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 |
|---|---|---|---|---|
| Vogelxo Testosterone | — Medicare Part D | — | — | — |
| Accentrate PNV Prenatal Multivitamin Tablet and combination Omega-3 Softgel/Mineral Capsule | — Medicare Part D | — | — | — |
| Estradiol Transdermal System Estradiol | — Medicare Part D | — | — | — |
| Oxygen/Nitrogen 25/75 Oxygen/Nitrogen 25/75 | — Medicare Part D | — | — | — |
| TRANEXAMIC ACID IN SODIUM CHLORIDE TRANEXAMIC ACID | — Medicare Part D | — | — | — |
| Azilect Rasagiline mesylate | — Medicare Part D | — | — | — |
| Kalbitor Ecallantide | — Medicare Part D | — | — | — |
| Nimodipine nimodipine | — Medicare Part D | — | — | — |
| Oxycodone Hydchloride Oxycodone Hydchloride | — Medicare Part D | — | — | — |
| SUTENT Sunitinib malate | — Medicare Part D | — | — | — |
| MELEYA Norethindrone | — Medicare Part D | — | — | — |
| Cotempla XR-ODT Methylphenidate | — Medicare Part D | — | — | — |
| Betaine BETAINE - BUFO BUFO CUTANEOUS GLAND - CALCIUM CARBONATE - CHROMIC SULFATE - CICUTA VIROSA ROOT - COPPER - FOLIC ACID - GOLD - COBALAMIN - IRON - LACHESIS MUTA VENOM - MELATONIN - MOLYBDENUM - NEUROTROPHIN-3 - NEUROTROPHIN-4 - OXYTOCIN - SILICON DIOXIDE - SUS SCROFA FRONTAL LOBE - SUS SCROFA TEMPORAL LOBE - THYROTROPIN ALFA - UBIDECARENONE - VANADIUM - ZINC - BRAIN-DERIVED NEUROTROPHIC FACTOR HUMAN - | — Medicare Part D | — | — | — |
| Potassium Chloride in Dextrose and Sodium Chloride DEXTROSE MONOHYDRATE, SODIUM CHLORIDE, and POTASSIUM CHLORIDE | — Medicare Part D | — | — | — |
| Pitavastatin Calcium pitavastatin | — Medicare Part D | — | — | — |
| Quillivant XR methylphenidate hydrochloride | — Medicare Part D | — | — | — |
| Asenapine Asenapine | — Medicare Part D | — | — | — |
| Epclusa Velpatasvir and Sofosbuvir | — Medicare Part D | — | — | — |
| Optiray 320, Optiray 300, Optiray 350 | — Medicare Part D | — | — | — |
| Atralin Tretinoin | — Medicare Part D | — | — | — |
| Zycubo copper histidinate | — Medicare Part D | — | — | — |
| Adrenalin epinephrine | — Medicare Part D | — | — | — |
| Multi-Specialty Kit Depo-Medrol, Lidocaine, Isopropyl Alcohol | — Medicare Part D | — | — | — |
| LOSARTAN POTASSIUM 50 mg LOSARTAN POTASSIUM | — Medicare Part D | — | — | — |
| Prepidil dinoprostone | — Medicare Part D | — | — | — |
| SIMVASTATIN Simvastatin | — Medicare Part D | — | — | — |
| TABLOID thioguanine | — Medicare Part D | — | — | — |
| CARISOPRODOL CARISOPRODOL | — Medicare Part D | — | — | — |
| Lopid gemfibrozil | — Medicare Part D | — | — | — |
| Hydroxyzine Pamoate hydroxyzine pamoate | — Medicare Part D | — | — | — |
| Memantine memantine hydrochloride and donepezil hydrochloride | — Medicare Part D | — | — | — |
| Milrinone Lactate Milrinone Lactate | — Medicare Part D | — | — | — |
| Ampicillin Sodium and Sulbactam Sodium Ampicillin Sodium and Sulbactam Sodium | — Medicare Part D | — | — | — |
| Avastin bevacizumab | — Medicare Part D | — | — | — |
| Inmazeb atoltivimab, maftivimab, and odesivimab-ebgn | — Medicare Part D | — | — | — |
| TEVIMBRA tislelizumab-jsgr | — Medicare Part D | — | — | — |
| Canasa Mesalamine | — Medicare Part D | — | — | — |
| Amethyst Levonorgestrel and Ethinyl Estradiol | — Medicare Part D | — | — | — |
| FORMOTEROL FUMARATE Formoterol Fumarate | — Medicare Part D | — | — | — |
| Midazolam In Sodium Chloride Midazolam | — Medicare Part D | — | — | — |
| Fluopar fluocinonide, dimethicone | — Medicare Part D | — | — | — |
| CYTARABINE cytarabine | — Medicare Part D | — | — | — |
| REDEMPLO plozasiran | — Medicare Part D | — | — | — |
| Cysview Hexaminolevulinate hydrochloride | — Medicare Part D | — | — | — |
| SRONYX Levonorgestrel and Ethinyl Estradiol | — Medicare Part D | — | — | — |
| MiloPhene Clomiphene Citrate | — Medicare Part D | — | — | — |
| Temazepam temazepam | — Medicare Part D | — | — | — |
| Nystatin Topical Powder | — Medicare Part D | — | — | — |
| Prazosin Prazosin Hydrochloride | — Medicare Part D | — | — | — |
| VinCRIStine Sulfate VINCRISTINE SULFATE | — Medicare Part D | — | — | — |