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2022 Medicare Part D Formulary Search By Drug Letter

This is archive material for research purposes. Please see PDPFinder.com or MAFinder.com for current plans.
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

Top Medicare Drugs (Long List) in Alphabetical Order

Drug Name
Packaging NDC On This Nbr of 2022 Formularies
PDPs MAPDs
ABILIFY 10MG TABLET
(Aripiprazole)
30 BOT 59148000813 2
PDPs
2
MAPDs
ABILIFY 15MG TABLET
(Aripiprazole)
30 BOT 59148000913 2
PDPs
2
MAPDs
ABILIFY 20MG TABLET
(Aripiprazole)
30 BOT 59148001013 2
PDPs
2
MAPDs
ABILIFY 2MG TABLET
(Aripiprazole)
30 BOX 59148000613 2
PDPs
2
MAPDs
ABILIFY 30MG TABLET
(Aripiprazole)
30 BOT 59148001113 2
PDPs
2
MAPDs
ABILIFY 5 MG TABLET
(Aripiprazole)
30 tablets BOT 59148000713 2
PDPs
2
MAPDs
ACTIQ 400MCG LOZENGE
(Fentanyl Citrate)
30 BOT 63459050430 0
PDPs
6
MAPDs
ACTONEL 150 MG TABLET
(Risedronate)
1 tablet   00430047801 2
PDPs
1
MAPDs
ACTONEL 35 MG TABLET
(Risedronate)
4 tablets   00430047203 2
PDPs
1
MAPDs
ACTOS 15 MG TABLET
(Pioglitazone HCL)
    64764015104 2
PDPs
3
MAPDs
ACTOS 30 MG TABLET
(Pioglitazone HCL)
    64764030114 2
PDPs
3
MAPDs
ACTOS 45 MG TABLET
(Pioglitazone HCL)
    64764045124 2
PDPs
3
MAPDs
ADDERALL XR 20MG CAPSULE SA
(Amphetamine-Dextroamphetamine)
100 BOT 54092038701 2
PDPs
1
MAPDs
ADVAIR DISKUS MIS 100/50
(Fluticasone-Salmeterol)
60 DOSE INHL 00173069500 52
PDPs
303
MAPDs
ADVAIR DISKUS MIS 250/50
(Fluticasone-Salmeterol)
60 DOSE BLPK 00173069600 52
PDPs
303
MAPDs
ADVAIR DISKUS MIS 500/50
(Fluticasone-Salmeterol)
60 BLPK 00173069700 52
PDPs
303
MAPDs
ALTACE 10MG CAPSULE (100 CT)
(Ramipril)
100 CAPS BOTPL 61570012001 2
PDPs
3
MAPDs
ARICEPT 10MG TABLET
(Donepezil HCL)
30 BOT 62856024630 2
PDPs
1
MAPDs
ARIPIPRAZOLE 1 MG/ML SOLUTION [Abilify]
(Aripiprazole)
60 MLS   54838057059 63
PDPs
404
MAPDs
ARIPIPRAZOLE 10 MG TABLET [Abilify]
(Aripiprazole)
30 tablets   13668021830 63
PDPs
404
MAPDs
ARIPIPRAZOLE 15 MG TABLET [Abilify]
(Aripiprazole)
30 TABLETS   13668021930 63
PDPs
404
MAPDs
ARIPIPRAZOLE 2 MG TABLET [Abilify]
(Aripiprazole)
30 tablets   13668021630 63
PDPs
404
MAPDs
ARIPIPRAZOLE 20 MG TABLET [Abilify]
(Aripiprazole)
30 tablets   13668022030 63
PDPs
404
MAPDs
ARIPIPRAZOLE 30 MG TABLET [Abilify]
(Aripiprazole)
30 TABLETS   13668022130 63
PDPs
404
MAPDs
ARIPIPRAZOLE 5 MG TABLET [Abilify]
(Aripiprazole)
30 tablets   13668021730 63
PDPs
404
MAPDs
ARIPIPRAZOLE ODT 10 MG TABLET RAPDIS [Abilify Discmelt]
