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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 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 2022 Formularies
PDPs MAPDs
ALPRAZOLAM 0.25 MG TABLET [Xanax]
(Alprazolam)
30 TABLETS   00228202796 33
PDPs
328
MAPDs
ALPRAZOLAM ER 1 MG TABLET 24H [Xanax XR]
(Alprazolam)
30 tablets   65862045560 2
PDPs
109
MAPDs
ALPRAZOLAM ER 2 MG TABLET 24H [Xanax XR]
(Alprazolam)
30 tablets   65862045660 2
PDPs
109
MAPDs
ALPRAZOLAM ER 3 MG TABLET 24H [Xanax XR]
(Alprazolam)
30 tablets   65862045760 2
PDPs
109
MAPDs
BROMFENAC SODIUM 0.09% EYE DROPS [Xibrom]
(BROMFENAC SODIUM)
1.7 MLS   62332050817 12
PDPs
240
MAPDs
HYDROCODONE-ACETAMIN 10-300 MG TABLET [Xodol]
(Hydrocodone Bitartrate, Acetaminophen)
120 TABLETS   00406037805 8
PDPs
142
MAPDs
HYDROCODONE-ACETAMIN 5-300 MG TABLET [Xodol]
(Hydrocodone Bitartrate, Acetaminophen)
12 tablets   43386035101 8
PDPs
142
MAPDs
HYDROCODONE-ACETAMIN 7.5-300 TABLET [Xodol]
(Hydrocodone Bitartrate, Acetaminophen)
30 TABLETS   27808011501 8
PDPs
145
MAPDs
HYDROCODONE-IBUPROFEN 10-200 TABLET [Xylon 10]
(Hydrocodone Bitartrate, Ibuprofen)
30 TABLETS   53746011701 7
PDPs
175
MAPDs
LEVALBUTEROL 0.31 MG/3 ML SOL VIAL-NEB [Xopenex Pediatric]
(Levalbuterol Tartrate)
90 MLS   66993002127 10
PDPs
254
MAPDs
LEVALBUTEROL 0.63 MG/3 ML SOL VIAL-NEB [Xopenex]
(Levalbuterol Tartrate)
75 MLS   66993002227 10
PDPs
254
MAPDs
LEVALBUTEROL 1.25 MG/3 ML SOL VIAL-NEB [Xopenex]
(Levalbuterol Tartrate)
75 MLS   76204090025 11
PDPs
273
MAPDs
LEVALBUTEROL CONC 1.25 MG/0.5 VIAL-NEB [Xopenex]
(Levalbuterol Tartrate)
30 UNITS   00093414756 10
PDPs
265
MAPDs
LEVALBUTEROL TAR HFA 45MCG INH [Xopenex]
(Levalbuterol HCl)
15.000 GM   00591292754 23
PDPs
234
MAPDs
LEVOCETIRIZINE 5 MG TABLET [Xyzal Allergy 24 Hour]
(LEVOCETIRIZINE)
30 tablets   31722055190 38
PDPs
350
MAPDs
LIDOCAINE HCL 4% SOLUTION [Xylocaine]
()
50 MLS   00054350547 30
PDPs
317
MAPDs
TETRABENAZINE 12.5 MG TABLET [XENAZINE]
(Tetrabenazine)
112 EA   47335027723 38
PDPs
350
MAPDs
TETRABENAZINE 25 MG TABLET [XENAZINE]
(Tetrabenazine)
112 EA   47335017923 38
PDPs
350
MAPDs
XALATAN EYE DROPS 125MCG 2.5ML BOTPL
(Latanoprost Ophth)
2.5 ML BOTPL 00013830304 0
PDPs
1
MAPDs
Xalkori 200mg/1 60 CAPSULE BOTTLE
(CRIZOTINIB)
60 CAPSULE in 1 BOTTLE   00069814120 38
PDPs
350
MAPDs
Xalkori 250mg/1 60 CAPSULE BOTTLE
(CRIZOTINIB)
60 CAPSULE in 1 BOTTLE   00069814020 38
