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2024 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 2024 Formularies
PDPs MAPDs
BAQSIMI 3 MG SPRAY ONE PACK
(Glucagon)
2 UNITS   00002614511 29
PDPs
202
MAPDs
BEVESPI AEROSPHERE INHALER
(Glycopyrrolate and formoterol fumarate)
10.700 GM   00310460012 15
PDPs
149
MAPDs
BREZTRI AEROSPHERE INHALER HFA AER AD
(Budesonide, Glycopyrrolate, Formoterol)
10.7 GRAMS   00310461612 33
PDPs
336
MAPDs
COPAXONE 20MG/ML 30 BLISTER PACK IN 1 CRTN
(Glatiramer Acetate)
    68546031730 30
PDPs
160
MAPDs
COPAXONE 40 MG/ML SYRINGE
(Glatiramer Acetate)
1 ML   68546032512 31
PDPs
163
MAPDs
CROMOLYN 100 MG/5 ML ORAL CONC [Gastrocrom]
(Cromolyn )
480 MLS   42571013252 54
PDPs
369
MAPDs
CUVPOSA 1 MG/5 ML SOLUTION
(Glycopyrrolate)
    00259050116 0
PDPs
2
MAPDs
DAURISMO 100 MG TABLET
(Glasdegib)
tablets   00069153130 54
PDPs
369
MAPDs
DAURISMO 25 MG TABLET
(Glasdegib)
tablets   00069029860 54
PDPs
369
MAPDs
EMGALITY 120 MG/ML PEN INJCTR
(Galcanezumab)
1 ml   00002143611 38
PDPs
274
MAPDs
EMGALITY 120 MG/ML SYRINGE
(Galcanezumab)
1 ml   00002237711 38
PDPs
274
MAPDs
EMGALITY 300 MG (100 MG X3SYR) SYRINGE
(Galcanezumab)
3 mls   00002311509 36
PDPs
225
MAPDs
ENDARI 5 GRAM POWDER PACKET
(Glutamine Powder (For Sickle Cell Disease))
UNITS   42457042001 50
PDPs
349
MAPDs
ESTRADIOL VALERATE 100 MG/5 ML VIAL [Gynogen LA]
()
5 MLS   00517042001 43
PDPs
302
MAPDs
FINGOLIMOD 0.5 MG CAPSULE [Gilenya]
()
30 CAPSULES   00378452593 42
PDPs
363
MAPDs
GABAPENTIN 100 MG CAPSULE [Neurontin]
()
90 CAPSULES   69097081312 54
PDPs
369
MAPDs
GABAPENTIN 250 MG/5 ML SOLUTION [Neurontin]
()
30 MLS   42192060816 54
PDPs
369
MAPDs
GABAPENTIN 300 MG CAPSULE [Neurontin]
()
90 CAPSULES   45963055650 54
PDPs
369
MAPDs
GABAPENTIN 400 MG CAPSULE [Neurontin]
()
90 CAPSULES   65162010350 54
PDPs
369
MAPDs
GABAPENTIN 600 MG TABLET
(Gabapentin)
500.000 EA   68462012605 54
PDPs
369
MAPDs
GABAPENTIN 800 MG TABLET
(Gabapentin)
500.000 EA   68462012705 54
PDPs
369
MAPDs
GABAPENTIN ER 300 MG TABLET 24H [Gralise]
()
30 TABLETS   68382060816 0
PDPs
46
MAPDs
GABAPENTIN ER 600 MG TABLET 24H [Neurontin]
()
90 TABLETS   68382060716 0
PDPs
47
MAPDs
GALAFOLD 123 MG CAPSULE
(Migalastat)
capsules   71904010001 1
PDPs
137
MAPDs
GALANTAMINE 4 MG/ML ORAL SOLUTION
(Galantamine Hydrobromide)
100 mL in 1 BOTTLE   00054013749 50
PDPs
348
MAPDs
GALANTAMINE ER 16 MG CAPSULE 24H PEL [Reminyl]