(Aripiprazole)
30 units   62332010330 63
PDPs
404
MAPDs
ARIPIPRAZOLE ODT 15 MG TABLET RAPDIS [Abilify Discmelt]
(Aripiprazole)
units   62332010430 63
PDPs
401
MAPDs
ATORVASTATIN 10 MG TABLET [Lipitor]
(Atorvastatin Calcium)
1000.000 EA   60505257808 63
PDPs
404
MAPDs
ATORVASTATIN 20 MG TABLET [Lipitor]
(Atorvastatin Calcium)
1000.000 EA   60505257908 63
PDPs
404
MAPDs
ATORVASTATIN 40 MG TABLET [Lipitor]
(Atorvastatin Calcium)
1000 EA   60505258008 63
PDPs
404
MAPDs
ATORVASTATIN 80 MG TABLET [Lipitor]
(Atorvastatin Calcium)
30 tablets   60505267108 63
PDPs
404
MAPDs
CLOPIDOGREL 75 MG TABLET [Plavix]
(Clopidogrel)
30 TABLETS   16729021816 63
PDPs
404
MAPDs
CRESTOR 10 MG TABLET
(Rosuvastatin Calcium)
30 TABLETS   00310757090 2
PDPs
1
MAPDs
CRESTOR 20 MG TABLET
(Rosuvastatin Calcium)
90 TABLETS   00310758090 2
PDPs
1
MAPDs
CRESTOR 40 MG TABLET
(Rosuvastatin Calcium)
90 TABLETS   00310759030 2
PDPs
1
MAPDs
CRESTOR 5 MG TABLET
(Rosuvastatin Calcium)
90 TABLETS   00310756090 2
PDPs
1
MAPDs
CYMBALTA 20MG CAPSULE
(Duloxetine HCl Enteric Coated Pellets)
60 BOT 00002323560 2
PDPs
1
MAPDs
CYMBALTA 60 MG CAPSULE
(Duloxetine HCl Enteric Coated Pellets)
30.000 EA   00002327030 2
PDPs
1
MAPDs
CYMBALTA CAPSULES DELAYED RELEASE 30MG (30 CT)
(Duloxetine HCl Enteric Coated Pellets)
30 BOT 00002324030 2
PDPs
1
MAPDs
DIOVAN 160MG TABLET
(Valsartan)
90 BOT 00078035934 2
PDPs
3
MAPDs
DIOVAN 320MG TABLET
(Valsartan)
90 BOT 00078036034 2
PDPs
3
MAPDs
DIOVAN 40MG TABLET
(Valsartan)
30 BOT 00078042315 2
PDPs
3
MAPDs
DIOVAN 80MG TABLET
(Valsartan)
90 BOX 00078035834 2
PDPs
3
MAPDs
DIOVAN HCT 160/12.5MG TABLET
(Valsartan)
90 BOT 00078031534 2
PDPs
3
MAPDs
DIOVAN HCT 160/25MG TABLET
(Valsartan)
90 BOT 00078038334 2
PDPs
3
MAPDs
DIOVAN HCT 320/12.5MG TABLET
(Valsartan)
90 BOT 00078047134 2
PDPs
3
MAPDs
DIOVAN HCT 320/25MG TABLET
(Valsartan)
90 BOT 00078047234 2
PDPs
3
MAPDs
DIOVAN HCT 80/12.5MG TABLET
(Valsartan)
90 BOT 00078031434 2
PDPs
3
MAPDs
DULOXETINE HCL DR 20 MG CAPSULE [Cymbalta]
(Duloxetine)
30 units   57237001760 63
PDPs
404
MAPDs
DULOXETINE HCL DR 40 MG CAPSULE [Irenka]
(Duloxetine)
30 units   68180029706 12
PDPs
164
MAPDs
ENDOCET 5/325 TABLET
(Oxycodone w/ Acetaminophen)
500 BOT 60951060285 63
PDPs
372
MAPDs
ESCITALOPRAM 10 MG TABLET [Lexapro]
(Escitalopram)
30 TABLETS   43547028111 63
PDPs
404
MAPDs
ESCITALOPRAM 20 MG TABLET [Lexapro]
(Escitalopram)
30 TABLETS   43547028211 63
PDPs
404
MAPDs
ESCITALOPRAM 5 MG TABLET [Lexapro]