PDPs
350
MAPDs
XANAX 0.25 MG TABLET
(Alprazolam)
100.000 EA   00009002901 0
PDPs
1
MAPDs
Xanax 0.5mg/1 100 TABLET BOTTLE
(Alprazolam)
100 TABLET in 1 BOTTLE   00009005501 0
PDPs
1
MAPDs
Xanax 1mg/1 100 TABLET BOTTLE
(Alprazolam)
100 TABLET in 1 BOTTLE   00009009001 0
PDPs
1
MAPDs
Xanax 2mg/1 100 TABLET BOTTLE
(Alprazolam)
100 TABLET in 1 BOTTLE   00009009401 0
PDPs
1
MAPDs
Xanax XR 0.5mg/1 60 TABLET, EXTENDED RELEASE in 1 BOTTLE
(Alprazolam)
60 TABLET in BOTTLE   00009005707 0
PDPs
1
MAPDs
Xanax XR 1mg/1 60 TABLET, EXTENDED RELEASE in 1 BOTTLE
(Alprazolam)
60 TABLET in BOTTLE   00009005907 0
PDPs
1
MAPDs
Xanax XR 2mg/1 60 TABLET, EXTENDED RELEASE in 1 BOTTLE
(Alprazolam)
60 TABLET in BOTTLE   00009006607 0
PDPs
1
MAPDs
Xanax XR 3mg/1 60 TABLET, EXTENDED RELEASE in 1 BOTTLE
(Alprazolam)
60 TABLET in BOTTLE   00009006807 0
PDPs
1
MAPDs
XARELTO 1 MG/ML ORAL SUSPENSION
(Rivaroxaban)
MLS   50458057501 25
PDPs
281
MAPDs
XARELTO 10 MG TABLET
(Rivaroxaban)
30.000 EA   50458058030 36
PDPs
347
MAPDs
XARELTO 15 MG TABLET
(Rivaroxaban)
30.000 EA   50458057830 36
PDPs
347
MAPDs
XARELTO 2.5 MG TABLET
(Rivaroxaban)
60 tablets   50458057760 36
PDPs
344
MAPDs
XARELTO 20 MG TABLET
(Rivaroxaban)
30.000 EA   50458057930 36
PDPs
347
MAPDs
XARELTO STARTER PACK
(Rivaroxaban)
51 EA   50458058451 36
PDPs
344
MAPDs
XATMEP 2.5 MG/ML ORAL SOLUTION
(Methotrexate)
40 MLS   52652200106 38
PDPs
341
MAPDs
XCOPRI 100 MG TABLET
(Cenobamate)
TABLETS   71699010030 38
PDPs
350
MAPDs
XCOPRI 12.5-25 MG TITRATION PK TABLET DS PK
(Cenobamate)
UNITS   71699020128 38
PDPs
350
MAPDs
XCOPRI 150 MG TABLET
(Cenobamate)
TABLETS   71699015030 38
PDPs
350
MAPDs
XCOPRI 150-200 MG TITRATION PK TABLET DS PK
(Cenobamate)
UNITS   71699020328 38
PDPs
350
MAPDs
XCOPRI 200 MG TABLET
(Cenobamate)
90 TABLETS   71699020030 38
PDPs
350
MAPDs
XCOPRI 250 MG DAILY DOSE PACK TABLET
(Cenobamate)
TABLETS   71699010456 38
PDPs
349
MAPDs
XCOPRI 350 MG DAILY DOSE PACK TABLET
(Cenobamate)
TABLETS   71699010356 38
PDPs
350
MAPDs
XCOPRI 50 MG TABLET
(Cenobamate)
TABLETS   71699005030 38
PDPs
350
MAPDs
XCOPRI 50-100 MG TITRATION PAK TABLET DS PK
(Cenobamate)
UNITS   71699020228 38
PDPs
350
MAPDs
XELJANZ 1 MG/ML SOLUTION
(Tofacitinib Citrate)
MLS   00069102902 27
PDPs
284
MAPDs
XELJANZ 10 MG TABLET
(Tofacitinib Citrate)
60 tablets   00069100201 29
PDPs
290
MAPDs
XELJANZ 5 MG TABLET
(Tofacitinib Citrate)
60 EA   00069100101 29
