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2020 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
Packaging NDC On This Nbr of 2020 Formularies
PDPs MAPDs
ACTIGALL 300 MG CAPSULE
(Ursodiol)
60 capsules   00023614501 3
PDPs
7
MAPDs
AMPICILLIN-SULBACTAM 15 GM VIAL [Unasyn]
(Ampicillin & Sulbactam Sodium For)
ml   67457064910 49
PDPs
324
MAPDs
AMPICILLIN-SULBACTAM 3 GM VIAL [Unasyn]
(Ampicillin & Sulbactam Sodium For)
ml   25021014330 67
PDPs
388
MAPDs
ANORO ELLIPTA 62.5-25 MCG INH
(umeclidinium and vilanterol inhalation powder)
    00173086910 65
PDPs
365
MAPDs
FEBUXOSTAT 40 MG TABLET [Uloric]
(Febuxostat)
30 TABLETS   62332019030 23
PDPs
257
MAPDs
FEBUXOSTAT 80 MG TABLET [Uloric]
(Febuxostat)
30 TABLETS   62332019130 25
PDPs
257
MAPDs
INCRUSE ELLIPTA 62.5 MCG INH
(Umeclidinium)
    00173087310 51
PDPs
300
MAPDs
METHENAMINE HIPP 1 GM TABLET [Urex]
(Methenamine)
60 tablets   65862078201 61
PDPs
371
MAPDs
MOEXIPRIL HCL 15 MG TABLET [Univasc]
(Moexipril HCl)
30 tablets   00093515001 53
PDPs
349
MAPDs
RINVOQ ER 15 MG TABLET ER 24H
(Upadacitinib)
TABLETs   00074230630 48
PDPs
301
MAPDs
STELARA 45 MG/0.5 ML SYRINGE
(Ustekinumab)
0.5ML   57894006003 64
PDPs
374
MAPDs
STELARA 45 MG/0.5 ML VIAL
(Ustekinumab)
    57894006002 58
PDPs
355
MAPDs
STELARA 90 MG/ML SYRINGE
(Ustekinumab)
1ML   57894006103 61
PDPs
385
MAPDs
TRAMADOL ER 300 MG TABLET TBMP 24HR [Ultram ER]
(Tramadol)
30 units   10370022311 11
PDPs
135
MAPDs
TRAMADOL HCL ER 300 MG Tablet ER 24H [Ultram ER]
(TRAMADOL)
30 tablets   68180069906 21
PDPs
174
MAPDs
UBRELVY 100 MG TABLET
(Ubrogepant)
10 TABLETS   00023650110 4
PDPs
26
MAPDs
UBRELVY 50 MG TABLET
(Ubrogepant)
10 TABLETS   00023649810 4
PDPs
26
MAPDs
UCERIS 2 MG RECTAL FOAM FOAM/APPL
(Budesonide)
66.8 grams   65649065103 1
PDPs
161
MAPDs
UCERIS 9 MG ER TABLET
(budesonide)
    68012030930 0
PDPs
8
MAPDs
UDENYCA 6 MG/0.6 ML SYRINGE
(Pegfilgrastim (E. coli))
ml   70114010101 20
PDPs
191
MAPDs
ULORIC TABLETS 40MG 30 BOT
(Febuxostat)
30 BOT 64764091830 12
PDPs
83
MAPDs
ULORIC TABLETS 80MG 30 BOT
(Febuxostat)
30 BOT 64764067730 14
PDPs
83
MAPDs
ULTRACET TABLET
(Tramadol-Acetaminophen)
100.000 EA   50458065060 3
PDPs
7
MAPDs
ULTRAM 50MG TABLETS
(Tramadol HCl)
100 BOT 50458065960 3
PDPs
7
MAPDs
ULTRAVATE 0.05 % 60 ML
(Halobetasol Propionate)
    10631012204 0
PDPs
8
MAPDs
UNASYN 15GM VIAL
(Ampicillin & Sulbactam Sodium For)
15 GM BOT 00049002428 0
PDPs
3
MAPDs
UNASYN 3 GM VIAL
(Ampicillin, Sulbactam)
ml   00049001483 0
PDPs
3
MAPDs
UNITHROID 100 MCG TABLET
(Levothyroxine Sodium)
100 EA   60846080501 62
PDPs
338
MAPDs
UNITHROID 112 MCG TABLET
(Levothyroxine Sodium)
100 EA   60846080601 62
PDPs
338
MAPDs
UNITHROID 125 MCG TABLET
