Coverage tools
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.
| Drug | Payer | PA | Step therapy | Tier |
|---|---|---|---|---|
| ASTAGRAF XL tacrolimus extended-release capsules | — Medicare Part D | — | — | — |
| Tinidazole Tinidazole | — Medicare Part D | — | — | — |
| Isolyte S pH 7.4 SODIUM CHLORIDE, SODIUM GLUCONATE, SODIUM ACETATE, POTASSIUM CHLORIDE, MAGNESIUM CHLORIDE, SODIUM PHOSPHATE, DIBASIC, and POTASSIUM PHOSPHATE | — Medicare Part D | — | — | — |
| Colcrys Colchicine | — Medicare Part D | — | — | — |
| PIPERACILLIN AND TAZOBACTAM Piperacillin and Tazobactam | — Medicare Part D | — | — | — |
| JUBLIA efinaconazole | — Medicare Part D | — | — | — |
| TRYPTYR Acoltremon | — Medicare Part D | — | — | — |
| Catapres-TTS-1, Catapres-TTS-2, Catapres-TTS-3 | — Medicare Part D | — | — | — |
| HYZAAR losartan potassium and hydrochlorothiazide | — Medicare Part D | — | — | — |
| Calcium Gluconate Calcium Gluconate | — Medicare Part D | — | — | — |
| PCXX PEPPERMINT APF F Sodium Fluoride | — Medicare Part D | — | — | — |
| Aranelle norethindrone and ethinyl estradiol | — Medicare Part D | — | — | — |
| POTASSIUM CITRATE Potassium Citrate | — Medicare Part D | — | — | — |
| Glycate Glycopyrrolate | — Medicare Part D | — | — | — |
| COMBIVIR lamivudine and zidovudine | — Medicare Part D | — | — | — |
| CLINDAMYCIN AND BENZOYL PEROXIDE clindamycin and benzoyl peroxide | — Medicare Part D | — | — | — |
| RIZATRIPTAN BENZOATE Rizatriptan Benzoate | — Medicare Part D | — | — | — |
| INSULIN GLARGINE insulin glargine | — Medicare Part D | — | — | — |
| Omeprazole and Sodium Bicarbonate Omeprazole and Sodium Bicarbonate | — Medicare Part D | — | — | — |
| Creon Pancrelipase | — Medicare Part D | — | — | — |
| Indomethacin ER Indomethacin | — Medicare Part D | — | — | — |
| NARCAN naloxone hydrochloride nasal | — Medicare Part D | — | — | — |
| Fludarabine FLUDARABINE PHOSPHATE | — Medicare Part D | — | — | — |
| LULICONAZOLE Luliconazole | — Medicare Part D | — | — | — |
| Cleocin Hydrochloride clindamycin hydrochloride | — Medicare Part D | — | — | — |
| Prednisolone Sodium Phosphate Oral Solution prednisoLONE sodium phosphate | — Medicare Part D | — | — | — |
| Azelastine Azelastine | — Medicare Part D | — | — | — |
| ARISTADA INITIO aripiprazole lauroxil | — Medicare Part D | Yes | — | — |
| DIANEAL LOW CALCIUM WITH DEXTROSE, DIANEAL PD-2 WITH DEXTROSE | — Medicare Part D | — | — | — |
| Meloxicam meloxicam | — Medicare Part D | — | — | — |
| DEXAMETHASONE SODIUM PHOSPHATE DEXAMETHASONE SODIUM PHOSPHATE | — Medicare Part D | — | — | — |
| IOMERVU Iomeprol Injection | — Medicare Part D | — | — | — |
| MENEST esterified estrogens | — Medicare Part D | — | — | — |
| Dorzolamide Hydrochloride and Timolol Maleate Preservative Free Dorzolamide Hydrochloride and Timolol Maleate Preservative Free | — Medicare Part D | — | — | — |
| NITROGEN NITROGEN | — Medicare Part D | — | — | — |
| Carbon Dioxide Nitrogen Carbon Dioxide Nitrogen | — Medicare Part D | — | — | — |
| XPOVIO selinexor | — Medicare Part D | — | — | — |
| Alprazolam C-IV Alprazolam C-IV | — Medicare Part D | — | — | — |
| Mavenclad Cladribine | — Medicare Part D | — | — | — |
| Neoral cyclosporine | — Medicare Part D | Yes | — | — |
| Oxygen/Nitrogen 40/60 Oxygen/Nitrogen 40/60 | — Medicare Part D | — | — | — |
| Zolpidem Tartrate zolpidem tartrate | — Medicare Part D | — | — | — |
| Clinolipid Olive Oil and Soybean Oil | — Medicare Part D | Yes | — | — |
| SSKI Potassium Iodide | — Medicare Part D | — | — | — |
| Doxepin Hydrochloride doxepin hydrochloride | — Medicare Part D | — | — | — |
| esomeprazole esomeprazole magnesium | — Medicare Part D | — | — | — |
| MINZOYA levonorgestrel and ethinyl estradiol and ferrous bisglycinate | — Medicare Part D | — | — | — |
| OFLOXACIN OTIC Ofloxacin | — Medicare Part D | — | — | — |
| MECLIZINE HYDROCHLORIDE MECLIZINE HYDROCHLORIDE | — Medicare Part D | — | — | — |
| VIJOICE alpelisib | — Medicare Part D | — | — | — |