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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:
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Drug Names Containing the Letter G 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
AMARYL 1MG TABLET
(Glimepiride)
100 BOT 00039022110 0
PDPs
1
MAPDs
AMARYL 2MG TABLET
(Glimepiride)
100 BOT 00039022210 0
PDPs
1
MAPDs
AMARYL 4MG TABLET
(Glimepiride)
100 BOT 00039022310 0
PDPs
1
MAPDs
BAQSIMI 3 MG SPRAY ONE PACK
(Glucagon)
2 UNITS   00002614511 17
PDPs
174
MAPDs
BEVESPI AEROSPHERE INHALER
(Glycopyrrolate and formoterol fumarate)
10.700 GM   00310460012 14
PDPs
129
MAPDs
BREZTRI AEROSPHERE INHALER HFA AER AD
(Budesonide, Glycopyrrolate, Formoterol)
10.7 GRAMS   00310461612 26
PDPs
296
MAPDs
COPAXONE 20MG/ML 30 BLISTER PACK IN 1 CRTN
(Glatiramer Acetate)
    68546031730 24
PDPs
134
MAPDs
COPAXONE 40 MG/ML SYRINGE
(Glatiramer Acetate)
1 ML   68546032512 24
PDPs
135
MAPDs
CROMOLYN 100 MG/5 ML ORAL CONC [Gastrocrom]
(Cromolyn )
480 MLS   42571013252 38
PDPs
350
MAPDs
CUVPOSA 1 MG/5 ML SOLUTION
(Glycopyrrolate)
    00259050116 0
PDPs
46
MAPDs
DARTISLA ODT 1.7 MG TABLET RAPDIS
(Glycopyrrolate)
UNITS   82111051801 0
PDPs
2
MAPDs
DAURISMO 100 MG TABLET
(Glasdegib)
tablets   00069153130 38
PDPs
350
MAPDs
DAURISMO 25 MG TABLET
(Glasdegib)
tablets   00069029860 38
PDPs
350
MAPDs
EMGALITY 120 MG/ML PEN INJCTR
(Galcanezumab)
1 ml   00002143611 24
PDPs
247
MAPDs
EMGALITY 120 MG/ML SYRINGE
(Galcanezumab)
1 ml   00002237711 20
PDPs
246
MAPDs
EMGALITY 300 MG (100 MG X3SYR) SYRINGE
(Galcanezumab)
3 mls   00002311509 11
PDPs
175
MAPDs
ENDARI 5 GRAM POWDER PACKET
(Glutamine Powder (For Sickle Cell Disease))
UNITS   42457042001 12
PDPs
227
MAPDs
ESTRADIOL VALERATE 100 MG/5 ML VIAL [Gynogen LA]
()
5 MLS   00517042001 30
PDPs
281
MAPDs
GABAPENTIN 100 MG CAPSULE [Neurontin]
()
90 CAPSULES   67877022210 38
PDPs
350
MAPDs
GABAPENTIN 250 MG/5 ML SOLUTION [Neurontin]
()
30 MLS   42192060816 38
PDPs
350
MAPDs
GABAPENTIN 300 MG CAPSULE [Neurontin]
()
90 CAPSULES   67877022310 38
PDPs
350
MAPDs
GABAPENTIN 400 MG CAPSULE [Neurontin]
(Gabapentin)
90 capsules   67877022405 38
PDPs
350
MAPDs
GABAPENTIN 600 MG TABLET
(Gabapentin)
500.000 EA   68462012605 38
PDPs
350
MAPDs
GABAPENTIN 800 MG TABLET
(Gabapentin)
500.000 EA   68462012705 38
PDPs
350
MAPDs
GABITRIL 12 MG TABLET
(Tiagabine HCl)
30 EA   63459041230 0
PDPs
2
MAPDs
GABITRIL 16mg/1
(Tiagabine HCl)
    63459041630 0
PDPs
2
MAPDs
GABITRIL 2mg/1
(Tiagabine HCl)
    63459040230 0
PDPs
2
MAPDs
GABITRIL 4mg/1
(Tiagabine HCl)
    63459040430 0
PDPs
2
MAPDs
