2026 BlueCross Rx Value (PDP) formulary (drug list)
Contract S5953, plan 001 · South Carolina · 3,082 drugs on file · formulary ID 00026220. Each drug links to its cost in every CMS PDP Region 09 plan.
4 drugs starting with Y.
| Drug name | Tier | 30-day preferred pharmacy | 90-day mail order | Usage management |
|---|---|---|---|---|
| YARGESA 100 mg CapsuleMiglustat | 5Specialty Tier | 25% | N/A |
|
| YF-VAX 4.74 [PFU]/.5mL Injection, Powder, Lyophilized, For SuspensionYellow Fever Virus Strain 17D-204 Live Antigen | 1Preferred Generic | $12.00 | $30.00 | None |
| YONSA 125 mg TabletAbiraterone Acetate | 5Specialty Tier | 25% | N/A |
|
| YUVAFEM 10 ug TabletEstradiol | 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.