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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 30
PDPs
200
MAPDs
BEVESPI AEROSPHERE INHALER
(Glycopyrrolate and formoterol fumarate)
10.700 GM   00310460012 15
PDPs
150
MAPDs
BREZTRI AEROSPHERE INHALER HFA AER AD
(Budesonide, Glycopyrrolate, Formoterol)
10.7 GRAMS   00310461612 34
PDPs
337
MAPDs
COPAXONE 20MG/ML 30 BLISTER PACK IN 1 CRTN
(Glatiramer Acetate)
    68546031730 30
PDPs
122
MAPDs
COPAXONE 40 MG/ML SYRINGE
(Glatiramer Acetate)
1 ML   68546032512 31
PDPs
125
MAPDs
CROMOLYN 100 MG/5 ML ORAL CONC [Gastrocrom]
(Cromolyn )
480 MLS   42571013252 55
PDPs
370
MAPDs
CUVPOSA 1 MG/5 ML SOLUTION
(Glycopyrrolate)
    00259050116 0
PDPs
2
MAPDs
DARTISLA ODT 1.7 MG TABLET RAPDIS
(Glycopyrrolate)
UNITS   82111051801 0
PDPs
2
MAPDs
DAURISMO 100 MG TABLET
(Glasdegib)
tablets   00069153130 55
PDPs
370
MAPDs
DAURISMO 25 MG TABLET
(Glasdegib)
tablets   00069029860 55
PDPs
370
MAPDs
EMGALITY 120 MG/ML PEN INJCTR
(Galcanezumab)
1 ml   00002143611 39
PDPs
268
MAPDs
EMGALITY 120 MG/ML SYRINGE
(Galcanezumab)
1 ml   00002237711 39
PDPs
268
MAPDs
EMGALITY 300 MG (100 MG X3SYR) SYRINGE
(Galcanezumab)
3 mls   00002311509 37
PDPs
222
MAPDs
ENDARI 5 GRAM POWDER PACKET
(Glutamine Powder (For Sickle Cell Disease))
UNITS   42457042001 51
PDPs
350
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 43
PDPs
363
MAPDs
GABAPENTIN 100 MG CAPSULE [Neurontin]
()
90 CAPSULES   69097081312 55
PDPs
370
MAPDs
GABAPENTIN 250 MG/5 ML SOLUTION [Neurontin]
()
30 MLS   42192060816 55
PDPs
370
MAPDs
GABAPENTIN 300 MG CAPSULE [Neurontin]
()
90 CAPSULES   69097094312 55
PDPs
370
MAPDs
GABAPENTIN 400 MG CAPSULE [Neurontin]
()
90 CAPSULES   65162010350 55
PDPs
370
MAPDs
GABAPENTIN 600 MG TABLET
(Gabapentin)
500.000 EA   68462012605 55
PDPs
370
MAPDs
GABAPENTIN 800 MG TABLET
(Gabapentin)
500.000 EA   68462012705 55
PDPs
370
MAPDs
GALAFOLD 123 MG CAPSULE
(Migalastat)
capsules   71904010001 1
PDPs
138
MAPDs
GALANTAMINE 4 MG/ML ORAL SOLUTION
(Galantamine Hydrobromide)
100 mL in 1 BOTTLE   00054013749 51
PDPs
349
MAPDs
GALANTAMINE ER 16 MG CAPSULE 24H PEL [Reminyl]
()
30 UNITS   65862074530 52
PDPs
362
MAPDs
GALANTAMINE ER 24 MG CAPSULE 24H PEL [Reminyl]
()
30 UNITS   65862074630 52
PDPs
362
MAPDs
GALANTAMINE ER 8 MG CAPSULE 24H PEL [Reminyl]
()
30 UNITS   65862074430 52
PDPs
362
MAPDs
GALANTAMINE HBR 12 MG TABLET [Reminyl]
()
180 TABLETS   57237005160 52
PDPs
362
MAPDs
GALANTAMINE HBR 4 MG TABLET [Reminyl]
()
60 tablets   57237004960 52
PDPs
362
MAPDs
GALANTAMINE HBR 8 MG TABLET [Reminyl]
()
60 TABLETS   57237005060 52
PDPs
362
MAPDs
GAMMAGARD LIQUID 10% VIAL
(Immune Globulin (Human) IV)
1 BOTTLE, GLASS in CARTON   00944270003 19
