2026 Humana Premier Rx Plan (PDP) formulary (drug list)
Contract S5884, plan 167 · Louisiana · 3,076 drugs on file · formulary ID 00026402. Each drug links to its cost in every CMS PDP Region 21 plan.
138 drugs starting with N.
| Drug name | Tier | 30-day preferred pharmacy | 90-day mail order | Usage management |
|---|---|---|---|---|
| NABUMETONE 500 mg Tablet, Film Coated | 1Preferred Generic | $0.00 | $0.00 | None |
| NABUMETONE 750 mg Tablet | 1Preferred Generic | $0.00 | $0.00 | None |
| NAFCILLIN 1 g/4mL Injection, Powder, For SolutionNafcillin Sodium | 4Non-Preferred Drug | 50% | 50% | None |
| NAFCILLIN 10 g Injection, Powder, For Solution | 4Non-Preferred Drug | 50% | 50% | None |
| NAFCILLIN 2 g/8mL Injection, Powder, Lyophilized, For SolutionNafcillin Sodium | 4Non-Preferred Drug | 50% | 50% | None |
| NALOXONE HYDROCHLORIDE .4 mg/mL Injection, Solution | 1Preferred Generic | $0.00 | $0.00 | None |
| NALOXONE HYDROCHLORIDE .4 mg/mL Injection, Solution | 1Preferred Generic | $0.00 | $0.00 | None |
| NALOXONE HYDROCHLORIDE .4 mg/mL Injection, Solution | 1Preferred Generic | $0.00 | $0.00 | None |
| NALOXONE HYDROCHLORIDE 1 mg/mL Injection | 1Preferred Generic | $0.00 | $0.00 | None |
| NALTREXONE HYDROCHLORIDE 50 mg Tablet, Film Coated | 2Generic | $4.00 | $0.00 | None |
| NAPROXEN 250 mg Tablet | 1Preferred Generic | $0.00 | $0.00 | None |
| NAPROXEN 375 mg Tablet | 1Preferred Generic | $0.00 | $0.00 | None |
| NAPROXEN 375 mg Tablet, Delayed Release | 2Generic | $4.00 | $0.00 | None |
| NAPROXEN 500 mg Tablet | 1Preferred Generic | $0.00 | $0.00 | None |
| NAPROXEN SODIUM 275 mg Tablet, Film Coated | 4Non-Preferred Drug | 50% | 50% | None |
| NAPROXEN SODIUM 550 mg Tablet | 4Non-Preferred Drug | 50% | 50% | None |
| NARATRIPTAN 1 mg Tablet | 3Preferred Brand | $45.00 | $125.00 |
|
| NARATRIPTAN 2.5 mg Tablet | 3Preferred Brand | $45.00 | $125.00 |
|
| NATACYN 50 mg/mL Suspension/ DropsNatamycin | 4Non-Preferred Drug | 50% | 50% | None |
| NATEGLINIDE 120 mg Tablet, Film Coated | 1Preferred Generic | $0.00 | $0.00 | None |
| NATEGLINIDE 60 mg Tablet, Film Coated | 1Preferred Generic | $0.00 | $0.00 | None |
| NAYZILAM 5 mg/.1mL SprayMidazolam | 4Non-Preferred Drug | 50% | 50% |
|
| NEBIVOLOL 10 mg Tablet | 4Non-Preferred Drug | 50% | 50% |
|
| NEBIVOLOL 2.5 mg Tablet | 3Preferred Brand | $45.00 | $125.00 |
|
| NEBIVOLOL 20 mg Tablet | 4Non-Preferred Drug | 50% | 50% |
|
| NEBIVOLOL 5 mg Tablet | 3Preferred Brand | $45.00 | $125.00 |
|
| NECON KitNorethindrone And Ethinyl Estradiol | 2Generic | $4.00 | $0.00 | None |
