MedicarePartD.guide

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

Contract S5884, plan 188 · South Carolina · 3,009 drugs on file · formulary ID 00026400. Each drug links to its cost in every CMS PDP Region 09 plan.

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128 drugs starting with F.

Drug nameTier30-day preferred pharmacy90-day mail orderUsage management
FALMINA KitLevonorgestrel And Ethinyl Estradiol2Generic$0.00$0.00None
FAMCICLOVIR 125 mg Tablet, Film Coated4Non-Preferred Drug34%N/A
  • QL 9 per 30 days
FAMCICLOVIR 250 mg Tablet, Film Coated4Non-Preferred Drug34%N/A
  • QL 9 per 30 days
FAMCICLOVIR 500 mg Tablet, Film Coated4Non-Preferred Drug34%N/A
  • QL 9 per 30 days
FAMOTIDINE 20 mg Tablet, Film Coated2Generic$0.00$0.00None
FAMOTIDINE 40 mg Tablet, Film Coated2Generic$0.00$0.00None
FAMOTIDINE 40 mg/5mL Powder, For Suspension4Non-Preferred Drug34%N/ANone
FANAPT 1 mg TabletIloperidone4Non-Preferred Drug34%N/A
  • PA
  • QL 6 per 30 days
FANAPT 10 mg TabletIloperidone4Non-Preferred Drug34%N/A
  • PA
  • QL 6 per 30 days
FANAPT 12 mg TabletIloperidone4Non-Preferred Drug34%N/A
  • PA
  • QL 6 per 30 days
FANAPT 2 mg TabletIloperidone4Non-Preferred Drug34%N/A
  • PA
  • QL 6 per 30 days
FANAPT 4 mg TabletIloperidone4Non-Preferred Drug34%N/A
  • PA
  • QL 6 per 30 days
FANAPT 6 mg TabletIloperidone4Non-Preferred Drug34%N/A
  • PA
  • QL 6 per 30 days
FANAPT 8 mg TabletIloperidone4Non-Preferred Drug34%N/A
  • PA
  • QL 6 per 30 days
FANAPT KitIloperidone4Non-Preferred Drug34%N/A
  • PA
  • QL 56 per 28 days
FARXIGA 10 mg Tablet, Film CoatedDapagliflozin3Preferred Brand19%14%
  • QL 3 per 30 days
FARXIGA 5 mg Tablet, Film CoatedDapagliflozin3Preferred Brand19%14%
  • QL 3 per 30 days
FEIRZA 1.5/30 TM KitNorethindrone Acetate And Ethinyl Estradiol Tablets Usp, 1.5 Mg/30 Mcg And Ferrous Fumarate Tablets, 75 Mg2Generic$0.00$0.00None
FEIRZA 1/20 KitNorethindrone Acetate And Ethinyl Estradiol Tablets Usp, 1 Mg/0.02 Mg And Ferrous Fumarate Tablets, 75 Mg2Generic$0.00$0.00None
FELBAMATE 400 mg Tablet4Non-Preferred Drug34%N/A
  • PA
FELBAMATE 600 mg Tablet4Non-Preferred Drug34%N/A
  • PA
FELBAMATE 600 mg/5mL Suspension4Non-Preferred Drug34%N/A
  • PA
FELODIPINE 10 mg Tablet, Extended Release2Generic$0.00$0.00None
FELODIPINE 2.5 mg Tablet, Extended Release2Generic$0.00$0.00None
FELODIPINE 5 mg Tablet, Extended Release2Generic$0.00$0.00None
FEMLYV KitNorethindrone Acetate/Ethinyl Estradiol4Non-Preferred Drug34%N/ANone
FENOFIBRATE 134 mg Capsule3Preferred Brand19%14%
  • QL 3 per 30 days
FENOFIBRATE 145 mg Tablet3Preferred Brand19%14%
