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 |
|---|---|---|---|---|
| ProAir Digihaler albuterol sulfate | — Medicare Part D | — | — | — |
| PreviDent OrthoDefense SODIUM FLUORIDE | — Medicare Part D | — | — | — |
| Ceftriaxone Sodium Ceftriaxone Sodium | — Medicare Part D | — | — | — |
| Selexipag, Selexipag TITRATION PACK | — Medicare Part D | Yes | — | — |
| Tri Femynor norgestimate and ethinyl estradiol | — Medicare Part D | — | — | — |
| Syntherma Plus Lidocaine | — Medicare Part D | — | — | — |
| ZINPLAVA bezlotoxumab | — Medicare Part D | — | — | — |
| Zemplar Paricalcitol | — Medicare Part D | — | — | — |
| Obagi Nu-Derm System Normal-Oily Skin Transformation HYDROQUINONE, HOMOSALATE, OCTISALATE, ZINC OXIDE | — Medicare Part D | — | — | — |
| Jalyn DUTASTERIDE and TAMSULOSIN HYDROCHLORIDE | — Medicare Part D | — | — | — |
| ZERVIATE cetirizine | — Medicare Part D | — | — | — |
| PROCHLORPERAZINE MALEATE Prochlorperazine Maleate | — Medicare Part D | — | — | — |
| AZITHROMYCIN DIHYDRATE Azithromycin dihydrate | — Medicare Part D | — | — | — |
| TECVAYLI teclistamab | — Medicare Part D | — | — | — |
| Intuniv guanfacine | — Medicare Part D | — | — | — |
| AUVI-Q AUVI-Q | — Medicare Part D | — | — | — |
| Alprazolam Extended Release Alprazolam | — Medicare Part D | — | — | — |
| PCXX NEUTRAL RNS PEPPERMINT FLUORIDE TREATMENT | — Medicare Part D | — | — | — |
| FLUOROMETHOLONE fluorometholone | — Medicare Part D | Yes | — | — |
| FILSPARI sparsentan | — Medicare Part D | — | — | — |
| Olanzapine and Fluoxetine Olanzapine and Fluoxetine | — Medicare Part D | — | — | — |
| Acetaminophen Acetaminophen | — Medicare Part D | — | No | — |
| NALMEFENE HYDROCHLORIDE Nalmefene Hydrochloride | — Medicare Part D | Yes | — | — |
| Female Support Chamomilla, Cimicifuga Racemosa, Helonias Dioica, Mentha Piperita, Senna (Cassia Angustifolia), Valeriana Officinalis, Viola Odorata, Agnus Castus, Ledum Palustre, Lilium Tigrinum, Staphysagria, Crocus Sativus, Hydrastis Canadensis, Cinchona Officinalis, Convallaria Majalis, Cyclamen Europaeum, Cinnamomum, Murex Purpurea, Naja Tripudians | — Medicare Part D | — | — | — |
| Fluocinolone Acetonide fluocinolone acetonide | — Medicare Part D | — | — | — |
| Colestipol Hydrochloride Colestipol Hydrochloride | — Medicare Part D | — | — | — |
| Rocklatan netarsudil and latanoprost ophthalmic solution, 0.02%/0.005% | — Medicare Part D | — | — | — |
| Arixtra fondaparinux sodium | — Medicare Part D | — | — | — |
| olmesartan medoxomil / amlodipine besylate / hydrochlorothiazide olmesartan medoxomil / amlodipine besylate / hydrochlorothiazide | — Medicare Part D | — | — | — |
| Lysodren mitotane | — Medicare Part D | — | — | — |
| Nilotinib Nilotinib | — Medicare Part D | — | — | — |
| Hydroxate Gel HYDROCORTISONE 2% | — Medicare Part D | — | — | — |
| Isosorbide Dinitrate Isosorbide Dinitrate | — Medicare Part D | — | — | — |
| Qbrelis lisinopril | — Medicare Part D | — | — | — |
| Fetroja Cefiderocol sulfate tosylate | — Medicare Part D | — | — | — |
| LURASIDONE HYDROCHLORIDE LURASIDONE HYDROCHLORIDE | — Medicare Part D | — | — | — |
| CICLOPIROX Ciclopirox | — Medicare Part D | — | — | — |
| Dovato dolutegravir sodium and lamivudine | — Medicare Part D | Yes | — | — |
| Luzu LULICONAZOLE | — Medicare Part D | — | — | — |
| Tirosint SOL Levothyroxine Sodium | — Medicare Part D | — | — | — |
| DICLOFENAC SODIUM diclofenac sodium | — Medicare Part D | — | — | — |
| Atomoxetine Atomoxetine | — Medicare Part D | — | — | — |
| Dyrenium Triamterene | — Medicare Part D | — | — | — |
| Alkindi Sprinkle Hydrocortisone | — Medicare Part D | — | — | — |
| XHANCE fluticasone propionate | — Medicare Part D | — | — | — |
| Multivitamin Multivitamin | — Medicare Part D | — | — | — |
| Zoledronic Acid Zoledronic Acid | — Medicare Part D | — | — | — |
| Pantoprazole sodium delayed-release Pantoprazole sodium delayed-release | — Medicare Part D | — | — | — |
| Romidepsin Romidepsin | — Medicare Part D | — | — | — |
| TRIAMCINOLONE ACETONIDE Triamcinolone Acetonide | — Medicare Part D | — | — | — |