(Escitalopram)
30 TABLETS   43547028010 63
PDPs
404
MAPDs
ESCITALOPRAM OXALATE 5 MG/5 ML SOLUTION [Lexapro]
(Escitalopram)
300 MLS   54838055170 63
PDPs
404
MAPDs
ESOMEPRAZOLE DR 10 MG SUSPDR PACKET [Nexium]
(Esomeprazole)
30 UNITS   69097052734 9
PDPs
74
MAPDs
ESOMEPRAZOLE DR 20 MG SUSPDR PACKET [Nexium]
(Esomeprazole)
30 UNITS   69097052834 9
PDPs
74
MAPDs
ESOMEPRAZOLE DR 40 MG SUSPDR PACKET [Nexium]
(Esomeprazole)
30 UNITS   69097052934 9
PDPs
74
MAPDs
ESOMEPRAZOLE MAG DR 40 MG CAPSULE DR [Nexium]
()
30 UNITS   65862078430 45
PDPs
380
MAPDs
FEMARA 2.5MG TABLET
(Letrozole)
30 BOT 00078024915 2
PDPs
2
MAPDs
FENTORA TABLET 100MCG
(Fentanyl Citrate)
28 BLPK 63459054128 1
PDPs
40
MAPDs
FLOVENT HFA 110ug/1 120 AEROSOL, METERED in 1 INHALER
(Fluticasone Propionate HFA)
120 AEROSOL, METERED   00173071920 58
PDPs
375
MAPDs
FOCALIN XR 5 MG CAPSULE
(Dexmethylphenidate HCl)
100 BOT 00078043005 0
PDPs
1
MAPDs
FUROSEMIDE 10 MG/ML SOLUTION
(Furosemide)
60.000 ML   00054329446 59
PDPs
398
MAPDs
FUROSEMIDE 100 MG/10 ML VIAL
(Furosemide)
3 MLS   36000028425 63
PDPs
403
MAPDs
Furosemide 10mg/mL 10 CARTON in 1 CONTAINER / 1 SYRINGE, PLASTIC in 1 CARTON / 4 mL in 1 SYRINGE, P
(Furosemide)
10 CARTON in 1 CONTAINER   00409963104 63
PDPs
388
MAPDs
FUROSEMIDE 20 MG TABLET [Lasix]
(Furosemide)
90 TABLETS   00904717761 63
PDPs
404
MAPDs
FUROSEMIDE 40 MG TABLET [Lasix]
(Furosemide)
30 TABLETS   69315011710 63
PDPs
404
MAPDs
FUROSEMIDE 40MG/5ML TUBEX
(Furosemide)
500 ML BOT 00054329863 39
PDPs
361
MAPDs
FUROSEMIDE 80 MG TABLET [Lasix]
(Furosemide)
30 TABLETS   43547040350 63
PDPs
404
MAPDs
Humira 2 KIT per CARTON / 1 KIT in 1 KIT
(Adalimumab)
2 KIT in 1 CARTON / 1 KIT   00074379902 63
PDPs
404
MAPDs
HUMIRA 40 MG/0.8 ML PEN
(ADALIMUMAB)
2 EA   00074433902 63
PDPs
401
MAPDs
HUMULIN 70/30 VIAL
(Insulin Isophane & Regular (Human))
1 X 10 ML VIAL 00002871501 42
PDPs
164
MAPDs
HUMULIN N 100U/ML VIAL
(Insulin Isophane (Human))
10 ML VIAL 00002831501 42
PDPs
164
MAPDs
HYDROCODON-ACETAMINOPH 7.5-325
(Hydrocodone-Acetaminophen)
100.000 EA   00406012401 63
PDPs
404
MAPDs
HYDROCODON-ACETAMINOPHEN 5-325
(Hydrocodone-Acetaminophen)
100.000 EA   00406012301 63
PDPs
404
MAPDs
HYDROCODONE-ACETAMN 7.5-325/15 SOLUTION [Hycet]
(Hydrocodone Bitartrate, Acetaminophen)
473 MLS   66689002316 59
PDPs
376
MAPDs
ISENTRESS 400MG TABLET
(Raltegravir Potassium)
60 BOT 00006022761 63
PDPs
404
MAPDs
JANUVIA 25MG TABLET
(Sitagliptin Phosphate)
30 BOT 00006022131 59
