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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 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 2023 Formularies
PDPs MAPDs
ALPRAZOLAM 0.25 MG TABLET [Xanax]
(Alprazolam)
30 TABLETS   00781106110 57
PDPs
368
MAPDs
ALPRAZOLAM 0.5 MG TABLET [Xanax]
(Alprazolam)
30 TABLETS   00781107710 57
PDPs
368
MAPDs
ALPRAZOLAM 1 MG TABLET [Xanax]
(Alprazolam)
60 TABLETS   00781107905 57
PDPs
368
MAPDs
ALPRAZOLAM 2 MG TABLET [Xanax]
(Alprazolam)
60 TABLETS   00781108901 57
PDPs
368
MAPDs
ALPRAZOLAM ER 1 MG TABLET 24H [Xanax XR]
(Alprazolam)
30 tablets   65862045560 2
PDPs
104
MAPDs
ALPRAZOLAM ER 2 MG TABLET 24H [Xanax XR]
(Alprazolam)
30 tablets   65862045660 2
PDPs
104
MAPDs
ALPRAZOLAM ER 3 MG TABLET 24H [Xanax XR]
(Alprazolam)
30 tablets   65862045760 2
PDPs
104
MAPDs
BROMFENAC SODIUM 0.09% EYE DROPS [Xibrom]
(BROMFENAC SODIUM)
1.7 MLS   62332050817 16
PDPs
205
MAPDs
CYPROHEPTADINE 4 MG TABLET [Periactin]
()
30 TABLETS   70710111001 50
PDPs
319
MAPDs
HYDROCODONE-ACETAMIN 10-300 MG TABLET [Xodol]
(Hydrocodone Bitartrate, Acetaminophen)
120 TABLETS   00406037805 20
PDPs
128
MAPDs
HYDROCODONE-ACETAMIN 5-300 MG TABLET [Xodol]
(Hydrocodone Bitartrate, Acetaminophen)
30 TABLETS   27808011401 21
PDPs
153
MAPDs
HYDROCODONE-ACETAMIN 7.5-300 TABLET [Xodol]
(Hydrocodone Bitartrate, Acetaminophen)
60 TABLETS   00406037705 20
PDPs
128
MAPDs
HYDROCODONE-IBUPROFEN 10-200 TABLET [Xylon 10]
(Hydrocodone Bitartrate, Ibuprofen)
30 TABLETS   53746011701 17
PDPs
219
MAPDs
LEVALBUTEROL 0.31 MG/3 ML SOL VIAL-NEB [Xopenex Pediatric]
(Levalbuterol Tartrate)
90 MLS   76204070025 12
PDPs
243
MAPDs
LEVALBUTEROL 0.63 MG/3 ML SOL VIAL-NEB [Xopenex]
(Levalbuterol Tartrate)
75 MLS   66993002227 12
PDPs
243
MAPDs
LEVALBUTEROL 1.25 MG/3 ML SOL VIAL-NEB [Xopenex]
(Levalbuterol Tartrate)
75 MLS   76204090025 13
PDPs
263
MAPDs
LEVALBUTEROL CONC 1.25 MG/0.5 VIAL-NEB [Xopenex]
(Levalbuterol Tartrate)
30 UNITS   00378699393 12
PDPs
253
MAPDs
LEVALBUTEROL TAR HFA 45MCG INH [Xopenex]
(Levalbuterol HCl)
15.000 GM   00591292754 24
PDPs
244
MAPDs
LEVOCETIRIZINE 2.5 MG/5 ML SOLUTION [Xyzal Solution]
()
148 MLS   31722065931 14
PDPs
256
MAPDs
LEVOCETIRIZINE 5 MG TABLET [Xyzal Allergy 24 Hour]
(LEVOCETIRIZINE)
30 tablets   31722055190 62
PDPs
392
MAPDs
LIDOCAINE HCL 4% SOLUTION [Xylocaine]
()
50 MLS   00054350547 50
PDPs
349
MAPDs
TETRABENAZINE 12.5 MG TABLET [Xenazine]
(Tetrabenazine)
60 TABLETS   43598039467 62
PDPs
392
MAPDs
TETRABENAZINE 25 MG TABLET [Xenazine]
(Tetrabenazine)
84 TABLETS   43598039567 62
PDPs
392
MAPDs
XALATAN EYE DROPS 125MCG 2.5ML BOTPL
(Latanoprost Ophth)
2.5 ML BOTPL 00013830304 0
PDPs
2
MAPDs
Xalkori 200mg/1 60 CAPSULE BOTTLE
(CRIZOTINIB)
60 CAPSULE in 1 BOTTLE   00069814120 62
PDPs
392
MAPDs
Xalkori 250mg/1 60 CAPSULE BOTTLE
(CRIZOTINIB)
60 CAPSULE in 1 BOTTLE   00069814020 62
PDPs
392
MAPDs
XARELTO 1 MG/ML ORAL SUSPENSION
(Rivaroxaban)
MLS   50458057501 51
PDPs
327
MAPDs
XARELTO 10 MG TABLET
(Rivaroxaban)
30.000 EA   50458058030 62
PDPs
389
