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2023 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 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 2023 Formularies
PDPs MAPDs
AMARYL 1MG TABLET
(Glimepiride)
100 BOT 00039022110 1
PDPs
2
MAPDs
AMARYL 2MG TABLET
(Glimepiride)
100 BOT 00039022210 1
PDPs
2
MAPDs
AMARYL 4MG TABLET
(Glimepiride)
100 BOT 00039022310 1
PDPs
2
MAPDs
BAQSIMI 3 MG SPRAY ONE PACK
(Glucagon)
2 UNITS   00002614511 27
PDPs
206
MAPDs
BEVESPI AEROSPHERE INHALER
(Glycopyrrolate and formoterol fumarate)
10.700 GM   00310460012 13
PDPs
159
MAPDs
BREZTRI AEROSPHERE INHALER HFA AER AD
(Budesonide, Glycopyrrolate, Formoterol)
10.7 GRAMS   00310461612 38
PDPs
353
MAPDs
COPAXONE 20MG/ML 30 BLISTER PACK IN 1 CRTN
(Glatiramer Acetate)
    68546031730 42
PDPs
173
MAPDs
COPAXONE 40 MG/ML SYRINGE
(Glatiramer Acetate)
1 ML   68546032512 42
PDPs
174
MAPDs
CROMOLYN 100 MG/5 ML ORAL CONC [Gastrocrom]
(Cromolyn )
480 MLS   42571013252 62
PDPs
392
MAPDs
CUVPOSA 1 MG/5 ML SOLUTION
(Glycopyrrolate)
    00259050116 0
PDPs
4
MAPDs
DARTISLA ODT 1.7 MG TABLET RAPDIS
(Glycopyrrolate)
UNITS   82111051801 0
PDPs
4
MAPDs
DAURISMO 100 MG TABLET
(Glasdegib)
tablets   00069153130 62
PDPs
392
MAPDs
DAURISMO 25 MG TABLET
(Glasdegib)
tablets   00069029860 62
PDPs
392
MAPDs
EMGALITY 120 MG/ML PEN INJCTR
(Galcanezumab)
1 ml   00002143611 50
PDPs
294
MAPDs
EMGALITY 120 MG/ML SYRINGE
(Galcanezumab)
1 ml   00002237711 46
PDPs
293
MAPDs
EMGALITY 300 MG (100 MG X3SYR) SYRINGE
(Galcanezumab)
3 mls   00002311509 38
PDPs
240
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 53
PDPs
323
MAPDs
GABAPENTIN 100 MG CAPSULE [Neurontin]
()
90 CAPSULES   69097081312 62
PDPs
392
MAPDs
GABAPENTIN 250 MG/5 ML SOLUTION [Neurontin]
()
30 MLS   42192060816 62
PDPs
392
MAPDs
GABAPENTIN 300 MG CAPSULE [Neurontin]
()
90 CAPSULES   69097094312 62
PDPs
392
MAPDs
GABAPENTIN 400 MG CAPSULE [Neurontin]
()
90 CAPSULES   65162010350 62
PDPs
392
MAPDs
GABAPENTIN 600 MG TABLET
(Gabapentin)
500.000 EA   68462012605 62
PDPs
392
MAPDs
GABAPENTIN 800 MG TABLET
(Gabapentin)
500.000 EA   68462012705 62
PDPs
392
MAPDs
GABITRIL 12 MG TABLET
(Tiagabine HCl)
30 EA   63459041230 1
PDPs
3
MAPDs
GABITRIL 16mg/1
(Tiagabine HCl)
    63459041630 1
PDPs
3
MAPDs
GABITRIL 2mg/1
(Tiagabine HCl)
    63459040230 1
PDPs
3
MAPDs
GABITRIL 4mg/1
(Tiagabine HCl)
    63459040430 1
PDPs
3
MAPDs
GALAFOLD 123 MG CAPSULE
(Migalastat)
capsules   71904010001 5
PDPs
156
MAPDs
GALANTAMINE 4 MG/ML ORAL SOLUTION