PDPs
262
MAPDs
GAMMAGARD S-D 10 G (IGA<1) SOLUTION
(Immune Globulin (Human) IV)
    00944265804 18
PDPs
248
MAPDs
GAMMAGARD S-D 5 G (IGA<1) SOLUTION
(Immune Globulin (Human) IV)
    00944265603 18
PDPs
248
MAPDs
GAMMAKED 1 GRAM/10 ML VIAL
(Immune Globulin)
10 ML   76125090001 12
PDPs
200
MAPDs
GAMMAPLEX 10 GRAM/100 ML VIAL
(immune globulin)
    64208823506 27
PDPs
249
MAPDs
GAMMAPLEX 10 GRAM/200 ML VIAL
(immune globulin)
100 MLS   64208823407 25
PDPs
253
MAPDs
GAMMAPLEX 20 GRAM/200 ML VIAL
(immune globulin)
    64208823507 27
PDPs
250
MAPDs
GAMMAPLEX 5 GRAM/50 ML VIAL
(immune globulin)
    64208823505 27
PDPs
253
MAPDs
Gamunex-C 10g/100mL 10 mL in 1 VIAL, GLASS
(Immune Globulin (Human) IV)
10 mL in 1 VIAL, GLASS   13533080012 42
PDPs
296
MAPDs
GARDASIL 9 SYRINGE
(Quadrivalent Human Papillomavirus (HPV) Recombinant Vac)
    00006412102 55
PDPs
370
MAPDs
GARDASIL 9 VIAL
(Quadrivalent Human Papillomavirus (HPV) Recombinant Vac)
    00006411903 55
PDPs
370
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 20
PDPs
272
MAPDs
GATTEX 5 MG 30-VIAL KIT
(teduglutide)
1.000 EA   68875010201 45
PDPs
339
MAPDs
GAVILYTE-C SOLUTION
(Polyethylene Glycol 3350 Oral)
278.26 g in 1 BOTTLE   43386006019 55
PDPs
367
MAPDs
GAVILYTE-G SOLUTION
(Polyethylene Glycol 3350 Oral)
274.31 g in 1 BOTTLE   43386009019 52
PDPs
360
MAPDs
GAVRETO 100 MG CAPSULE
(Pralsetinib)
60 CAPSULES   50242021060 55
PDPs
370
MAPDs
GEFITINIB 250 MG TABLET [Iressa]
()
TABLETS   50742036630 55
PDPs
368
MAPDs
GELNIQUE 10% GEL SACHET PACKET
(Oxybutynin Chloride)
GRAM   00023586111 1
PDPs
11
MAPDs
GEMFIBROZIL 600 MG TABLET
(Gemfibrozil)
500 EA   69097082112 55
PDPs
370
MAPDs
GEMMILY 1 MG-20 MCG CAPSULE [Taytulla]
(Ethinyl Estradiol, Norethindrone;Ferrous Fumarate)
28 CAPSULES   70700015285 10
PDPs
66
MAPDs
GEMTESA 75 MG TABLET
(Vibegron)
30 TABLETS   73336007530 34
PDPs
217
MAPDs
GENERLAC 10 GM/15 ML SOLUTION
(Lactulose (Encephalopathy))
473.000 ML   60432003816 55
PDPs
366
MAPDs
GENGRAF 100 MG CAPSULE
(Cyclosporine Modified)
30 EA   00074310932 55
PDPs
364
MAPDs
GENGRAF 100MG/ML SOLUTION
(Cyclosporine Modified)
50 ML BOTGL 00074726950 55
PDPs
363
MAPDs
GENGRAF 25 MG CAPSULE
(Cyclosporine Modified)
30 EA   00074310832 55
PDPs
364
MAPDs
GENOTROPIN 13.8MG CARTRIDGE
(Somatropin For)
1 X 13.8 MG CTG 00013264681 27
PDPs
149
MAPDs
GENOTROPIN 5 MG CARTRIDGE
(Somatropin For)
1 PKGCOM 00013262681 27
PDPs
150
MAPDs
GENOTROPIN MINIQUICK 0.2MG
(Somatropin For)
7 X 0.2 MG VIALPAT 00013264902 27
PDPs
149
MAPDs
GENOTROPIN MINIQUICK 0.4MG
(Somatropin For)
7 X 0.4 MG VIALPAT 00013265002 27
PDPs
150
MAPDs
GENOTROPIN MINIQUICK 0.6MG
(Somatropin For)
7 X 0.6 MG VIALPAT 00013265102 27
PDPs
150
MAPDs
