MedicarePartD.guide

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2026 Humana Value Rx Plan (PDP) formulary (drug list)

Contract S5884, plan 194 · Kentucky · 3,009 drugs on file · formulary ID 00026400. Each drug links to its cost in every CMS PDP Region 15 plan.

Hide drugs on tiers

45 drugs starting with X.

Drug nameTier30-day preferred pharmacy90-day mail orderUsage management
XALKORI 150 mg Capsule, Coated PelletsCrizotinib5Specialty Tier26%N/A
  • PA
  • QL 18 per 30 days
XALKORI 20 mg Capsule, Coated PelletsCrizotinib5Specialty Tier26%N/A
  • PA
  • QL 12 per 30 days
XALKORI 200 mg CapsuleCrizotinib5Specialty Tier26%N/A
  • PA
  • QL 12 per 30 days
XALKORI 250 mg CapsuleCrizotinib5Specialty Tier26%N/A
  • PA
  • QL 12 per 30 days
XALKORI 50 mg Capsule, Coated PelletsCrizotinib5Specialty Tier26%N/A
  • PA
  • QL 24 per 30 days
XARAH FE KitNorethindrone Acetate And Ethinyl Estradiol And Ferrous Fumarate Tablets2Generic$0.00$0.00None
XARELTO 10 mg Tablet, Film CoatedRivaroxaban3Preferred Brand20%15%
  • QL 3 per 30 days
XARELTO 15 mg Tablet, Film CoatedRivaroxaban3Preferred Brand20%15%
  • QL 6 per 30 days
XARELTO 155 mg Granule, For SuspensionRivaroxaban3Preferred Brand20%15%
  • ST
  • QL 6 per 30 days
XARELTO 2.5 mg Tablet, Film CoatedRivaroxaban3Preferred Brand20%15%
  • QL 6 per 30 days
XARELTO 20 mg Tablet, Film CoatedRivaroxaban3Preferred Brand20%15%
  • QL 3 per 30 days
XARELTO KitRivaroxaban3Preferred Brand20%15%
  • QL 51 per 30 days
XATMEP 2.5 mg/mL SolutionMethotrexate4Non-Preferred Drug34%N/A
  • PA
XCOPRI 100 mg Tablet, Film CoatedCenobamate4Non-Preferred Drug34%N/A
  • PA
  • QL 3 per 30 days
XCOPRI 150 mg Tablet, Film CoatedCenobamate4Non-Preferred Drug34%N/A
  • PA
  • QL 6 per 30 days
XCOPRI 200 mg Tablet, Film CoatedCenobamate4Non-Preferred Drug34%N/A
  • PA
  • QL 6 per 30 days
XCOPRI 25 mg Tablet, Film CoatedCenobamate4Non-Preferred Drug34%N/A
  • PA
  • QL 3 per 30 days
XCOPRI 50 mg Tablet, Film CoatedCenobamate4Non-Preferred Drug34%N/A
  • PA
  • QL 3 per 30 days
XCOPRI MAINTENANCE PACK KitCenobamate4Non-Preferred Drug34%N/A
  • PA
  • QL 56 per 28 days
XCOPRI MAINTENANCE PACK KitCenobamate4Non-Preferred Drug34%N/A
  • PA
  • QL 56 per 28 days
XCOPRI TITRATION PACK KitCenobamate4Non-Preferred Drug34%N/A
  • PA
  • QL 28 per 28 days
XCOPRI TITRATION PACK KitCenobamate4Non-Preferred Drug34%N/A
  • PA
  • QL 28 per 28 days
XCOPRI TITRATION PACK KitCenobamate4Non-Preferred Drug34%N/A
  • PA
  • QL 28 per 28 days
XDEMVY 2.5 mg/mL Solution/ DropsLotilaner Ophthalmic Solution4Non-Preferred Drug34%N/A
  • PA
  • QL 1 per 42 days
XERMELO 250 mg TabletTelotristat Ethyl5Specialty Tier26%N/A
  • PA
  • QL 84 per 28 days
XGEVA 120 mg/1.7mL InjectionDenosumab5Specialty Tier26%N/A
  • PA
  • QL 1.7 per 28 days
XIFAXAN 200 mg TabletRifaximin4Non-Preferred Drug34%N/A
  • PA
  • QL 9 per 30 days
XIFAXAN 550 mg TabletRifaximin5Specialty Tier26%N/A
  • PA
  • QL 84 per 28 days
XOLAIR 300 mg/2mL Injection, SolutionOmalizumab5Specialty Tier26%N/A
  • PA
  • QL 8 per 28 days
XOLAIR 300 mg/2mL Injection, SolutionOmalizumab5Specialty Tier26%N/A
  • PA
  • QL 8 per 28 days
XOLAIR PFS 150 mg/mL Injection, SolutionOmalizumab5Specialty Tier26%N/A
  • PA
  • QL 8 per 28 days
XOLAIR PFS 75 mg/.5mL Injection, SolutionOmalizumab5Specialty Tier26%N/A
  • PA
  • QL 4 per 28 days
XOSPATA 40 mg TabletGilteritinib5Specialty Tier26%N/A
  • PA
  • QL 9 per 30 days
XPOVIO 10 mg Tablet, Film CoatedSelinexor5Specialty Tier26%N/A
  • PA
  • QL 16 per 28 days
XPOVIO 20 mg Tablet, Film CoatedSelinexor5Specialty Tier26%N/A
  • PA
  • QL 24 per 28 days
XPOVIO 20 mg Tablet, Film CoatedSelinexor5Specialty Tier26%N/A
  • PA
  • QL 32 per 28 days
XPOVIO 40 mg Tablet, Film CoatedSelinexor5Specialty Tier26%N/A
  • PA
  • QL 8 per 28 days
XPOVIO 40 mg Tablet, Film CoatedSelinexor5Specialty Tier26%N/A
  • PA
  • QL 8 per 28 days
XPOVIO 50 mg Tablet, Film CoatedSelinexor5Specialty Tier26%N/A
  • PA
  • QL 8 per 28 days
XPOVIO 60 mg Tablet, Film CoatedSelinexor5Specialty Tier26%N/A
  • PA
  • QL 4 per 28 days
XPOVIO 80 mg Tablet, Film CoatedSelinexor5Specialty Tier26%N/A
  • PA
  • QL 4 per 28 days
XTANDI 40 mg CapsuleEnzalutamide5Specialty Tier26%N/A
  • PA
  • QL 12 per 30 days
XTANDI 40 mg TabletEnzalutamide5Specialty Tier26%N/A
  • PA
  • QL 12 per 30 days
XTANDI 80 mg TabletEnzalutamide5Specialty Tier26%N/A
  • PA
  • QL 6 per 30 days
XULANE 150/35 ug/d PatchNorelgestromin And Ethinyl Estradiol3Preferred Brand20%15%
  • QL 3 per 28 days

PA = prior authorization, ST = step therapy, QL = quantity limit. Costs are the plan’s initial-coverage cost-sharing from the CMS 2026 formulary files; a drug not listed here is not on this plan’s formulary, though a formulary exception may still be possible.