(Levothyroxine Sodium)
100 EA   60846080701 62
PDPs
338
MAPDs
UNITHROID 150 MCG TABLET
(Levothyroxine Sodium)
100 EA   60846080901 62
PDPs
338
MAPDs
UNITHROID 175 MCG TABLET
(Levothyroxine Sodium)
100 EA   60846081001 62
PDPs
338
MAPDs
UNITHROID 200 MCG TABLET
(Levothyroxine Sodium)
100 EA   60846081101 62
PDPs
338
MAPDs
UNITHROID 25 MCG TABLET
(Levothyroxine Sodium)
100 EA   60846080101 62
PDPs
338
MAPDs
UNITHROID 300 MCG TABLET
(Levothyroxine Sodium)
100 EA   60846081201 62
PDPs
338
MAPDs
UNITHROID 50 MCG TABLET
(Levothyroxine Sodium)
100 EA   60846080201 62
PDPs
338
MAPDs
UNITHROID 75 MCG TABLET
(Levothyroxine Sodium)
100 EA   60846080301 62
PDPs
338
MAPDs
UNITHROID 88 MCG TABLET
(Levothyroxine Sodium)
100 EA   60846080401 62
PDPs
338
MAPDs
UPTRAVI 1,000 MCG TABLET
(Selexipag)
    66215061006 32
PDPs
285
MAPDs
UPTRAVI 1,200 MCG TABLET
(Selexipag)
    66215061206 32
PDPs
285
MAPDs
UPTRAVI 1,400 MCG TABLET
(Selexipag)
    66215061406 32
PDPs
285
MAPDs
UPTRAVI 1,600 MCG TABLET
(Selexipag)
    66215061606 32
PDPs
285
MAPDs
UPTRAVI 200 MCG TABLET
(Selexipag)
    66215060214 32
PDPs
285
MAPDs
UPTRAVI 200-800 TITRATION PACK
(Selexipag)
    66215062820 32
PDPs
279
MAPDs
UPTRAVI 400 MCG TABLET
(Selexipag)
    66215060406 32
PDPs
285
MAPDs
UPTRAVI 600 MCG TABLET
(Selexipag)
    66215060606 32
PDPs
285
MAPDs
UPTRAVI 800 MCG TABLET
(Selexipag)
    66215060806 32
PDPs
285
MAPDs
Urecholine 25mg/1 100 TABLET BOTTLE
(Bethanechol Chloride)
100 TABLET BOTTLE   51285069102 0
PDPs
5
MAPDs
Urecholine 50mg/1 100 TABLET BOTTLE
(Bethanechol Chloride)
100 TABLET BOTTLE   51285069202 0
PDPs
5
MAPDs
Urocit-K 10.000000meq/1 100 TABLET, EXTENDED RELEASE in 1 BOTTLE
(Potassium Citrate)
100 TABLET, EXTENDED RELE   00178061001 0
PDPs
6
MAPDs
Urocit-k 15.000000meq/1 100 TABLET, EXTENDED RELEASE in 1 BOTTLE
(Potassium Citrate)
100 TABLET, EXTENDED RELE   00178061501 0
PDPs
6
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
3
MAPDs
Urso 250 250mg/1
(Ursodiol)
    58914078510 0
PDPs
3
MAPDs
URSO FORTE TABLETS 500MG 100 BOT
(Ursodiol)
100 BOT 58914079010 0
PDPs
3
MAPDs
URSODIOL 250 MG TABLET
(Ursodiol)
100.000 EA   49884041201 67
PDPs
388
MAPDs
URSODIOL 300 MG CAPSULE [Actigall]
(Ursodiol)
60 capsules   00591315901 61
PDPs
363
MAPDs
URSODIOL 500 MG TABLET [Urso Forte]
(Ursodiol)
60 tablets   00591300501 67
PDPs
386
MAPDs
UTIBRON NEOHALER 27.5-15.6 MCG CAPSULE W/DEV
(Indacaterol and glycopyrrolate)
60 units   63402068160 0
PDPs
15
MAPDs
XURIDEN GRANULE PACKET
(Uridine Triacetate)
1 unit   69468015230 10
PDPs
127
MAPDs



(Chart Source: Centers for Medicare and Medicaid files: CMS Data June 2020)




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