GALAFOLD 123 MG CAPSULE
(Migalastat)
capsules   71904010001 7
PDPs
163
MAPDs
GALANTAMINE 4 MG/ML ORAL SOLUTION
(Galantamine Hydrobromide)
100 mL in 1 BOTTLE   00054013749 38
PDPs
330
MAPDs
GALANTAMINE ER 16 MG CAPSULE 24H PEL [Reminyl]
()
30 UNITS   65862074530 38
PDPs
342
MAPDs
GALANTAMINE ER 24 MG CAPSULE 24H PEL [Reminyl]
()
30 UNITS   65862074630 38
PDPs
342
MAPDs
GALANTAMINE ER 8 MG CAPSULE 24H PEL [Reminyl]
()
30 UNITS   65862074430 38
PDPs
342
MAPDs
GALANTAMINE HBR 12 MG TABLET [Reminyl]
()
180 TABLETS   57237005160 38
PDPs
343
MAPDs
GALANTAMINE HBR 4 MG TABLET [Reminyl]
()
60 tablets   57237004960 38
PDPs
343
MAPDs
GALANTAMINE HBR 8 MG TABLET [Reminyl]
()
60 TABLETS   57237005060 38
PDPs
343
MAPDs
GAMMAGARD LIQUID 10% VIAL
(Immune Globulin (Human) IV)
1 BOTTLE, GLASS in CARTON   00944270003 10
PDPs
277
MAPDs
GAMMAGARD S-D 10 G (IGA<1) SOLUTION
(Immune Globulin (Human) IV)
    00944265804 12
PDPs
274
MAPDs
GAMMAGARD S-D 5 G (IGA<1) SOLUTION
(Immune Globulin (Human) IV)
    00944265603 16
PDPs
274
MAPDs
GAMMAKED 1 GRAM/10 ML VIAL
(Immune Globulin)
10 ML   76125090001 13
PDPs
219
MAPDs
GAMMAPLEX 10 GRAM/100 ML VIAL
(immune globulin)
    64208823506 13
PDPs
256
MAPDs
GAMMAPLEX 10 GRAM/200 ML VIAL
(immune globulin)
100 MLS   64208823403 13
PDPs
260
MAPDs
GAMMAPLEX 20 GRAM/200 ML VIAL
(immune globulin)
    64208823507 13
PDPs
257
MAPDs
GAMMAPLEX 5 GRAM/50 ML VIAL
(immune globulin)
    64208823505 13
PDPs
257
MAPDs
Gamunex-C 10g/100mL 10 mL in 1 VIAL, GLASS
(Immune Globulin (Human) IV)
10 mL in 1 VIAL, GLASS   13533080012 17
PDPs
286
MAPDs
GARDASIL 9 SYRINGE
(Quadrivalent Human Papillomavirus (HPV) Recombinant Vac)
    00006412102 38
PDPs
350
MAPDs
GARDASIL 9 VIAL
(Quadrivalent Human Papillomavirus (HPV) Recombinant Vac)
    00006411903 38
PDPs
350
MAPDs
GASTROCROM 100 MG/5 ML CONC
(Cromolyn Sodium Oral)
    00037067896 0
PDPs
1
MAPDs
GATIFLOXACIN 0.5% EYE DROPS [Zymaxid]
()
2.5 MLS   60758061525 21
PDPs
293
MAPDs
GATTEX 5 MG 30-VIAL KIT
(teduglutide)
1.000 EA   68875010201 34
PDPs
347
MAPDs
GAVILYTE-C SOLUTION
(Polyethylene Glycol 3350 Oral)
278.26 g in 1 BOTTLE   43386006019 38
PDPs
346
MAPDs
GAVILYTE-G SOLUTION
(Polyethylene Glycol 3350 Oral)
274.31 g in 1 BOTTLE   43386009019 33
PDPs
336
MAPDs
GAVILYTE-N SOLUTION
(Polyethylene Glycol 3350 Oral)
438.4 g in 1 BOTTLE   43386005019 38
PDPs
347
MAPDs
GAVRETO 100 MG CAPSULE
(Pralsetinib)
60 CAPSULES   50242021060 38
PDPs
350
MAPDs
GELNIQUE 10% GEL SACHET PACKET
(Oxybutynin Chloride)
GRAM   00023586111 1
PDPs
21
MAPDs
GEMFIBROZIL 600 MG TABLET
(Gemfibrozil)
500 EA   69097082112 38
PDPs
350
MAPDs