GENOTROPIN MINIQUICK 0.8MG
(Somatropin For)
7 X 0.8 MG VIALPAT 00013265202 27
PDPs
150
MAPDs
GENOTROPIN MINIQUICK 1.2MG
(Somatropin For)
7 VIALPAT 00013265402 27
PDPs
150
MAPDs
GENOTROPIN MINIQUICK 1.4MG
(Somatropin For)
7 VIALPAT 00013265502 27
PDPs
150
MAPDs
GENOTROPIN MINIQUICK 1.6MG
(Somatropin For)
7 VIALPAT 00013265602 27
PDPs
150
MAPDs
GENOTROPIN MINIQUICK 1.8MG
(Somatropin For)
7 VIALPAT 00013265702 27
PDPs
150
MAPDs
GENOTROPIN MINIQUICK 1MG
(Somatropin For)
7 X 1.0 MG VIALPAT 00013265302 27
PDPs
150
MAPDs
GENOTROPIN MINIQUICK 2MG
(Somatropin For)
7 X 2.0 MG VIALPAT 00013265802 27
PDPs
150
MAPDs
GENTAMICIN 0.1% CREAM (G)
(Gentamicin)
15 GRAMS   00713068315 55
PDPs
370
MAPDs
GENTAMICIN 0.1% OINTMENT
(Gentamicin)
15 GRAMS   00713068215 55
PDPs
370
MAPDs
GENTAMICIN 0.3% EYE DROPS [Ocu-Mycin]
(Gentamicin Sulfate Ophth)
5 MLS   61314063305 55
PDPs
370
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 55
PDPs
369
MAPDs
Gentamicin Sulfate in Sodium Chloride 60mg/50mL 50 mL in 1 BAG
(Gentamicin Sulfate)
50 mL in 1 BAG   00338050741 33
PDPs
284
MAPDs
GENVOYA TABLET
(Elvitegravir, Cobicistat, Emtricitabine, and Tenofovir Alafenamide Fumarate)
    61958190101 54
PDPs
370
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)
60 capsules   00049005460 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
81
MAPDs
GILENYA 0.5 MG CAPSULE
(FINGOLIMOD HCL)
30 EA   00078060715 1
PDPs
15
MAPDs
GILOTRIF 20 MG TABLET
(afatinib)
30 EA   00597014130 55
PDPs
370
MAPDs
GILOTRIF 30 MG TABLET
(afatinib)
30 EA   00597013730 55
PDPs
370
MAPDs
GILOTRIF 40 MG TABLET
(afatinib)
30 EA   00597013830 55
PDPs
370
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
78
MAPDs
GLATIRAMER 20 MG/ML SYRINGE [Glatopa]
(Glatiramer)
mls   00378696093 36
PDPs
312
MAPDs
GLATIRAMER 40 MG/ML SYRINGE [Copaxone]
(Glatiramer Acetate)
1 ML   00378696112 36
PDPs
310
MAPDs
Glatopa 20 mg/ml syringe
(Glatiramer Acetate)
    00781323434 29
PDPs
280
MAPDs
GLATOPA 40 MG/ML SYRINGE
(Glatiramer)
12 mls   00781325089 30
PDPs
281
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 55
PDPs
370
MAPDs
GLEOSTINE 100 MG CAPSULE
(Lomustine)
CAPSULES   58181304205 55
PDPs
370
MAPDs
GLEOSTINE 40 MG CAPSULE
(Lomustine)
CAPSULES   58181304105 55
PDPs
370
MAPDs
GLIMEPIRIDE 1 MG TABLET [Amaryl]
()
90 TABLETS   55111032001 55
PDPs
370
MAPDs
GLIMEPIRIDE 2 MG TABLET [Amaryl]
()
90 TABLETS   55111032101 55
PDPs
370
MAPDs
GLIMEPIRIDE 4 MG TABLET [Amaryl]
()
90 TABLETS   16729000316 55
PDPs
370
MAPDs
GLIPIZIDE 10 MG TABLET
(Glipizide)
1000.000 EA   60505014201 55
PDPs
370
MAPDs
GLIPIZIDE 5 MG TABLET
(Glipizide)
1000.000 EA   60505014101 55
PDPs
370
MAPDs
GLIPIZIDE ER 10 MG TABLET ER 24 [Glucotrol XL]
()
