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 |
|---|---|---|---|---|
| LITHIUM CARBONATE LITHIUM CARBONATE LITHIUM CARBONATE | — Medicare Part D | — | — | — |
| Flecainide Acetate Flecainide Acetate | — Medicare Part D | — | — | — |
| Dexlido-M Kit Dexamethasone Sodium Phosphate, Lidocaine Hydrochloride, maricaine, Povidine Iodine | — Medicare Part D | — | — | — |
| Sorafenib sorafenib | — Medicare Part D | — | — | — |
| Ionite APF Neutral Sodium Fluoride | — Medicare Part D | — | — | — |
| Aurum muriaticum kalinatum POTASSIUM TETRACHLOROAURATE DIHYDRATE | — Medicare Part D | — | — | — |
| Vitamin K1 PHYTONADIONE | — Medicare Part D | — | — | — |
| Phentermine HCL C-IV Phentermine HCL C-IV | — Medicare Part D | — | — | — |
| Sumaxin Cleansing Pads, Sumaxin CP | — Medicare Part D | — | — | — |
| ONGLYZA SAXAGLIPTIN | — Medicare Part D | — | — | — |
| ADAPALENE AND BENZOYL PEROXIDE adapalene and benzoyl peroxide topical | — Medicare Part D | — | — | — |
| Eltrombopag Olamine Eltrombopag Olamine | — Medicare Part D | — | — | — |
| GATIFLOXACIN GATIFLOXACIN | — Medicare Part D | — | — | — |
| Liomny Liothyronine Sodium | — Medicare Part D | — | — | — |
| Avopef etoposide | — Medicare Part D | — | — | — |
| Benzamycin erythromycin and benzoyl peroxide | — Medicare Part D | — | — | — |
| Sodium Nitrite Sodium Nitrite | — Medicare Part D | — | — | — |
| THEOPHYLLINE Theophylline | — Medicare Part D | — | — | — |
| Pioglitazone HCL and Metformin HCL Pioglitazone HCL and Metformin HCL | — Medicare Part D | — | — | — |
| SAPHNELO Anifrolumab-fnia | — Medicare Part D | — | — | — |
| sodium sulfate, potassium sulfate, and magnesium sulfate sodium sulfate, potassium sulfate, and magnesium sulfate | — Medicare Part D | — | — | — |
| PROCTOZONE-HC hydrocortisone 2.5% | — Medicare Part D | — | — | — |
| Cyclobenzaprine Hydrochloride CYCLOBENZAPRINE HYDROCHLORIDE | — Medicare Part D | — | — | — |
| Desloratadine DESLORATADINE | — Medicare Part D | — | — | — |
| Arakoda Tafenoquine | — Medicare Part D | — | — | — |
| Potassium Chloride POTASSIUM CHLORIDE | — Medicare Part D | — | — | — |
| Sodium Fluoride 5000 Plus Sodium Fluoride | — Medicare Part D | — | — | — |
| Kaletra Lopinavir and Ritonavir | — Medicare Part D | — | — | — |
| Amlodipine and Benazepril Hydrochloride Amlodipine and Benazepril Hydrochloride | — Medicare Part D | — | — | — |
| Boncresa denosumab-mobz | — Medicare Part D | — | — | — |
| Xatmep Methotrexate | — Medicare Part D | — | — | — |
| Floravita Mini Floravita Mini | — Medicare Part D | — | — | — |
| SOOLANTRA IVERMECTIN | — Medicare Part D | — | — | — |
| Sirolimus Sirolimus | — Medicare Part D | — | — | — |
| Methazolamide Methazolamide | — Medicare Part D | — | — | — |
| Oxcarbazepine oxcarbazepine | — Medicare Part D | — | — | — |
| VIGADRONE vigabatrin | — Medicare Part D | — | — | — |
| Etonogestrel and Ethinyl Estradiol Vaginal Ring Etonogestrel and Ethinyl Estradiol Vaginal Ring | — Medicare Part D | Yes | — | — |
| Duraclon clonidine hydrochloride | — Medicare Part D | — | — | — |
| Nebivolol nebivolol | — Medicare Part D | — | — | — |
| Karbinal ER Carbinoxamine Maleate | — Medicare Part D | — | — | — |
| Livmarli maralixibat chloride | — Medicare Part D | — | — | — |
| RAMELTEON Ramelteon | — Medicare Part D | — | — | — |
| COLISTIMETHATE SODIUM COLISTIMETHATE SODIUM | — Medicare Part D | — | — | — |
| Microvara Probiotic Dietary Supplement | — Medicare Part D | — | — | — |
| Pulmotech MAA kit for the preparation of technetium Tc 99m albumin aggregated | — Medicare Part D | — | — | — |
| NP Thyroid 120 LEVOTHYROXINE, LIOTHYRONINE | — Medicare Part D | — | — | — |
| Manganese Chelidonium Majus, Iodium, Lycopus Virginicus, Ginkgo Biloba, Pinus Sylvestris, Fucus Vesiculosus, Spongia Tosta, Germanium Sesquioxide, Hypophysis Suis, Thyroidinum (Suis), Cysteinum, Manganese Gluconate, Alpha-Ketoglutaricum Acidum, Calcarea Carbonica, Ferrum Iodatum, Fumaricum Acidum, Kali Iodatum, Natrum Oxalaceticum, Pulsatilla (Vulgaris), Argentum Metallicum, Aurum Metallicum, Cuprum Metallicum, Eugenol, Formalinum, Lidocaine, Mercurius Solubilis, Molybdenum Metallicum, Niccolum Metallicum, | — Medicare Part D | — | — | — |
| Phenytoin Sodium Phenytoin Sodium | — Medicare Part D | — | — | — |
| TESTOSTERONE Testosterone | — Medicare Part D | — | — | — |