GEMMILY 1 MG-20 MCG CAPSULE [Taytulla]
(Ethinyl Estradiol, Norethindrone;Ferrous Fumarate)
28 CAPSULES   70700015285 3
PDPs
31
MAPDs
GEMTESA 75 MG TABLET
(Vibegron)
30 TABLETS   73336007530 6
PDPs
28
MAPDs
GENERESS FE CHEWABLE TABLET
(norethindrone and ethinyl estradiol and ferrous fumarate)
28 chewable tablets   00023603003 0
PDPs
3
MAPDs
GENERLAC 10 GM/15 ML SOLUTION
(Lactulose (Encephalopathy))
473.000 ML   60432003816 38
PDPs
346
MAPDs
GENGRAF 100 MG CAPSULE
(Cyclosporine Modified)
30 EA   00074310932 38
PDPs
344
MAPDs
GENGRAF 100MG/ML SOLUTION
(Cyclosporine Modified)
50 ML BOTGL 00074726950 38
PDPs
345
MAPDs
GENGRAF 25 MG CAPSULE
(Cyclosporine Modified)
30 EA   00074310832 38
PDPs
344
MAPDs
GENOTROPIN 13.8MG CARTRIDGE
(Somatropin For)
1 X 13.8 MG CTG 00013264681 18
PDPs
184
MAPDs
GENOTROPIN 5 MG CARTRIDGE
(Somatropin For)
1 PKGCOM 00013262681 18
PDPs
182
MAPDs
GENOTROPIN MINIQUICK 0.2MG
(Somatropin For)
7 X 0.2 MG VIALPAT 00013264902 18
PDPs
179
MAPDs
GENOTROPIN MINIQUICK 0.4MG
(Somatropin For)
7 X 0.4 MG VIALPAT 00013265002 18
PDPs
181
MAPDs
GENOTROPIN MINIQUICK 0.6MG
(Somatropin For)
7 X 0.6 MG VIALPAT 00013265102 18
PDPs
181
MAPDs
GENOTROPIN MINIQUICK 0.8MG
(Somatropin For)
7 X 0.8 MG VIALPAT 00013265202 18
PDPs
181
MAPDs
GENOTROPIN MINIQUICK 1.2MG
(Somatropin For)
7 VIALPAT 00013265402 18
PDPs
184
MAPDs
GENOTROPIN MINIQUICK 1.4MG
(Somatropin For)
7 VIALPAT 00013265502 18
PDPs
184
MAPDs
GENOTROPIN MINIQUICK 1.6MG
(Somatropin For)
7 VIALPAT 00013265602 18
PDPs
184
MAPDs
GENOTROPIN MINIQUICK 1.8MG
(Somatropin For)
7 VIALPAT 00013265702 18
PDPs
184
MAPDs
GENOTROPIN MINIQUICK 1MG
(Somatropin For)
7 X 1.0 MG VIALPAT 00013265302 18
PDPs
184
MAPDs
GENOTROPIN MINIQUICK 2MG
(Somatropin For)
7 X 2.0 MG VIALPAT 00013265802 18
PDPs
184
MAPDs
GENTAK 3MG/GM EYE OINTMENT
(Gentamicin Sulfate Ophth)
3.5 GM TUBE 17478028435 38
PDPs
333
MAPDs
GENTAMICIN 3 MG/ML EYE DROPS
(Gentamicin Sulfate Ophth)
5 ML   60758018805 38
PDPs
345
MAPDs
Gentamicin Sulfate 40mg/mL 25 VIAL, SINGLE-DOSE in 1 TRAY / 2 mL in 1 VIAL, SINGLE-DOSE
(Gentamicin Sulfate)
25 VIAL, SINGLE-DOSE   00409120703 38
PDPs
346
MAPDs
GENTAMICIN SULFATE CREAM USP 0.1% 15GM TUBE
(Gentamicin Sulfate)
15 GM TUBE 45802005635 38
PDPs
350
MAPDs
Gentamicin Sulfate in Sodium Chloride 60mg/50mL 50 mL in 1 BAG
(Gentamicin Sulfate)
50 mL in 1 BAG   00338050741 24
PDPs
272
MAPDs
GENTAMICIN SULFATE OINTMENT USP 0.1% 15GM TUBE
(Gentamicin Sulfate)
15 GM TUBE 45802004635 38
PDPs
350
MAPDs
GENVOYA TABLET
(Elvitegravir, Cobicistat, Emtricitabine, and Tenofovir Alafenamide Fumarate)
    61958190101 38
PDPs
350