(Galantamine Hydrobromide)
100 mL in 1 BOTTLE   00054013749 59
PDPs
357
MAPDs
GALANTAMINE ER 16 MG CAPSULE 24H PEL [Reminyl]
()
30 UNITS   65862074530 60
PDPs
384
MAPDs
GALANTAMINE ER 24 MG CAPSULE 24H PEL [Reminyl]
()
30 UNITS   65862074630 60
PDPs
384
MAPDs
GALANTAMINE ER 8 MG CAPSULE 24H PEL [Reminyl]
()
30 UNITS   65862074430 60
PDPs
384
MAPDs
GALANTAMINE HBR 12 MG TABLET [Reminyl]
()
180 TABLETS   57237005160 60
PDPs
384
MAPDs
GALANTAMINE HBR 4 MG TABLET [Reminyl]
()
60 tablets   57237004960 60
PDPs
384
MAPDs
GALANTAMINE HBR 8 MG TABLET [Reminyl]
()
60 TABLETS   57237005060 60
PDPs
384
MAPDs
GAMMAGARD LIQUID 10% VIAL
(Immune Globulin (Human) IV)
1 BOTTLE, GLASS in CARTON   00944270003 17
PDPs
281
MAPDs
GAMMAGARD S-D 10 G (IGA<1) SOLUTION
(Immune Globulin (Human) IV)
    00944265804 19
PDPs
275
MAPDs
GAMMAGARD S-D 5 G (IGA<1) SOLUTION
(Immune Globulin (Human) IV)
    00944265603 19
PDPs
275
MAPDs
GAMMAKED 1 GRAM/10 ML VIAL
(Immune Globulin)
10 ML   76125090001 11
PDPs
209
MAPDs
GAMMAPLEX 10 GRAM/100 ML VIAL
(immune globulin)
    64208823506 22
PDPs
267
MAPDs
GAMMAPLEX 10 GRAM/200 ML VIAL
(immune globulin)
100 MLS   64208823407 20
PDPs
271
MAPDs
GAMMAPLEX 20 GRAM/200 ML VIAL
(immune globulin)
    64208823507 22
PDPs
268
MAPDs
GAMMAPLEX 5 GRAM/50 ML VIAL
(immune globulin)
    64208823505 22
PDPs
271
MAPDs
Gamunex-C 10g/100mL 10 mL in 1 VIAL, GLASS
(Immune Globulin (Human) IV)
10 mL in 1 VIAL, GLASS   13533080012 40
PDPs
310
MAPDs
GARDASIL 9 SYRINGE
(Quadrivalent Human Papillomavirus (HPV) Recombinant Vac)
    00006412102 62
PDPs
392
MAPDs
GARDASIL 9 VIAL
(Quadrivalent Human Papillomavirus (HPV) Recombinant Vac)
    00006411903 62
PDPs
392
MAPDs
GASTROCROM 100 MG/5 ML CONC
(Cromolyn Sodium Oral)
    00037067896 0
PDPs
2
MAPDs
GATIFLOXACIN 0.5% EYE DROPS [Zymaxid]
()
2.5 MLS   60758061525 19
PDPs
320
MAPDs
GATTEX 5 MG 30-VIAL KIT
(teduglutide)
1.000 EA   68875010201 58
PDPs
389
MAPDs
GAVILYTE-C SOLUTION
(Polyethylene Glycol 3350 Oral)
278.26 g in 1 BOTTLE   43386006019 62
PDPs
386
MAPDs
GAVILYTE-G SOLUTION
(Polyethylene Glycol 3350 Oral)
274.31 g in 1 BOTTLE   43386009019 59
PDPs
384
MAPDs
GAVRETO 100 MG CAPSULE
(Pralsetinib)
60 CAPSULES   50242021060 62
PDPs
392
MAPDs
GELNIQUE 10% GEL SACHET PACKET
(Oxybutynin Chloride)
GRAM   00023586111 1
PDPs
18
MAPDs
GEMFIBROZIL 600 MG TABLET
(Gemfibrozil)
500 EA   69097082112 62
PDPs
392
MAPDs
GEMMILY 1 MG-20 MCG CAPSULE [Taytulla]
(Ethinyl Estradiol, Norethindrone;Ferrous Fumarate)