PDPs
339
MAPDs
JANUVIA 50 MG TABLET
(Sitagliptin Phosphate)
30.000 EA   00006011231 59
PDPs
339
MAPDs
JANUVIA TABLET 100MG (30 CT)
(Sitagliptin Phosphate)
30 BOT 00006027731 59
PDPs
339
MAPDs
KALETRA 50-200MG TABLET
(Lopinavir-Ritonavir)
120 BOT 00074679922 21
PDPs
85
MAPDs
KEPPRA 500MG TABLET
(Levetiracetam)
120 TABS BOT 50474059540 2
PDPs
1
MAPDs
LAMICTAL 100MG TABLET
(Lamotrigine)
100 BOT 00173064255 2
PDPs
1
MAPDs
LANTUS 100U/ML VIAL
(Insulin Glargine)
10 ML VIAL 00088222033 53
PDPs
318
MAPDs
LANTUS SOLOSTAR INJECTION
(Insulin Glargine)
3 ML X 5 CRTG CRTN 00088221905 53
PDPs
318
MAPDs
LENALIDOMIDE 10 MG CAPSULE [Revlimid]
()
28 CAPSULES   00480124328 61
PDPs
392
MAPDs
LENALIDOMIDE 15 MG CAPSULE [Revlimid]
()
21 CAPSULES   00480124421 61
PDPs
392
MAPDs
LENALIDOMIDE 25 MG CAPSULE [Revlimid]
()
21 CAPSULES   00480124621 61
PDPs
392
MAPDs
LENALIDOMIDE 5 MG CAPSULE [Revlimid]
()
21 CAPSULES   00480124228 61
PDPs
392
MAPDs
LEVOTHYROXINE 100 MCG TABLET
(Levothyroxine Sodium)
1000.000 EA   00378180910 63
PDPs
404
MAPDs
LEVOTHYROXINE 112 MCG TABLET
(Levothyroxine Sodium)
1000.000 EA   00378181110 63
PDPs
404
MAPDs
LEVOTHYROXINE 137 MCG TABLET
(Levothyroxine Sodium)
90 EA   00378182377 63
PDPs
404
MAPDs
LEVOTHYROXINE 150 MCG TABLET
(Levothyroxine Sodium)
1000.000 EA   00378181510 63
PDPs
404
MAPDs
LEVOTHYROXINE 175 MCG TABLET
(Levothyroxine Sodium)
1000 EA   00378181710 63
PDPs
404
MAPDs
LEVOTHYROXINE 25 MCG TABLET
(Levothyroxine Sodium)
1000.000 EA   00378180010 63
PDPs
404
MAPDs
LEVOTHYROXINE 50 MCG TABLET
(Levothyroxine Sodium)
1000.000 EA   00378180310 63
PDPs
404
MAPDs
LEVOTHYROXINE 75 MCG TABLET
(Levothyroxine Sodium)
1000 EA   00378180510 63
PDPs
404
MAPDs
LEVOTHYROXINE 88 MCG TABLET
(Levothyroxine Sodium)
1000.000 EA   00378180710 63
PDPs
404
MAPDs
LEXAPRO 10MG TABLET
(Escitalopram Oxalate)
10 BOT 00456201001 2
PDPs
3
MAPDs
LEXAPRO 20MG TABLET
(Escitalopram Oxalate)
100 TABLETS BOT 00456202001 2
PDPs
3
MAPDs
LEXAPRO 5MG TABLET
(Escitalopram Oxalate)
100 BOT 00456200501 2
PDPs
3
MAPDs
LIPITOR 10MG TABLET
(Atorvastatin Calcium)
90 BOT 00071015523 2
PDPs
1
MAPDs
LIPITOR 20 MG TABLET
(Atorvastatin Calcium)
    00071015623 2
PDPs
1
MAPDs
LIPITOR 40 MG TABLET
(Atorvastatin Calcium)
90.000 EA   00071015723 2
PDPs
1
MAPDs
LIPITOR 80 MG TABLET
(Atorvastatin Calcium)
90.000 EA   00071015823 2
PDPs
1
MAPDs
LISINOPRIL 10 MG TABLET
(Lisinopril)
1000 EA   68180098003 63
PDPs
404
MAPDs
LISINOPRIL 2.5 MG TABLET
(Lisinopril)