90 UNITS   59651027001 55
PDPs
370
MAPDs
GLIPIZIDE ER 2.5MG TABLET SR OSMOTIC PUSH 24HR
(Glipizide)
30 BOTPL 00591090030 55
PDPs
370
MAPDs
GLIPIZIDE ER 5 MG TABLET ER 24 [Glucotrol XL]
()
90 UNITS   64980028005 55
PDPs
370
MAPDs
GLIPIZIDE-METFORMIN 2.5-250 MG TABLET [Metaglip]
(Glipizide, Metformin Hydrochloride)
30 TABLETS   68382018401 55
PDPs
369
MAPDs
GLIPIZIDE-METFORMIN 2.5-500 MG TABLET [Metaglip]
(Glipizide, Metformin Hydrochloride)
60 TABLETS   68382018501 55
PDPs
369
MAPDs
GLIPIZIDE-METFORMIN 5-500 MG TABLET [Metaglip]
(Glipizide, Metformin Hydrochloride)
60 TABLETS   68382018601 55
PDPs
369
MAPDs
GLUCAGEN 1MG HYPOKIT
(Glucagon HCl (rDNA) For)
1 X 1 MG PKGCOM 00169706515 35
PDPs
200
MAPDs
GLUCAGON 1MG EMERGENCY KIT
(Glucagon (rDNA) For)
1 KIT PKGCOM 00002803101 29
PDPs
181
MAPDs
GLUCOTROL XL 10 MG TABLET
(Glipizide)
100.000 EA   00049017807 0
PDPs
4
MAPDs
GLUCOTROL XL 2.5 MG TABLET
(Glipizide)
30 EA 00049017001 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 26
PDPs
218
MAPDs
GLYBURIDE 1.25MG TABLETS
(Glyburide)
100 TABLETS BOT 00093834201 33
PDPs
218
MAPDs
GLYBURIDE 2.5MG TABLET (100 CT)
(Glyburide)
100 TABLETS BOT 00093834301 33
PDPs
218
MAPDs
GLYBURIDE 5 MG TABLET [Micronase]
()
30 TABLETS   23155005810 33
PDPs
218
MAPDs
GLYBURIDE MICRO 1.5 MG TABLET [Glynase PresTab]
(Glyburide)
20 TABLETS   00093803401 24
PDPs
189
MAPDs
GLYBURIDE MICRO 3 MG TABLET [Glynase PresTab]
(Glyburide)
90 TABLETS   00093803501 24
PDPs
189
MAPDs
GLYBURIDE MICRO 6 MG TABLET [Glynase PresTab]
(Glyburide)
60 TABLETS   00093803601 24
PDPs
189
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
3
MAPDs
GLYCOPYRROLATE 1 MG TABLET [Robinul]
(Glycopyrrolate)
60 TABLETS   23155060601 54
PDPs
362
MAPDs
GLYCOPYRROLATE 1 MG/5 ML SOLUTION [Cuvposa]
()
350 MLS   49884004233 4
PDPs
56
MAPDs
GLYCOPYRROLATE 1.5 MG TABLET [Glycate]
()
60 TABLETS   72887016003 5
PDPs
35
MAPDs
GLYCOPYRROLATE 2 MG TABLET [Robinul Forte]
()
60 TABLETS   23155060701 54
PDPs
362
MAPDs
GLYXAMBI 10 MG-5 MG TABLET
(Empagliflozin and Linagliptin)
    00597018230 48
PDPs
315
MAPDs
GLYXAMBI 25 MG-5 MG TABLET
(Empagliflozin and Linagliptin)
    00597016430 48
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
57
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
57
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
335
MAPDs
GRANIX 300 MCG/0.5 ML SYRINGE
(Tbo-Filgrastim)
5 mls   63459091017 16
PDPs
95
MAPDs
GRANIX 300 MCG/ML VIAL
(tbo-filgrastim)
MLS   63459091859 16
PDPs
98
MAPDs
GRANIX 480 MCG/0.8 ML SYRINGE
(Tbo-Filgrastim)
5.6 mls   63459091217 16
PDPs
95
MAPDs
GRANIX 480 MCG/1.6 ML VIAL
(tbo-filgrastim)
MLS   63459092059 16
PDPs
98
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 55