28 CAPSULES   70700015285 11
PDPs
76
MAPDs
GEMTESA 75 MG TABLET
(Vibegron)
30 TABLETS   73336007530 16
PDPs
162
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 62
PDPs
388
MAPDs
GENGRAF 100 MG CAPSULE
(Cyclosporine Modified)
30 EA   00074310932 62
PDPs
386
MAPDs
GENGRAF 100MG/ML SOLUTION
(Cyclosporine Modified)
50 ML BOTGL 00074726950 62
PDPs
387
MAPDs
GENGRAF 25 MG CAPSULE
(Cyclosporine Modified)
30 EA   00074310832 62
PDPs
386
MAPDs
GENOTROPIN 13.8MG CARTRIDGE
(Somatropin For)
1 X 13.8 MG CTG 00013264681 19
PDPs
189
MAPDs
GENOTROPIN 5 MG CARTRIDGE
(Somatropin For)
1 PKGCOM 00013262681 19
PDPs
187
MAPDs
GENOTROPIN MINIQUICK 0.2MG
(Somatropin For)
7 X 0.2 MG VIALPAT 00013264902 19
PDPs
187
MAPDs
GENOTROPIN MINIQUICK 0.4MG
(Somatropin For)
7 X 0.4 MG VIALPAT 00013265002 19
PDPs
189
MAPDs
GENOTROPIN MINIQUICK 0.6MG
(Somatropin For)
7 X 0.6 MG VIALPAT 00013265102 19
PDPs
189
MAPDs
GENOTROPIN MINIQUICK 0.8MG
(Somatropin For)
7 X 0.8 MG VIALPAT 00013265202 19
PDPs
189
MAPDs
GENOTROPIN MINIQUICK 1.2MG
(Somatropin For)
7 VIALPAT 00013265402 19
PDPs
189
MAPDs
GENOTROPIN MINIQUICK 1.4MG
(Somatropin For)
7 VIALPAT 00013265502 19
PDPs
189
MAPDs
GENOTROPIN MINIQUICK 1.6MG
(Somatropin For)
7 VIALPAT 00013265602 19
PDPs
189
MAPDs
GENOTROPIN MINIQUICK 1.8MG
(Somatropin For)
7 VIALPAT 00013265702 19
PDPs
189
MAPDs
GENOTROPIN MINIQUICK 1MG
(Somatropin For)
7 X 1.0 MG VIALPAT 00013265302 19
PDPs
189
MAPDs
GENOTROPIN MINIQUICK 2MG
(Somatropin For)
7 X 2.0 MG VIALPAT 00013265802 19
PDPs
189
MAPDs
GENTAK 3MG/GM EYE OINTMENT
(Gentamicin Sulfate Ophth)
3.5 GM TUBE 17478028435 62
PDPs
379
MAPDs
GENTAMICIN 0.1% CREAM (G)
(Gentamicin)
15 GRAMS   00713068315 62
PDPs
392
MAPDs
GENTAMICIN 0.1% OINTMENT
(Gentamicin)
15 GRAMS   00713068215 62
PDPs
392
MAPDs
GENTAMICIN 3 MG/ML EYE DROPS
(Gentamicin Sulfate Ophth)
5 ML   60758018805 62
PDPs
390
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 62
PDPs
391
MAPDs
Gentamicin Sulfate in Sodium Chloride 60mg/50mL 50 mL in 1 BAG
(Gentamicin Sulfate)
50 mL in 1 BAG   00338050741 41
PDPs
306
MAPDs
GENVOYA TABLET
(Elvitegravir, Cobicistat, Emtricitabine, and Tenofovir Alafenamide Fumarate)
    61958190101 61
PDPs
392
MAPDs
GEODON 20 MG CAPSULE
(Ziprasidone HCl)
30 CAPSULES   00049035260 1
PDPs
2
MAPDs
GEODON 20MG VIAL
(Ziprasidone HCl)
1 VIAL VIALSD 00049392083 1
PDPs
8
MAPDs
GEODON 40 MG CAPSULE
(Ziprasidone)
60 capsules   00049005460 1
PDPs
2
MAPDs
GEODON 60 MG CAPSULE
(Ziprasidone HCl)
60 CAPSULES   00049035660 1