500.000 EA   68180051202 63
PDPs
404
MAPDs
LISINOPRIL 20 MG TABLET
(Lisinopril)
1000 EA   68180098103 63
PDPs
404
MAPDs
LISINOPRIL 30 MG TABLET
(Lisinopril)
100 EA   68180098201 63
PDPs
404
MAPDs
LISINOPRIL 5 MG TABLET
(Lisinopril)
1000.000 EA   68180051303 63
PDPs
404
MAPDs
LISINOPRIL-HCTZ 10-12.5 MG TABLET
(Lisinopril)
500.000 EA   68180051802 63
PDPs
404
MAPDs
LISINOPRIL-HCTZ 20-12.5 MG TABLET
(Lisinopril)
500.000 EA   68180051902 63
PDPs
404
MAPDs
LISINOPRIL-HCTZ 20-25 MG TABLET
(Lisinopril)
500.000 EA   68180052002 63
PDPs
404
MAPDs
LYRICA 50MG CAPSULE
(Pregabalin)
90 BOT 00071101368 2
PDPs
1
MAPDs
MEMANTINE HCL 10 MG TABLET [Namenda]
(Memantine HCl)
60 tablets   29300017216 63
PDPs
404
MAPDs
MEMANTINE HCL 2 MG/ML SOLUTION [Namenda]
(Memantine HCl)
    00527194313 59
PDPs
379
MAPDs
MEMANTINE HCL 5 MG TABLET [Namenda]
(Memantine HCl)
60 tablets   29300017116 63
PDPs
404
MAPDs
METFORMIN HCL 1,000 MG TABLET
(Metformin HCl)
1000.000 EA   23155010410 63
PDPs
404
MAPDs
METFORMIN HCL 500 MG TABLET
(Metformin HCl)
1000.000 EA   23155010210 63
PDPs
404
MAPDs
METFORMIN HCL 625 MG TABLET
(Metformin HCl)
60 TABLETS   72336006430 0
PDPs
5
MAPDs
METOPROLOL TARTRATE 25 MG TABLET
(Metoprolol Tartrate)
500.000 EA   00378001805 63
PDPs
404
MAPDs
METOPROLOL TARTRATE 37.5 MG TABLET
(Metoprolol Tartrate)
60 TABLETS   52817035810 24
PDPs
203
MAPDs
METOPROLOL TARTRATE 75 MG TABLET
(Metoprolol Tartrate)
60 TABLETS   52817035910 24
PDPs
203
MAPDs
MICARDIS 80MG TABLET
(Telmisartan)
3 X 10 BLPK 00597004137 2
PDPs
3
MAPDs
MICARDIS HCT 80/12.5MG TABLET
(Telmisartan-Hydrochlorothiazide)
3 X 10 BLPK 00597004437 2
PDPs
3
MAPDs
NAMENDA 10MG TABLET
(Memantine HCl)
60 BOT 00456321060 2
PDPs
1
MAPDs
NAMENDA 5-10MG TITRATION PK
(Memantine HCl)
49 COUNT 00456320014 4
PDPs
4
MAPDs
NAMENDA 5MG TABLET
(Memantine HCl)
60 BOT 00456320560 2
PDPs
1
MAPDs
NAMENDA XR 14 MG CAPSULE
(Memantine HCl)
30 EA   00456341433 0
PDPs
1
MAPDs
NAMENDA XR 21 MG CAPSULE
(Memantine HCl)
    00456342133 0
PDPs
1
MAPDs
NAMENDA XR 28 MG CAPSULE
(Memantine HCl)
30.000 EA   00456342833 0
PDPs
1
MAPDs
NAMENDA XR 7 MG CAPSULE
(Memantine HCl)
    00456340733 0
PDPs
1
MAPDs
NEXIUM 10mg/1 30 GRANULE, DELAYED RELEASE per CARTON
(Esomeprazole Magnesium)
30 GRANULE, DELAYED RELEA   00186401001 2
PDPs
10
MAPDs
NEXIUM 20MG SUSP FOR RECON DELAYED REL. IN A PACKET
(Esomeprazole Magnesium)
20 MG PKT X 30 PKT 00186402001 2
PDPs
21
MAPDs
NEXIUM 40MG SUSP FOR RECON DELAYED REL. IN A PACKET