| NEFAZODONE HYDROCHLORIDE 100 mg Tablet | 4Non-Preferred Drug | 50% | 50% | None |
| NEFAZODONE HYDROCHLORIDE 150 mg Tablet | 4Non-Preferred Drug | 50% | 50% | None |
| NEFAZODONE HYDROCHLORIDE 200 mg Tablet | 4Non-Preferred Drug | 50% | 50% | None |
| NEFAZODONE HYDROCHLORIDE 250 mg Tablet | 4Non-Preferred Drug | 50% | 50% | None |
| NEFAZODONE HYDROCHLORIDE 50 mg Tablet | 4Non-Preferred Drug | 50% | 50% | None |
| NEOMYCIN AND POLYMYXIN B SULFATES AND BACITRACIN ZINC 3.5/10000/400 mg/g/[USP'U]/g OintmentNeomycin Sulfate, Polymyxin B Sulfate And Bacitracin Zinc | 3Preferred Brand | $45.00 | $125.00 | None |
| NEOMYCIN AND POLYMYXIN B SULFATES AND DEXAMETHASONE 3.5/10000/1 mg/g/[USP'U]/g OintmentNeomycin Sulfate, Polymyxin B Sulfate, And Dexamethasone | 2Generic | $4.00 | $0.00 | None |
| NEOMYCIN AND POLYMYXIN B SULFATES AND GRAMICIDIN 1.75/10000/.025 mg/mL/[USP'U]/mL Solution/ DropsNeomycin Sulfate, Polymyxin B Sulfate And Gramicidin | 3Preferred Brand | $45.00 | $125.00 | None |
| NEOMYCIN AND POLYMYXIN B SULFATES AND HYDROCORTISONE 10/3.5/10000 mg/mL/[USP'U]/mL Suspension/ DropsNeomycin Sulfate, Polymyxin B Sulfate And Hydrocortisone | 3Preferred Brand | $45.00 | $125.00 | None |
| NEOMYCIN AND POLYMYXIN B SULFATES AND HYDROCORTISONE 3.5/10000/10 mg/mL/[USP'U]/mL Solution/ DropsNeomycin Sulfate, Polymyxin B Sulfate, Hydrocortisone | 3Preferred Brand | $45.00 | $125.00 | None |
| NEOMYCIN AND POLYMYXIN B SULFATES AND HYDROCORTISONE 3.5/10000/10 mg/mL/[USP'U]/mL SuspensionNeomycin Sulfate, Polymyxin B Sulfate And Hydrocortisone | 4Non-Preferred Drug | 50% | 50% | None |
| NEOMYCIN AND POLYMYXIN B SULFATES, BACITRACIN ZINC AND HYDROCORTISONE 3.5/10000/400/10 mg/g/[USP'U]/g OintmentNeomycin Sulfate And Polymyxin B Sulfate, Bacitracin Zinc And Hydrocortisone | 3Preferred Brand | $45.00 | $125.00 | None |
| NEOMYCIN POLYMYXIN B SULFATES AND DEXAMETHASONE 3.5/10000/1 mg/mL/[USP'U]/mL Suspension/ DropsNeomycin Sulfate, Polymyxin B Sulfate And Dexamethasone | 2Generic | $4.00 | $0.00 | None |
| NEOMYCIN SULFATE 500 mg Tablet | 3Preferred Brand | $45.00 | $125.00 | None |
| NERLYNX 40 mg TabletNeratinib | 5Specialty Tier | 33% | N/A |
|
| NEVIRAPINE 200 mg Tablet | 2Generic | $4.00 | $0.00 |
|
| NEVIRAPINE 400 mg Tablet, Extended Release | 4Non-Preferred Drug | 50% | 50% |
|
| NEVIRAPINE 50 mg/5mL Suspension | 4Non-Preferred Drug | 50% | 50% |
|
| NEXLETOL 180 mg Tablet, Film CoatedBempedoic Acid | 3Preferred Brand | $45.00 | $125.00 |
|
| NEXLIZET 180/10 mg Tablet, Film CoatedBempedoic Acid And Ezetimibe | 3Preferred Brand | $45.00 | $125.00 |
|