PDPs
290
MAPDs
XELJANZ XR 11 MG TABLET
(Tofacitinib Citrate)
    00069050130 29
PDPs
290
MAPDs
XELJANZ XR 22 MG TABLET ER 24H
(Tofacitinib Citrate)
TABLETS   00069050230 29
PDPs
290
MAPDs
XELPROS 0.005% EYE DROPS EMULS
()
mls   47335031790 0
PDPs
35
MAPDs
XENAZINE TABLET 25 MG
(Tetrabenazine)
112 BOT 67386042201 0
PDPs
2
MAPDs
XENAZINE TABLETS 12.5MG 112 BOT
(Tetrabenazine)
112 BOT 67386042101 0
PDPs
2
MAPDs
XENLETA 600 MG TABLET
(Lefamulin)
tablets   72000011030 1
PDPs
68
MAPDs
XERESE 5%-1% CREAM
(acyclovir and hydrocortisone topical)
5 GM   00187510401 0
PDPs
6
MAPDs
XERMELO 250 MG TABLET
(Telotristat Ethyl)
TABLETS   70720012585 30
PDPs
299
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 38
PDPs
350
MAPDs
XHANCE 93 MCG NASAL SPRAY AER BR.ACT
(Fluticasone Propionate)
16 mls   71143037501 0
PDPs
63
MAPDs
XIFAXAN 200MG TABLET
(Rifaximin)
30 BOT 65649030103 19
PDPs
234
MAPDs
XIFAXAN 550 MG TABLET
(Rifaximin)
60.000 EA   65649030302 38
PDPs
350
MAPDs
XIGDUO XR 10 MG-1,000 MG TAB
(Dapagliflozin and Metformin Hydrochloride)
30 EA   00310628030 31
PDPs
279
MAPDs
XIGDUO XR 10 MG-500 MG TABLET
(Dapagliflozin and Metformin Hydrochloride)
30 EA   00310627030 31
PDPs
279
MAPDs
XIGDUO XR 2.5 MG-1,000 MG TABLET
(Dapagliflozin and Metformin Hydrochloride)
60   00310622560 31
PDPs
279
MAPDs
XIGDUO XR 5 MG-1,000 MG TABLET
(Dapagliflozin and Metformin Hydrochloride)
60 EA   00310626060 31
PDPs
279
MAPDs
XIGDUO XR 5 MG-500 MG TABLET
(Dapagliflozin and Metformin Hydrochloride)
30 EA   00310625030 31
PDPs
279
MAPDs
XIIDRA 5% EYE DROPS DROPERETTE
(Lifitegrast)
60 UNITS   00078091112 22
PDPs
194
MAPDs
XOFLUZA 40 MG TABLET
(Baloxavir)
1 TABLET   50242086001 18
PDPs
252
MAPDs
XOFLUZA 80 MG TABLET
(Baloxavir)
1 TABLET   50242087701 18
PDPs
257
MAPDs
XOLAIR 150 MG/ML SYRINGE
(Omalizumab (Hamster))
2 mls   50242021501 38
PDPs
350
MAPDs
XOLAIR 150MG VIAL
(Omalizumab For)
1 X VIAL 50242004062 38
PDPs
350
MAPDs
XOLAIR 75 MG/0.5 ML SYRINGE
(Omalizumab (Hamster))
ml   50242021401 38
PDPs
350
MAPDs
XOPENEX 0.31 MG/3 ML SOLUTION
(Levalbuterol HCl)
3 ML   17478017224 0
PDPs
6
MAPDs
XOPENEX 0.63 MG/3 ML SOLUTION
(Levalbuterol HCl)
    17478017324 0
PDPs
6
MAPDs
XOPENEX 1.25 MG/3 ML SOLUTION
(Levalbuterol HCl)
    17478017424 0
PDPs
6
MAPDs
XOPENEX CONC 1.25 MG/0.5 ML
(Levalbuterol HCl)
    17478017130 0
PDPs
6
MAPDs
XOPENEX HFA 45MCG HFA AEROSOL WITH ADAPTER