(Esomeprazole Magnesium)
40 MG PKT X 30 PKT 00186404001 2
PDPs
21
MAPDs
NEXIUM DR 2.5 MG PACKET
(Esomeprazole Magnesium)
    00186402501 8
PDPs
30
MAPDs
NEXIUM DR 20 MG CAPSULE
(Esomeprazole Magnesium)
30.000 EA   00186502031 2
PDPs
1
MAPDs
NEXIUM DR 40 MG CAPSULE
(Esomeprazole Magnesium)
30.000 EA   00186504031 2
PDPs
1
MAPDs
NEXIUM DR 5 MG PACKET
(Esomeprazole Magnesium)
    00186405001 8
PDPs
30
MAPDs
OCELLA 3MG/0.03MG TABLET
(Drospirenone-Ethinyl Estradiol)
3 X 28 PKG 00555913167 48
PDPs
280
MAPDs
PIOGLITAZONE HCL 15 MG TABLET [Actos]
(Pioglitazone HCL)
30 TABLETS   00093727198 63
PDPs
404
MAPDs
PIOGLITAZONE HCL 30 MG TABLET [Actos]
(Pioglitazone HCL)
30 TABLETS   00093727298 63
PDPs
404
MAPDs
PIOGLITAZONE HCL 45 MG TABLET [Actos]
(Pioglitazone HCL)
90 TABLETS   00093727398 63
PDPs
404
MAPDs
PLAVIX 75 MG TABLET
(Clopidogrel Bisulfate)
90 TABLETS   00024117190 2
PDPs
1
MAPDs
QUETIAPINE ER 150 MG TABLET ER 24H [Seroquel XR]
(Quetiapine Fumarate)
30 tablets   16729010912 46
PDPs
356
MAPDs
QUETIAPINE ER 200 MG TABLET ER 24H [Seroquel XR]
(Quetiapine Fumarate)
30 tablets   16729009512 46
PDPs
356
MAPDs
QUETIAPINE ER 300 MG TABLET ER 24H [Seroquel XR]
(Quetiapine Fumarate)
30 tablets   16729009612 46
PDPs
356
MAPDs
QUETIAPINE ER 400 MG TABLET [Seroquel]
(Quetiapine Fumarate)
60.000 EA   16729009712 46
PDPs
356
MAPDs
QUETIAPINE ER 50 MG TABLET ER 24H [Seroquel XR]
(Quetiapine Fumarate)
30 TABLETS   16729013212 46
PDPs
356
MAPDs
QUETIAPINE FUMARATE 100 MG TABLET [Seroquel]
(Quetiapine Fumarate)
30 TABLETS   67877025001 63
PDPs
404
MAPDs
QUETIAPINE FUMARATE 200 MG TABLET [Seroquel]
(Quetiapine Fumarate)
30 TABLETS   67877024601 63
PDPs
404
MAPDs
QUETIAPINE FUMARATE 25 MG TABLET [Seroquel]
(Quetiapine Fumarate)
30 TABLETS   67877024201 63
PDPs
404
MAPDs
QUETIAPINE FUMARATE 300 MG TABLET [Seroquel]
(Quetiapine Fumarate)
30 TABLETS   67877024760 63
PDPs
404
MAPDs
QUETIAPINE FUMARATE 400 MG TABLET [Seroquel]
(Quetiapine Fumarate)
30 TABLETS   67877024801 63
PDPs
404
MAPDs
QUETIAPINE FUMARATE 50 MG TABLET [Seroquel]
(Quetiapine Fumarate)
30 TABLETS   67877024901 63
PDPs
404
MAPDs
REVLIMID 10 MG CAPSULE
(Lenalidomide)
28.000 EA   59572041028 59
PDPs
306
MAPDs
REVLIMID 15MG CAPSULE 21 BOT
(Lenalidomide)
21 BOT 59572041521 59
PDPs
306
MAPDs
REVLIMID 2.5 MG CAPSULE
(Lenalidomide)
28.000 EA   59572040228 63
PDPs
404
MAPDs
REVLIMID 20 MG CAPSULE
(Lenalidomide)
21.000 EA   59572042021 63
PDPs
404
MAPDs
REVLIMID 25 MG CAPSULE
(Lenalidomide)