PDPs
2
MAPDs
GEODON 80 MG CAPSULE
(Ziprasidone HCl)
30 CAPSULES   00049035860 1
PDPs
2
MAPDs
GILENYA 0.5 MG CAPSULE
(FINGOLIMOD HCL)
30 EA   00078060715 51
PDPs
382
MAPDs
GILOTRIF 20 MG TABLET
(afatinib)
30 EA   00597014130 62
PDPs
392
MAPDs
GILOTRIF 30 MG TABLET
(afatinib)
30 EA   00597013730 62
PDPs
392
MAPDs
GILOTRIF 40 MG TABLET
(afatinib)
30 EA   00597013830 62
PDPs
392
MAPDs
GIMOTI 15 MG NASAL SPRAY SPRAY/PUMP
(Metoclopramide)
MLS   72089030715 0
PDPs
9
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
101
MAPDs
GLATIRAMER 20 MG/ML SYRINGE [Glatopa]
(Glatiramer)
mls   00378696093 33
PDPs
325
MAPDs
GLATIRAMER 40 MG/ML SYRINGE [Copaxone]
(Glatiramer Acetate)
1 ML   00378696112 33
PDPs
323
MAPDs
Glatopa 20 mg/ml syringe
(Glatiramer Acetate)
    00781323434 29
PDPs
294
MAPDs
GLATOPA 40 MG/ML SYRINGE
(Glatiramer)
12 mls   00781325089 29
PDPs
295
MAPDs
GLEEVEC 100MG TABLET (90 CT)
(Imatinib Mesylate)
90 BOT 00078040134 1
PDPs
5
MAPDs
GLEEVEC 400 MG TABLET
(Imatinib Mesylate)
30 EA   00078064930 1
PDPs
5
MAPDs
GLIMEPIRIDE 1 MG TABLET [Amaryl]
()
90 TABLETS   55111032001 62
PDPs
392
MAPDs
GLIMEPIRIDE 2 MG TABLET [Amaryl]
()
90 TABLETS   55111032101 62
PDPs
392
MAPDs
GLIMEPIRIDE 4 MG TABLET [Amaryl]
()
90 TABLETS   16729000316 62
PDPs
392
MAPDs
GLIPIZIDE 10 MG TABLET
(Glipizide)
1000.000 EA   60505014201 62
PDPs
392
MAPDs
GLIPIZIDE 5 MG TABLET
(Glipizide)
1000.000 EA   60505014101 62
PDPs
392
MAPDs
GLIPIZIDE ER 10 MG TABLET ER 24 [Glucotrol XL]
()
90 UNITS   59651027001 62
PDPs
390
MAPDs
GLIPIZIDE ER 2.5MG TABLET SR OSMOTIC PUSH 24HR
(Glipizide)
30 BOTPL 00591090030 62
PDPs
390
MAPDs
GLIPIZIDE ER 5 MG TABLET ER 24 [Glucotrol XL]
()
90 UNITS   64980028005 62
PDPs
390
MAPDs
GLIPIZIDE-METFORMIN 2.5-250 MG TABLET [Metaglip]
(Glipizide, Metformin Hydrochloride)
30 TABLETS   68382018401 62
PDPs
391
MAPDs
GLIPIZIDE-METFORMIN 2.5-500 MG TABLET [Metaglip]
(Glipizide, Metformin Hydrochloride)
60 TABLETS   68382018501 62
PDPs
391
MAPDs
GLIPIZIDE-METFORMIN 5-500 MG TABLET [Metaglip]
(Glipizide, Metformin Hydrochloride)
60 TABLETS   68382018601 62
PDPs
391
MAPDs
GLUCAGEN 1MG HYPOKIT
(Glucagon HCl (rDNA) For)
1 X 1 MG PKGCOM 00169706515 39
PDPs
212
MAPDs
GLUCAGON 1MG EMERGENCY KIT
(Glucagon (rDNA) For)
1 KIT PKGCOM 00002803101 25
PDPs
201
MAPDs
Glucose 50 MG/ML / Potassium Chloride 0.02 MEQ/ML / Sodium Chloride 0.154 MEQ/ML Injectable Solution
()
    00338080304 33
PDPs
289
MAPDs
GLUCOTROL XL 10 MG TABLET
(Glipizide)
100.000 EA   00049017807 1
