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 |
|---|---|---|---|---|
| Sotalol, Sotalol Hydrochloride AF | — Medicare Part D | — | — | — |
| Oxygen/Nitrogen 10/90 Oxygen/Nitrogen 10/90 | — Medicare Part D | — | — | — |
| Flurbiprofen Sodium Flurbiprofen Sodium | — Medicare Part D | — | — | — |
| Dimethyl Fumarate, DIMETHYL FUMARATE | — Medicare Part D | — | — | — |
| Hydroxyzine Pamoate hydroxyzine pamoate | — Medicare Part D | — | — | — |
| Physiolyte Sodium Chloride, Sodium Gluconate, Sodium Acetate, Potassium Chloride, and Magnesium Chloride | — Medicare Part D | — | — | — |
| Anticoagulant Citrate Dextrose (ACD-A) Anticoagulant Citrate Dextrose A ACD-A | — Medicare Part D | — | Step therapy | — |
| CLINDAMYCIN PALMITATE HYDROCHLORIDE (Pediatric) Clindamycin Palmitate Hydrochloride | — Medicare Part D | — | — | — |
| Liothyronine Sodium liothyronine sodium | — Medicare Part D | — | — | — |
| LIRAGLUTIDE Liraglutide | — Medicare Part D | — | — | — |
| Bexagliflozin Bexagliflozin | — Medicare Part D | — | — | — |
| Urea 40% Urea | — Medicare Part D | — | — | — |
| PureVit DualFe Plus Ferrous Fumarate, Polysaccharide Iron Complex | — Medicare Part D | — | — | — |
| Bepreve bepotastine besilate | — Medicare Part D | — | — | — |
| Oxycodone Hydrochloride Oral Solution OXYCODONE HYDROCHLORIDE | — Medicare Part D | — | — | — |
| Melphalan Hydrochloride Melphalan hydrochloride | — Medicare Part D | — | — | — |
| DICYCLOMINE HYDROCHLORIDE Dicyclomine Hydrochloride | — Medicare Part D | — | — | — |
| NORLIQVA amlodipine | — Medicare Part D | — | — | — |
| SODIUM PHENYLACETATE AND SODIUM BENZOATE sodium phenylacetate and sodium benzoate | — Medicare Part D | — | — | — |
| DOBUTAMINE IN DEXTROSE DOBUTAMINE IN DEXTROSE | — Medicare Part D | — | — | — |
| CAPTOPRIL AND HYDROCHLOROTHIAZIDE CAPTOPRIL AND HYDROCHLOROTHIAZIDE | — Medicare Part D | — | — | — |
| Toviaz fesoterodine fumarate | — Medicare Part D | — | — | — |
| Hepzato Kit melphalan hydrochloride injection, powder, lyophilized, for solution | — Medicare Part D | — | — | — |
| Gentamicin Sulfate GENTAMICIN SULFATE | — Medicare Part D | — | — | — |
| Nardil Phenelzine Sulfate | — Medicare Part D | — | — | — |
| Rifadin IV rifampin | — Medicare Part D | — | — | — |
| Rylaze asparaginase erwinia chrysanthemi (recombinant)-rywn | — Medicare Part D | — | — | — |
| Methotrexate Sodium Methotrexate Sodium | — Medicare Part D | — | — | — |
| Reyvow lasmiditan | — Medicare Part D | — | — | — |
| CP2D CP2D | — Medicare Part D | — | — | — |
| LIDOCAINE HCI AND EPINEPHRINE LIDOCAINE HCI AND EPINEPHRINE | — Medicare Part D | — | — | — |
| Lidotral 5 Percent Roll On Gel Lidocaine Hydrochloride | — Medicare Part D | — | — | — |
| FOSAMAX PLUS D ALENDRONATE SODIUM and CHOLECALCIFEROL | — Medicare Part D | — | — | — |
| Tyblume Levonorgestrel and Ethinyl Estradiol | — Medicare Part D | — | — | — |
| ESTRADIOL AND NORETHINDRONE ACETATE estradiol and norethindrone acetate | — Medicare Part D | — | — | — |
| Cephalexin Cephalexin | — Medicare Part D | — | — | — |
| Misoprostol MISOPROSTOL | — Medicare Part D | — | — | — |
| ALTAFLUOR Fluorescein Sodium and Benoxinate Hydrochloride | — Medicare Part D | — | — | — |
| Myalept metreleptin | — Medicare Part D | Yes | — | — |
| Lubiprostone Lubiprostone | — Medicare Part D | — | — | — |
| Skyrizi Risankizumab-rzaa | — Medicare Part D | Yes | — | — |
| XIGDUO XR dapagliflozin and metformin hydrochloride | — Medicare Part D | — | — | — |
| WEGOVY semaglutide | — Medicare Part D | Yes | — | — |
| Ondansetron Hydrochloride Ondansetron Hydrochloride | — Medicare Part D | — | — | — |
| BUTALBITAL, ASPIRIN, AND CAFFEINE Butalbital, aspirin, and caffeine | — Medicare Part D | — | — | — |
| Cobenfy xanomeline and trospium chloride | — Medicare Part D | — | — | — |
| Tudorza Pressair aclidinium bromide | — Medicare Part D | — | — | — |
| Larin 1/20 Norethindrone Acetate/Ethinyl Estradiol | — Medicare Part D | — | — | — |
| Fem Repair Non-Preg Fem Glandular and Tissue Aid | — Medicare Part D | — | — | — |
| Hydroxyzine Pamoate hydroxyzine pamoate | — Medicare Part D | — | — | — |