MedicarePartD.guide

A non-government resource built from CMS public data

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

Contract S5884, plan 106 · Tennessee · 2,972 drugs on file · formulary ID 00026399. Each drug links to its cost in every CMS PDP Region 12 plan.

Hide drugs on tiers

112 drugs starting with B.

Drug nameTier30-day preferred pharmacy90-day mail orderUsage management
BACITRACIN ZINC AND POLYMYXIN B SULFATE 500/10000 [USP'U]/g Ointment2Generic$1.00$0.00None
BACLOFEN 10 mg Tablet3Preferred Brand25%20%None
BACLOFEN 20 mg Tablet3Preferred Brand25%20%None
BACLOFEN 5 mg Tablet3Preferred Brand25%20%
  • QL 9 per 30 days
BALSALAZIDE DISODIUM 750 mg Capsule4Non-Preferred Drug34%N/ANone
BALVERSA 3 mg Tablet, Film CoatedErdafitinib5Specialty Tier25%N/A
  • PA
  • QL 9 per 30 days
BALVERSA 4 mg Tablet, Film CoatedErdafitinib5Specialty Tier25%N/A
  • PA
  • QL 6 per 30 days
BALVERSA 5 mg Tablet, Film CoatedErdafitinib5Specialty Tier25%N/A
  • PA
  • QL 3 per 30 days
BAQSIMI 3 mg PowderGlucagon3Preferred Brand25%20%None
BARACLUDE .05 mg/mL SolutionEntecavir5Specialty Tier25%N/A
  • QL 63 per 30 days
BCG VACCINE 50 mg Injection, Powder, Lyophilized, For SolutionBacillus Calmette-Guerin Substrain Tice Live Antigen1Preferred Generic$0.00$0.00None
BELSOMRA 10 mg Tablet, Film CoatedSuvorexant3Preferred Brand25%20%
  • QL 6 per 30 days
BELSOMRA 15 mg Tablet, Film CoatedSuvorexant3Preferred Brand25%20%
  • QL 3 per 30 days
BELSOMRA 20 mg Tablet, Film CoatedSuvorexant3Preferred Brand25%20%
  • QL 3 per 30 days
BELSOMRA 5 mg Tablet, Film CoatedSuvorexant3Preferred Brand25%20%
  • QL 12 per 30 days
BENAZEPRIL HYDROCHLORIDE 10 mg Tablet, Coated2Generic$1.00$0.00None
BENAZEPRIL HYDROCHLORIDE 20 mg Tablet, Coated2Generic$1.00$0.00None
BENAZEPRIL HYDROCHLORIDE 40 mg Tablet, Coated2Generic$1.00$0.00None
BENAZEPRIL HYDROCHLORIDE 5 mg Tablet, Coated2Generic$1.00$0.00None
BENAZEPRIL HYDROCHLORIDE AND HYDROCHLOROTHIAZIDE 10/12.5 mg Tablet, Film Coated3Preferred Brand25%20%None
BENAZEPRIL HYDROCHLORIDE AND HYDROCHLOROTHIAZIDE 20/12.5 mg Tablet, Film Coated3Preferred Brand25%20%None
BENAZEPRIL HYDROCHLORIDE AND HYDROCHLOROTHIAZIDE 20/25 mg Tablet, Film Coated3Preferred Brand25%20%None
BENAZEPRIL HYDROCHLORIDE AND HYDROCHLOROTHIAZIDE 5/6.25 mg Tablet, Film Coated3Preferred Brand25%20%None
BENLYSTA 200 mg/mL SolutionBelimumab5Specialty Tier25%N/A
  • PA
  • QL 8 per 28 days
BENLYSTA 200 mg/mL SolutionBelimumab5Specialty Tier25%N/A
  • PA
  • QL 8 per 28 days
BENZTROPINE MESYLATE .5 mg Tablet3Preferred Brand25%20%None
BENZTROPINE MESYLATE 1 mg Tablet3Preferred Brand25%20%None
