPs		 5
MAPDs
URSODIOL 250 MG TABLET
(Ursodiol)		 100.000 EA   49884041201 62
PDPs		 350
MAPDs
URSODIOL 300 MG CAPSULE
(Ursodiol)		     42806050301 57
PDPs		 321
MAPDs
URSODIOL 500 MG TABLET
(Ursodiol)		 100.000 EA   49884041301 62
PDPs		 348
MAPDs
UTIBRON NEOHALER 27.5-15.6 MCG CAP W/DEV
(Indacaterol and glycopyrrolate)		 60 units   63402068160 1
PDPs		 23
MAPDs
XURIDEN GRANULE PACKET
(Uridine Triacetate)		     69468015202 10
PDPs		 114
MAPDs



(Chart Source: Centers for Medicare and Medicaid files: CMS Data September 2019)


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