()
30 UNITS   65862074530 51
PDPs
361
MAPDs
GALANTAMINE ER 24 MG CAPSULE 24H PEL [Reminyl]
()
30 UNITS   65862074630 51
PDPs
361
MAPDs
GALANTAMINE ER 8 MG CAPSULE 24H PEL [Reminyl]
()
30 UNITS   65862074430 51
PDPs
361
MAPDs
GALANTAMINE HBR 12 MG TABLET [Reminyl]
()
180 TABLETS   57237005160 51
PDPs
361
MAPDs
GALANTAMINE HBR 4 MG TABLET [Reminyl]
()
60 tablets   57237004960 51
PDPs
361
MAPDs
GALANTAMINE HBR 8 MG TABLET [Reminyl]
()
60 TABLETS   57237005060 51
PDPs
361
MAPDs
GAMMAGARD LIQUID 10% VIAL
(Immune Globulin (Human) IV)
1 BOTTLE, GLASS in CARTON   00944270003 19
PDPs
261
MAPDs
GAMMAGARD S-D 10 G (IGA<1) SOLUTION
(Immune Globulin (Human) IV)
    00944265804 18
PDPs
247
MAPDs
GAMMAGARD S-D 5 G (IGA<1) SOLUTION
(Immune Globulin (Human) IV)
    00944265603 18
PDPs
247
MAPDs
GAMMAKED 1 GRAM/10 ML VIAL
(Immune Globulin)
10 ML   76125090001 12
PDPs
199
MAPDs
GAMMAPLEX 10 GRAM/100 ML VIAL
(immune globulin)
    64208823506 27
PDPs
251
MAPDs
GAMMAPLEX 10 GRAM/200 ML VIAL
(immune globulin)
100 MLS   64208823407 25
PDPs
252
MAPDs
GAMMAPLEX 20 GRAM/200 ML VIAL
(immune globulin)
    64208823507 27
PDPs
252
MAPDs
GAMMAPLEX 5 GRAM/50 ML VIAL
(immune globulin)
    64208823505 27
PDPs
255
MAPDs
Gamunex-C 10g/100mL 10 mL in 1 VIAL, GLASS
(Immune Globulin (Human) IV)
10 mL in 1 VIAL, GLASS   13533080012 42
PDPs
295
MAPDs
GARDASIL 9 SYRINGE
(Quadrivalent Human Papillomavirus (HPV) Recombinant Vac)
    00006412102 54
PDPs
369
MAPDs
GARDASIL 9 VIAL
(Quadrivalent Human Papillomavirus (HPV) Recombinant Vac)
    00006411903 54
PDPs
369
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 19
PDPs
272
MAPDs
GATTEX 5 MG 30-VIAL KIT
(teduglutide)
1.000 EA   68875010201 45
PDPs
338
MAPDs
GAVILYTE-C SOLUTION
(Polyethylene Glycol 3350 Oral)
278.26 g in 1 BOTTLE   43386006019 54
PDPs
366
MAPDs
GAVILYTE-G SOLUTION
(Polyethylene Glycol 3350 Oral)
274.31 g in 1 BOTTLE   43386009019 51
PDPs
359
MAPDs
GAVRETO 100 MG CAPSULE
(Pralsetinib)
60 CAPSULES   71332000660 54
PDPs
369
MAPDs
GEFITINIB 250 MG TABLET [Iressa]
()
TABLETS   50742036630 54
PDPs
367
MAPDs
GEMFIBROZIL 600 MG TABLET
(Gemfibrozil)
500 EA   69097082112 54
PDPs
369
MAPDs
GEMMILY 1 MG-20 MCG CAPSULE [Taytulla]
(Ethinyl Estradiol, Norethindrone;Ferrous Fumarate)
28 CAPSULES   70700015285 10
PDPs
69
MAPDs
GEMTESA 75 MG TABLET
(Vibegron)
30 TABLETS   73336007530 33
PDPs
220
MAPDs