BENZTROPINE MESYLATE 2 mg Tablet3Preferred Brand25%20%None
BESREMI 500 ug/mL InjectionRopeginterferon Alfa-2B5Specialty Tier25%N/A
  • PA
  • QL 2 per 28 days
BETAINE 1 g/g Powder, For Solution5Specialty Tier25%N/ANone
BETAMETHASONE DIPROPIONATE .5 mg/g Cream4Non-Preferred Drug34%N/A
  • QL 9 per 30 days
BETAMETHASONE DIPROPIONATE .5 mg/g Cream, Augmented3Preferred Brand25%20%
  • QL 1 per 30 days
BETAMETHASONE DIPROPIONATE .5 mg/g Gel4Non-Preferred Drug34%N/A
  • QL 1 per 30 days
BETAMETHASONE DIPROPIONATE .5 mg/g Lotion4Non-Preferred Drug34%N/A
  • QL 12 per 30 days
BETAMETHASONE DIPROPIONATE .5 mg/g Ointment4Non-Preferred Drug34%N/A
  • QL 9 per 30 days
BETAMETHASONE DIPROPIONATE .5 mg/g Ointment, Augmented4Non-Preferred Drug34%N/A
  • QL 1 per 30 days
BETAMETHASONE DIPROPIONATE .5 mg/mL Lotion, Augmented4Non-Preferred Drug34%N/A
  • QL 12 per 30 days
BETAMETHASONE VALERATE 1 mg/mL Lotion4Non-Preferred Drug34%N/A
  • QL 12 per 30 days
BETAMETHASONE VALERATE 1.2 mg/g Cream3Preferred Brand25%20%
  • QL 18 per 30 days
BETAMETHASONE VALERATE 1.2 mg/g Ointment3Preferred Brand25%20%
  • QL 18 per 30 days
BETAXOLOL HYDROCHLORIDE 5.6 mg/mL Solution/ Drops3Preferred Brand25%20%None
BETHANECHOL CHLORIDE 10 mg Tablet3Preferred Brand25%20%None
BETHANECHOL CHLORIDE 25 mg Tablet3Preferred Brand25%20%None
BETHANECHOL CHLORIDE 5 mg Tablet3Preferred Brand25%20%None
BETHANECHOL CHLORIDE 50 mg Tablet3Preferred Brand25%20%None
BEXAROTENE 10 mg/g Gel5Specialty Tier25%N/A
  • PA
  • QL 24 per 30 days
BEXAROTENE 75 mg Capsule, Liquid Filled5Specialty Tier25%N/A
  • PA
  • QL 3 per 30 days
BEXSERO 50/50/50/25 ug/.5mL Injection, SuspensionNeisseria Meningitidis Serogroup B Nhba Fusion Protein Antigen, Neisseria Meningitidis Serogroup B Fhbp Fusion Protein Antigen And Neisseria Meningitidis Serogroup B Nada Protein Antigen1Preferred Generic$0.00$0.00None
BICALUTAMIDE 50 mg Tablet3Preferred Brand25%20%
  • QL 3 per 30 days
BICILLIN L-A 1200000 [iU]/2mL Injection, SuspensionPenicillin G Benzathine4Non-Preferred Drug34%N/ANone
BICILLIN L-A 2400000 [iU]/4mL Injection, SuspensionPenicillin G Benzathine4Non-Preferred Drug34%N/ANone
BICILLIN L-A 600000 [iU]/mL Injection, SuspensionPenicillin G Benzathine4Non-Preferred Drug34%N/ANone
BIKTARVY 30/120/15 mg TabletBictegravir Sodium, Emtricitabine, And Tenofovir Alafenamide Fumarate5Specialty Tier25%N/A
  • QL 3 per 30 days
BIKTARVY 50/200/25 mg TabletBictegravir Sodium, Emtricitabine, And Tenofovir Alafenamide Fumarate5Specialty Tier25%N/A
  • QL 3 per 30 days
BISOPROLOL FUMARATE 10 mg Tablet2Generic$1.00$0.00None