PDPs
2
MAPDs
GLUCOTROL XL 2.5 MG TABLET
(Glipizide)
30 EA 00049017001 1
PDPs
2
MAPDs
GLUCOTROL XL 5 MG TABLET ER 24
(Glipizide)
    00049017402 1
PDPs
2
MAPDs
GLUMETZA ER 1,000 MG TABLETERGR24H
(Metformin Hydrochloride)
30 UNITS   68012000316 0
PDPs
2
MAPDs
GLUMETZA ER 500 MG TABLETERGR24H
(Metformin Hydrochloride)
30 units   68012000450 0
PDPs
2
MAPDs
GLYBURID-METFORMIN 1.25-250 MG [Glucovance]
(Glyburide-Metformin)
100.000 EA   65862008001 26
PDPs
218
MAPDs
GLYBURIDE 1.25MG TABLETS
(Glyburide)
100 TABLETS BOT 00093834201 37
PDPs
216
MAPDs
GLYBURIDE 2.5MG TABLET (100 CT)
(Glyburide)
100 TABLETS BOT 00093834301 37
PDPs
216
MAPDs
GLYBURIDE 5 MG TABLET [Micronase]
()
30 TABLETS   23155005810 37
PDPs
216
MAPDs
GLYBURIDE MICRO 1.5 MG TABLET [Glynase PresTab]
(Glyburide)
20 TABLETS   00093803401 31
PDPs
197
MAPDs
GLYBURIDE MICRO 3 MG TABLET [Glynase PresTab]
(Glyburide)
90 TABLETS   00093803501 31
PDPs
197
MAPDs
GLYBURIDE MICRO 6 MG TABLET [Glynase PresTab]
(Glyburide)
60 TABLETS   00093803601 31
PDPs
197
MAPDs
GLYBURIDE-METFORMIN 2.5-500 MG
(Glyburide)
100.000 EA   65862008101 26
PDPs
218
MAPDs
GLYBURIDE-METFORMIN 5-500 MG
(Glyburide)
100.000 EA   65862008201 26
PDPs
218
MAPDs
GLYCATE 1.5 MG TABLET
(Glycopyrrolate)
TABLETS   80056016010 0
PDPs
4
MAPDs
GLYCOPYRROLATE 1 MG TABLET [Robinul]
(Glycopyrrolate)
60 TABLETS   23155060601 59
PDPs
383
MAPDs
GLYCOPYRROLATE 1 MG/5 ML SOLUTION [Cuvposa]
()
350 MLS   49884004233 6
PDPs
108
MAPDs
GLYCOPYRROLATE 1.5 MG TABLET [Glycate]
()
60 TABLETS   72887016003 11
PDPs
43
MAPDs
GLYCOPYRROLATE 2 MG TABLET [Robinul Forte]
()
60 TABLETS   23155060701 59
PDPs
383
MAPDs
GLYXAMBI 10 MG-5 MG TABLET
(Empagliflozin and Linagliptin)
    00597018230 49
PDPs
331
MAPDs
GLYXAMBI 25 MG-5 MG TABLET
(Empagliflozin and Linagliptin)
    00597016430 49
PDPs
331
MAPDs
GOCOVRI ER 137 MG CAPSULE
(Amantadine)
    70482017060 4
PDPs
24
MAPDs
GOCOVRI ER 68.5 MG CAPSULE
(Amantadine)
    70482008560 4
PDPs
24
MAPDs
GOLYTELY SOLUTION 236 GM/2.97 GM/6 GM
(PEG 3350-KCl-Na Bicarb-NaCl-Na Sulfate For)
4 L BOT 52268010001 13
PDPs
110
MAPDs
GRALISE ER 300 MG TABLET ER 24H
(Gabapentin)
90 TABLETS   52427080390 2
PDPs
58
MAPDs
GRALISE ER 600 MG TABLET ER 24H
(Gabapentin)
90 TABLETS   52427080690 2
PDPs
58
MAPDs
GRANISETRON HCL 1 MG TABLET [Kytril]
()
30 TABLETS   51991073520 42
PDPs
360
MAPDs
GRANIX 300 MCG/0.5 ML SYRINGE
(Tbo-Filgrastim)
5 mls   63459091017 21
PDPs
107
MAPDs
GRANIX 300 MCG/ML VIAL
(tbo-filgrastim)
MLS   63459091859 21
PDPs