MAPDs
GEODON 20 MG CAPSULE
(Ziprasidone HCl)
30 CAPSULES   00049035260 0
PDPs
1
MAPDs
GEODON 20MG VIAL
(Ziprasidone HCl)
1 VIAL VIALSD 00049392083 1
PDPs
8
MAPDs
GEODON 40 MG CAPSULE
(Ziprasidone)
60 capsules   00049005460 0
PDPs
1
MAPDs
GEODON 60 MG CAPSULE
(Ziprasidone HCl)
60 CAPSULES   00049035660 0
PDPs
1
MAPDs
GEODON 80 MG CAPSULE
(Ziprasidone HCl)
30 CAPSULES   00049035860 0
PDPs
1
MAPDs
GILENYA 0.5 MG CAPSULE
(FINGOLIMOD HCL)
30 EA   00078060715 35
PDPs
345
MAPDs
GILOTRIF 20 MG TABLET
(afatinib)
30 EA   00597014130 38
PDPs
350
MAPDs
GILOTRIF 30 MG TABLET
(afatinib)
30 EA   00597013730 38
PDPs
350
MAPDs
GILOTRIF 40 MG TABLET
(afatinib)
30 EA   00597013830 38
PDPs
350
MAPDs
GIMOTI 15 MG NASAL SPRAY SPRAY/PUMP
(Metoclopramide)
MLS   72089030715 0
PDPs
8
MAPDs
GLASSIA 1g/50mL 1 VIAL, GLASS per CARTON / 50 mL in 1 VIAL, GLASS
(ALPHA-1-PROTEINASE INHIBITOR (HUMAN))
1 VIAL, GLASS in 1 CARTON   00944288401 2
PDPs
96
MAPDs
GLATIRAMER 20 MG/ML SYRINGE [Glatopa]
(Glatiramer)
mls   00378696093 17
PDPs
298
MAPDs
GLATIRAMER 40 MG/ML SYRINGE [Copaxone]
(Glatiramer Acetate)
1 ML   00378696112 17
PDPs
296
MAPDs
Glatopa 20 mg/ml syringe
(Glatiramer Acetate)
    00781323434 13
PDPs
264
MAPDs
GLATOPA 40 MG/ML SYRINGE
(Glatiramer)
12 mls   00781325089 13
PDPs
266
MAPDs
GLEEVEC 100MG TABLET (90 CT)
(Imatinib Mesylate)
90 BOT 00078040134 0
PDPs
3
MAPDs
GLEEVEC 400 MG TABLET
(Imatinib Mesylate)
30 EA   00078064930 0
PDPs
3
MAPDs
GLIMEPIRIDE 1 MG TABLET [Amaryl]
()
90 TABLETS   55111032001 38
PDPs
350
MAPDs
GLIMEPIRIDE 2 MG TABLET [Amaryl]
()
90 TABLETS   55111032101 38
PDPs
350
MAPDs
GLIMEPIRIDE 4 MG TABLET [Amaryl]
()
90 TABLETS   55111032201 38
PDPs
350
MAPDs
GLIPIZIDE 10 MG TABLET
(Glipizide)
1000.000 EA   60505014201 38
PDPs
350
MAPDs
GLIPIZIDE 5 MG TABLET
(Glipizide)
1000.000 EA   60505014101 38
PDPs
350
MAPDs
GLIPIZIDE ER 10 MG TABLET ER 24 [Glucotrol XL]
()
90 UNITS   64980028101 38
PDPs
350
MAPDs
GLIPIZIDE ER 2.5MG TABLET SR OSMOTIC PUSH 24HR
(Glipizide)
30 BOTPL 00591090030 38
PDPs
350
MAPDs
GLIPIZIDE ER 5 MG TABLET ER 24 [Glucotrol XL]
()
90 UNITS   64980028005 38
PDPs
350
MAPDs
GLIPIZIDE-METFORMIN 2.5-250 MG TABLET [Metaglip]
(Glipizide, Metformin Hydrochloride)
30 TABLETS   68382018401 38
PDPs
349
MAPDs
GLIPIZIDE-METFORMIN 2.5-500 MG TABLET [Metaglip]
(Glipizide, Metformin Hydrochloride)
60 TABLETS   68382018501 38
PDPs
349
MAPDs
GLIPIZIDE-METFORMIN 5-500 MG TABLET [Metaglip]
(Glipizide, Metformin Hydrochloride)
60 TABLETS   68382018601 38
PDPs
349
MAPDs
GLOPERBA 0.6 MG/5 ML SOLUTION
(Colchicine)
150 MLS   75854080101 0
PDPs
5
MAPDs
GLUCAGEN 1MG HYPOKIT
