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 |
|---|---|---|---|---|
| OLMESARTAN MEDOXOMIL AND HYDROCHLOROTHIAZIDE Olmesartan Medoxomil and Hydrochlorothiazide | — Medicare Part D | — | — | — |
| Niacin niacin | — Medicare Part D | — | — | — |
| SODIUM SULFATE, POTASSIUM SULFATE AND MAGNESIUM SULFATE Sodium Sulfate, Potassium Sulfate and Magnesium Sulfate | — Medicare Part D | — | — | — |
| Blisovi 24 Fe norethindrone acetate and ethinyl estradiol | — Medicare Part D | — | — | — |
| CIMETIDINE HYDROCHLORIDE CIMETIDINE HYDROCHLORIDE | — Medicare Part D | — | — | — |
| SODIUM ACETATE Sodium Acetate | — Medicare Part D | — | — | — |
| Modafinil Modafinil | — Medicare Part D | — | — | — |
| BUSULFEX busulfan | — Medicare Part D | — | — | — |
| COSOPT dorzolamide hydrochloride and timolol maleate | — Medicare Part D | — | — | — |
| Albuterol Sulfate HFA Albuterol Sulfate | — Medicare Part D | — | — | — |
| Ipratroprium Bromide Ipratroprium Bromide | — Medicare Part D | — | — | — |
| Doxylamine Succinate and Pyridoxine Hydrochloride Doxylamine succinate and pyridoxine hydrochloride | — Medicare Part D | — | — | — |
| Megatope Iodinated I-131 Albumin | — Medicare Part D | — | — | — |
| Injectafer Ferric Carboxymaltose Injection | — Medicare Part D | — | — | — |
| Augmentin Amoxicillin and Clavulanate Potassium | — Medicare Part D | — | — | — |
| Ecoza econazole nitrate | — Medicare Part D | — | — | — |
| Zepbound, ZEPBOUND, Zepbound KwikPen | — Medicare Part D | Yes | — | — |
| AVERI desogestrel and ethinyl estradiol | — Medicare Part D | — | — | — |
| Naproxen Sodium, Naproxen | — Medicare Part D | — | — | — |
| Feraheme ferumoxytol | — Medicare Part D | — | — | — |
| Ampicillin and Sulbactam ampicillin and sulbactam | — Medicare Part D | — | — | — |
| Hydrocortisone Hydrocortisone | — Medicare Part D | — | — | — |
| Zyvox LINEZOLID | — Medicare Part D | — | — | — |
| Tramadol Hydrochloride TRAMADOL HYDROCHLORIDE | — Medicare Part D | — | — | — |
| Insulin Diluting Medium for NovoLog, NOVOLOG | — Medicare Part D | Yes | — | — |
| Clobetasol Propionate clobetasol propionate | — Medicare Part D | — | — | — |
| Dantrium dantrolene sodium | — Medicare Part D | — | — | — |
| CYSTADROPS cysteamine hydrochloride | — Medicare Part D | — | — | — |
| Prazosin Hydrochloride Prazosin Hydrochloride | — Medicare Part D | — | — | — |
| ParaGard T 380A Copper | — Medicare Part D | — | — | — |
| IMJUDO tremelimumab | — Medicare Part D | — | — | — |
| SUNITINIB MALATE Sunitinib malate | — Medicare Part D | — | — | — |
| Rituxan rituximab | — Medicare Part D | — | — | — |
| IMATINIB MESYLATE imatinib mesylate | — Medicare Part D | — | — | — |
| Tretinoin Cream Tretinoin | — Medicare Part D | — | — | — |
| SOTYLIZE SOTALOL HYDROCHLORIDE | — Medicare Part D | — | — | — |
| Chlorpromazine Hydrochloride Chlorpromazine Hydrochloride | — Medicare Part D | — | — | — |
| Vaseretic enalapril maleate and hydrochlorothiazide | — Medicare Part D | — | — | — |
| BUTALBITAL AND ACETAMINOPHEN butalbital and acetaminophen | — Medicare Part D | — | — | — |
| Methocarbamol Tablets, USP, 500 mg | — Medicare Part D | — | — | — |
| ARMOUR THYROID THYROID, PORCINE | — Medicare Part D | — | — | — |
| LIDOCAINE Lidocaine HCl, Menthol | — Medicare Part D | — | — | — |
| Otrexup methotrexate | — Medicare Part D | — | — | — |
| YUNAKERA | — Medicare Part D | — | — | — |
| LEVEMIR insulin detemir | — Medicare Part D | — | — | — |
| Budesonide and Formoterol Fumarate Dihydrate Budesonide and Formoterol Fumarate Dihydrate | — Medicare Part D | — | — | — |
| Atovaquone Atovaquone | — Medicare Part D | — | — | — |
| ciprofloxacin hydrochloride and hydrocortisone ciprofloxacin hydrochloride and hydrocortisone | — Medicare Part D | — | — | — |
| Phentermine PHENTERMINE HYDROCHLORIDE | — Medicare Part D | — | — | — |
| Carbinoxamine Maleate Carbinoxamine Maleate | — Medicare Part D | — | — | — |