  • QL 3 per 30 days
FENOFIBRATE 160 mg Tablet2Generic$0.00$0.00
  • QL 3 per 30 days
FENOFIBRATE 200 mg Capsule3Preferred Brand19%14%
  • QL 3 per 30 days
FENOFIBRATE 48 mg Tablet3Preferred Brand19%14%
  • QL 6 per 30 days
FENOFIBRATE 54 mg Tablet2Generic$0.00$0.00
  • QL 6 per 30 days
FENOFIBRATE 67 mg Capsule3Preferred Brand19%14%
  • QL 6 per 30 days
FENTANYL 100 ug/h Patch4Non-Preferred Drug34%N/A
  • QL 2 per 30 days
FENTANYL 12 ug/h Patch4Non-Preferred Drug34%N/A
  • QL 2 per 30 days
FENTANYL 25 ug/h Patch4Non-Preferred Drug34%N/A
  • QL 2 per 30 days
FENTANYL 50 ug/h Patch4Non-Preferred Drug34%N/A
  • QL 2 per 30 days
FENTANYL 75 ug/h Patch4Non-Preferred Drug34%N/A
  • QL 2 per 30 days
FESOTERODINE FUMARATE 4 mg Tablet, Film Coated, Extended Release3Preferred Brand19%14%
  • QL 3 per 30 days
FESOTERODINE FUMARATE 8 mg Tablet, Film Coated, Extended Release3Preferred Brand19%14%
  • QL 3 per 30 days
FETZIMA 120 mg Capsule, Extended ReleaseLevomilnacipran Hydrochloride4Non-Preferred Drug34%N/A
  • PA
  • QL 3 per 30 days
FETZIMA 20 mg Capsule, Extended ReleaseLevomilnacipran Hydrochloride4Non-Preferred Drug34%N/A
  • PA
  • QL 3 per 30 days
FETZIMA 40 mg Capsule, Extended ReleaseLevomilnacipran Hydrochloride4Non-Preferred Drug34%N/A
  • PA
  • QL 3 per 30 days
FETZIMA 80 mg Capsule, Extended ReleaseLevomilnacipran Hydrochloride4Non-Preferred Drug34%N/A
  • PA
  • QL 3 per 30 days
FETZIMA KitLevomilnacipran Hydrochloride4Non-Preferred Drug34%N/A
  • PA
  • QL 28 per 28 days
FIASP 100 [iU]/mL Injection, SolutionInsulin Aspart Injection3Preferred Brand19%14%None
FIASP 100 [iU]/mL Injection, SolutionInsulin Aspart Injection3Preferred Brand19%14%None
FIASP 100 [iU]/mL Injection, SolutionInsulin Aspart Injection3Preferred Brand19%14%None
FIDAXOMICIN 200 mg Tablet, Film Coated5Specialty Tier26%N/ANone
FINASTERIDE 5 mg Tablet, Film Coated2Generic$0.00$0.00
  • QL 3 per 30 days
FINGOLIMOD HYDROCHLORIDE .5 mg Capsule3Preferred Brand19%14%
  • PA
  • QL 3 per 30 days
FINTEPLA 2.2 mg/mL SolutionFenfluramine5Specialty Tier26%N/A
  • PA
  • QL 36 per 30 days
FIRMAGON KitDegarelix4Non-Preferred Drug34%N/A
  • PA
FIRMAGON KitDegarelix5Specialty Tier26%N/A
  • PA
FLECAINIDE ACETATE 100 mg TabletFlecainide Acetate Tablet3Preferred Brand19%14%None
FLECAINIDE ACETATE 150 mg TabletFlecainide Acetate Tablet3Preferred Brand19%14%None
FLECAINIDE ACETATE 50 mg TabletFlecainide Acetate Tablet3Preferred Brand19%14%None
FLUCONAZOLE 10 mg/mL Powder, For Suspension3Preferred Brand19%14%None
FLUCONAZOLE 100 mg Tablet2Generic$0.00$0.00None