(Glucagon HCl (rDNA) For)
1 X 1 MG PKGCOM 00169706515 20
PDPs
182
MAPDs
GLUCAGON 1MG EMERGENCY KIT
(Glucagon (rDNA) For)
1 KIT PKGCOM 00002803101 17
PDPs
180
MAPDs
Glucose 50 MG/ML / Potassium Chloride 0.02 MEQ/ML / Sodium Chloride 0.154 MEQ/ML Injectable Solution
()
    00338080304 30
PDPs
279
MAPDs
GLUCOTROL XL 10 MG TABLET
(Glipizide)
100.000 EA   00049017807 0
PDPs
1
MAPDs
GLUCOTROL XL 2.5 MG TABLET
(Glipizide)
30 EA 00049017001 0
PDPs
1
MAPDs
GLUCOTROL XL 5 MG TABLET ER 24
(Glipizide)
    00049017402 0
PDPs
1
MAPDs
GLUMETZA ER 1,000 MG TABLETERGR24H
(Metformin Hydrochloride)
30 UNITS   68012000316 0
PDPs
1
MAPDs
GLUMETZA ER 500 MG TABLETERGR24H
(Metformin Hydrochloride)
30 units   68012000450 0
PDPs
1
MAPDs
GLYBURID-METFORMIN 1.25-250 MG [Glucovance]
(Glyburide-Metformin)
100.000 EA   65862008001 13
PDPs
195
MAPDs
GLYBURIDE 1.25MG TABLETS
(Glyburide)
100 TABLETS BOT 00093834201 17
PDPs
179
MAPDs
GLYBURIDE 2.5MG TABLET (100 CT)
(Glyburide)
100 TABLETS BOT 00093834301 17
PDPs
179
MAPDs
GLYBURIDE 5 MG TABLET [Micronase]
()
30 TABLETS   23155005810 17
PDPs
179
MAPDs
GLYBURIDE MICRO 1.5 MG TABLET [Glynase PresTab]
(Glyburide)
20 TABLETS   00093803401 11
PDPs
162
MAPDs
GLYBURIDE MICRO 3 MG TABLET [Glynase PresTab]
(Glyburide)
90 TABLETS   00093803501 11
PDPs
162
MAPDs
GLYBURIDE MICRO 6 MG TABLET [Glynase PresTab]
(Glyburide)
60 TABLETS   00093803601 11
PDPs
162
MAPDs
GLYBURIDE-METFORMIN 2.5-500 MG
(Glyburide)
100.000 EA   65862008101 13
PDPs
195
MAPDs
GLYBURIDE-METFORMIN 5-500 MG
(Glyburide)
100.000 EA   65862008201 13
PDPs
195
MAPDs
GLYCOPYRROLATE 1 MG TABLET [Robinul]
(Glycopyrrolate)
60 TABLETS   23155060601 38
PDPs
349
MAPDs
GLYCOPYRROLATE 1 MG/5 ML SOLUTION [Cuvposa]
()
350 MLS   49884004233 0
PDPs
79
MAPDs
GLYCOPYRROLATE 2 MG TABLET [Robinul Forte]
()
60 TABLETS   23155060701 38
PDPs
349
MAPDs
GLYXAMBI 10 MG-5 MG TABLET
(Empagliflozin and Linagliptin)
    00597018230 29
PDPs
284
MAPDs
GLYXAMBI 25 MG-5 MG TABLET
(Empagliflozin and Linagliptin)
    00597016430 29
PDPs
284
MAPDs
GOCOVRI ER 137 MG CAPSULE
(Amantadine)
    70482017060 2
PDPs
15
MAPDs
GOCOVRI ER 68.5 MG CAPSULE
(Amantadine)
    70482008560 2
PDPs
15
MAPDs
GOLYTELY SOLUTION 236 GM/2.97 GM/6 GM
(PEG 3350-KCl-Na Bicarb-NaCl-Na Sulfate For)
4 L BOT 52268010001 11
PDPs
110
MAPDs
GONITRO 0.4 MG SUBLINGUAL PWD POWDER PACK
(Nitroglycerin)
1 UNIT   28595070536 0
PDPs
4
MAPDs
GRALISE ER 300 MG TABLET ER 24H
(Gabapentin)
90 TABLETS   52427080390 4
PDPs
58
MAPDs
GRALISE ER 600 MG TABLET ER 24H
(Gabapentin)
90 TABLETS   52427080690 4
PDPs
58
MAPDs
GRANISETRON HCL 1 MG TABLET [Kytril]
