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 |
|---|---|---|---|---|
| VUSION miconazole nitrate, zinc oxide, white petrolatum | — Medicare Part D | — | — | — |
| Sevoflurane SEVOFLURANE | — Medicare Part D | — | — | — |
| Khindivi Hydrocortisone | — Medicare Part D | — | — | — |
| Tralement Trace Elements Injection 4 | — Medicare Part D | — | — | — |
| Quetiapine Extended-Release Quetiapine | — Medicare Part D | — | — | — |
| OCELLA drospirenone and ethinyl estradiol | — Medicare Part D | — | — | — |
| Ephedrine Sulfate Ephedrine Sulfate | — Medicare Part D | — | — | — |
| BLISOVI FE 1.5/30 norethindrone acetate and ethinyl estradiol | — Medicare Part D | — | — | — |
| TOBI Tobramycin | — Medicare Part D | — | — | — |
| Denavir penciclovir | — Medicare Part D | — | — | — |
| Darzalex Faspro daratumumab and hyaluronidase-fihj (human recombinant) | — Medicare Part D | — | — | — |
| DaTscan Ioflupane I-123 | — Medicare Part D | — | — | — |
| Chlorpromazine Hydrochloride Chlorpromazine Hydrochloride | — Medicare Part D | — | — | — |
| BRIMONIDINE brimonidine | — Medicare Part D | — | — | — |
| OFLOXACIN ofloxacin | — Medicare Part D | — | — | — |
| Prednisone prednisone | — Medicare Part D | — | — | — |
| GLATIRAMER ACETATE Glatiramer Acetate Injection | — Medicare Part D | — | — | — |
| Emtriva EMTRICITABINE | — Medicare Part D | — | — | — |
| Balanced Salt Sodium Chloride, Potassium Chloride, Calcium Chloride, Magnesium Chloride, Sodium Acetate, and Sodium Citrate | — Medicare Part D | — | — | — |
| Sephience sepiapterin | — Medicare Part D | — | — | — |
| ESTRADIOL VALERATE Estradiol Valerate | — Medicare Part D | — | — | — |
| Lunsumio Velo Mosunetuzumab | — Medicare Part D | — | — | — |
| CLOTIC (clotrimazole) otic solution | — Medicare Part D | — | — | — |
| DALVANCE Dalbavancin | — Medicare Part D | — | — | — |
| MESNA MESNA | — Medicare Part D | — | — | — |
| Praluent alirocumab | — Medicare Part D | Yes | — | — |
| FLECTOR diclofenac epolamine | — Medicare Part D | — | — | — |
| Metopirone Metyrapone | — Medicare Part D | — | — | — |
| Alclometasone Dipropionate Alclometasone Dipropionate | — Medicare Part D | — | — | — |
| Flu Immune Anas barbarie hepatis et cordis extractum | — Medicare Part D | — | — | — |
| Scopolamine scopolamine | — Medicare Part D | — | — | — |
| Probenecid and Colchicine Probenecid and Colchicine | — Medicare Part D | — | — | — |
| BUPROPION HYDROCHLORIDE (XL) Bupropion hydrochloride | — Medicare Part D | — | — | — |
| FENOPRON TM FENOPROFEN CALCIUM | — Medicare Part D | — | — | — |
| HYALURONIDASE HYALURONIDASE | — Medicare Part D | — | — | — |
| RIMSO-50 Dimethyl Sulfoxide | — Medicare Part D | — | — | — |
| Ulspira Ulspira | — Medicare Part D | — | — | — |
| Blujepa gepotidacin | — Medicare Part D | — | — | — |
| Tranylcypromine Tranylcypromine | — Medicare Part D | — | — | — |
| EGATEN triclabendazole | — Medicare Part D | — | — | — |
| DOTAREM gadoterate meglumine | — Medicare Part D | — | — | — |
| ERMEZA levothyroxine sodium | — Medicare Part D | — | — | — |
| Prednisolone Sodium Phosphate prednisoLONE sodium phosphate | — Medicare Part D | — | — | — |
| Sodium Chloride for Irrigation Sodium Chloride for Irrigation | — Medicare Part D | — | — | — |
| Depakote Sprinkles Divalproex Sodium | — Medicare Part D | — | — | — |
| Sitagliptin and Metformin Hydrochloride SITAGLIPTIN and METFORMIN HYDROCHLORIDE | — Medicare Part D | — | — | — |
| Lumizyme ALGLUCOSIDASE ALFA | — Medicare Part D | — | — | — |
| PERAMPANEL Perampanel | — Medicare Part D | — | — | — |
| Dichlorphenamide Dichlorphenamide | — Medicare Part D | — | — | — |
| RoxyBond Oxycodone hydrochloride | — Medicare Part D | — | — | — |