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 |
|---|---|---|---|---|
| Bupropion Hydrochloride XL Bupropion Hydrochloride | — Medicare Part D | — | — | — |
| Desvenlafaxine Succinate desvenlafaxine succinate | — Medicare Part D | — | — | — |
| TAVALISSE FOSTAMATINIB | — Medicare Part D | — | — | — |
| Deluxe Dental Emergency Kit Epinephrine, Albuterol Sulfate, Nitroglycerin, Diphenhydramine Hydrochloride, Aspirin | — Medicare Part D | — | — | — |
| Gefitinib Gefitinib | — Medicare Part D | — | — | — |
| PROVAYBLUE methylene blue | — Medicare Part D | — | — | — |
| BUPIVACAINE HCI AND EPINEPHRINE BUPIVACAINE HCI AND EPINEPHRINE | — Medicare Part D | — | — | — |
| PYRAZINAMIDE Pyrazinamide | — Medicare Part D | — | — | — |
| QUESTRAN Cholestyramine | — Medicare Part D | — | — | — |
| Isosorbide Mononitrate Isosorbide Mononitrate | — Medicare Part D | — | — | — |
| Eltrombopag Olamine Eltrombopag Olamine | — Medicare Part D | — | — | — |
| Camptosar irinotecan hydrochloride | — Medicare Part D | — | — | — |
| Nitrous Oxide NITROUS OXIDE | — Medicare Part D | — | — | — |
| Metformin hydrochloride ER, Metformin hydrochloride | — Medicare Part D | — | — | — |
| Fosfomycin Tromethamine Fosfomycin Tromethamine | — Medicare Part D | — | — | — |
| cocaine hydrochloride nasal cocaine hydrochloride nasal | — Medicare Part D | — | — | — |
| Cabergoline Cabergoline | — Medicare Part D | — | — | — |
| INGREZZA, INGREZZA Sprinkle | — Medicare Part D | Yes | — | — |
| Esomeprazole Sodium Esomeprazole Sodium | — Medicare Part D | — | — | — |
| RYONCIL remestemcel-l-rknd | — Medicare Part D | — | — | — |
| LANOXIN digoxin | — Medicare Part D | — | — | — |
| Monsels Solution Ferric Subsulfate | — Medicare Part D | — | — | — |
| Hydroxym Cream HYDROCORTISONE | — Medicare Part D | — | — | — |
| Progesterone vaginal insert Progesterone | — Medicare Part D | — | — | — |
| Azathioprine Sodium Azathioprine Sodium | — Medicare Part D | — | — | — |
| ANAFRANIL clomipramine hydrochloride | — Medicare Part D | — | — | — |
| OPZELURA ruxolitinib | — Medicare Part D | — | — | — |
| Inveltys loteprednol etabonate | — Medicare Part D | — | — | — |
| Strophanthus hispidus Histaminum hydrochloricum,Thyroidinum, Aconitum nap., Arsenicum alb., Bryonia, Cactus, Calc. fluor., Ceanothus, Cinchona, Convallaria, Digitalis, Gelsemium, Glonoinum, Hydrocoyle, Kali carb., Lachesis, Naja, nat carb., Nat mur., Nux vom., Phosphorus, Pullsatilla, Rhus toxicodendron, Strophanthus hispidus, Sulphur, Echinacea | — Medicare Part D | — | — | — |
| Raloxifene Hydrochloride Raloxifene hydrochloride | — Medicare Part D | — | — | — |
| MECLIZINE HYDROCHLORIDE MECLIZINE HYDROCHLORIDE | — Medicare Part D | — | — | — |
| LUIZZA 1.5/30 norethindrone acetate and ethinyl estradiol | — Medicare Part D | — | — | — |
| SAJAZIR ICATIBANT | — Medicare Part D | — | — | — |
| Exdensur depemokimab | — Medicare Part D | — | — | — |
| BUTALBITAL, ASPIRIN, CAFFEINE AND CODEINE PHOSPHATE Butalbital, Aspirin, Caffeine and Codeine Phosphate | — Medicare Part D | — | — | — |
| Gleostine lomustine | — Medicare Part D | — | — | — |
| OSHIH norethindrone acetate and ethinyl estradiol and ferrous fumarate | — Medicare Part D | — | — | — |
| Tolterodine Tartrate Tolterodine Tartrate | — Medicare Part D | — | — | — |
| LISINOPRIL AND HYDROCHLOROTHIAZIDE Lisinopril and Hydrochlorothiazide Tablets | — Medicare Part D | — | — | — |
| Ferumoxytol Ferumoxytol | — Medicare Part D | — | — | — |
| Sodium Sulfacetamide Sodium Sulfacetamide | — Medicare Part D | — | — | — |
| ITRACONAZOLE Itraconazole | — Medicare Part D | — | — | — |
| CEVIMELINE HYDROCHLORIDE cevimeline hydrochloride | — Medicare Part D | — | — | — |
| Ovide Malathion | — Medicare Part D | — | — | — |
| Pemetrexed PEMETREXED DISODIUM | — Medicare Part D | — | — | — |
| Copaxone Glatiramer Acetate | — Medicare Part D | — | — | — |
| Varibar Pudding Barium Sulfate | — Medicare Part D | — | — | — |
| CLENPIQ SODIUM PICOSULFATE, MAGNESIUM OXIDE, and ANHYDROUS CITRIC ACID | — Medicare Part D | — | — | — |
| BREKIYA Dihydroergotamine Mesylate | — Medicare Part D | — | — | — |
| Prenatol-M Multivitamin | — Medicare Part D | — | — | — |