110
MAPDs
GRANIX 480 MCG/0.8 ML SYRINGE
(Tbo-Filgrastim)
5.6 mls   63459091217 21
PDPs
107
MAPDs
GRANIX 480 MCG/1.6 ML VIAL
(tbo-filgrastim)
MLS   63459092059 21
PDPs
110
MAPDs
GRASTEK 2,800 BAU SUBLIGUAL TABLET
(timothy grass pollen allergen extract)
TABLETS   52709150103 1
PDPs
18
MAPDs
GRISEOFULVIN 125 MG/5 ML ORAL SUSPENSION [Grifulvin V]
(Griseofulvin Microsize)
120 MLS   69097036108 62
PDPs
391
MAPDs
GRISEOFULVIN MICRO 500 MG TABLET
(Griseofulvin Microsize)
100 EA   00781551501 60
PDPs
369
MAPDs
GRISEOFULVIN ULTRA 125 MG TABLET [Gris-Peg]
(Griseofulvin, Ultramicrocrystalline)
84 tablets   00115172401 61
PDPs
346
MAPDs
GRISEOFULVIN ULTRA 250 MG TABLET [Gris-Peg]
(Griseofulvin, Ultramicrocrystalline)
30 tablets   00115172501 61
PDPs
346
MAPDs
GUANFACINE 1 MG TABLET [Tenex]
(Guanfacine HCl)
30 TABLETS   65162071110 34
PDPs
310
MAPDs
GUANFACINE 2 MG TABLET
(Guanfacine HCl)
100.000 EA   65162071310 34
PDPs
310
MAPDs
GUANFACINE HCL ER 1 MG TABLET 24H [Intuniv]
()
30 TABLETS   60505392701 52
PDPs
351
MAPDs
GUANFACINE HCL ER 2 MG TABLET ER 24H [Intuniv]
()
30 TABLETS   24979053401 52
PDPs
351
MAPDs
GUANFACINE HCL ER 3 MG TABLET ER 24H [Intuniv]
()
30 TABLETS   60505392901 52
PDPs
351
MAPDs
GUANFACINE HCL ER 4 MG TABLET 24H [Intuniv]
()
30 TABLETS   60505393001 52
PDPs
351
MAPDs
GVOKE 1 MG/0.2 ML KIT VIAL
(Glucagon)
ML   72065014011 44
PDPs
305
MAPDs
GVOKE HYPOPEN 2-PK 1 MG/0.2 ML AUTO INJECTOR
(Glucagon)
0.4 ML   72065012112 43
PDPs
308
MAPDs
GVOKE HYPOPEN 2PK 0.5MG/0.1 ML AUTO INJECTOR
(Glucagon)
0.1 ML   72065012012 45
PDPs
306
MAPDs
GVOKE PFS 1-PK 1 MG/0.2 ML SYRINGE
(Glucagon)
0.2 ML   72065013111 45
PDPs
307
MAPDs
GVOKE PFS 1PK 0.5MG/0.1 ML SYRINGE
(Glucagon)
ML   72065013011 45
PDPs
305
MAPDs
GYNAZOLE-1 2% CREAM
(Butoconazole Nitrate (One Dose) Vaginal)
5 GM   45802039601 0
PDPs
13
MAPDs
HORIZANT ER 300 MG TABLET
(GABAPENTIN ENACARBIL)
    53451010301 1
PDPs
14
MAPDs
HORIZANT ER 600 MG TABLET
(GABAPENTIN ENACARBIL)
    53451010101 1
PDPs
14
MAPDs
IMATINIB MESYLATE 100 MG TABLET [Gleevec]
()
90 TABLETS   00093762998 62
PDPs
392
MAPDs
IMATINIB MESYLATE 400 MG TABLET [Gleevec]
()
30 tablets   00093763056 62
PDPs
392
MAPDs
IRESSA 250 MG TABLET
(Gefitinib)
30 EA   00310048230 62
PDPs
392
MAPDs
ISOTON GENTAMICIN 80MG/100ML
(Gentamicin in Saline)
100 ML BAG 00338050348 43
PDPs
308
MAPDs
ISOTONIC GENTAMICIN 100 MG/100 ML
(Gentamicin in Saline)
100 ML   00338050548 41
PDPs
308
MAPDs
ISOTONIC GENTAMICIN 80 MG/50 ML
(Gentamicin in Saline)
