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2022 Medicare Part D Formulary Search By Drug Letter

Select a Letter below:
Links to Summaries by State for LTC Drugs on LIS/SNP Plans:
AK  AL  AR  AZ  CA  CO  CT  DC  DE  FL  GA  HI  IA  ID  IL  IN  KS  KY  LA  MA  MD  ME  MI  MN  MO  MS  MT  NC  ND  NE  NH  NJ  NM  NV  NY  OH  OK  OR  PA  PR  RI  SC  SD  TN  TX  UT  VA  VT  WA  WI  WV  WY

Drug Names Containing the Letter 9 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 2022 Formularies
PDPs MAPDs
ACETAMINOPHEN-COD #3 TABLET [Tylenol with Codeine No.3]
(Acetaminophen w/ Codeine)
20 tablets   00406048410 63
PDPs
402
MAPDs
HYDROCODONE-IBUPROFEN 10-200 TABLET [Xylon 10]
(Hydrocodone Bitartrate, Ibuprofen)
30 TABLETS   53746011701 16
PDPs
208
MAPDs
IBU 800 MG TABLET [Samson-8]
(Ibuprofen)
30 tablets   55111068405 63
PDPs
392
MAPDs
IBUPROFEN 800 MG TABLET [Samson-8]
(Ibuprofen)
30 TABLETS   64380080707 63
PDPs
402
MAPDs
KLOR-CON 20 MEQ PACKET
(Potassium Chloride Microencapsulated Crys CR)
    00245036030 28
PDPs
260
MAPDs
KLOR-CON 8 MEQ TABLET [Slow-K]
(Potassium Chloride)
90 TABLETS   00245531515 62
PDPs
341
MAPDs
KLOR-CON M10 MEQ TABLET [Klotrix]
()
30 TABLETS   00245531615 62
PDPs
344
MAPDs
KLOR-CON M15 TABLET ER PRT
(Potassium Chloride)
30 UNITS   00245531811 60
PDPs
387
MAPDs
KLOR-CON M20 TABLET ER PRT
(Potassium Chloride)
30 UNITS   00245531990 63
PDPs
393
MAPDs
Methoxsalen 10 mg Capsule [8-MOP]
(Methoxsalen)
    64380075216 23
PDPs
273
MAPDs
ODACTRA 12 SQ-HDM SUBLIGUAL TABLET
(Dermatophagoides farinae, Dermatophagoides pteronyssinus)
30 TABLETS   52709170103 1
PDPs
18
MAPDs
Orencia 4 SYRINGE, GLASS in 1 CARTON > 0.4 mL in 1 SYRINGE, GLASS
(Abatacept For IV)
    00003281411 26
PDPs
191
MAPDs
Orencia 4 SYRINGE, GLASS in 1 CARTON > 0.7 mL in 1 SYRINGE, GLASS
(Abatacept For IV)
    00003281811 26
PDPs
191
MAPDs
POTASSIUM CL ER 15 MEQ TABLET ER PRT [Klor-Con M15]
(Potassium Chloride Microencapsulated Crys CR)
60 UNITS   72865019505 58
PDPs
378
MAPDs
PREDNISOLONE 20 MG/5 ML SOLUTION [Veripred-20]
(Prednisolone)
50 mls   69101041001 7
PDPs
152
MAPDs
SULFACETAMIDE 10% EYE DROPS [Sulf-10]
(Sulfacetamide)
15 mls   61314070101 63
PDPs
402
MAPDs



(Chart Source: Centers for Medicare and Medicaid files: CMS Data November 2021)




Tips & Disclaimers
  • The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change.
  • Medicare has neither reviewed nor endorsed the information on our site.
  • We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227.
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  • Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Our PDP-Compare.com and MA-Compare.com provide highlights of annual plan benefit changes.
  • The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
  • Limitations, copayments, and restrictions may apply.
  • We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
  • 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.