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 |
|---|---|---|---|---|
| LEVEMIR insulin detemir | — Medicare Part D | — | — | — |
| LEUCOVORIN CALCIUM Leucovorin Calcium | — Medicare Part D | — | — | — |
| Doxycycline doxycycline | — Medicare Part D | — | — | — |
| 0.9% SODIUM CHLORIDE SODIUM CHLORIDE | — Medicare Part D | — | — | — |
| Rhofade oxymetazoline hydrochloride | — Medicare Part D | — | — | — |
| Olopatadine Hydrochloride Olopatadine Hydrochloride | — Medicare Part D | — | — | — |
| ACETAMINOPHEN AND CODEINE PHOSPHATE acetaminophen and codeine phosphate | — Medicare Part D | — | — | — |
| PROPYLTHIOURACIL Propylthiouracil | — Medicare Part D | — | — | — |
| VIDAZA azacitidine | — Medicare Part D | — | — | — |
| BUPHENYL, Buphenyl | — Medicare Part D | Yes | — | — |
| Agnus castus Agnus castus | — Medicare Part D | — | — | — |
| AKYNZEO Netupitant and Palonosetron | — Medicare Part D | — | — | — |
| JAIMIESS levonorgestrel / ethinyl estradiol and ethinyl estradiol | — Medicare Part D | — | — | — |
| ERLOTINIB Erlotinib Hydrochloride | — Medicare Part D | — | — | — |
| FLUTICASONE PROPIONATE FLUTICASONE PROPIONATE | — Medicare Part D | — | — | — |
| PEG-3350, sodium chloride, sodium bicarbonate and potassium chloride polyethylene glycol 3350, sodium chloride, sodium bicarbonate, potassium chloride | — Medicare Part D | — | — | — |
| DuoDote atropine and pralidoxime chloride | — Medicare Part D | — | — | — |
| Strong Iodine Solution Lugols Solution Strong Iodine Solution | — Medicare Part D | — | — | — |
| Acitretin ACITRETIN | — Medicare Part D | — | — | — |
| Estazolam Estazolam | — Medicare Part D | — | — | — |
| HADLIMA adalimumab-bwwd | — Medicare Part D | — | — | — |
| teruflex blood bag system with diversion blood sampling arm 70 ml cpda-1 | — Medicare Part D | — | — | — |
| Gallifrey Norethindrone Acetate | — Medicare Part D | — | — | — |
| EGRIFTA SV tesamorelin | — Medicare Part D | Yes | — | — |
| AUVELITY dextromethorphan hydrobromide, bupropion hydrochloride | — Medicare Part D | — | — | — |
| Clorazepate Dipotassium Clorazepate Dipotassium | — Medicare Part D | — | — | — |
| Diclofenac Sodium and Misoprostol Diclofenac Sodium and Misoprostol | — Medicare Part D | — | — | — |
| Cetrotide cetrorelix acetate | — Medicare Part D | — | — | — |
| Foltira Folate, Vitamin D3 | — Medicare Part D | — | — | — |
| Probenecid Probenecid | — Medicare Part D | — | — | — |
| House Dust Mite, Dermatophagoides farinae, House Dust Mite, Dermatophagoides pteronyssinus | — Medicare Part D | — | — | — |
| Simvastatin, SIMVASTATIN | — Medicare Part D | — | — | — |
| ETHOSUXIMIDE Ethosuximide | — Medicare Part D | — | — | — |
| LOMAIRA PHENTERMINE HYDROCHLORIDE | — Medicare Part D | — | — | — |
| Silodosin Silodosin | — Medicare Part D | — | — | — |
| vilazodone, Vilazodone | — Medicare Part D | — | — | — |
| Norethindrone Acetate norethindrone acetate and ethinyl estradiol | — Medicare Part D | — | — | — |
| IBUPAK Ibuprofen | — Medicare Part D | — | — | — |
| FLUORESCITE fluorescein sodium | — Medicare Part D | — | — | — |
| Levora levonorgestrel and ethinyl estradiol | — Medicare Part D | — | — | — |
| Cefixime 400 mg Cefixime | — Medicare Part D | — | — | — |
| Ropidex Dexamethasone Sodium Phosphate, Ropivacaine Hydrochloride, Povidine Iodine | — Medicare Part D | — | — | — |
| Ziprasidone ziprasidone | — Medicare Part D | — | — | — |
| Epoprostenol Epoprostenol | — Medicare Part D | — | — | — |
| LEVOPHED NOREPINEPHRINE BITARTRATE | — Medicare Part D | — | — | — |
| Dexmedetomidine, Dexmedetomidine Hydrochloride | — Medicare Part D | — | — | — |
| Larin 24 Fe Norethindrone acetate/Ethinyl Estradiol and Ferrous Fumarate | — Medicare Part D | — | — | — |
| Dexrazoxane Dexrazoxane for Injection | — Medicare Part D | — | — | — |
| Crestor Rosuvastatin | — Medicare Part D | — | — | — |
| DURYSTA bimatoprost | — Medicare Part D | — | — | — |