21.000 EA   59572042521 59
PDPs
306
MAPDs
REVLIMID 5 MG CAPSULE
(Lenalidomide)
28.000 EA   59572040528 59
PDPs
306
MAPDs
RISEDRONATE SODIUM 150 MG TABLET [Actonel]
(Risedronate Sodium)
3 TABLETS   00093777179 24
PDPs
352
MAPDs
RISEDRONATE SODIUM 30 MG TABLET [Actonel]
(Risedronate Sodium)
30 EA   00093310056 20
PDPs
307
MAPDs
RISEDRONATE SODIUM 35 MG TABLET [Actonel]
(Risedronate Sodium)
4 TABLETS   33342010937 24
PDPs
337
MAPDs
RISEDRONATE SODIUM 35 MG TABLET [Actonel]
(Risedronate Sodium)
4 tablets   33342010950 24
PDPs
337
MAPDs
RISEDRONATE SODIUM 35 MG TABLET [Actonel]
(Risedronate Sodium)
4.000 EA   60505316500 24
PDPs
351
MAPDs
RISEDRONATE SODIUM 5 MG TABLET [Actonel]
(Risedronate Sodium)
30 tablets   33342010707 22
PDPs
337
MAPDs
ROSUVASTATIN CALCIUM 10 MG TABLET [Crestor]
(Rosuvastatin Calcium)
90 TABLETS   72205000390 63
PDPs
404
MAPDs
ROSUVASTATIN CALCIUM 20 MG TABLET [Crestor]
(Rosuvastatin Calcium)
30 TABLETS   72205000490 63
PDPs
404
MAPDs
ROSUVASTATIN CALCIUM 40 MG TABLET [Crestor]
(Rosuvastatin Calcium)
90 tablets   31722088530 63
PDPs
404
MAPDs
ROSUVASTATIN CALCIUM 5 MG TABLET [Crestor]
(Rosuvastatin Calcium)
90 TABLETS   72205002790 63
PDPs
404
MAPDs
SENSIPAR 30MG TABLET
(Cinacalcet HCl)
30 BOT 55513007330 2
PDPs
1
MAPDs
SEROQUEL 100MG TABLET
(Quetiapine Fumarate)
100 BOT 00310027110 2
PDPs
1
MAPDs
SEROQUEL 200MG TABLET
(Quetiapine Fumarate)
100 BOT 00310027210 2
PDPs
1
MAPDs
SEROQUEL 25MG TABLET
(Quetiapine Fumarate)
100 BOT 00310027510 2
PDPs
1
MAPDs
SEROQUEL 300MG TABLET
(Quetiapine Fumarate)
60 BOT 00310027460 2
PDPs
1
MAPDs
SEROQUEL 400MG TABLET
(Quetiapine Fumarate)
100 BOT 00310027910 2
PDPs
1
MAPDs
SEROQUEL 50MG TABLET (100 CT)
(Quetiapine Fumarate)
100 BOT 00310027810 2
PDPs
1
MAPDs
SEROQUEL XR 150 MG TABLET
(Quetiapine Fumarate)
60.000 EA   00310028160 2
PDPs
2
MAPDs
SEROQUEL XR 200 MG TABLET
(Quetiapine Fumarate)
60.000 EA   00310028260 2
PDPs
2
MAPDs
SEROQUEL XR 300MG TABLET 60X300MG BOT
(Quetiapine Fumarate)
60 X 300 MG BOT 00310028360 2
PDPs
2
MAPDs
SEROQUEL XR 400 MG TABLET
(Quetiapine Fumarate)
60.000 EA   00310028460 2
PDPs
2
MAPDs
SEROQUEL XR 50 MG TABLET
(Quetiapine Fumarate)
60.000 EA   00310028060 2
PDPs
2
MAPDs
SIMVASTATIN 10 MG TABLET
(Simvastatin)
1000.000 EA   16729000417 63
PDPs
404
MAPDs
SIMVASTATIN 20 MG TABLET
(Simvastatin)
1000.000 EA   16729000517 63
PDPs
404
MAPDs
SIMVASTATIN 40 MG TABLET
(Simvastatin)
1000.000 EA   16729000617 63
PDPs
404
MAPDs
SPIRIVA 18 MCG CP-HANDIHALER