50 ML   00338050941 41
PDPs
306
MAPDs
LACTULOSE 10 GM/15 ML SOLUTION [Generlac]
()
237 MLS   00121087316 62
PDPs
392
MAPDs
LONHALA MAGNAIR 25 MCG REFILL VIAL-NEB
(Glycopyrrolate)
mls   63402030101 2
PDPs
72
MAPDs
LOPID 600 MG TABLET
(Gemfibrozil)
60 EA   00071073720 1
PDPs
2
MAPDs
MAVYRET 100-40 MG TABLET
(Glecaprevir and Pibrentasvir)
84 EA   00074262528 23
PDPs
270
MAPDs
MAVYRET 50-20 MG PELLET PACKET
(Glecaprevir and Pibrentasvir)
UNITS   00074260028 23
PDPs
242
MAPDs
METFORMIN ER 1,000 MG GASTR-TB TABERGR24H [Glumetza]
(Metformin Hydrochloride)
180 units   68682001890 1
PDPs
6
MAPDs
METFORMIN ER 500 MG GASTRC-TB TABERGR24H [Glumetza]
(Metformin Hydrochloride)
90 UNITS   68682002150 2
PDPs
11
MAPDs
METFORMIN ER 500 MG OSMOTIC TABLET ER 24 [Glumetza]
(Metformin HCl)
30 UNITS   50742063360 5
PDPs
16
MAPDs
METFORMIN HCL 1,000 MG TABLET [Glucophage]
(Metformin Hydrochloride)
180 TABLETS   70010006510 62
PDPs
392
MAPDs
METFORMIN HCL 500 MG TABLET [Glucophage]
(Metformin Hydrochloride)
180 TABLETS   70010006310 62
PDPs
392
MAPDs
METFORMIN HCL 850 MG TABLET [Glucophage]
(Metformin Hydrochloride)
180 TABLETS   65862000905 62
PDPs
392
MAPDs
METFORMIN HCL ER 500 MG TABLET 24H [Glumetza]
(Metformin Hydrochloride)
90 TABLETS   70010049105 62
PDPs
392
MAPDs
METFORMIN HCL ER 750 MG TABLET 24H [Glucophage XR]
(Metformin HCl)
90 TABLETS   67877041401 62
PDPs
392
MAPDs
MIGLITOL 100 MG TABLET [Glyset]
(Miglitol)
TABLETS   69367030501 6
PDPs
176
MAPDs
MIGLITOL 25 MG TABLET [Glyset]
(Miglitol)
    57664068488 6
PDPs
176
MAPDs
MIGLITOL 50 MG TABLET [Glyset]
(Miglitol)
TABLETS   69367030401 6
PDPs
176
MAPDs
NEOMYCIN/POLYMY/GRAM EYE DROPS 0.025MG/ML 1.75MG/M
(Neomycin-Polymyxin B-Gramicidin Ophth)
10 ML BOT 24208079062 62
PDPs
389
MAPDs
NEURONTIN 100MG CAPSULE
(Gabapentin)
100 BOT 00071080324 1
PDPs
2
MAPDs
NEURONTIN 250 MG/5 ML SOLUTION
(Gabapentin)
60 MLS   00071201244 1
PDPs
2
MAPDs
NEURONTIN 300MG CAPSULE
(Gabapentin)
100 BOT 00071080524 1
PDPs
2
MAPDs
NEURONTIN 400MG CAPSULE
(Gabapentin)
100 BOT 00071080624 1
PDPs
2
MAPDs
NEURONTIN 600MG TABLET
(Gabapentin)
100 BOT 00071051324 1
PDPs
2
MAPDs
NEURONTIN 800MG TABLET
(Gabapentin)
100 BOT 00071040124 1
PDPs
2
MAPDs
ORALAIR 300 IR SUBLINGUAL TAB
(Grass Pollen Allergen Extract)
30 EA   59617001502 3
PDPs
39
MAPDs
PIOGLITAZONE-GLIMEPIRIDE 30-2 TABLET [Duetact]
(Pioglitazone, Glimepiride)
tablets   66993082130 19
PDPs
129
MAPDs
PIOGLITAZONE-GLIMEPIRIDE 30-4 Tablet [Duetact]
(Pioglitazone, Glimepiride)