FLUCONAZOLE 150 mg Tablet2Generic$0.00$0.00None
FLUCONAZOLE 2 mg/mL Injection, Solution3Preferred Brand19%14%None
FLUCONAZOLE 2 mg/mL Injection, Solution3Preferred Brand19%14%None
FLUCONAZOLE 200 mg Tablet2Generic$0.00$0.00None
FLUCONAZOLE 40 mg/mL Powder, For Suspension3Preferred Brand19%14%None
FLUCONAZOLE 50 mg Tablet2Generic$0.00$0.00None
FLUCYTOSINE 250 mg Capsule5Specialty Tier26%N/ANone
FLUCYTOSINE 500 mg Capsule5Specialty Tier26%N/ANone
FLUDROCORTISONE ACETATE .1 mg Tablet2Generic$0.00$0.00None
FLUOCINOLONE ACETONIDE .1 mg/mL Solution4Non-Preferred Drug34%N/A
  • QL 18 per 30 days
FLUOCINOLONE ACETONIDE .11 mg/118.28mL Oil4Non-Preferred Drug34%N/A
  • QL 118.28 per 30 days
FLUOCINOLONE ACETONIDE .25 mg/g Cream4Non-Preferred Drug34%N/A
  • QL 12 per 30 days
FLUOCINOLONE ACETONIDE .25 mg/g Ointment4Non-Preferred Drug34%N/A
  • QL 12 per 30 days
FLUOCINOLONE ACETONIDE OIL .11 mg/mL OilFluocinolone Acetonide3Preferred Brand19%14%None
FLUOCINONIDE .5 mg/g Cream4Non-Preferred Drug34%N/A
  • QL 12 per 30 days
FLUOCINONIDE .5 mg/g Gel4Non-Preferred Drug34%N/A
  • QL 12 per 30 days
FLUOCINONIDE .5 mg/g Ointment4Non-Preferred Drug34%N/A
  • QL 12 per 30 days
FLUOCINONIDE .5 mg/mL SolutionFluocinonide Topical Solution Usp, 0.05%4Non-Preferred Drug34%N/A
  • QL 12 per 30 days
FLUOROMETHOLONE OPHTHALMIC SUSPENSION 1 mg/mL Suspension/ DropsFluorometholone3Preferred Brand19%14%None
FLUOROURACIL 20 mg/mL Solution3Preferred Brand19%14%
  • QL 3 per 30 days
FLUOROURACIL 50 mg/g Cream4Non-Preferred Drug34%N/ANone
FLUOROURACIL 50 mg/mL Solution3Preferred Brand19%14%
  • QL 6 per 30 days
FLUOXETINE 10 mg Capsule2Generic$0.00$0.00
  • QL 6 per 30 days
FLUOXETINE 10 mg Tablet2Generic$0.00$0.00
  • QL 24 per 30 days
FLUOXETINE 10 mg Tablet, Film Coated2Generic$0.00$0.00
  • QL 24 per 30 days
FLUOXETINE 20 mg Capsule1Preferred Generic$0.00$0.00
  • QL 12 per 30 days
FLUOXETINE 20 mg Tablet2Generic$0.00$0.00
  • QL 12 per 30 days
FLUOXETINE 20 mg Tablet, Film Coated2Generic$0.00$0.00
  • QL 12 per 30 days
FLUOXETINE 20 mg/5mL Solution3Preferred Brand19%14%None
FLUOXETINE 40 mg Capsule1Preferred Generic$0.00$0.00
  • QL 9 per 30 days
FLUOXETINE 60 mg TabletFluoxetine Hydrochloride2Generic$0.00$0.00
  • QL 3 per 30 days
FLUPHENAZINE DECANOATE 25 mg/mL Injection, Solution4Non-Preferred Drug34%N/ANone
FLUPHENAZINE HYDROCHLORIDE .5 mg/mL Elixir4Non-Preferred Drug34%N/ANone
FLUPHENAZINE HYDROCHLORIDE 1 mg Tablet, Film Coated4Non-Preferred Drug34%N/ANone
FLUPHENAZINE HYDROCHLORIDE 10 mg Tablet, Film Coated4Non-Preferred Drug34%N/ANone
FLUPHENAZINE HYDROCHLORIDE 2.5 mg Tablet, Film Coated4Non-Preferred Drug34%N/ANone