BISOPROLOL FUMARATE 2.5 mg Tablet, Film Coated2Generic$1.00$0.00None
BISOPROLOL FUMARATE 5 mg Tablet2Generic$1.00$0.00None
BISOPROLOL FUMARATE AND HYDROCHLOROTHIAZIDE 6.25/10 mg Tablet2Generic$1.00$0.00None
BISOPROLOL FUMARATE AND HYDROCHLOROTHIAZIDE 6.25/2.5 mg Tablet2Generic$1.00$0.00None
BISOPROLOL FUMARATE AND HYDROCHLOROTHIAZIDE 6.25/5 mg Tablet2Generic$1.00$0.00None
BLISOVI 24 FE KitNorethindrone Acetate And Ethinyl Estradiol3Preferred Brand25%20%None
BLISOVI FE 1.5/30 KitNorethindrone Acetate And Ethinyl Estradiol3Preferred Brand25%20%None
BOOSTRIX 5/2.5/8/8/2.5 [iU]/.5mL/ug/.5mL SuspensionTetanus Toxoid, Reduced Diphtheria Toxoid And Acellular Pertussis Vaccine, Adsorbed1Preferred Generic$0.00$0.00None
BOSULIF 100 mg CapsuleBosutinib5Specialty Tier25%N/A
  • PA
  • QL 18 per 30 days
BOSULIF 100 mg Tablet, Film CoatedBosutinib5Specialty Tier25%N/A
  • PA
  • QL 12 per 30 days
BOSULIF 400 mg Tablet, Film CoatedBosutinib5Specialty Tier25%N/A
  • PA
  • QL 3 per 30 days
BOSULIF 50 mg CapsuleBosutinib5Specialty Tier25%N/A
  • PA
  • QL 36 per 30 days
BOSULIF 500 mg Tablet, Film CoatedBosutinib5Specialty Tier25%N/A
  • PA
  • QL 3 per 30 days
BRAFTOVI 75 mg CapsuleEncorafenib5Specialty Tier25%N/A
  • PA
  • QL 18 per 30 days
BREO ELLIPTA 100/25 ug PowderFluticasone Furoate And Vilanterol Trifenatate3Preferred Brand25%20%
  • QL 6 per 30 days
BREO ELLIPTA 200/25 ug PowderFluticasone Furoate And Vilanterol Trifenatate3Preferred Brand25%20%
  • QL 6 per 30 days
BREO ELLIPTA 50/25 ug PowderFluticasone Furoate And Vilanterol Trifenatate3Preferred Brand25%20%
  • QL 6 per 30 days
BREZTRI 160/9/4.8 ug Aerosol, MeteredBudesonide, Glycopyrrolate, And Formoterol Fumarate3Preferred Brand25%20%
  • QL 10.7 per 30 days
BRIMONIDINE TARTRATE 2 mg/mL Solution/ Drops1Preferred Generic$0.00$0.00None
BRIVIACT 10 mg Tablet, Film CoatedBrivaracetam4Non-Preferred Drug34%N/A
  • PA
  • QL 6 per 30 days
BRIVIACT 10 mg/mL SolutionBrivaracetam4Non-Preferred Drug34%N/A
  • PA
  • QL 6 per 30 days
BRIVIACT 100 mg Tablet, Film CoatedBrivaracetam4Non-Preferred Drug34%N/A
  • PA
  • QL 6 per 30 days
BRIVIACT 25 mg Tablet, Film CoatedBrivaracetam4Non-Preferred Drug34%N/A
  • PA
  • QL 6 per 30 days
BRIVIACT 50 mg Tablet, Film CoatedBrivaracetam4Non-Preferred Drug34%N/A
  • PA
  • QL 6 per 30 days
BRIVIACT 75 mg Tablet, Film CoatedBrivaracetam4Non-Preferred Drug34%N/A
  • PA
  • QL 6 per 30 days
BROMOCRIPTINE MESYLATE 2.5 mg Tablet4Non-Preferred Drug34%N/ANone
BRUKINSA 160 mg Tablet, Film CoatedZanubrutinib5Specialty Tier25%N/A
  • PA
  • QL 12 per 30 days
