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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 X 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
ALPRAZOLAM 0.25 MG TABLET [Xanax]
(Alprazolam)
30 tablets   00781106105 64
PDPs
372
MAPDs
ALPRAZOLAM ER 1 MG TABLET 24H [Xanax XR]
(Alprazolam)
30 tablets   65862045560 4
PDPs
160
MAPDs
ALPRAZOLAM ER 2 MG TABLET 24H [Xanax XR]
(Alprazolam)
30 tablets   65862045660 4
PDPs
158
MAPDs
ALPRAZOLAM ER 3 MG TABLET 24H [Xanax XR]
(Alprazolam)
30 tablets   65862045760 4
PDPs
158
MAPDs
BROMFENAC SODIUM 0.09% EYE DROPS [Xibrom]
(BROMFENAC SODIUM)
1.7 mls   50383024971 27
PDPs
279
MAPDs
HYDROCODONE-ACETAMIN 10-300 MG TABLET [Xodol]
(Hydrocodone Bitartrate, Acetaminophen)
60 tablets   43386035301 18
PDPs
210
MAPDs
HYDROCODONE-ACETAMIN 5-300 MG TABLET [Xodol]
(Hydrocodone Bitartrate, Acetaminophen)
12 tablets   43386035101 18
PDPs
208
MAPDs
HYDROCODONE-ACETAMIN 7.5-300 TABLET [Xodol]
(Hydrocodone Bitartrate, Acetaminophen)
12 tablets   43386035201 18
PDPs
212
MAPDs
LEVALBUTEROL 0.31 MG/3 ML SOL VIAL-NEB [Xopenex Pediatric]
(Levalbuterol Tartrate)
72 mls   00115993076 17
PDPs
271
MAPDs
LEVALBUTEROL 0.63 MG/3 ML SOL VIAL-NEB [Xopenex]
(Levalbuterol Tartrate)
72 mls   00115993176 17
PDPs
271
MAPDs
LEVALBUTEROL 1.25 MG/3 ML SOL VIAL-NEB [Xopenex]
(Levalbuterol Tartrate)
72 mls   00115993276 22
PDPs
290
MAPDs
LEVALBUTEROL TAR HFA 45MCG INH [Xopenex]
(Levalbuterol HCl)
15.000 GM   00591292754 28
PDPs
220
MAPDs
LEVOCETIRIZINE 5 MG TABLET [Xyzal Allergy 24 Hour]
(LEVOCETIRIZINE)
30 tablets   31722055190 67
PDPs
386
MAPDs
TETRABENAZINE 12.5 MG TABLET [XENAZINE]
(Tetrabenazine)
112 EA   47335027723 67
PDPs
386
MAPDs
TETRABENAZINE 25 MG TABLET [XENAZINE]
(Tetrabenazine)
112 EA   47335017923 67
PDPs
386
MAPDs
XALATAN EYE DROPS 125MCG 2.5ML BOTPL
(Latanoprost Ophth)
2.5 ML BOTPL 00013830304 0
PDPs
6
MAPDs
Xalkori 200mg/1 60 CAPSULE BOTTLE
(CRIZOTINIB)
60 CAPSULE in 1 BOTTLE   00069814120 67
PDPs
388
MAPDs
Xalkori 250mg/1 60 CAPSULE BOTTLE
(CRIZOTINIB)
60 CAPSULE in 1 BOTTLE   00069814020 67
PDPs
388
MAPDs
XANAX 0.25 MG TABLET
(Alprazolam)
100.000 EA   00009002901 0
PDPs
3
MAPDs
Xanax 0.5mg/1 100 TABLET BOTTLE
(Alprazolam)
100 TABLET in 1 BOTTLE   00009005501 0
PDPs
3
MAPDs
Xanax 1mg/1 100 TABLET BOTTLE
(Alprazolam)
100 TABLET in 1 BOTTLE   00009009001 0
PDPs
3
MAPDs
Xanax 2mg/1 100 TABLET BOTTLE
(Alprazolam)
100 TABLET in 1 BOTTLE   00009009401 0
PDPs
3
MAPDs
Xanax XR 0.5mg/1 60 TABLET, EXTENDED RELEASE in 1 BOTTLE
(Alprazolam)
60 TABLET in BOTTLE   00009005707 0
PDPs
3
MAPDs
Xanax XR 1mg/1 60 TABLET, EXTENDED RELEASE in 1 BOTTLE
