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 |
|---|---|---|---|---|
| WELIREG belzutifan | — Medicare Part D | — | — | — |
| Streptomycin Streptomycin | — Medicare Part D | — | — | — |
| Camrese Levonorgestrel / Ethinyl Estradiol and Ethinyl Estradiol | — Medicare Part D | — | — | — |
| ZIANA clindamycin phosphate and tretinoin | — Medicare Part D | — | — | — |
| DALFAMPRIDINE Dalfampridine | — Medicare Part D | — | — | — |
| Orabloc articaine hydrochloride and epinephrine bitartrate | — Medicare Part D | — | — | — |
| Cisatracurium Besylate Cisatracurium besylate | — Medicare Part D | — | — | — |
| Lenalidomide Lenalidomide | — Medicare Part D | — | — | — |
| SUMATRIPTAN Sumatriptan Succinate | — Medicare Part D | — | — | — |
| Fraxinus americana Ash White | — Medicare Part D | — | — | — |
| XYLOCAINE MPF LIDOCAINE HYDROCHLORIDE | — Medicare Part D | — | — | — |
| Dextromethorphan hydrobromide and quinidine sulfate dextromethorphan hydrobromide and quinidine sulfate | — Medicare Part D | — | — | — |
| WELLBUTRIN XL bupropion hydrochloride | — Medicare Part D | — | — | — |
| NITROGLYCERIN Nitroglycerin | — Medicare Part D | — | — | — |
| DILTIAZEM HYDROCHLORIDE in SODIUM CHLORIDE Diltiazem Hydrochloride | — Medicare Part D | — | — | — |
| CHLOROTHIAZIDE SODIUM CHLOROTHIAZIDE SODIUM | — Medicare Part D | — | — | — |
| LO LOESTRIN FE norethindrone acetate and ethinyl estradiol, ethinyl estradiol and ferrous fumarate | — Medicare Part D | — | — | — |
| Nicardipine Hydrochloride in Sodium Chloride Nicardipine Hydrochloride | — Medicare Part D | — | — | — |
| Oxacillin Oxacillin Sodium | — Medicare Part D | — | — | — |
| Chlorhexidine Gluconate chlorhexidine gluconate | — Medicare Part D | — | — | — |
| Bortezomib BORTEZOMIB | — Medicare Part D | — | — | — |
| Pralatrexate Pralatrexate | — Medicare Part D | — | — | — |
| Ceftaroline Fosamil ceftaroline fosamil | — Medicare Part D | Yes | — | — |
| PRECEDEX DEXMEDETOMIDINE HYDROCHLORIDE | — Medicare Part D | — | — | — |
| Evoxac cevimeline hydrochloride | — Medicare Part D | — | — | — |
| Biorphen Phenylephrine hydrochloride | — Medicare Part D | — | — | — |
| Lunavira Multivitamin | — Medicare Part D | — | — | — |
| Letairis AMBRISENTAN | — Medicare Part D | — | — | — |
| UREDEX UREA | — Medicare Part D | — | — | — |
| AZATHIOPRINE AZATHIOPRINE | — Medicare Part D | — | — | — |
| PreviDent 5000 Sensitive Sodium fluoride and Potassium nitrate | — Medicare Part D | — | — | — |
| Multi-Vitamin with Fluoride VITAMIN A, ASCORBIC ACID, CHOLECALCIFEROL, ALPHA-TOCOPHEROL ACETATE, THIAMINE HYDROCHLORIDE, RIBOFLAVIN 5-PHOSPHATE SODIUM, CYANOCOBALAMIN, NIACINAMIDE, PYRIDOXINE HYDROCHLORIDE and SODIUM FLUORIDE | — Medicare Part D | — | — | — |
| RELEXXII methylphenidate hydrochloride | — Medicare Part D | — | — | — |
| Marinol Dronabinol | — Medicare Part D | — | — | — |
| AZELEX azelaic acid | — Medicare Part D | — | — | — |
| RIFAMPIN Rifampin | — Medicare Part D | — | — | — |
| Eslicarbazepine Acetate eslicarbazepine acetate | — Medicare Part D | — | — | — |
| Ocrevus Zunovo ocrelizumab and hyaluronidase | — Medicare Part D | — | — | — |
| Thiola EC tiopronin | — Medicare Part D | — | — | — |
| COSOPT PF dorzolamide hydrochloride and timolol maleate | — Medicare Part D | — | — | — |
| EC-NAPROXEN naproxen | — Medicare Part D | — | — | — |
| TOBRAMYCIN AND DEXAMETHASONE Tobramycin and dexamethasone | — Medicare Part D | — | — | — |
| Amphetamine DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE MONOHYDRATE, DEXTROAMPHETAMINE SULFATE, AMPHETAMINE SULFATE | — Medicare Part D | — | — | — |
| Morbillinum MEASLES VIRUS | — Medicare Part D | — | — | — |
| ICATIBANT Icatibant | — Medicare Part D | — | — | — |
| Clopidogrel Clopidogrel | — Medicare Part D | — | — | — |
| Desogestrel and Ethinyl Estradiol Desogestrel and Ethinyl Estradiol | — Medicare Part D | — | — | — |
| APLISOL Tuberculin Purified Protein Derivative | — Medicare Part D | — | — | — |
| NP THYROID 30 LEVOTHYROXINE, LIOTHYRONINE | — Medicare Part D | — | — | — |
| Nalocet oxycodone and acetaminophen | — Medicare Part D | — | — | — |