2026 MedicareBlue Rx Standard (PDP) formulary (drug list)
Contract S5743, plan 001 · Montana · 2,948 drugs on file · formulary ID 00026248. Each drug links to its cost in every CMS PDP Region 25 plan.
19 drugs starting with W.
| Drug name | Tier | 30-day preferred pharmacy | 90-day mail order | Usage management |
|---|---|---|---|---|
| WARFARIN SODIUM 1 mg Tablet | 1Preferred Generic | $0.00 | $0.00 | None |
| WARFARIN SODIUM 10 mg Tablet | 1Preferred Generic | $0.00 | $0.00 | None |
| WARFARIN SODIUM 2 mg Tablet | 1Preferred Generic | $0.00 | $0.00 | None |
| WARFARIN SODIUM 2.5 mg Tablet | 1Preferred Generic | $0.00 | $0.00 | None |
| WARFARIN SODIUM 3 mg Tablet | 1Preferred Generic | $0.00 | $0.00 | None |
| WARFARIN SODIUM 4 mg Tablet | 1Preferred Generic | $0.00 | $0.00 | None |
| WARFARIN SODIUM 5 mg Tablet | 1Preferred Generic | $0.00 | $0.00 | None |
| WARFARIN SODIUM 6 mg Tablet | 1Preferred Generic | $0.00 | $0.00 | None |
| WARFARIN SODIUM 7.5 mg Tablet | 1Preferred Generic | $0.00 | $0.00 | None |
| WELIREG 40 mg Tablet, Film CoatedBelzutifan | 5Specialty Tier | 25% | N/A |
|
| WINREVAIR KitSotatercept-Csrk | 5Specialty Tier | 25% | N/A |
|
| WINREVAIR KitSotatercept-Csrk | 5Specialty Tier | 25% | N/A |
|
| WINREVAIR KitSotatercept-Csrk | 5Specialty Tier | 25% | N/A |
|
| WINREVAIR KitSotatercept-Csrk | 5Specialty Tier | 25% | N/A |
|
| WIXELA INHUB 100/50 ug PowderFluticasone Propionate And Salmeterol | 3Preferred Brand | 22% | 22% |
|
| WIXELA INHUB 250/50 ug PowderFluticasone Propionate And Salmeterol | 3Preferred Brand | 22% | 22% |
|
| WIXELA INHUB 500/50 ug PowderFluticasone Propionate And Salmeterol | 3Preferred Brand | 22% | 22% |
|
| WYMZYA FE KitNorethindrone And Ethinyl Estradiol | 4Non-Preferred Drug | 42% | 42% | None |
| WYOST 120 mg/1.7mL InjectionDenosumab | 5Specialty Tier | 25% | N/A |
|
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.