(Alprazolam)
60 TABLET in BOTTLE   00009005907 0
PDPs
3
MAPDs
Xanax XR 2mg/1 60 TABLET, EXTENDED RELEASE in 1 BOTTLE
(Alprazolam)
60 TABLET in BOTTLE   00009006607 0
PDPs
3
MAPDs
Xanax XR 3mg/1 60 TABLET, EXTENDED RELEASE in 1 BOTTLE
(Alprazolam)
60 TABLET in BOTTLE   00009006807 0
PDPs
3
MAPDs
XARELTO 10 MG TABLET
(Rivaroxaban)
30.000 EA   50458058030 66
PDPs
383
MAPDs
XARELTO 15 MG TABLET
(Rivaroxaban)
30.000 EA   50458057830 66
PDPs
383
MAPDs
XARELTO 2.5 MG TABLET
(Rivaroxaban)
60 tablets   50458057760 66
PDPs
380
MAPDs
XARELTO 20 MG TABLET
(Rivaroxaban)
30.000 EA   50458057930 66
PDPs
383
MAPDs
XARELTO STARTER PACK
(Rivaroxaban)
51 EA   50458058451 66
PDPs
381
MAPDs
XATMEP 2.5 MG/ML ORAL SOLUTION
(Methotrexate)
120 ML   52652200101 67
PDPs
381
MAPDs
XELJANZ 10 MG TABLET
(Tofacitinib Citrate)
60 tablets   00069100201 67
PDPs
388
MAPDs
XELJANZ 5 MG TABLET
(Tofacitinib Citrate)
60 EA   00069100101 67
PDPs
388
MAPDs
XELJANZ XR 11 MG TABLET
(Tofacitinib Citrate)
    00069050130 43
PDPs
278
MAPDs
XELJANZ XR 22 MG TABLET ER 24H
(Tofacitinib Citrate)
TABLETS   00069050230 43
PDPs
275
MAPDs
XELPROS 0.005% EYE DROPS EMULS
()
mls   47335031790 0
PDPs
31
MAPDs
XENAZINE TABLET 25 MG
(Tetrabenazine)
112 BOT 67386042201 3
PDPs
20
MAPDs
XENAZINE TABLETS 12.5MG 112 BOT
(Tetrabenazine)
112 BOT 67386042101 3
PDPs
20
MAPDs
XENLETA 600 MG TABLET
(Lefamulin)
tablets   72000011030 5
PDPs
53
MAPDs
XEPI 1% CREAM (g)
(Ozenoxacin)
grams   70363001130 0
PDPs
18
MAPDs
XERESE 5%-1% CREAM
(acyclovir and hydrocortisone topical)
5 GM   00187510401 0
PDPs
42
MAPDs
XERMELO 250 MG TABLET
(Telotristat Ethyl)
    70183012584 9
PDPs
123
MAPDs
XGEVA 120mg/1.7mL 1 VIAL, SINGLE-USE per CARTON / 1.7 mL in 1 VIAL, SINGLE-USE
(DENOSUMAB)
1 VIAL, SINGLE-USE   55513073001 67
PDPs
362
MAPDs
XHANCE 93 MCG NASAL SPRAY AER BR.ACT
(Fluticasone Propionate)
16 mls   71143037501 0
PDPs
50
MAPDs
XIFAXAN 200MG TABLET
(Rifaximin)
30 BOT 65649030103 20
PDPs
251
MAPDs
XIFAXAN 550 MG TABLET
(Rifaximin)
60.000 EA   65649030302 59
PDPs
376
MAPDs
XIGDUO XR 10 MG-1,000 MG TAB
(Dapagliflozin and Metformin Hydrochloride)
30 EA   00310628030 35
PDPs
188
MAPDs
XIGDUO XR 10 MG-500 MG TABLET
(Dapagliflozin and Metformin Hydrochloride)
30 EA   00310627030 35
PDPs
188
MAPDs
XIGDUO XR 2.5 MG-1,000 MG TABLET
(Dapagliflozin and Metformin Hydrochloride)
60   00310622560 35
PDPs
188
MAPDs
XIGDUO XR 5 MG-1,000 MG TABLET
(Dapagliflozin and Metformin Hydrochloride)
60 EA   00310626060 35
PDPs
188
MAPDs
XIGDUO XR 5 MG-500 MG TABLET
(Dapagliflozin and Metformin Hydrochloride)
30 EA   00310625030 35
PDPs
188
MAPDs
XIIDRA 5% EYE DROPS