MAPDs
XARELTO 15 MG TABLET
(Rivaroxaban)
30.000 EA   50458057830 62
PDPs
389
MAPDs
XARELTO 2.5 MG TABLET
(Rivaroxaban)
60 tablets   50458057760 62
PDPs
389
MAPDs
XARELTO 20 MG TABLET
(Rivaroxaban)
30.000 EA   50458057930 62
PDPs
389
MAPDs
XARELTO STARTER PACK
(Rivaroxaban)
51 EA   50458058451 62
PDPs
387
MAPDs
XATMEP 2.5 MG/ML ORAL SOLUTION
(Methotrexate)
40 MLS   52652200106 62
PDPs
382
MAPDs
XCOPRI 100 MG TABLET
(Cenobamate)
TABLETS   71699010030 62
PDPs
392
MAPDs
XCOPRI 12.5-25 MG TITRATION PK TABLET DS PK
(Cenobamate)
UNITS   71699020128 62
PDPs
392
MAPDs
XCOPRI 150 MG TABLET
(Cenobamate)
TABLETS   71699015030 62
PDPs
392
MAPDs
XCOPRI 150-200 MG TITRATION PK TABLET DS PK
(Cenobamate)
UNITS   71699020328 62
PDPs
392
MAPDs
XCOPRI 200 MG TABLET
(Cenobamate)
90 TABLETS   71699020030 62
PDPs
392
MAPDs
XCOPRI 250 MG DAILY DOSE PACK TABLET
(Cenobamate)
TABLETS   71699010456 62
PDPs
391
MAPDs
XCOPRI 350 MG DAILY DOSE PACK TABLET
(Cenobamate)
TABLETS   71699010356 62
PDPs
392
MAPDs
XCOPRI 50 MG TABLET
(Cenobamate)
TABLETS   71699005030 62
PDPs
392
MAPDs
XCOPRI 50-100 MG TITRATION PAK TABLET DS PK
(Cenobamate)
UNITS   71699020228 62
PDPs
392
MAPDs
XELJANZ 1 MG/ML SOLUTION
(Tofacitinib Citrate)
MLS   00069102902 52
PDPs
329
MAPDs
XELJANZ 10 MG TABLET
(Tofacitinib Citrate)
60 tablets   00069100201 53
PDPs
332
MAPDs
XELJANZ 5 MG TABLET
(Tofacitinib Citrate)
60 EA   00069100101 53
PDPs
332
MAPDs
XELJANZ XR 11 MG TABLET
(Tofacitinib Citrate)
    00069050130 53
PDPs
332
MAPDs
XELJANZ XR 22 MG TABLET ER 24H
(Tofacitinib Citrate)
TABLETS   00069050230 53
PDPs
332
MAPDs
XELPROS 0.005% EYE DROPS EMULS
()
mls   47335031790 0
PDPs
17
MAPDs
XENAZINE TABLET 25 MG
(Tetrabenazine)
112 BOT 67386042201 1
PDPs
3
MAPDs
XENAZINE TABLETS 12.5MG 112 BOT
(Tetrabenazine)
112 BOT 67386042101 1
PDPs
3
MAPDs
XENLETA 600 MG TABLET
(Lefamulin)
tablets   72000011030 2
PDPs
71
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
312
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 62
PDPs
392
MAPDs
XHANCE 93 MCG NASAL SPRAY AER BR.ACT
(Fluticasone Propionate)
16 mls   71143037501 16
PDPs
161
MAPDs
XIFAXAN 200MG TABLET
(Rifaximin)
30 BOT 65649030103 22
PDPs
252
MAPDs
XIFAXAN 550 MG TABLET
(Rifaximin)
60.000 EA   65649030302 62
PDPs
392
MAPDs
XIGDUO XR 10 MG-1,000 MG TAB
(Dapagliflozin and Metformin Hydrochloride)
30 EA   00310628030 54
PDPs
343
MAPDs
XIGDUO XR 10 MG-500 MG TABLET
(Dapagliflozin and Metformin Hydrochloride)
30 EA   00310627030 54
PDPs
343
MAPDs
XIGDUO XR 2.5 MG-1,000 MG TABLET
(Dapagliflozin and Metformin Hydrochloride)
60   00310622560 54
PDPs
343
MAPDs
XIGDUO XR 5 MG-1,000 MG TABLET
(Dapagliflozin and Metformin Hydrochloride)
60 EA   00310626060 54
PDPs
343
MAPDs
XIGDUO XR 5 MG-500 MG TABLET
(Dapagliflozin and Metformin Hydrochloride)
30 EA   00310625030 54
PDPs
343
MAPDs
XIIDRA 5% EYE DROPS DROPERETTE
(Lifitegrast)
60 UNITS   00078091112 23
PDPs
225
MAPDs
XIMINO ER 135 MG CAPSULE ER 24H
(Minocycline Hydrochloride)
CAPSULES   69489012330 0
PDPs
1
MAPDs
XIMINO ER 45 MG CAPSULE ER 24H