GENERLAC 10 GM/15 ML SOLUTION
(Lactulose (Encephalopathy))
473.000 ML   60432003816 54
PDPs
366
MAPDs
GENGRAF 100 MG CAPSULE
(Cyclosporine Modified)
30 EA   00074310932 54
PDPs
363
MAPDs
GENGRAF 100MG/ML SOLUTION
(Cyclosporine Modified)
50 ML BOTGL 00074726950 54
PDPs
362
MAPDs
GENGRAF 25 MG CAPSULE
(Cyclosporine Modified)
30 EA   00074310832 54
PDPs
363
MAPDs
GENOTROPIN 13.8MG CARTRIDGE
(Somatropin For)
1 X 13.8 MG CTG 00013264681 26
PDPs
150
MAPDs
GENOTROPIN 5 MG CARTRIDGE
(Somatropin For)
1 PKGCOM 00013262681 26
PDPs
151
MAPDs
GENOTROPIN MINIQUICK 0.2MG
(Somatropin For)
7 X 0.2 MG VIALPAT 00013264902 26
PDPs
150
MAPDs
GENOTROPIN MINIQUICK 0.4MG
(Somatropin For)
7 X 0.4 MG VIALPAT 00013265002 26
PDPs
151
MAPDs
GENOTROPIN MINIQUICK 0.6MG
(Somatropin For)
7 X 0.6 MG VIALPAT 00013265102 26
PDPs
151
MAPDs
GENOTROPIN MINIQUICK 0.8MG
(Somatropin For)
7 X 0.8 MG VIALPAT 00013265202 26
PDPs
151
MAPDs
GENOTROPIN MINIQUICK 1.2MG
(Somatropin For)
7 VIALPAT 00013265402 26
PDPs
151
MAPDs
GENOTROPIN MINIQUICK 1.4MG
(Somatropin For)
7 VIALPAT 00013265502 26
PDPs
151
MAPDs
GENOTROPIN MINIQUICK 1.6MG
(Somatropin For)
7 VIALPAT 00013265602 26
PDPs
151
MAPDs
GENOTROPIN MINIQUICK 1.8MG
(Somatropin For)
7 VIALPAT 00013265702 26
PDPs
151
MAPDs
GENOTROPIN MINIQUICK 1MG
(Somatropin For)
7 X 1.0 MG VIALPAT 00013265302 26
PDPs
151
MAPDs
GENOTROPIN MINIQUICK 2MG
(Somatropin For)
7 X 2.0 MG VIALPAT 00013265802 26
PDPs
151
MAPDs
GENTAMICIN 0.1% CREAM (G)
(Gentamicin)
15 GRAMS   00713068315 54
PDPs
369
MAPDs
GENTAMICIN 0.1% OINTMENT
(Gentamicin)
15 GRAMS   00713068215 54
PDPs
369
MAPDs
GENTAMICIN 0.3% EYE DROPS [Ocu-Mycin]
(Gentamicin Sulfate Ophth)
5 MLS   61314063305 54
PDPs
369
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 54
PDPs
368
MAPDs
Gentamicin Sulfate in Sodium Chloride 60mg/50mL 50 mL in 1 BAG
(Gentamicin Sulfate)
50 mL in 1 BAG   00338050741 33
PDPs
283
MAPDs
GENVOYA TABLET
(Elvitegravir, Cobicistat, Emtricitabine, and Tenofovir Alafenamide Fumarate)
    61958190101 53
PDPs
369
MAPDs
GEODON 20 MG CAPSULE
(Ziprasidone HCl)
30 CAPSULES   00049035260 0
PDPs
4
MAPDs
GEODON 20MG VIAL
(Ziprasidone HCl)
1 VIAL VIALSD 00049392083 0
PDPs
8
MAPDs
GEODON 40 MG CAPSULE
(Ziprasidone HCl)
60 CAPSULES   00049035460 0
PDPs
4
MAPDs
GEODON 60 MG CAPSULE
(Ziprasidone HCl)
60 CAPSULES   00049035660 0
PDPs
4
MAPDs
GEODON 80 MG CAPSULE
(Ziprasidone HCl)
30 CAPSULES   00049035860 0