| NEXPLANON 68 mg ImplantEtonogestrel | 3Preferred Brand | $45.00 | $125.00 | None |
| NIACIN 1000 mg Tablet, Extended Release | 4Non-Preferred Drug | 50% | 50% | None |
| NIACIN 500 mg Tablet, Extended Release | 4Non-Preferred Drug | 50% | 50% | None |
| NIACIN 750 mg Tablet, Film Coated, Extended Release | 4Non-Preferred Drug | 50% | 50% | None |
| NICOTROL 10 mg/mL Spray, MeteredNicotine | 4Non-Preferred Drug | 50% | 50% | None |
| NIFEDIPINE 30 mg Tablet, Extended Release | 3Preferred Brand | $45.00 | $125.00 | None |
| NIFEDIPINE 30 mg Tablet, Film Coated, Extended Release | 3Preferred Brand | $45.00 | $125.00 | None |
| NIFEDIPINE 60 mg Tablet, Extended Release | 3Preferred Brand | $45.00 | $125.00 | None |
| NIFEDIPINE 60 mg Tablet, Film Coated, Extended Release | 3Preferred Brand | $45.00 | $125.00 | None |
| NIFEDIPINE 90 mg Tablet, Extended Release | 3Preferred Brand | $45.00 | $125.00 | None |
| NIFEDIPINE 90 mg Tablet, Film Coated, Extended Release | 3Preferred Brand | $45.00 | $125.00 | None |
| NIKKI KitDrospirenone And Ethinyl Estradiol | 2Generic | $4.00 | $0.00 | None |
| NILOTINIB 150 mg Capsule | 5Specialty Tier | 33% | N/A |
|
| NILOTINIB 150 mg Capsule | 5Specialty Tier | 33% | N/A |
|
| NILOTINIB 200 mg Capsule | 5Specialty Tier | 33% | N/A |
|
| NILOTINIB 200 mg Capsule | 5Specialty Tier | 33% | N/A |
|
| NILOTINIB 50 mg Capsule | 5Specialty Tier | 33% | N/A |
|
| NILOTINIB 50 mg Capsule | 5Specialty Tier | 33% | N/A |
|
| NILUTAMIDE 150 mg Tablet | 5Specialty Tier | 33% | N/A |
|
| NIMODIPINE 30 mg Capsule, Liquid Filled | 4Non-Preferred Drug | 50% | 50% | None |
| NIMODIPINE 60 mg/20mL Solution | 5Specialty Tier | 33% | N/A |
|
| NINLARO 2.3 mg CapsuleIxazomib | 5Specialty Tier | 33% | N/A |
|
| NINLARO 3 mg CapsuleIxazomib | 5Specialty Tier | 33% | N/A |
|
| NINLARO 4 mg CapsuleIxazomib | 5Specialty Tier | 33% | N/A |
|
| NITAZOXANIDE 500 mg Tablet, Film Coated | 5Specialty Tier | 33% | N/A | None |
| NITISINONE 10 mg Capsule | 5Specialty Tier | 33% | N/A | None |
| NITISINONE 2 mg Capsule | 5Specialty Tier | 33% | N/A | None |
| NITISINONE 20 mg Capsule | 5Specialty Tier | 33% | N/A | None |
| NITISINONE 5 mg Capsule | 5Specialty Tier | 33% | N/A | None |
| NITROFURANTOIN (MACROCRYSTALS) 100 mg Capsule | 4Non-Preferred Drug | 50% | 50% | None |
| NITROFURANTOIN (MONOHYDRATE/MACROCRYSTALS) 75/25 mg Capsule | 3Preferred Brand | $45.00 | $125.00 | None |
| NITROFURANTOIN MACROCRYSTALS 50 mg Capsule | 4Non-Preferred Drug | 50% | 50% | None |
| NITROGLYCERIN .1 mg/h Patch | 2Generic | $4.00 | $0.00 | None |
| NITROGLYCERIN .2 mg/h Patch | 2Generic | $4.00 | $0.00 | None |