(Levalbuterol Tartrate)
200 INHALATIONS BOX 63402051001 0
PDPs
39
MAPDs
XOSPATA 40 MG TABLET
(Gilteritinib)
tablets   00469142590 38
PDPs
350
MAPDs
XPOVIO 100 MG ONCE WEEKLY DOSE TABLET
(Selinexor)
TABLETS   72237010305 38
PDPs
349
MAPDs
XPOVIO 40 MG ONCE WEEKLY DOSE TABLET
(Selinexor)
TABLETS   72237010207 38
PDPs
349
MAPDs
XPOVIO 40 MG TWICE WEEKLY DOSE TABLET
(Selinexor)
TABLETS   72237010206 38
PDPs
349
MAPDs
XPOVIO 60 MG ONCE WEEKLY DOSE TABLET
(Selinexor)
TABLETS   72237010401 38
PDPs
349
MAPDs
XPOVIO 60 MG TWICE WEEKLY DOSE TABLET
(Selinexor)
6 TABLETS   72237010103 38
PDPs
350
MAPDs
XPOVIO 80 MG ONCE WEEKLY DOSE TABLET
(Selinexor)
TABLETS   72237010202 38
PDPs
349
MAPDs
XPOVIO 80 MG TWICE WEEKLY DOSE TABLET
(Selinexor)
8 TABLETS   72237010104 38
PDPs
350
MAPDs
XTAMPZA ER 13.5 MG CAPSULE
(Oxycodone)
    24510011510 10
PDPs
134
MAPDs
XTAMPZA ER 18 MG CAPSULE
(Oxycodone)
    24510012010 10
PDPs
134
MAPDs
XTAMPZA ER 27 MG CAPSULE
(Oxycodone)
    24510013010 10
PDPs
134
MAPDs
XTAMPZA ER 36 MG CAPSULE
(Oxycodone)
    24510014010 10
PDPs
134
MAPDs
XTAMPZA ER 9 MG CAPSULE
(Oxycodone)
    24510011010 10
PDPs
134
MAPDs
XTANDI 40 MG CAPSULE
(enzalutamide)
    00469012599 38
PDPs
350
MAPDs
XTANDI 40 MG TABLET
(enzalutamide)
TABLETS   00469062599 38
PDPs
350
MAPDs
XTANDI 80 MG TABLET
(enzalutamide)
TABLETS   00469072560 38
PDPs
350
MAPDs
Xulane Patch
(norelgestromin / ethinyl estradiol)
    00378334053 13
PDPs
257
MAPDs
XULTOPHY 100 UNIT-3.6MG/ML PEN
(Insulin Degludec and Liraglutide)
3 ML   00169291115 24
PDPs
258
MAPDs
XURIDEN GRANULE PACKET
(Uridine Triacetate)
1 unit   69468015230 9
PDPs
118
MAPDs
XYOSTED 100 MG/0.5 ML AUTO-INJECT
(Testosterone Enanthate)
2 mls   54436020004 0
PDPs
46
MAPDs
XYOSTED 50 MG/0.5 ML AUTO-INJ AUTO INJCT
(Testosterone Enanthate)
2 MLS   54436025004 0
PDPs
46
MAPDs
XYOSTED 75 MG/0.5 ML AUTO-INJECT
(Testosterone Enanthate)
2 mls   54436027504 0
PDPs
46
MAPDs
XYREM 500MG/ML ORAL SOLUTION
(Sodium Oxybate Oral)
180 ML BOT 68727010001 37
PDPs
350
MAPDs
XYWAV 0.5 GM/ML ORAL SOLUTION
(Calcium Oxybate, Magnesium Oxybate, Potassium Oxybate, Sodium Oxybate (Gamma Hydroxybutyrate Or Ghb))
MLS   68727015001 4
PDPs
65
MAPDs
ZAFEMY 150-35 MCG/DAY PATCH [Xulane]
(Norelgestromin, Ethinyl Estradiol)
3 PATCHES   65162035803 13
PDPs
244
MAPDs



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




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