PDPs
4
MAPDs
GILENYA 0.25 MG CAPSULE
(FINGOLIMOD HCL)
CAPSULES   00078096589 4
PDPs
84
MAPDs
GILENYA 0.5 MG CAPSULE
(FINGOLIMOD HCL)
30 EA   00078060715 1
PDPs
15
MAPDs
GILOTRIF 20 MG TABLET
(afatinib)
30 EA   00597014130 54
PDPs
369
MAPDs
GILOTRIF 30 MG TABLET
(afatinib)
30 EA   00597013730 54
PDPs
369
MAPDs
GILOTRIF 40 MG TABLET
(afatinib)
30 EA   00597013830 54
PDPs
369
MAPDs
GIMOTI 15 MG NASAL SPRAY SPRAY/PUMP
(Metoclopramide)
MLS   72089030715 0
PDPs
7
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 3
PDPs
77
MAPDs
GLATIRAMER 20 MG/ML SYRINGE [Glatopa]
(Glatiramer)
mls   00378696093 35
PDPs
311
MAPDs
GLATIRAMER 40 MG/ML SYRINGE [Copaxone]
(Glatiramer Acetate)
1 ML   00378696112 35
PDPs
309
MAPDs
Glatopa 20 mg/ml syringe
(Glatiramer Acetate)
    00781323434 29
PDPs
279
MAPDs
GLATOPA 40 MG/ML SYRINGE
(Glatiramer)
12 mls   00781325089 30
PDPs
280
MAPDs
GLEEVEC 100MG TABLET (90 CT)
(Imatinib Mesylate)
90 BOT 00078040134 0
PDPs
6
MAPDs
GLEEVEC 400 MG TABLET
(Imatinib Mesylate)
30 EA   00078064930 0
PDPs
6
MAPDs
GLEOSTINE 10 MG CAPSULE
(Lomustine)
CAPSULE   58181304005 54
PDPs
369
MAPDs
GLEOSTINE 100 MG CAPSULE
(Lomustine)
CAPSULES   58181304205 54
PDPs
369
MAPDs
GLEOSTINE 40 MG CAPSULE
(Lomustine)
CAPSULES   58181304105 54
PDPs
369
MAPDs
GLIMEPIRIDE 1 MG TABLET [Amaryl]
()
90 TABLETS   55111032001 54
PDPs
369
MAPDs
GLIMEPIRIDE 2 MG TABLET [Amaryl]
()
90 TABLETS   55111032101 54
PDPs
369
MAPDs
GLIMEPIRIDE 4 MG TABLET [Amaryl]
()
90 TABLETS   16729000316 54
PDPs
369
MAPDs
GLIPIZIDE 10 MG TABLET
(Glipizide)
1000.000 EA   60505014201 54
PDPs
369
MAPDs
GLIPIZIDE 2.5 MG TABLET
(Glipizide)
30 TABLETS   52817038510 23
PDPs
177
MAPDs
GLIPIZIDE 5 MG TABLET
(Glipizide)
1000.000 EA   60505014101 54
PDPs
369
MAPDs
GLIPIZIDE ER 10 MG TABLET ER 24 [Glucotrol XL]
()
90 UNITS   59651027001 54
PDPs
369
MAPDs
GLIPIZIDE ER 2.5MG TABLET SR OSMOTIC PUSH 24HR
(Glipizide)
30 BOTPL 00591090030 54
PDPs
369
MAPDs
GLIPIZIDE ER 5 MG TABLET ER 24 [Glucotrol XL]
()
90 UNITS   64980028005 54
PDPs
369
MAPDs
GLIPIZIDE-METFORMIN 2.5-250 MG TABLET [Metaglip]
(Glipizide, Metformin Hydrochloride)
30 TABLETS   68382018401 54
PDPs
368
MAPDs
GLIPIZIDE-METFORMIN 2.5-500 MG TABLET [Metaglip]
(Glipizide, Metformin Hydrochloride)
60 TABLETS   68382018501 54
PDPs
368
MAPDs
GLIPIZIDE-METFORMIN 5-500 MG TABLET [Metaglip]
(Glipizide, Metformin Hydrochloride)
60 TABLETS   68382018601 54