PDPs
369
MAPDs
GRISEOFULVIN MICRO 500 MG TABLET
(Griseofulvin Microsize)
100 EA   00781551501 55
PDPs
347
MAPDs
GRISEOFULVIN ULTRA 125 MG TABLET [Gris-Peg]
(Griseofulvin, Ultramicrocrystalline)
84 tablets   00115172401 55
PDPs
326
MAPDs
GRISEOFULVIN ULTRA 250 MG TABLET [Gris-Peg]
(Griseofulvin, Ultramicrocrystalline)
30 tablets   00115172501 55
PDPs
326
MAPDs
GUANFACINE 1 MG TABLET [Tenex]
(Guanfacine HCl)
30 TABLETS   65162071110 36
PDPs
302
MAPDs
GUANFACINE 2 MG TABLET
(Guanfacine HCl)
100.000 EA   65162071310 36
PDPs
302
MAPDs
GUANFACINE HCL ER 1 MG TABLET 24H [Intuniv]
()
30 TABLETS   60505392701 48
PDPs
330
MAPDs
GUANFACINE HCL ER 2 MG TABLET ER 24H [Intuniv]
()
30 TABLETS   24979053401 48
PDPs
330
MAPDs
GUANFACINE HCL ER 3 MG TABLET ER 24H [Intuniv]
()
30 TABLETS   60505392901 48
PDPs
330
MAPDs
GUANFACINE HCL ER 4 MG TABLET 24H [Intuniv]
()
30 TABLETS   60505393001 48
PDPs
330
MAPDs
GVOKE 1 MG/0.2 ML KIT VIAL
(Glucagon)
ML   72065014011 43
PDPs
287
MAPDs
GVOKE HYPOPEN 2-PK 1 MG/0.2 ML AUTO INJECTOR
(Glucagon)
0.4 ML   72065012112 43
PDPs
292
MAPDs
GVOKE HYPOPEN 2PK 0.5MG/0.1 ML AUTO INJECTOR
(Glucagon)
0.1 ML   72065012012 43
PDPs
289
MAPDs
GVOKE PFS 1-PK 1 MG/0.2 ML SYRINGE
(Glucagon)
0.2 ML   72065013111 43
PDPs
291
MAPDs
GVOKE PFS 1PK 0.5MG/0.1 ML SYRINGE
(Glucagon)
ML   72065013011 43
PDPs
288
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 55
PDPs
370
MAPDs
IMATINIB MESYLATE 400 MG TABLET [Gleevec]
()
30 tablets   00093763056 55
PDPs
370
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
288
MAPDs
ISOTONIC GENTAMICIN 100 MG/100 ML
(Gentamicin in Saline)
100 ML   00338050548 33
PDPs
285
MAPDs
ISOTONIC GENTAMICIN 80 MG/50 ML
(Gentamicin in Saline)
50 ML   00338050941 33
PDPs
284
MAPDs
LACTULOSE 10 GM/15 ML SOLUTION [Generlac]
()
237 MLS   00121087316 55
PDPs
370
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 0
PDPs
40
MAPDs
LUMRYZ ER 6 GM PACKET
(Sodium Oxybate (Gamma Hydroxybutyrate Or Ghb))
7 UNITS   13551000230 0
PDPs
40
MAPDs
LUMRYZ ER 7.5 GM PACKET
(Sodium Oxybate (Gamma Hydroxybutyrate Or Ghb))
7 UNITS   13551000330 0
PDPs
40
MAPDs
LUMRYZ ER 9 GM PACKET
(Sodium Oxybate (Gamma Hydroxybutyrate Or Ghb))
7 UNITS   13551000430 0
PDPs
40
MAPDs
MAVYRET 100-40 MG TABLET
(Glecaprevir and Pibrentasvir)
84 EA   00074262528 24
PDPs
248
MAPDs
MAVYRET 50-20 MG PELLET PACKET
(Glecaprevir and Pibrentasvir)
UNITS   00074260028 24
PDPs
224
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   70010006510 55
PDPs
370
MAPDs
METFORMIN HCL 500 MG TABLET [Glucophage]
(Metformin Hydrochloride)
180 TABLETS   70010006310 55
PDPs
370
MAPDs
METFORMIN HCL 850 MG TABLET [Glucophage]
(Metformin Hydrochloride)
180 TABLETS   65862000905 55