| NITROGLYCERIN .3 mg Tablet | 3Preferred Brand | $45.00 | $125.00 | None |
| NITROGLYCERIN .4 mg Tablet | 3Preferred Brand | $45.00 | $125.00 | None |
| NITROGLYCERIN .4 mg/h Patch | 2Generic | $4.00 | $0.00 | None |
| NITROGLYCERIN .6 mg Tablet | 3Preferred Brand | $45.00 | $125.00 | None |
| NITROGLYCERIN .6 mg/h Patch | 2Generic | $4.00 | $0.00 | None |
| NITROGLYCERIN 4 mg/g Ointment | 4Non-Preferred Drug | 50% | 50% |
|
| NIVESTYM 300 ug/.5mL Injection, SolutionFilgrastim-Aafi | 5Specialty Tier | 33% | N/A |
|
| NIVESTYM 300 ug/mL Injection, SolutionFilgrastim-Aafi | 5Specialty Tier | 33% | N/A |
|
| NIVESTYM 480 ug/.8mL Injection, SolutionFilgrastim-Aafi | 5Specialty Tier | 33% | N/A |
|
| NIVESTYM 480 ug/1.6mL Injection, SolutionFilgrastim-Aafi | 5Specialty Tier | 33% | N/A |
|
| NIZATIDINE 150 mg Capsule | 2Generic | $4.00 | $0.00 | None |
| NIZATIDINE 300 mg Capsule | 2Generic | $4.00 | $0.00 | None |
| NORA BE .35 mg TabletNorethindrone | 2Generic | $4.00 | $0.00 | None |
| NORELGESTROMIN AND ETHINYL ESTRADIOL 150/35 ug/mg Patch | 3Preferred Brand | $45.00 | $125.00 |
|
| NORETHINDRONE .35 mg Tablet | 2Generic | $4.00 | $0.00 | None |
| NORETHINDRONE ACETATE 5 mg Tablet | 3Preferred Brand | $45.00 | $125.00 | None |
| NORETHINDRONE ACETATE AND ETHINYL ESTRADIOL 1/.02 mg Tablet | 3Preferred Brand | $45.00 | $125.00 | None |
| NORGESTIMATE AND ETHINYL ESTRADIOL Kit | 2Generic | $4.00 | $0.00 | None |
| NORGESTIMATE AND ETHINYL ESTRADIOL Kit | 2Generic | $4.00 | $0.00 | None |
| NORGESTIMATE AND ETHINYL ESTRADIOL Kit | 2Generic | $4.00 | $0.00 | None |
| NORTREL 21 DAY 1/.035 mg TabletNorethindrone And Ethinyl Estradiol | 2Generic | $4.00 | $0.00 | None |
| NORTREL 28 DAY KitNorethindrone And Ethinyl Estradiol | 2Generic | $4.00 | $0.00 | None |
| NORTREL 28 DAY KitNorethindrone And Ethinyl Estradiol | 2Generic | $4.00 | $0.00 | None |
| NORTREL 7/7/7 (28 DAY REGIMEN) KitNorethindrone And Ethinyl Estradiol | 2Generic | $4.00 | $0.00 | None |
| NORTRIPTYLINE HYDROCHLORIDE 10 mg Capsule | 4Non-Preferred Drug | 50% | 50% | None |
| NORTRIPTYLINE HYDROCHLORIDE 10 mg/5mL Solution | 4Non-Preferred Drug | 50% | 50% | None |
| NORTRIPTYLINE HYDROCHLORIDE 25 mg Capsule | 4Non-Preferred Drug | 50% | 50% | None |
| NORTRIPTYLINE HYDROCHLORIDE 50 mg Capsule | 4Non-Preferred Drug | 50% | 50% | None |
| NORTRIPTYLINE HYDROCHLORIDE 75 mg Capsule | 4Non-Preferred Drug | 50% | 50% | None |
| NORVIR 100 mg PowderRitonavir | 4Non-Preferred Drug | 50% | 50% |
|
| NOVOLIN 70/30 100 [iU]/mL Injection, SuspensionHuman Insulin | 3Preferred Brand | $45.00 | $125.00 | None |