PDPs
368
MAPDs
GLOPERBA 0.6 MG/5 ML SOLUTION
(Colchicine)
60 MLS   69557022201 0
PDPs
12
MAPDs
GLUCAGON 1 MG EMERGENCY KIT VIAL
(Glucagon (rDNA) For)
1 ML   00548585000 30
PDPs
188
MAPDs
GLUCOTROL XL 10 MG TABLET
(Glipizide)
100.000 EA   00049017807 0
PDPs
4
MAPDs
GLUCOTROL XL 5 MG TABLET ER 24
(Glipizide)
    00049017402 0
PDPs
4
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 25
PDPs
217
MAPDs
GLYBURIDE 1.25MG TABLETS
(Glyburide)
100 TABLETS BOT 00093834201 32
PDPs
219
MAPDs
GLYBURIDE 2.5MG TABLET (100 CT)
(Glyburide)
100 TABLETS BOT 00093834301 32
PDPs
219
MAPDs
GLYBURIDE 5 MG TABLET [Micronase]
()
30 TABLETS   23155005810 32
PDPs
219
MAPDs
GLYBURIDE MICRO 1.5 MG TABLET [Glynase PresTab]
(Glyburide)
20 TABLETS   00093803401 24
PDPs
188
MAPDs
GLYBURIDE MICRO 3 MG TABLET [Glynase PresTab]
(Glyburide)
90 TABLETS   00093803501 24
PDPs
188
MAPDs
GLYBURIDE MICRO 6 MG TABLET [Glynase PresTab]
(Glyburide)
60 TABLETS   00093803601 24
PDPs
188
MAPDs
GLYBURIDE-METFORMIN 2.5-500 MG
(Glyburide)
100.000 EA   65862008101 25
PDPs
217
MAPDs
GLYBURIDE-METFORMIN 5-500 MG
(Glyburide)
100.000 EA   65862008201 25
PDPs
217
MAPDs
GLYCATE 1.5 MG TABLET
(Glycopyrrolate)
TABLETS   80056016010 0
PDPs
3
MAPDs
GLYCOPYRROLATE 1 MG TABLET [Robinul]
(Glycopyrrolate)
60 TABLETS   23155060601 53
PDPs
361
MAPDs
GLYCOPYRROLATE 1 MG/5 ML SOLUTION [Cuvposa]
()
350 MLS   49884004233 4
PDPs
55
MAPDs
GLYCOPYRROLATE 1.5 MG TABLET [Glycate]
()
60 TABLETS   72887016003 5
PDPs
35
MAPDs
GLYCOPYRROLATE 2 MG TABLET [Robinul Forte]
()
60 TABLETS   23155060701 53
PDPs
361
MAPDs
GLYXAMBI 10 MG-5 MG TABLET
(Empagliflozin and Linagliptin)
    00597018230 47
PDPs
315
MAPDs
GLYXAMBI 25 MG-5 MG TABLET
(Empagliflozin and Linagliptin)
    00597016430 47
PDPs
315
MAPDs
GOCOVRI ER 137 MG CAPSULE
(Amantadine)
    70482017060 3
PDPs
24
MAPDs
GOCOVRI ER 68.5 MG CAPSULE
(Amantadine)
    70482008560 3
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 10
PDPs
36
MAPDs
GRALISE ER 300 MG TABLET ER 24H
(Gabapentin)
90 TABLETS   52427080390 2
PDPs
50
MAPDs
GRALISE ER 450 MG TABLET 24H
(Gabapentin)
30 TABLETS   52427080460 2
PDPs
57
MAPDs
GRALISE ER 600 MG TABLET ER 24H
(Gabapentin)
90 TABLETS   52427080690 2
PDPs
50
MAPDs
GRALISE ER 750 MG TABLET 24H
(Gabapentin)
TABLETS   52427085060 2
PDPs
57
MAPDs
GRALISE ER 900 MG TABLET 24H
(Gabapentin)
TABLETS   52427089060 2
PDPs
57
MAPDs