(Tiotropium Bromide Monohydrate)
30.000 EA   00597007541 41
PDPs
265
MAPDs
SPIRIVA RESPIMAT INHAL SPRAY
(Tiotropium Bromide Monohydrate)
4 GM   00597010061 41
PDPs
267
MAPDs
STRATTERA 40MG CAPSULE
(Atomoxetine HCl)
30 BOT 00002322930 2
PDPs
1
MAPDs
SUSTIVA 600MG TABLET
(Efavirenz)
30 BOT 00056051030 2
PDPs
1
MAPDs
TARCEVA 150MG TABLET
(Erlotinib)
30 BOT 50242006401 2
PDPs
4
MAPDs
TOBRADEX SUSPENSION OPHTHALMIC 0.1%/0.3% 5ML BOT
(Tobramycin Sulfate)
5 ML BOT 00065064705 2
PDPs
3
MAPDs
TRILEPTAL 300MG TABLET
(Oxcarbazepine)
100 BOT 00078033705 2
PDPs
2
MAPDs
TRUVADA 200/300MG TABLET
(Emtricitabine-Tenofovir Disoproxil Fumarate)
    61958070101 3
PDPs
12
MAPDs
VALCYTE 450MG TABLET
(Valganciclovir HCl)
60 TABLETS BOT 00004003822 2
PDPs
1
MAPDs
VALSARTAN 160 MG TABLET [Diovan]
(Valsartan-Hydrochlorothiazide)
30 TABLETS   33342006410 61
PDPs
403
MAPDs
VALSARTAN 320 MG TABLET [Diovan]
(Valsartan-Hydrochlorothiazide)
30 TABLETS   00378581577 61
PDPs
403
MAPDs
VALSARTAN 40 MG TABLET [Diovan]
(Valsartan-Hydrochlorothiazide)
30 TABLETS   33342006207 61
PDPs
403
MAPDs
VALSARTAN 80 MG TABLET [Diovan]
(Valsartan-Hydrochlorothiazide)
30 TABLETS   33342006310 61
PDPs
403
MAPDs
VALSARTAN-HCTZ 160-12.5 MG TABLET [Diovan HCT]
(Valsartan-Hydrochlorothiazide)
30 TABLETS   00378632277 61
PDPs
402
MAPDs
VALSARTAN-HCTZ 160-25 MG TABLET [Diovan HCT]
(Valsartan-Hydrochlorothiazide)
30 TABLETS   00378632377 61
PDPs
402
MAPDs
VALSARTAN-HCTZ 320-12.5 MG TABLET [Diovan HCT]
(Valsartan-Hydrochlorothiazide)
90 TABLETS   00378632477 61
PDPs
402
MAPDs
VALSARTAN-HCTZ 320-25 MG TABLET [Diovan HCT]
(Valsartan-Hydrochlorothiazide)
90 TABLETS   00378632577 61
PDPs
402
MAPDs
VALSARTAN-HCTZ 80-12.5 MG TABLET [Diovan HCT]
(Valsartan-Hydrochlorothiazide)
30 tablets   33342007410 61
PDPs
402
MAPDs
VIREAD 300MG TABLET
(Tenofovir Disoproxil Fumarate)
    61958040101 2
PDPs
1
MAPDs
VYVANSE 30MG CAPSULE
(Lisdexamfetamine Dimesylate)
100 BOT 59417010310 14
PDPs
104
MAPDs
WELCHOL 625MG TABLET
(Colesevelam HCl)
180 BOTPL 65597070118 6
PDPs
1
MAPDs
XALATAN EYE DROPS 125MCG 2.5ML BOTPL
(Latanoprost Ophth)
2.5 ML BOTPL 00013830304 0
PDPs
1
MAPDs
YASMIN 28 3-0.03MG TABLET
(Drospirenone-Ethinyl Estradiol)
21 YELLOW + 7 WHITE X 3 BOX 50419040203 2
PDPs
3
MAPDs
YAZ 3-0.02MG TABLET
(Drospirenone-Ethinyl Estradiol)
24 X 3 BOX 50419040503 2
PDPs
3
MAPDs



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





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