| NOVOLIN 70/30 100 [iU]/mL Injection, SuspensionHuman Insulin | 3Preferred Brand | $45.00 | $125.00 | None |
| NOVOLIN N 100 [iU]/mL Injection, SuspensionHuman Insulin | 3Preferred Brand | $45.00 | $125.00 | None |
| NOVOLIN N 100 [iU]/mL Injection, SuspensionHuman Insulin | 3Preferred Brand | $45.00 | $125.00 | None |
| NOVOLIN R 100 [iU]/mL Injection, SolutionHuman Insulin | 3Preferred Brand | $45.00 | $125.00 | None |
| NOVOLIN R 100 [iU]/mL Injection, SolutionHuman Insulin | 3Preferred Brand | $45.00 | $125.00 | None |
| NOVOLOG 100 [iU]/mL Injection, SolutionInsulin Aspart | 3Preferred Brand | $45.00 | $125.00 | None |
| NOVOLOG 100 [iU]/mL Injection, SolutionInsulin Aspart | 3Preferred Brand | $45.00 | $125.00 | None |
| NOVOLOG 100 [iU]/mL Injection, SolutionInsulin Aspart | 3Preferred Brand | $45.00 | $125.00 | None |
| NOVOLOG MIX 70/30 100 [iU]/mL Injection, SuspensionInsulin Aspart | 3Preferred Brand | $45.00 | $125.00 | None |
| NOVOLOG MIX 70/30 100 [iU]/mL Injection, SuspensionInsulin Aspart | 3Preferred Brand | $45.00 | $125.00 | None |
| NUBEQA 300 mg Tablet, Film CoatedDarolutamide | 5Specialty Tier | 33% | N/A |
|
| NUEDEXTA 20/10 mg Capsule, Gelatin CoatedDextromethorphan Hydrobromide And Quinidine Sulfate | 5Specialty Tier | 33% | N/A |
|
| NUPLAZID 10 mg Tablet, CoatedPimavanserin Tartrate | 5Specialty Tier | 33% | N/A |
|
| NUPLAZID 34 mg CapsulePimavanserin Tartrate | 5Specialty Tier | 33% | N/A |
|
| NUTRILIPID I.V. FAT EMULSION 20 g/100mL Injection, SolutionSoybean Oil | 4Non-Preferred Drug | 50% | 50% |
|
| NYAMYC 100000 [USP'U]/g PowderNystatin | 4Non-Preferred Drug | 50% | 50% | None |
| NYLIA 1/35 KitNorethindrone And Ethinyl Estradiol | 2Generic | $4.00 | $0.00 | None |
| NYLIA 7/7/7 KitNorethindrone And Ethinyl Estradiol | 2Generic | $4.00 | $0.00 | None |
| NYSTATIN 100000 [USP'U]/g Cream | 2Generic | $4.00 | $0.00 | None |
| NYSTATIN 100000 [USP'U]/g Ointment | 2Generic | $4.00 | $0.00 | None |
| NYSTATIN 100000 [USP'U]/g Powder | 4Non-Preferred Drug | 50% | 50% | None |
| NYSTATIN 100000 [USP'U]/mL Suspension | 2Generic | $4.00 | $0.00 | None |
| NYSTATIN 500000 [USP'U] Tablet, Coated | 3Preferred Brand | $45.00 | $125.00 | None |
| NYSTATIN AND TRIAMCINOLONE ACETONIDE 100000/1 [USP'U]/g/mg/g CreamNystatin, Triamcinolone Acetonide | 4Non-Preferred Drug | 50% | 50% | None |
| NYSTATIN AND TRIAMCINOLONE ACETONIDE 100000/1 [USP'U]/g/mg/g Ointment | 4Non-Preferred Drug | 50% | 50% | None |
| NYSTOP 100000 [USP'U]/g PowderNystatin | 4Non-Preferred Drug | 50% | 50% | None |
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.