GRANISETRON HCL 1 MG TABLET [Kytril]
()
30 TABLETS   51991073520 35
PDPs
336
MAPDs
GRANIX 300 MCG/0.5 ML SYRINGE
(Tbo-Filgrastim)
5 mls   63459091017 16
PDPs
97
MAPDs
GRANIX 300 MCG/ML VIAL
(tbo-filgrastim)
MLS   63459091859 16
PDPs
100
MAPDs
GRANIX 480 MCG/0.8 ML SYRINGE
(Tbo-Filgrastim)
5.6 mls   63459091217 16
PDPs
97
MAPDs
GRANIX 480 MCG/1.6 ML VIAL
(tbo-filgrastim)
MLS   63459092059 16
PDPs
100
MAPDs
GRASTEK 2,800 BAU SUBLIGUAL TABLET
(timothy grass pollen allergen extract)
TABLETS   52709150103 1
PDPs
17
MAPDs
GRISEOFULVIN 125 MG/5 ML ORAL SUSPENSION [Grifulvin V]
(Griseofulvin Microsize)
120 MLS   69097036108 54
PDPs
368
MAPDs
GRISEOFULVIN MICRO 500 MG TABLET
(Griseofulvin Microsize)
100 EA   00781551501 54
PDPs
346
MAPDs
GRISEOFULVIN ULTRA 125 MG TABLET [Gris-Peg]
(Griseofulvin, Ultramicrocrystalline)
84 tablets   00115172401 54
PDPs
325
MAPDs
GRISEOFULVIN ULTRA 250 MG TABLET [Gris-Peg]
(Griseofulvin, Ultramicrocrystalline)
30 tablets   00115172501 54
PDPs
325
MAPDs
GUANFACINE 1 MG TABLET [Tenex]
(Guanfacine HCl)
30 TABLETS   65162071110 35
PDPs
301
MAPDs
GUANFACINE 2 MG TABLET
(Guanfacine HCl)
100.000 EA   65162071310 35
PDPs
301
MAPDs
GUANFACINE HCL ER 1 MG TABLET 24H [Intuniv]
()
30 TABLETS   60505392701 47
PDPs
329
MAPDs
GUANFACINE HCL ER 2 MG TABLET ER 24H [Intuniv]
()
30 TABLETS   24979053401 47
PDPs
329
MAPDs
GUANFACINE HCL ER 3 MG TABLET ER 24H [Intuniv]
()
30 TABLETS   60505392901 47
PDPs
329
MAPDs
GUANFACINE HCL ER 4 MG TABLET 24H [Intuniv]
()
30 TABLETS   60505393001 47
PDPs
329
MAPDs
GVOKE 1 MG/0.2 ML KIT VIAL
(Glucagon)
ML   72065014011 42
PDPs
291
MAPDs
GVOKE HYPOPEN 2-PK 1 MG/0.2 ML AUTO INJECTOR
(Glucagon)
0.4 ML   72065012112 42
PDPs
296
MAPDs
GVOKE HYPOPEN 2PK 0.5MG/0.1 ML AUTO INJECTOR
(Glucagon)
0.1 ML   72065012012 42
PDPs
293
MAPDs
GVOKE PFS 1-PK 1 MG/0.2 ML SYRINGE
(Glucagon)
0.2 ML   72065013111 42
PDPs
295
MAPDs
GYNAZOLE-1 2% CREAM
(Butoconazole Nitrate (One Dose) Vaginal)
5 GM   45802039601 0
PDPs
14
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 54
PDPs
369
MAPDs
IMATINIB MESYLATE 400 MG TABLET [Gleevec]
()
30 tablets   00093763056 54
PDPs
369
MAPDs
IRESSA 250 MG TABLET
(Gefitinib)
30 EA   00310048230 0
PDPs
28
MAPDs
ISOTON GENTAMICIN 80MG/100ML
(Gentamicin in Saline)
100 ML BAG 00338050348 36
PDPs
287
MAPDs
ISOTONIC GENTAMICIN 100 MG/100 ML
(Gentamicin in Saline)
100 ML   00338050548 33
PDPs
284
MAPDs
