MedicarePartD.guide

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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.

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53 drugs starting with Z.

Drug nameTier30-day preferred pharmacy90-day mail orderUsage management
ZAFEMY 150/35 ug/d PatchNorelgestromin And Ethinyl Estradiol4Non-Preferred Drug50%50%None
ZAFIRLUKAST 10 mg Tablet, Film Coated4Non-Preferred Drug50%50%None
ZAFIRLUKAST 20 mg Tablet, Film Coated4Non-Preferred Drug50%50%None
ZALEPLON 10 mg Capsule3Preferred Brand17%17%
  • QL 6 per 30 days
ZALEPLON 5 mg Capsule3Preferred Brand17%17%
  • QL 3 per 30 days
ZARXIO 300 ug/.5mL Injection, SolutionFilgrastim-Sndz5Specialty Tier25%N/ANone
ZARXIO 480 ug/.8mL Injection, SolutionFilgrastim-Sndz5Specialty Tier25%N/ANone
ZEJULA 100 mg Tablet, Film CoatedNiraparib5Specialty Tier25%N/A
  • PA
  • QL 3 per 30 days
ZEJULA 200 mg Tablet, Film CoatedNiraparib5Specialty Tier25%N/A
  • PA
ZEJULA 300 mg Tablet, Film CoatedNiraparib5Specialty Tier25%N/A
  • PA
ZELBORAF 240 mg Tablet, Film CoatedVemurafenib5Specialty Tier25%N/A
  • PA
ZELVYSIA 500 mg Powder, For SolutionSapropterin Dihydrochloride5Specialty Tier25%N/A
  • PA
ZENATANE 10 mg Capsule, Gelatin CoatedIsotretinoin4Non-Preferred Drug50%50%None
ZENATANE 20 mg Capsule, Gelatin CoatedIsotretinoin4Non-Preferred Drug50%50%None
ZENATANE 30 mg Capsule, Gelatin CoatedIsotretinoin4Non-Preferred Drug50%50%None
ZENATANE 40 mg Capsule, Gelatin CoatedIsotretinoin4Non-Preferred Drug50%50%None
ZENPEP 10000/32000/42000 [USP'U] Capsule, Delayed ReleasePancrelipase Lipase, Pancrelipase Protease, Pancrelipase Amylase3Preferred Brand17%17%None
ZENPEP 15000/47000/63000 [USP'U] Capsule, Delayed ReleasePancrelipase Lipase, Pancrelipase Protease, Pancrelipase Amylase3Preferred Brand17%17%None
ZENPEP 20000/63000/84000 [USP'U] Capsule, Delayed ReleasePancrelipase Lipase, Pancrelipase Protease, Pancrelipase Amylase3Preferred Brand17%17%None
ZENPEP 25000/79000/105000 [USP'U] Capsule, Delayed ReleasePancrelipase Lipase, Pancrelipase Protease, Pancrelipase Amylase3Preferred Brand17%17%None
ZENPEP 3000/10000/14000 [USP'U] Capsule, Delayed ReleasePancrelipase Lipase, Pancrelipase Protease, Pancrelipase Amylase3Preferred Brand17%17%None
ZENPEP 40000/126000/168000 [USP'U] Capsule, Delayed ReleasePancrelipase Lipase, Pancrelipase Protease, Pancrelipase Amylase3Preferred Brand17%17%None
ZENPEP 5000/17000/24000 [USP'U] Capsule, Delayed ReleasePancrelipase Lipase, Pancrelipase Protease, Pancrelipase Amylase3Preferred Brand17%17%None
ZENPEP 60000/189600/252600 [USP'U] Capsule, Delayed ReleasePancrelipase Lipase, Pancrelipase Protease, Pancrelipase Amylase3Preferred Brand17%17%None
ZIDOVUDINE 10 mg/mL Syrup3Preferred Brand17%17%
  • QL 192 per 30 days
ZIDOVUDINE 100 mg Capsule3Preferred Brand17%17%
  • QL 18 per 30 days
ZIDOVUDINE 300 mg Tablet3Preferred Brand17%17%
  • QL 6 per 30 days
ZIPRASIDONE 20 mg Capsule3Preferred Brand17%17%
  • QL 6 per 30 days
ZIPRASIDONE 40 mg Capsule3Preferred Brand17%17%
  • QL 6 per 30 days
ZIPRASIDONE 60 mg Capsule3Preferred Brand17%17%
  • QL 6 per 30 days
ZIPRASIDONE 80 mg Capsule3Preferred Brand17%17%
  • QL 6 per 30 days
ZIPRASIDONE MESYLATE 20 mg/mL Injection, Powder, Lyophilized, For Solution4Non-Preferred Drug50%50%
  • QL 6 per 30 days
ZIRGAN 1.5 mg/g GelGanciclovir4Non-Preferred Drug50%50%None
ZOKINVY 50 mg CapsuleLonafarnib5Specialty Tier25%N/A
  • PA
  • QL 12 per 30 days
ZOKINVY 75 mg CapsuleLonafarnib5Specialty Tier25%N/A
  • PA
  • QL 12 per 30 days
ZOLINZA 100 mg CapsuleVorinostat5Specialty Tier25%N/A
  • PA
ZOLMITRIPTAN 2.5 mg Tablet4Non-Preferred Drug50%50%
  • QL 12 per 30 days
ZOLMITRIPTAN 5 mg Tablet4Non-Preferred Drug50%50%
  • QL 12 per 30 days
ZOLPIDEM TARTRATE 10 mg Tablet, Film Coated2Generic$17.00$42.50
  • QL 3 per 30 days
ZOLPIDEM TARTRATE 5 mg Tablet, Film Coated2Generic$17.00$42.50
  • QL 3 per 30 days
ZONISADE 100 mg/5mL SuspensionZonisamide4Non-Preferred Drug50%50%
  • ST
ZONISAMIDE 100 mg Capsule2Generic$17.00$42.50None
ZONISAMIDE 25 mg Capsule2Generic$17.00$42.50None
ZONISAMIDE 50 mg Capsule2Generic$17.00$42.50None
ZOVIA 1/35 KitEthynodiol Diacetate And Ethinyl Estradiol Tablets3Preferred Brand17%17%None
ZTALMY 50 mg/mL SuspensionGanaxolone5Specialty Tier25%N/A
  • PA
ZURZUVAE 20 mg CapsuleZuranolone5Specialty Tier25%N/A
  • PA
  • QL 28 per 14 days
ZURZUVAE 25 mg CapsuleZuranolone5Specialty Tier25%N/A
  • PA
  • QL 28 per 14 days
ZURZUVAE 30 mg CapsuleZuranolone5Specialty Tier25%N/A
  • PA
  • QL 14 per 14 days
ZYDELIG 100 mg Tablet, Film CoatedIdelalisib5Specialty Tier25%N/A
  • PA
ZYDELIG 150 mg Tablet, Film CoatedIdelalisib5Specialty Tier25%N/A
  • PA
ZYKADIA 150 mg Tablet, Film CoatedCeritinib5Specialty Tier25%N/A
  • PA
ZYLET 5/3 mg/mL Suspension/ DropsLoteprednol Etabonate And Tobramycin4Non-Preferred Drug50%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.