()
30 TABLETS   51991073520 28
PDPs
331
MAPDs
GRANIX 300 MCG/0.5 ML SYRINGE
(Tbo-Filgrastim)
5 mls   63459091017 1
PDPs
65
MAPDs
GRANIX 300 MCG/ML VIAL
(tbo-filgrastim)
MLS   63459091859 1
PDPs
66
MAPDs
GRANIX 480 MCG/0.8 ML SYRINGE
(Tbo-Filgrastim)
5.6 mls   63459091217 1
PDPs
65
MAPDs
GRANIX 480 MCG/1.6 ML VIAL
(tbo-filgrastim)
MLS   63459092059 1
PDPs
66
MAPDs
GRASTEK 2,800 BAU SUBLIGUAL TABLET
(timothy grass pollen allergen extract)
TABLETS   52709150103 1
PDPs
19
MAPDs
GRISEOFULVIN 125 MG/5 ML ORAL SUSPENSION [Grifulvin V]
(Griseofulvin Microsize)
240 MLS   00472001304 38
PDPs
346
MAPDs
GRISEOFULVIN MICRO 500 MG TABLET
(Griseofulvin Microsize)
100 EA   00781551501 35
PDPs
329
MAPDs
GRISEOFULVIN ULTRA 125 MG TABLET [Gris-Peg]
(Griseofulvin, Ultramicrocrystalline)
84 tablets   00115172401 37
PDPs
305
MAPDs
GRISEOFULVIN ULTRA 250 MG TABLET [Gris-Peg]
(Griseofulvin, Ultramicrocrystalline)
30 tablets   00115172501 37
PDPs
305
MAPDs
GUANFACINE 1 MG TABLET [Tenex]
(Guanfacine HCl)
30 TABLETS   65162071110 24
PDPs
280
MAPDs
GUANFACINE 2 MG TABLET
(Guanfacine HCl)
100.000 EA   65162071310 24
PDPs
280
MAPDs
GUANFACINE HCL ER 1 MG TABLET ER 24H [Intuniv]
()
30 TABLETS   24979053301 28
PDPs
312
MAPDs
GUANFACINE HCL ER 2 MG TABLET ER 24H [Intuniv]
()
30 TABLETS   24979053401 28
PDPs
312
MAPDs
GUANFACINE HCL ER 3 MG TABLET ER 24H [Intuniv]
()
30 TABLETS   60505392901 28
PDPs
312
MAPDs
GUANFACINE HCL ER 4 MG TABLET ER 24H [Intuniv]
()
30 TABLETS   24979053801 30
PDPs
312
MAPDs
GVOKE HYPOPEN 2-PK 1 MG/0.2 ML AUTO INJECTOR
(Glucagon)
0.4 ML   72065012112 29
PDPs
278
MAPDs
GVOKE HYPOPEN 2PK 0.5MG/0.1 ML AUTO INJECTOR
(Glucagon)
0.1 ML   72065012012 29
PDPs
276
MAPDs
GVOKE PFS 1-PK 1 MG/0.2 ML SYRINGE
(Glucagon)
0.2 ML   72065013111 29
PDPs
277
MAPDs
GVOKE PFS 1PK 0.5MG/0.1 ML SYRINGE
(Glucagon)
ML   72065013011 29
PDPs
275
MAPDs
GYNAZOLE-1 2% CREAM
(Butoconazole Nitrate (One Dose) Vaginal)
5 GM   45802039601 0
PDPs
9
MAPDs
HORIZANT ER 300 MG TABLET
(GABAPENTIN ENACARBIL)
    53451010301 1
PDPs
7
MAPDs
HORIZANT ER 600 MG TABLET
(GABAPENTIN ENACARBIL)
    53451010101 1
PDPs
7
MAPDs
IMATINIB MESYLATE 100 MG TABLET [Gleevec]
()
90 TABLETS   00093762998 38
PDPs
350
MAPDs
IMATINIB MESYLATE 400 MG TABLET [Gleevec]
()
30 tablets   00093763056 38
PDPs
350
MAPDs
IRESSA 250 MG TABLET
(Gefitinib)
30 EA   00310048230 38
PDPs
350
MAPDs
ISOTON GENTAMICIN 80MG/100ML
(Gentamicin in Saline)
100 ML BAG 00338050348 28
PDPs
276
MAPDs
ISOTONIC GENTAMICIN 100 MG/100 ML
(Gentamicin in Saline)
100 ML   00338050548 24
PDPs
274
MAPDs
ISOTONIC GENTAMICIN 80 MG/50 ML