PDPs
370
MAPDs
METFORMIN HCL ER 500 MG TABLET 24H [Glumetza]
(Metformin Hydrochloride)
90 TABLETS   70010049105 55
PDPs
370
MAPDs
METFORMIN HCL ER 750 MG TABLET 24H [Glucophage XR]
(Metformin HCl)
90 TABLETS   67877041401 55
PDPs
370
MAPDs
MIGLITOL 100 MG TABLET [Glyset]
(Miglitol)
TABLETS   69367030501 6
PDPs
154
MAPDs
MIGLITOL 25 MG TABLET [Glyset]
(Miglitol)
270 TABLETS   69367030301 6
PDPs
154
MAPDs
MIGLITOL 50 MG TABLET [Glyset]
(Miglitol)
TABLETS   69367030401 6
PDPs
154
MAPDs
NEOMYCIN/POLYMY/GRAM EYE DROPS 0.025MG/ML 1.75MG/M
(Neomycin-Polymyxin B-Gramicidin Ophth)
10 ML BOT 24208079062 55
PDPs
367
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
10
MAPDs
RAVICTI 1.1 GRAM/ML LIQUID
(Glycerol Phenylbutyrate)
25 ML   75987005006 2
PDPs
147
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
SANCUSO TRANSDERMAL SYSTEM 3.1MG/24HRS 1 PATCH CRTN
(Granisetron Transdermal)
1 PATCH CRTN 42747072601 8
PDPs
81
MAPDs
SIMPONI 100 MG/ML PEN INJECTOR
(Golimumab Subcutaneous)
1 ML   57894007102 1
PDPs
75
MAPDs
SIMPONI 100 MG/ML SYRINGE
(Golimumab Subcutaneous)
1 ML   57894007101 1
PDPs
75
MAPDs
SIMPONI 50 MG/0.5 ML PEN INJEC
(Golimumab Subcutaneous)
0.5 ML   57894007002 2
PDPs
75
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
75
MAPDs
TIAGABINE HCL 12 MG TABLET [Gabitril]
()
30 tablets   00093807256 55
PDPs
370
MAPDs
TIAGABINE HCL 16 MG TABLET [Gabitril]
()
tablets   00093807656 55
PDPs
370
MAPDs
TIAGABINE HCL 2 MG TABLET [Gabitril]
()
49 TABLETS   62756020083 55
PDPs
370
MAPDs
TIAGABINE HCL 4 MG TABLET [Gabitril]
()
TABLETS   62756022483 55
PDPs
370
MAPDs
TREMFYA 100 MG/ML AUTOINJECTOR
(Guselkumab)
ml   57894064011 1
PDPs
86
MAPDs
TREMFYA 100 MG/ML SYRINGE
(Guselkumab)
    57894064001 1
PDPs
86
MAPDs
XOSPATA 40 MG TABLET
(Gilteritinib)
tablets   00469142590 55
PDPs
370
MAPDs
ZIPRASIDONE 20 MG/ML VIAL [Geodon]
()
1 ML   43598084858 55
PDPs
370
MAPDs
ZIPRASIDONE HCL 20 MG CAPSULE [Geodon]
(Ziprasidone HCl)
60.000 EA   55111025660 55
PDPs
370
MAPDs
ZIPRASIDONE HCL 40 MG CAPSULE [Geodon]
(Ziprasidone HCl)
60.000 EA   55111025760 55
PDPs
370
MAPDs
ZIPRASIDONE HCL 60 MG CAPSULE [Geodon]
(Ziprasidone HCl)
    55111025860 55
PDPs
370
MAPDs
ZIPRASIDONE HCL 80 MG CAPSULE [Geodon]
(Ziprasidone HCl)
60.000 EA   55111025960 55
PDPs
370
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 39
PDPs
301
MAPDs
ZTALMY 50 MG/ML ORAL SUSPENSION
(Ganaxolone)
MLS   81583010005 55
PDPs
370
MAPDs
ZYMAXID 5mg/mL 1 BOTTLE, DROPPER per CARTON / 2.5 mL in 1 BOTTLE, DROPPER
(Gatifloxacin Ophth)
1 BOTTLE, DROPPER   00023361525 0
PDPs
1
MAPDs



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





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