FLUPHENAZINE HYDROCHLORIDE 2.5 mg/mL Injection, Solution4Non-Preferred Drug34%N/ANone
FLUPHENAZINE HYDROCHLORIDE 5 mg Tablet, Film Coated4Non-Preferred Drug34%N/ANone
FLUPHENAZINE HYDROCHLORIDE 5 mg/mL Solution, Concentrate4Non-Preferred Drug34%N/ANone
FLURBIPROFEN 100 mg Tablet4Non-Preferred Drug34%N/ANone
FLURBIPROFEN SODIUM .3 mg/mL Solution/ Drops2Generic$0.00$0.00None
FLUTICASONE PROPIONATE .5 mg/g Cream3Preferred Brand19%14%
  • QL 24 per 30 days
FLUTICASONE PROPIONATE 50 ug Spray, Metered2Generic$0.00$0.00
  • QL 16 per 30 days
FLUVOXAMINE MALEATE 100 mg Tablet3Preferred Brand19%14%
  • QL 9 per 30 days
FLUVOXAMINE MALEATE 25 mg Tablet3Preferred Brand19%14%
  • QL 9 per 30 days
FLUVOXAMINE MALEATE 50 mg Tablet3Preferred Brand19%14%
  • QL 9 per 30 days
FORTEO 250 ug/mL Injection, SolutionTeriparatide5Specialty Tier26%N/A
  • PA
  • QL 2.24 per 28 days
FOSAMPRENAVIR CALCIUM 700 mg Tablet, Film Coated5Specialty Tier26%N/A
  • QL 12 per 30 days
FOSFOMYCIN TROMETHAMINE 3 g PowderGranules For Oral Solution4Non-Preferred Drug34%N/ANone
FOSINOPRIL SODIUM 10 mg TabletFosinopirl Sodium2Generic$0.00$0.00None
FOSINOPRIL SODIUM 20 mg Tablet2Generic$0.00$0.00None
FOSINOPRIL SODIUM 40 mg Tablet2Generic$0.00$0.00None
FOSINOPRIL SODIUM AND HYDROCHLOROTHIAZIDE 10/12.5 mg Tablet2Generic$0.00$0.00None
FOSINOPRIL SODIUM AND HYDROCHLOROTHIAZIDE 20/12.5 mg Tablet2Generic$0.00$0.00None
FRUZAQLA 1 mg CapsuleFruquintinib5Specialty Tier26%N/A
  • PA
  • QL 84 per 28 days
FRUZAQLA 5 mg CapsuleFruquintinib5Specialty Tier26%N/A
  • PA
  • QL 21 per 28 days
FUROSEMIDE 10 mg/mL Injection, Solution4Non-Preferred Drug34%N/ANone
FUROSEMIDE 10 mg/mL Solution4Non-Preferred Drug34%N/ANone
FUROSEMIDE 20 mg Tablet1Preferred Generic$0.00$0.00None
FUROSEMIDE 40 mg Tablet1Preferred Generic$0.00$0.00None
FUROSEMIDE 40 mg/5mL Solution4Non-Preferred Drug34%N/ANone
FUROSEMIDE 80 mg Tablet1Preferred Generic$0.00$0.00None
FYCOMPA .5 mg/mL SuspensionPerampanel4Non-Preferred Drug34%N/A
  • PA
  • QL 68 per 28 days
FYCOMPA 10 mg TabletPerampanel4Non-Preferred Drug34%N/A
  • PA
  • QL 3 per 30 days
FYCOMPA 12 mg TabletPerampanel4Non-Preferred Drug34%N/A
  • PA
  • QL 3 per 30 days
FYCOMPA 2 mg TabletPerampanel4Non-Preferred Drug34%N/A
  • PA
  • QL 3 per 30 days
FYCOMPA 4 mg TabletPerampanel4Non-Preferred Drug34%N/A
  • PA
  • QL 3 per 30 days
FYCOMPA 6 mg TabletPerampanel4Non-Preferred Drug34%N/A
  • PA
  • QL 3 per 30 days
FYCOMPA 8 mg TabletPerampanel4Non-Preferred Drug34%N/A
  • PA
  • QL 3 per 30 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.