30 tablets   66993082230 19
PDPs
129
MAPDs
PRED G OPHTHALMIC SUSPENSION 1;0.3%;% 5 ML BOTDR
(Gentamicin-Prednisolone Ace Ophth)
5 ML BOTDR 00023010605 4
PDPs
101
MAPDs
PRED-G S.O.P. EYE OINTMENT
(Gentamicin-Prednisolone Ace Ophth)
3.5 GM TUBE 00023006604 6
PDPs
58
MAPDs
QBREXZA 2.4% CLOTH TOWELETTE
(Glycopyrronium)
30 UNITS   69489041130 0
PDPs
11
MAPDs
RAVICTI 1.1 GRAM/ML LIQUID
(Glycerol Phenylbutyrate)
25 ML   75987005006 12
PDPs
231
MAPDs
RAZADYNE ER 16MG CAPSULE
(Galantamine Hydrobromide)
30 CAPSULES BOT 50458038830 1
PDPs
2
MAPDs
RAZADYNE ER 24MG CAPSULE
(Galantamine Hydrobromide)
30 CAPSULES BOT 50458038930 1
PDPs
2
MAPDs
RAZADYNE ER 8MG CAPSULE
(Galantamine Hydrobromide)
30 CAPSULES BOT 50458038730 1
PDPs
2
MAPDs
ROBINUL 1 MG TABLET
(Glycopyrrolate)
60 TABLETS   70199000790 0
PDPs
3
MAPDs
ROBINUL FORTE 2 MG TABLET
(Glycopyrrolate)
60 TABLETS   70199000890 0
PDPs
3
MAPDs
SANCUSO TRANSDERMAL SYSTEM 3.1MG/24HRS 1 PATCH CRTN
(Granisetron Transdermal)
1 PATCH CRTN 42747072601 8
PDPs
108
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
80
MAPDs
SIMPONI 50 MG/0.5 ML PEN INJEC
(Golimumab Subcutaneous)
0.5 ML   57894007002 1
PDPs
80
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 62
PDPs
392
MAPDs
TIAGABINE HCL 16 MG TABLET [Gabitril]
()
tablets   00093807656 62
PDPs
392
MAPDs
TIAGABINE HCL 2 MG TABLET [Gabitril]
()
49 TABLETS   62756020083 62
PDPs
392
MAPDs
TIAGABINE HCL 4 MG TABLET [Gabitril]
()
TABLETS   62756022483 62
PDPs
392
MAPDs
TREMFYA 100 MG/ML AUTOINJECTOR
(Guselkumab)
ml   57894064011 8
PDPs
100
MAPDs
TREMFYA 100 MG/ML SYRINGE
(Guselkumab)
    57894064001 8
PDPs
100
MAPDs
XOSPATA 40 MG TABLET
(Gilteritinib)
tablets   00469142590 62
PDPs
392
MAPDs
ZIPRASIDONE 20 MG/ML VIAL [Geodon]
()
1 ML   43598084858 62
PDPs
392
MAPDs
ZIPRASIDONE HCL 20 MG CAPSULE [Geodon]
(Ziprasidone HCl)
60.000 EA   55111025660 62
PDPs
392
MAPDs
ZIPRASIDONE HCL 40 MG CAPSULE [Geodon]
(Ziprasidone HCl)
60.000 EA   55111025760 62
PDPs
392
MAPDs
ZIPRASIDONE HCL 60 MG CAPSULE [Geodon]
(Ziprasidone HCl)
    55111025860 62
PDPs
392
MAPDs
ZIPRASIDONE HCL 80 MG CAPSULE [Geodon]
(Ziprasidone HCl)
60.000 EA   55111025960 62
PDPs
392
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 41
PDPs
352
MAPDs
ZYMAXID 5mg/mL 1 BOTTLE, DROPPER per CARTON / 2.5 mL in 1 BOTTLE, DROPPER
(Gatifloxacin Ophth)
1 BOTTLE, DROPPER   00023361525 0
PDPs
2
MAPDs



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


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