(Gentamicin in Saline)
50 ML   00338050941 24
PDPs
272
MAPDs
LACTULOSE 10 GM/15 ML SOLUTION [Generlac]
()
237 MLS   00121087316 38
PDPs
350
MAPDs
LONHALA MAGNAIR 25 MCG REFILL VIAL-NEB
(Glycopyrrolate)
mls   63402030101 1
PDPs
61
MAPDs
LOPID 600 MG TABLET
(Gemfibrozil)
60 EA   00071073720 0
PDPs
1
MAPDs
MAVYRET 100-40 MG TABLET
(Glecaprevir and Pibrentasvir)
84 EA   00074262528 22
PDPs
265
MAPDs
MAVYRET 50-20 MG PELLET PACKET
(Glecaprevir and Pibrentasvir)
UNITS   00074260028 22
PDPs
237
MAPDs
METFORMIN ER 1,000 MG GASTR-TB TABERGR24H [Glumetza]
(Metformin Hydrochloride)
180 units   68682001890 0
PDPs
4
MAPDs
METFORMIN ER 500 MG GASTRC-TB TABERGR24H [Glumetza]
(Metformin Hydrochloride)
90 UNITS   68682002150 1
PDPs
11
MAPDs
METFORMIN ER 500 MG OSMOTIC TABLET ER 24 [Glumetza]
(Metformin HCl)
30 UNITS   50742063360 3
PDPs
15
MAPDs
METFORMIN HCL 850 MG TABLET [Glucophage]
(Metformin Hydrochloride)
180 TABLETS   65862000905 38
PDPs
350
MAPDs
METFORMIN HCL ER 750 MG TABLET ER 24H [Glucophage XR]
(Metformin Hydrochloride)
60 TABLETS   62756014301 38
PDPs
350
MAPDs
MIGLITOL 100 MG TABLET [Glyset]
(Miglitol)
    57664068688 3
PDPs
169
MAPDs
MIGLITOL 25 MG TABLET [Glyset]
(Miglitol)
    57664068488 3
PDPs
172
MAPDs
MIGLITOL 50 MG TABLET [Glyset]
(Miglitol)
    57664068588 3
PDPs
169
MAPDs
NEOMYCIN/POLYMY/GRAM EYE DROPS 0.025MG/ML 1.75MG/M
(Neomycin-Polymyxin B-Gramicidin Ophth)
10 ML BOT 24208079062 38
PDPs
347
MAPDs
NEURONTIN 100MG CAPSULE
(Gabapentin)
100 BOT 00071080324 0
PDPs
1
MAPDs
NEURONTIN 250 MG/5 ML SOLUTION
(Gabapentin)
60 MLS   00071201244 0
PDPs
1
MAPDs
NEURONTIN 300MG CAPSULE
(Gabapentin)
100 BOT 00071080524 0
PDPs
1
MAPDs
NEURONTIN 400MG CAPSULE
(Gabapentin)
100 BOT 00071080624 0
PDPs
1
MAPDs
NEURONTIN 600MG TABLET
(Gabapentin)
100 BOT 00071051324 0
PDPs
1
MAPDs
NEURONTIN 800MG TABLET
(Gabapentin)
100 BOT 00071040124 0
PDPs
1
MAPDs
ORALAIR 300 IR SUBLINGUAL TAB
(Grass Pollen Allergen Extract)
30 EA   59617001502 1
PDPs
17
MAPDs
PIOGLITAZONE-GLIMEPIRIDE 30-2 TABLET [Duetact]
(Pioglitazone, Glimepiride)
tablets   66993082130 3
PDPs
102
MAPDs
PIOGLITAZONE-GLIMEPIRIDE 30-4 Tablet [Duetact]
(Pioglitazone, Glimepiride)
30 tablets   66993082230 3
PDPs
102
MAPDs
PRED G OPHTHALMIC SUSPENSION 1;0.3%;% 5 ML BOTDR
(Gentamicin-Prednisolone Ace Ophth)
5 ML BOTDR 00023010605 4
PDPs
106
MAPDs
PRED-G S.O.P. EYE OINTMENT
(Gentamicin-Prednisolone Ace Ophth)
3.5 GM TUBE 00023006604 4
PDPs
83
MAPDs
QBREXZA 2.4% CLOTH TOWELETTE
(Glycopyrronium)
30 units   70428001112 0
PDPs
17
MAPDs
RAVICTI 1.1 GRAM/ML LIQUID
(Glycerol Phenylbutyrate)
25 ML   75987005006 13
PDPs