ISOTONIC GENTAMICIN 80 MG/50 ML
(Gentamicin in Saline)
50 ML   00338050941 33
PDPs
283
MAPDs
LACTULOSE 10 GM/15 ML SOLUTION [Generlac]
()
237 MLS   00121087316 54
PDPs
369
MAPDs
LOPID 600 MG TABLET
(Gemfibrozil)
60 EA   00071073720 0
PDPs
4
MAPDs
LUMRYZ ER 4.5 GM PACKET
(Sodium Oxybate (Gamma Hydroxybutyrate Or Ghb))
7 UNITS   13551000130 11
PDPs
66
MAPDs
LUMRYZ ER 6 GM PACKET
(Sodium Oxybate (Gamma Hydroxybutyrate Or Ghb))
7 UNITS   13551000230 11
PDPs
66
MAPDs
LUMRYZ ER 7.5 GM PACKET
(Sodium Oxybate (Gamma Hydroxybutyrate Or Ghb))
7 UNITS   13551000330 11
PDPs
66
MAPDs
LUMRYZ ER 9 GM PACKET
(Sodium Oxybate (Gamma Hydroxybutyrate Or Ghb))
7 UNITS   13551000430 11
PDPs
66
MAPDs
MAVYRET 100-40 MG TABLET
(Glecaprevir and Pibrentasvir)
84 EA   00074262528 23
PDPs
247
MAPDs
MAVYRET 50-20 MG PELLET PACKET
(Glecaprevir and Pibrentasvir)
UNITS   00074260028 23
PDPs
226
MAPDs
METFORMIN ER 1,000 MG GASTRC-TABLET 24H [Glumetza]
(Metformin HCl)
90 UNITS   42571033490 1
PDPs
6
MAPDs
METFORMIN ER 500 MG GASTRC-TABLET 24H [Glumetza]
(Metformin HCl)
90 UNITS   42571033301 2
PDPs
13
MAPDs
METFORMIN ER 500 MG OSMOTIC TABLET 24H [Glumetza]
(Metformin HCl)
30 UNITS   50742063360 5
PDPs
16
MAPDs
METFORMIN HCL 1,000 MG TABLET [Glucophage]
(Metformin Hydrochloride)
180 TABLETS   71717010611 54
PDPs
369
MAPDs
METFORMIN HCL 500 MG TABLET [Glucophage]
(Metformin Hydrochloride)
180 TABLETS   70010006310 54
PDPs
369
MAPDs
METFORMIN HCL 850 MG TABLET [Glucophage]
(Metformin Hydrochloride)
180 TABLETS   65862000905 54
PDPs
369
MAPDs
METFORMIN HCL ER 500 MG TABLET 24H [Glumetza]
(Metformin Hydrochloride)
90 TABLETS   70010049105 54
PDPs
369
MAPDs
METFORMIN HCL ER 750 MG TABLET 24H [Glucophage XR]
(Metformin HCl)
90 TABLETS   67877041401 54
PDPs
369
MAPDs
MIGLITOL 100 MG TABLET [Glyset]
(Miglitol)
TABLETS   69367030501 6
PDPs
153
MAPDs
MIGLITOL 25 MG TABLET [Glyset]
(Miglitol)
270 TABLETS   69367030301 6
PDPs
153
MAPDs
MIGLITOL 50 MG TABLET [Glyset]
(Miglitol)
TABLETS   69367030401 6
PDPs
153
MAPDs
NEOMYCIN/POLYMY/GRAM EYE DROPS 0.025MG/ML 1.75MG/M
(Neomycin-Polymyxin B-Gramicidin Ophth)
10 ML BOT 24208079062 54
PDPs
366
MAPDs
NEURONTIN 100MG CAPSULE
(Gabapentin)
100 BOT 00071080324 0
PDPs
4
MAPDs
NEURONTIN 250 MG/5 ML SOLUTION
(Gabapentin)
60 MLS   00071201247 0
PDPs
4
MAPDs
NEURONTIN 300MG CAPSULE
(Gabapentin)
100 BOT 00071080524 0
PDPs
4
MAPDs
NEURONTIN 400MG CAPSULE
