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 |
|---|---|---|---|---|
| XYLOCAINE- MPF (LIDOCAINE HCl ) XYLOCAINE-MPF WITH EPI | — Medicare Part D | — | — | — |
| PAXIL CR paroxetine hydrochloride | — Medicare Part D | — | — | — |
| Propofol propofol | — Medicare Part D | — | — | — |
| Adenosine ADENOSINE | — Medicare Part D | — | — | — |
| 50% MAGNESIUM SULFATE 50% MAGNESIUM SULFATE | — Medicare Part D | — | — | — |
| Dobutamine dobutamine | — Medicare Part D | — | — | — |
| TaperDex 6-day DEXAMETHASONE | — Medicare Part D | — | — | — |
| Dorzolamide Hydrochloride Ophthalmic Solution Dorzolamide Hydrochloride | — Medicare Part D | — | — | — |
| Tranylcypromine Sulfate Tranylcypromine sulfate | — Medicare Part D | — | — | — |
| REZZAYO rezafungin | — Medicare Part D | — | — | — |
| CALCIUM CHLORIDE SODIUM CHLORIDE, SODIUM LACTATE, POTASSIUM CHLORIDE, and CALCIUM CHLORIDE | — Medicare Part D | — | — | — |
| DORZOLAMIDE HYDROCHLORIDE AND TIMOLOL MALEATE Dorzolamide Hydrochloride and Timolol Maleate | — Medicare Part D | — | — | — |
| Vectical calcitriol | — Medicare Part D | — | — | — |
| Cefadroxil Cefadroxil | — Medicare Part D | — | — | — |
| METOCLOPRAMIDE hydrochloride Metoclopramide Hydrochloride | — Medicare Part D | — | — | — |
| Estradiol ESTRADIOL | — Medicare Part D | — | — | — |
| Miacalcin calcitonin salmon | — Medicare Part D | — | — | — |
| MEPRON atovaquone | — Medicare Part D | — | — | — |
| GAVILYTE G TM polyethylene glycol-3350 and Electrolytes | — Medicare Part D | — | — | — |
| Sodium Sulfacetamide Sodium Sulfacetamide | — Medicare Part D | — | — | — |
| Glucose dextrose(glucose),Levulose(fructose),Phosphoric acid | — Medicare Part D | — | — | — |
| CLINIMIX Leucine, Phenylalanine, Lysine, Methionine, Isoleucine, Valine, Histidine, Threonine, Tryptophan, Alanine, Glycine, Arginine, Proline, Serine, Tyrosine, Dextrose | — Medicare Part D | Yes | — | — |
| Glyburide and Metformin Hydrochloride Glyburide and Metformin Hydrochloride | — Medicare Part D | — | — | — |
| Kit for the Preparation of Technetium Tc 99m Medronate Kit For The Preparation Of Technetium Tc 99m Medronate | — Medicare Part D | — | — | — |
| Lansoprazole, Amoxicillin, Clarithromycin Lansoprazole, Amoxicillin, Clarithromycin | — Medicare Part D | — | — | — |
| Varenicline, Varenicline tartrate | — Medicare Part D | — | — | — |
| Zestoretic lisinopril and hydrochlorothiazide | — Medicare Part D | — | — | — |
| Methadone Hydrocloride methadone hydrochloride | — Medicare Part D | — | — | — |
| Divalproex Sodium Divalproex Sodium | — Medicare Part D | — | — | — |
| PRUCALOPRIDE PRUCALOPRIDE | — Medicare Part D | — | — | — |
| CARMUSTINE Carmustine | — Medicare Part D | — | — | — |
| Molindone Hydrochloride MOLINDONE HYDROCHLORIDE | — Medicare Part D | — | — | — |
| LAMIVUDINE lamivudine | — Medicare Part D | — | — | — |
| Atorvastatin Calcium Atorvastatin Calcium | — Medicare Part D | — | — | — |
| Anzupgo delgocitinib | — Medicare Part D | — | — | — |
| Tafinlar dabrafenib | — Medicare Part D | Yes | — | — |
| CICLOPIROX Ciclopirox | — Medicare Part D | — | — | — |
| TENORMIN Atenolol | — Medicare Part D | — | — | — |
| Teriparatide Teriparatide | — Medicare Part D | — | — | — |
| RIVASTIGMINE TARTRATE RIVASTIGMINE TARTRATE | — Medicare Part D | — | — | — |
| Renvela SEVELAMER CARBONATE | — Medicare Part D | — | — | — |
| Multitam Folic Acid | — Medicare Part D | — | — | — |
| Viltepso viltolarsen | — Medicare Part D | — | — | — |
| QUININE SULFATE QUININE SULFATE | — Medicare Part D | — | — | — |
| Lidotral Five Percent with Menthol Lidocaine Hydrochloride, Menthol | — Medicare Part D | — | — | — |
| Budesonide budesonide | — Medicare Part D | — | — | — |
| Xospata gilteritinib | — Medicare Part D | — | — | — |
| GIVLAARI givosiran sodium | — Medicare Part D | — | — | — |
| INDOCIN indomethacin | — Medicare Part D | — | — | — |
| Tridacaine III Lidocaine | — Medicare Part D | — | — | — |