236
MAPDs
RAZADYNE ER 16MG CAPSULE
(Galantamine Hydrobromide)
30 CAPSULES BOT 50458038830 0
PDPs
1
MAPDs
RAZADYNE ER 24MG CAPSULE
(Galantamine Hydrobromide)
30 CAPSULES BOT 50458038930 0
PDPs
1
MAPDs
RAZADYNE ER 8MG CAPSULE
(Galantamine Hydrobromide)
30 CAPSULES BOT 50458038730 0
PDPs
1
MAPDs
SANCUSO TRANSDERMAL SYSTEM 3.1MG/24HRS 1 PATCH CRTN
(Granisetron Transdermal)
1 PATCH CRTN 42747072601 9
PDPs
95
MAPDs
SIMPONI 100 MG/ML PEN INJECTOR
(Golimumab Subcutaneous)
1 ML   57894007102 1
PDPs
80
MAPDs
SIMPONI 100 MG/ML SYRINGE
(Golimumab Subcutaneous)
1 ML   57894007101 1
PDPs
76
MAPDs
SIMPONI 50 MG/0.5 ML PEN INJEC
(Golimumab Subcutaneous)
0.5 ML   57894007002 1
PDPs
77
MAPDs
SIMPONI GOLIMUMAB INJECTION 50MG/0.5ML 1 50 MG SINGLE DOSE SYR SYR
(Golimumab Subcutaneous)
1 50 MG SINGLE DOSE SYR SYR 57894007001 1
PDPs
80
MAPDs
TIAGABINE HCL 12 MG TABLET [Gabitril]
()
30 tablets   00093807256 38
PDPs
350
MAPDs
TIAGABINE HCL 16 MG TABLET [Gabitril]
()
tablets   00093807656 38
PDPs
350
MAPDs
TIAGABINE HCL 2 MG TABLET [Gabitril]
()
60 TABLETS   00093503056 38
PDPs
350
MAPDs
TIAGABINE HCL 4 MG TABLET [Gabitril]
()
30 tablets   00093503156 38
PDPs
350
MAPDs
TREMFYA 100 MG/ML AUTOINJECTOR
(Guselkumab)
ml   57894064011 1
PDPs
128
MAPDs
TREMFYA 100 MG/ML SYRINGE
(Guselkumab)
    57894064001 1
PDPs
128
MAPDs
XOSPATA 40 MG TABLET
(Gilteritinib)
tablets   00469142590 38
PDPs
350
MAPDs
ZIPRASIDONE 20 MG/ML VIAL [Geodon]
()
1 ML   43598084858 38
PDPs
350
MAPDs
ZIPRASIDONE HCL 20 MG CAPSULE [Geodon]
(Ziprasidone HCl)
60.000 EA   55111025660 38
PDPs
350
MAPDs
ZIPRASIDONE HCL 40 MG CAPSULE [Geodon]
(Ziprasidone HCl)
60.000 EA   55111025760 38
PDPs
350
MAPDs
ZIPRASIDONE HCL 60 MG CAPSULE [Geodon]
(Ziprasidone HCl)
    55111025860 38
PDPs
350
MAPDs
ZIPRASIDONE HCL 80 MG CAPSULE [Geodon]
(Ziprasidone HCl)
60.000 EA   55111025960 38
PDPs
350
MAPDs
ZIRGAN 1.5mg/g 1 TUBE, WITH APPLICATOR per CARTON / 5 g in 1 TUBE, WITH APPLICATOR
(Ganciclovir Ophth)
1 TUBE, WITH APPLICATOR   24208053535 38
PDPs
340
MAPDs
ZYMAXID 5mg/mL 1 BOTTLE, DROPPER per CARTON / 2.5 mL in 1 BOTTLE, DROPPER
(Gatifloxacin Ophth)
1 BOTTLE, DROPPER   00023361525 0
PDPs
1
MAPDs



(Chart Source: Centers for Medicare and Medicaid files: CMS Data May 2022)




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.
  • We are an independent education, research, and technology company. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. We are not compensated for Medicare plan enrollments. We do not sell leads or share your personal information.
  • 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.