(Minocycline Hydrochloride)
30 CAPSULES   69489012130 0
PDPs
1
MAPDs
XIMINO ER 90 MG CAPSULE ER 24H
(Minocycline Hydrochloride)
30 CAPSULES   69489012230 0
PDPs
1
MAPDs
XOFLUZA 40 MG TABLET
(Baloxavir)
1 TABLET   50242086001 40
PDPs
291
MAPDs
XOFLUZA 80 MG TABLET
(Baloxavir)
1 TABLET   50242087701 40
PDPs
296
MAPDs
XOLAIR 150 MG/ML SYRINGE
(Omalizumab (Hamster))
2 mls   50242021501 62
PDPs
392
MAPDs
XOLAIR 150MG VIAL
(Omalizumab For)
1 X VIAL 50242004062 62
PDPs
392
MAPDs
XOLAIR 75 MG/0.5 ML SYRINGE
(Omalizumab (Hamster))
ml   50242021401 62
PDPs
392
MAPDs
XOLEGEL 2% GEL
(Ketoconazole)
45 GRAMS   16110008045 0
PDPs
1
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 8
PDPs
55
MAPDs
XOSPATA 40 MG TABLET
(Gilteritinib)
tablets   00469142590 62
PDPs
392
MAPDs
XPOVIO 100 MG ONCE WEEKLY DOSE TABLET
(Selinexor)
TABLETS   72237010305 62
PDPs
391
MAPDs
XPOVIO 40 MG ONCE WEEKLY DOSE TABLET
(Selinexor)
TABLETS   72237010207 62
PDPs
391
MAPDs
XPOVIO 40 MG TWICE WEEKLY DOSE TABLET
(Selinexor)
TABLETS   72237010206 62
PDPs
391
MAPDs
XPOVIO 60 MG ONCE WEEKLY DOSE TABLET
(Selinexor)
TABLETS   72237010401 62
PDPs
391
MAPDs
XPOVIO 60 MG TWICE WEEKLY DOSE TABLET
(Selinexor)
6 TABLETS   72237010103 62
PDPs
392
MAPDs
XPOVIO 80 MG ONCE WEEKLY DOSE TABLET
(Selinexor)
TABLETS   72237010202 62
PDPs
391
MAPDs
XPOVIO 80 MG TWICE WEEKLY DOSE TABLET
(Selinexor)
8 TABLETS   72237010104 62
PDPs
392
MAPDs
XTAMPZA ER 13.5 MG CAPSULE
(Oxycodone)
    24510011510 12
PDPs
110
MAPDs
XTAMPZA ER 18 MG CAPSULE
(Oxycodone)
    24510012010 12
PDPs
110
MAPDs
XTAMPZA ER 27 MG CAPSULE
(Oxycodone)
    24510013010 12
PDPs
110
MAPDs
XTAMPZA ER 36 MG CAPSULE
(Oxycodone)
    24510014010 12
PDPs
110
MAPDs
XTAMPZA ER 9 MG CAPSULE
(Oxycodone)
    24510011010 12
PDPs
110
MAPDs
XTANDI 40 MG CAPSULE
(enzalutamide)
    00469012599 62
PDPs
392
MAPDs
XTANDI 40 MG TABLET
(enzalutamide)
TABLETS   00469062599 62
PDPs
392
MAPDs
XTANDI 80 MG TABLET
(enzalutamide)
TABLETS   00469072560 62
PDPs
392
MAPDs
Xulane Patch
(norelgestromin / ethinyl estradiol)
    00378334053 17
PDPs
275
MAPDs
XULTOPHY 100 UNIT-3.6MG/ML PEN
(Insulin Degludec and Liraglutide)
3 ML   00169291115 20
PDPs
239
MAPDs
XURIDEN GRANULE PACKET
(Uridine Triacetate)
1 unit   69468015230 3
PDPs
59
MAPDs
XYOSTED 100 MG/0.5 ML AUTO-INJECT
(Testosterone Enanthate)
2 mls   54436020004 0
PDPs
55
MAPDs
XYOSTED 50 MG/0.5 ML AUTO-INJ AUTO INJCT
(Testosterone Enanthate)
2 MLS   54436025004 0
PDPs
55
MAPDs
XYOSTED 75 MG/0.5 ML AUTO-INJECT
(Testosterone Enanthate)
2 mls   54436027504 0
PDPs
55
MAPDs
XYREM 500MG/ML ORAL SOLUTION
(Sodium Oxybate Oral)
180 ML BOT 68727010001 44
PDPs
366
MAPDs
XYWAV 0.5 GM/ML ORAL SOLUTION
(Calcium Oxybate, Magnesium Oxybate, Potassium Oxybate, Sodium Oxybate (Gamma Hydroxybutyrate Or Ghb))
MLS   68727015001 25
PDPs
95
MAPDs
ZAFEMY 150-35 MCG/DAY PATCH [Xulane]
(Norelgestromin, Ethinyl Estradiol)
3 PATCHES   65162035803 17
PDPs
260
MAPDs



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



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