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2024 PDP-DrugFinder:
Search Plan Formulary by Drug Letter

 Select a Letter below:
A  B  C  D  E  F  G  H  I  J  K  L  M  N  O  P  Q  R  S  T  U  V  W  X  Y  Z
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		 200
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		 272
MAPDs
EMGALITY 120 MG/ML SYRINGE
(Galcanezumab)		 1 ml   00002237711 38
PDPs		 272
MAPDs
EMGALITY 300 MG (100 MG X3SYR) SYRINGE
(Galcanezumab)		 3 mls   00002311509 36
PDPs		 223
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		 362
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   69097094312 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
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   50242021060 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		 68
MAPDs
GEMTESA 75 MG TABLET
(Vibegron)		 30 TABLETS   73336007530 33
PDPs		 218
MAPDs
GENERLAC 10 GM/15 ML SOLUTION
(Lactulose (Encephalopathy))		 473.000 ML   60432003816 54
PDPs		 365
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		 83
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		 171
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
GLUCAGEN 1MG HYPOKIT
(Glucagon HCl (rDNA) For)		 1 X 1 MG PKGCOM 00169706515 34
PDPs		 199
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 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 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		 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		 336
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 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		 289
MAPDs
GVOKE HYPOPEN 2-PK 1 MG/0.2 ML AUTO INJECTOR
(Glucagon)		 0.4 ML   72065012112 42
PDPs		 294
MAPDs
GVOKE HYPOPEN 2PK 0.5MG/0.1 ML AUTO INJECTOR
(Glucagon)		 0.1 ML   72065012012 42
PDPs		 291
MAPDs
GVOKE PFS 1-PK 1 MG/0.2 ML SYRINGE
(Glucagon)		 0.2 ML   72065013111 42
PDPs		 293
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 0
PDPs		 43
MAPDs
LUMRYZ ER 6 GM PACKET
(Sodium Oxybate (Gamma Hydroxybutyrate Or Ghb))		 7 UNITS   13551000230 0
PDPs		 43
MAPDs
LUMRYZ ER 7.5 GM PACKET
(Sodium Oxybate (Gamma Hydroxybutyrate Or Ghb))		 7 UNITS   13551000330 0
PDPs		 43
MAPDs
LUMRYZ ER 9 GM PACKET
(Sodium Oxybate (Gamma Hydroxybutyrate Or Ghb))		 7 UNITS   13551000430 0
PDPs		 43
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		 225
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 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
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		 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 1
PDPs		 123
MAPDs
TREMFYA 100 MG/ML SYRINGE
(Guselkumab)		     57894064001 1
PDPs		 123
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)		 MLS   81583010005 54
PDPs		 369
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





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  • Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Our PDPCompare.com and MACompare.com provide highlights of annual plan benefit changes.
  • The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
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  • We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
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  • When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium.
  • Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Read more on IRMAA.
  • Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
  • You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Members may enroll in a Medicare Advantage plan only during specific times of the year. Contact the Medicare plan for more information.
  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
  • Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.
  • A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Providers who do not contract with the plan are not required to see you except in an emergency.
  • Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home.
  • Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
  • Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition.
  • Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.
  • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
  • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
  • Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.
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