(Lifitegrast)
60.000 EA   54092060601 14
PDPs
126
MAPDs
XOFLUZA 20 MG TABLET (40 MG DOSE)
(Baloxavir)
2 tablets   50242082802 42
PDPs
273
MAPDs
XOFLUZA 40 MG TABLET (80 MG DOSE)
(Baloxavir)
2 tablets   50242086002 42
PDPs
268
MAPDs
XOLAIR 150 MG/ML SYRINGE
(Omalizumab (Hamster))
2 mls   50242021501 61
PDPs
365
MAPDs
XOLAIR 150MG VIAL
(Omalizumab For)
1 X VIAL 50242004062 67
PDPs
388
MAPDs
XOLAIR 75 MG/0.5 ML SYRINGE
(Omalizumab (Hamster))
ml   50242021401 61
PDPs
365
MAPDs
XOLEGEL 2% GEL
(Ketoconazole)
45 GRAMS   16110008045 0
PDPs
1
MAPDs
XOPENEX 0.31 MG/3 ML SOLUTION
(Levalbuterol HCl)
3 ML   17478017224 2
PDPs
18
MAPDs
XOPENEX 0.63 MG/3 ML SOLUTION
(Levalbuterol HCl)
    17478017324 2
PDPs
18
MAPDs
XOPENEX 1.25 MG/3 ML SOLUTION
(Levalbuterol HCl)
    17478017424 2
PDPs
18
MAPDs
XOPENEX CONC 1.25 MG/0.5 ML
(Levalbuterol HCl)
    17478017130 2
PDPs
18
MAPDs
XOPENEX HFA 45MCG HFA AEROSOL WITH ADAPTER
(Levalbuterol Tartrate)
200 INHALATIONS BOX 63402051001 13
PDPs
55
MAPDs
XOSPATA 40 MG TABLET
(Gilteritinib)
tablets   00469142590 67
PDPs
388
MAPDs
XPOVIO 100 MG ONCE WEEKLY DOSE TABLET
(Selinexor)
5 TABLETS   72237010105 67
PDPs
388
MAPDs
XPOVIO 60 MG ONCE WEEKLY DOSE TABLET
(Selinexor)
3 TABLETS   72237010101 67
PDPs
388
MAPDs
XPOVIO 80 MG ONCE WEEKLY DOSE TABLET
(Selinexor)
4 TABLETS   72237010102 67
PDPs
388
MAPDs
XPOVIO 80 MG TWICE WEEKLY DOSE TABLET
(Selinexor)
8 TABLETS   72237010104 67
PDPs
388
MAPDs
XTAMPZA ER 13.5 MG CAPSULE
(Oxycodone)
    24510011510 18
PDPs
169
MAPDs
XTAMPZA ER 18 MG CAPSULE
(Oxycodone)
    24510012010 18
PDPs
169
MAPDs
XTAMPZA ER 27 MG CAPSULE
(Oxycodone)
    24510013010 18
PDPs
169
MAPDs
XTAMPZA ER 36 MG CAPSULE
(Oxycodone)
    24510014010 18
PDPs
169
MAPDs
XTAMPZA ER 9 MG CAPSULE
(Oxycodone)
    24510011010 18
PDPs
169
MAPDs
XTANDI 40 MG CAPSULE
(enzalutamide)
    00469012599 67
PDPs
388
MAPDs
Xulane Patch
(norelgestromin / ethinyl estradiol)
    00378334053 31
PDPs
263
MAPDs
XULTOPHY 100 UNIT-3.6MG/ML PEN
(Insulin Degludec and Liraglutide)
3 ML   00169291115 26
PDPs
242
MAPDs
XURIDEN GRANULE PACKET
(Uridine Triacetate)
1 unit   69468015230 10
PDPs
127
MAPDs
XYOSTED 100 MG/0.5 ML AUTO-INJECT
(Testosterone Enanthate)
2 mls   54436020004 0
PDPs
44
MAPDs
XYOSTED 50 MG/0.5 ML AUTO INJCT
(Testosterone Enanthate)
mls   54436025002 0
PDPs
44
MAPDs
XYOSTED 75 MG/0.5 ML AUTO-INJECT
(Testosterone Enanthate)
2 mls   54436027504 0
PDPs
44
MAPDs
XYREM 500MG/ML ORAL SOLUTION
(Sodium Oxybate Oral)
180 ML BOT 68727010001 67
PDPs
388
MAPDs



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




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