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Prior authorization

6,799 Medicare Part D prior-authorization rules indexed from CMS SPUF (Standard Public Use File). Step therapy, quantity limits, tier assignments — authoritative, updated quarterly.

Why only Medicare Part D?

Medicare Part D formularies are published by CMS and we can cite them. Commercial plan rules vary by plan + year + region and aren't reliably published in a machine-readable form — so we don't surface them here. For your commercial plan, check your insurer's formulary PDF directly (“drug list” on the member site) or ask your pharmacist to run a test claim.

DrugPayerPAStep therapyTier
NP Thyroid 15

LEVOTHYROXINE, LIOTHYRONINE

—

Medicare Part D

———
Sodium Sulfacetamide 8% Sulfur 4% CLEANSER

Sodium Sulfacetamide and Sulfur

—

Medicare Part D

———
Meprobamate

Meprobamate

—

Medicare Part D

———
Chorionic Gonadotropin

Chorionic Gonadotropin

—

Medicare Part D

———
Phesgo

pertuzumab, trastuzumab, and hyaluronidase-zzxf

—

Medicare Part D

———
MOTEGRITY

PRUCALOPRIDE

—

Medicare Part D

———
Mono-Linyah

norgestimate and ethinyl estradiol

—

Medicare Part D

———
Fosfomycin Tromethamine

Fosfomycin Tromethamine

—

Medicare Part D

———
Pentamidine Isethionate

PENTAMIDINE ISETHIONATE

—

Medicare Part D

———
XIFAXAN

rifaximin

—

Medicare Part D

———
Hemgenix

etranacogene dezaparvovec

—

Medicare Part D

———
LMR Plus

Lidocaine

—

Medicare Part D

———
ZINC SULFATE

Zinc Sulfate Injection

—

Medicare Part D

———
Tocilizumab-anoh

tocilizumab

—

Medicare Part D

Yes——
PCXX PEPPERMINT NEUTRAL GL

Sodium Fluoride

—

Medicare Part D

———
Desmopressin Acetate

Desmopressin Acetate

—

Medicare Part D

———
Timolol Maleate

Timolol Maleate Ophthalmic

—

Medicare Part D

———
Gastrocrom

cromolyn sodium

—

Medicare Part D

———
SOLU-MEDROL

methylprednisolone sodium succinate

—

Medicare Part D

———
Orgovyx

relugolix

—

Medicare Part D

———
Desipramine HCL

DESIPRAMINE HCl

—

Medicare Part D

———
Rowasa

mesalamine

—

Medicare Part D

———
Oxycodone and Aspirin

Oxycodone and Aspirin

—

Medicare Part D

———
Ertapenem

Ertapenem Sodium

—

Medicare Part D

———
Sodium Tetradecyl Sulfate

SODIUM TETRADECYL SULFATE

—

Medicare Part D

———
DIFFERIN

Adapalene

—

Medicare Part D

———
METRONIDAZOLE

Metronidazole

—

Medicare Part D

———
LINCOMYCIN

Lincomycin Hydrochloride

—

Medicare Part D

———
Midazolam

Midazolam

—

Medicare Part D

———
PYLERA

BISMUTH SUBCITRATE POTASSIUM, METRONIDAZOLE, and TETRACYCLINE HYDROCHLORIDE

—

Medicare Part D

———
Plasma-Lyte 148 (pH 7.4)

Sodium Chloride, Sodium Gluconate, Sodium Acetate, Potassium Chloride, Magnesium Chloride

—

Medicare Part D

———
Polocaine-MPF, Polocaine

—

Medicare Part D

———
Nabi-HB

Hepatitis B Immune Globulin (Human)

—

Medicare Part D

———
THALLOUS CHLORIDE Tl 201

thallous chloride, Tl 201

—

Medicare Part D

———
Glatopa

Glatiramer Acetate

—

Medicare Part D

———
Travasol

Leucine, Phenylalanine, Lysine hydrochloride, Methionine, Isoleucine, Valine, Histidine, Threonine, Tryptophan, Alanine, Glycine, Arginine, Proline, Tyrosine, Serine

—

Medicare Part D

Yes——
INVANZ

ertapenem sodium

—

Medicare Part D

———
Lidocaine Viscous

Lidocaine Hydrochloride

—

Medicare Part D

———
Naloxone Hydrochloride Injection, USP, Auto-Injector

—

Medicare Part D

———
Sensorcaine MPF

BUPIVACAINE HYDROCHLORIDE

—

Medicare Part D

———
Xylocaine

XYLOCAINE

—

Medicare Part D

———
Gemcitabine hydrochloride

Gemcitabine Hydrochloride

—

Medicare Part D

———
LIPIODOL

ethiodized oil

—

Medicare Part D

———
Exelderm

Sulconazole Nitrate

—

Medicare Part D

———
Tretinoin

Tretinoin

—

Medicare Part D

———
Brimonidine Tartrate/Timolol Maleate Ophthalmic Solution

Brimonidine Tartrate and Timolol Maleate

—

Medicare Part D

———
Ery

Erythromycin

—

Medicare Part D

———
Akovaz

ephedrine sulfate

—

Medicare Part D

———
clobetasol propionate emollient formulation

clobetasol propionate

—

Medicare Part D

———
Armodafinil

armodafinil

—

Medicare Part D

———