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 |
|---|---|---|---|---|
| Neurozyl Lidocaine HCl 4.12 % | — Medicare Part D | — | — | — |
| ABRILADA adalimumab-afzb | — Medicare Part D | Yes | — | — |
| Abiraterone Acetate Abiraterone Acetate | — Medicare Part D | — | — | — |
| Dorzolamide HCl DORZOLAMIDE HCl | — Medicare Part D | — | — | — |
| Fluoxetine Fluoxetine Hydrochloride | — Medicare Part D | — | — | — |
| Ondansetron Hydrochloride Ondansetron Hydrochloride | — Medicare Part D | — | — | — |
| LEVOFLOXACIN Levofloxacin | — Medicare Part D | — | — | — |
| CARISOPRODOL CARISOPRODOL | — Medicare Part D | — | — | — |
| INFUMORPH 200, INFUMORPH 500 | — Medicare Part D | — | — | — |
| BIZALIDA | — Medicare Part D | — | — | — |
| Jatenzo testosterone undecanoate | — Medicare Part D | Yes | — | — |
| Cytomel liothyronine sodium | — Medicare Part D | — | — | — |
| Qulipta Atogepant | — Medicare Part D | — | — | — |
| Viread TENOFOVIR DISOPROXIL FUMARATE | — Medicare Part D | — | — | — |
| CHLORDIAZEPOXIDE HCL AND CLIDINIUM BROMIDE CHLORDIAZEPOXIDE HCL AND CLIDINIUM BROMIDE | — Medicare Part D | — | — | — |
| Lumryz sodium oxybate | — Medicare Part D | — | — | — |
| Lidocan VI Lidocaine 5% | — Medicare Part D | — | — | — |
| Tizanidine tizanidine | — Medicare Part D | — | — | — |
| Helium/Oxygen Mix Helium/Oxygen Mix | — Medicare Part D | — | — | — |
| LEVO-T Levothyroxine Sodium | — Medicare Part D | — | — | — |
| ALBUMINEX Albumin Human | — Medicare Part D | — | — | — |
| Pyrogenium Anthracinum, Baptisia Tinctoria, Calcarea Picrata, Echinacea (Angustifolia), Hepar Sulphuris Calcareum, Mercurius Corrosivus, Pyrogenium | — Medicare Part D | — | — | — |
| Lidocaine HCl - Hydrocortisone Acetate LIDOCAINE HCL - HYDROCORTISONE ACETATE | — Medicare Part D | — | — | — |
| Alvimopan Alvimopan | — Medicare Part D | — | — | — |
| Pitocin oxytocin | — Medicare Part D | — | — | — |
| Carglumic Acid Carglumic acid | — Medicare Part D | — | — | — |
| DoubleDex Kit Dexamethasone Sodium Phosphate, Povidine Iodine | — Medicare Part D | — | — | — |
| Baclofen (Intrathecal) Baclofen | — Medicare Part D | — | — | — |
| Primidone Primidone | — Medicare Part D | — | — | — |
| Terazosin Hydrochloride Terazosin Hydrochloride | — Medicare Part D | — | — | — |
| Varibar Thin Liquid barium sulfate | — Medicare Part D | — | — | — |
| Calcitrol calcitriol | — Medicare Part D | — | — | — |
| bupropion Bupropion hydrochloride | — Medicare Part D | — | — | — |
| Etonogestrel and Ethinyl Estradiol Vaginal Etonogestrel and Ethinyl Estradiol Vaginal | — Medicare Part D | Yes | — | — |
| DycloPro Dyclonine Hydrochloride | — Medicare Part D | — | — | — |
| VANCOMYCIN HYDROCHLORIDE Vancomycin Hydrochloride | — Medicare Part D | — | — | — |
| Proctocort HYDROCORTISONE | — Medicare Part D | — | — | — |
| Polocaine Mepivacaine Hydrochloride | — Medicare Part D | — | — | — |
| Tasigna nilotinib | — Medicare Part D | — | — | — |
| Ephedrine Sulfate Ephedrine Sulfate | — Medicare Part D | — | — | — |
| Dantrolene Dantrolene Sodium | — Medicare Part D | — | — | — |
| Verapamil Hydrochloride verapamil hydrochloride | — Medicare Part D | — | — | — |
| Cyclopentolate Hydrochloride Cyclopentolate hydrochloride | — Medicare Part D | — | — | — |
| SYNDROS Dronabinol | — Medicare Part D | — | — | — |
| Adalimumab-aacf adalimumab-aacf | — Medicare Part D | — | — | — |
| Mycamine Micafungin sodium | — Medicare Part D | — | — | — |
| ENALAPRIL MALEATE Enalapril Maleate | — Medicare Part D | — | — | — |
| Levofloxacin, levofloxacin | — Medicare Part D | — | — | — |
| Minoxidil Minoxidil | — Medicare Part D | — | — | — |
| Dasetta 7/7/7 norethindrone and ethinyl estradiol | — Medicare Part D | — | — | — |