BUDESONIDE .25 mg/2mL Suspension4Non-Preferred Drug34%N/A
  • PA
BUDESONIDE .5 mg/2mL Suspension4Non-Preferred Drug34%N/A
  • PA
BUDESONIDE 3 mg Capsule, Delayed Release3Preferred Brand25%20%None
BUDESONIDE 9 mg Tablet, Extended Release4Non-Preferred Drug34%N/A
  • PA
  • QL 3 per 30 days
BUMETANIDE .5 mg Tablet3Preferred Brand25%20%None
BUMETANIDE 1 mg Tablet3Preferred Brand25%20%None
BUMETANIDE 2 mg Tablet3Preferred Brand25%20%None
BUPRENORPHINE 10 ug/h Patch, Extended Release4Non-Preferred Drug34%N/A
  • PA
  • QL 4 per 28 days
BUPRENORPHINE 15 ug/h Patch, Extended Release4Non-Preferred Drug34%N/A
  • PA
  • QL 4 per 28 days
BUPRENORPHINE 2 mg Tablet2Generic$1.00$0.00
  • QL 12 per 30 days
BUPRENORPHINE 20 ug/h Patch, Extended Release4Non-Preferred Drug34%N/A
  • PA
  • QL 4 per 28 days
BUPRENORPHINE 5 ug/h Patch, Extended Release4Non-Preferred Drug34%N/A
  • PA
  • QL 4 per 28 days
BUPRENORPHINE 7.5 ug/h Patch, Extended Release4Non-Preferred Drug34%N/A
  • PA
  • QL 4 per 28 days
BUPRENORPHINE 8 mg Tablet2Generic$1.00$0.00
  • QL 12 per 30 days
BUPRENORPHINE AND NALOXONE 2/.5 mg Tablet2Generic$1.00$0.00None
BUPRENORPHINE AND NALOXONE 8/2 mg Tablet2Generic$1.00$0.00None
BUPROPION HYDROCHLORIDE 100 mg Tablet, Film Coated3Preferred Brand25%20%
  • QL 18 per 30 days
BUPROPION HYDROCHLORIDE 75 mg Tablet, Film Coated3Preferred Brand25%20%
  • QL 18 per 30 days
BUPROPION HYDROCHLORIDE SR 100 mg Tablet, Film Coated, Extended ReleaseBupropion Hydrochloride3Preferred Brand25%20%
  • QL 12 per 30 days
BUPROPION HYDROCHLORIDE SR 150 mg Tablet, Extended ReleaseBupropion Hydrochloride3Preferred Brand25%20%
  • QL 9 per 30 days
BUPROPION HYDROCHLORIDE SR 150 mg Tablet, Film Coated, Extended ReleaseBupropion Hydrochloride3Preferred Brand25%20%
  • QL 9 per 30 days
BUPROPION HYDROCHLORIDE SR 200 mg Tablet, Film Coated, Extended ReleaseBupropion Hydrochloride3Preferred Brand25%20%
  • QL 6 per 30 days
BUPROPION HYDROCHLORIDE XL 150 mg Tablet, Extended ReleaseBupropion Hydrochloride3Preferred Brand25%20%
  • QL 9 per 30 days
BUPROPION HYDROCHLORIDE XL 300 mg Tablet, Extended ReleaseBupropion Hydrochloride3Preferred Brand25%20%
  • QL 6 per 30 days
BUSPIRONE HYDROCHLORIDE 10 mg Tablet2Generic$1.00$0.00None
BUSPIRONE HYDROCHLORIDE 15 mg Tablet2Generic$1.00$0.00None
BUSPIRONE HYDROCHLORIDE 30 mg Tablet2Generic$1.00$0.00None
BUSPIRONE HYDROCHLORIDE 5 mg Tablet2Generic$1.00$0.00None
BUSPIRONE HYDROCHLORIDE 7.5 mg Tablet2Generic$1.00$0.00None
BUTALBITAL, ACETAMINOPHEN, AND CAFFEINE 50/325/40 mg Tablet4Non-Preferred Drug34%N/A
  • QL 18 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.