(Gabapentin)
100 BOT 00071080624 0
PDPs
4
MAPDs
NEURONTIN 600MG TABLET
(Gabapentin)
100 BOT 00071051324 0
PDPs
4
MAPDs
NEURONTIN 800MG TABLET
(Gabapentin)
100 BOT 00071040124 0
PDPs
4
MAPDs
ORALAIR 300 IR SUBLINGUAL TABLET
(Grass Pollen Allergen Extract)
30 EA   59617001502 2
PDPs
39
MAPDs
PIOGLITAZONE-GLIMEPIRIDE 30-2 TABLET [Duetact]
(Pioglitazone, Glimepiride)
tablets   66993082130 14
PDPs
112
MAPDs
PIOGLITAZONE-GLIMEPIRIDE 30-4 Tablet [Duetact]
(Pioglitazone, Glimepiride)
30 tablets   66993082230 14
PDPs
112
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 2
PDPs
146
MAPDs
ROBINUL 1 MG TABLET
(Glycopyrrolate)
60 TABLETS   70199000790 0
PDPs
2
MAPDs
ROBINUL FORTE 2 MG TABLET
(Glycopyrrolate)
60 TABLETS   70199000890 0
PDPs
2
MAPDs
SIMPONI 100 MG/ML PEN INJECTOR
(Golimumab Subcutaneous)
1 ML   57894007102 1
PDPs
74
MAPDs
SIMPONI 100 MG/ML SYRINGE
(Golimumab Subcutaneous)
1 ML   57894007101 1
PDPs
74
MAPDs
SIMPONI 50 MG/0.5 ML PEN INJEC
(Golimumab Subcutaneous)
0.5 ML   57894007002 2
PDPs
74
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
74
MAPDs
TIAGABINE HCL 12 MG TABLET [Gabitril]
()
30 tablets   00093807256 54
PDPs
369
MAPDs
TIAGABINE HCL 16 MG TABLET [Gabitril]
()
tablets   00093807656 54
PDPs
369
MAPDs
TIAGABINE HCL 2 MG TABLET [Gabitril]
()
49 TABLETS   62756020083 54
PDPs
369
MAPDs
TIAGABINE HCL 4 MG TABLET [Gabitril]
()
TABLETS   62756022483 54
PDPs
369
MAPDs
TREMFYA 100 MG/ML AUTOINJECTOR
(Guselkumab)
ml   57894064011 8
PDPs
190
MAPDs
TREMFYA 100 MG/ML SYRINGE
(Guselkumab)
    57894064001 8
PDPs
190
MAPDs
XOSPATA 40 MG TABLET
(Gilteritinib)
tablets   00469142590 54
PDPs
369
MAPDs
ZIPRASIDONE 20 MG/ML VIAL [Geodon]
()
1 ML   43598084858 54
PDPs
369
MAPDs
ZIPRASIDONE HCL 20 MG CAPSULE [Geodon]
(Ziprasidone HCl)
60.000 EA   55111025660 54
PDPs
369
MAPDs
ZIPRASIDONE HCL 40 MG CAPSULE [Geodon]
(Ziprasidone HCl)
60.000 EA   55111025760 54
PDPs
369
MAPDs
ZIPRASIDONE HCL 60 MG CAPSULE [Geodon]
(Ziprasidone HCl)
    55111025860 54
PDPs
369
MAPDs
ZIPRASIDONE HCL 80 MG CAPSULE [Geodon]
(Ziprasidone HCl)
60.000 EA   55111025960 54
PDPs
369
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
300
MAPDs
ZTALMY 50 MG/ML ORAL SUSPENSION
(Ganaxolone)
110 MLS   81583010001 54
PDPs
369
MAPDs



(Chart Source: Centers for Medicare and Medicaid files: CMS Data September 2024)





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