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 |
|---|---|---|---|---|
| ZINC SULFATE Zinc Sulfate Injection | — Medicare Part D | — | — | — |
| SUFLAVE polyethylene glycol 3350, sodium sulfate, potassium chloride, magnesium sulfate, and sodium chloride for oral solution | — Medicare Part D | — | — | — |
| KENALOG-40, KENALOG-80 | — Medicare Part D | — | — | — |
| ISOVUE 300, ISOVUE 370 | — Medicare Part D | — | — | — |
| LIDOCAINE HYDROCHLORIDE Lidocaine Hydrochloride | — Medicare Part D | — | — | — |
| Lidolog Kit lidocaine, kenalog, povidone iodine | — Medicare Part D | — | — | — |
| XALATAN Latanoprost | — Medicare Part D | — | — | — |
| Naftifine Hydrochloride Naftifine Hydrochloride | — Medicare Part D | — | — | — |
| VABOMERE Meropenem-Vaborbactam | — Medicare Part D | — | — | — |
| NP Thyroid 60 LEVOTHYROXINE, LIOTHYRONINE | — Medicare Part D | — | — | — |
| IBUPROFEN ibuprofen | — Medicare Part D | — | — | — |
| BUPROPION HYDROCHLORIDE Bupropion hydrochloride | — Medicare Part D | — | — | — |
| HYDRALAZINE HYDROCHLORIDE Hydralazine Hydrochloride | — Medicare Part D | — | — | — |
| PIOGLITAZONE Pioglitazone | — Medicare Part D | — | — | — |
| Oxymorphone Hydrochloride Oxymorphone hydrochloride | — Medicare Part D | — | — | — |
| Eohilia Budesonide | — Medicare Part D | — | — | — |
| Betaseron interferon beta-1b | — Medicare Part D | Yes | — | — |
| Pro-C-Dure 6 Kit kenalog | — Medicare Part D | — | — | — |
| CARISOPRODOL CARISOPRODOL | — Medicare Part D | — | — | — |
| Vocabria cabotegravir sodium | — Medicare Part D | — | — | — |
| Dexlansoprazole Dexlansoprazole | — Medicare Part D | — | — | — |
| BUFFERED PENICILLIN G POTASSIUM BUFFERED PENICILLIN G POTASSIUM | — Medicare Part D | — | — | — |
| Kelnor 1/35 Ethynodiol Diacetate and Ethinyl Estradiol | — Medicare Part D | — | — | — |
| BUPIVACAINE HYDROCHLORIDE BUPIVACAINE HYDROCHLORIDE | — Medicare Part D | — | — | — |
| Olumiant baricitinib | — Medicare Part D | — | — | — |
| Norgesic Forte Orphenadrine Citrate, Aspirin and Caffeine | — Medicare Part D | — | — | — |
| Rifabutin rifabutin | — Medicare Part D | — | — | — |
| Ampicillin Ampicillin | — Medicare Part D | — | — | — |
| PEDMARK SODIUM THIOSULFATE | — Medicare Part D | — | — | — |
| TYENNE Tocilizumab-aazg | — Medicare Part D | Yes | — | — |
| Leukine SARGRAMOSTIM | — Medicare Part D | Yes | — | — |
| Vyondys 53 golodirsen | — Medicare Part D | — | — | — |
| METOCLOPRAMIDE metoclopramide | — Medicare Part D | — | — | — |
| Lentocilin Penicillin G Benzathin | — Medicare Part D | — | — | — |
| Nesacaine, Nesacaine MPF | — Medicare Part D | — | — | — |
| NIFEDIPINE Nifedipine | — Medicare Part D | — | — | — |
| PREZISTA darunavir | — Medicare Part D | — | — | — |
| Kyleena Levonorgestrel | — Medicare Part D | — | — | — |
| ISOTONIC SODIUM CHLORIDE ISOTONIC SODIUM CHLORIDE | — Medicare Part D | — | — | — |
| Otezla apremilast | — Medicare Part D | — | — | — |
| Cefotetan Cefotetan | — Medicare Part D | — | — | — |
| Halcion triazolam | — Medicare Part D | — | — | — |
| OHM Venous Aid Aesculus Hippocastanum, Arnica Montana, Calendula Officinalis, Echinacea Purpurea, Hamamelis Virginiana, Paeonia Officinalis, Ratanhia. | — Medicare Part D | — | — | — |
| Infuvite Adult multiple vitamins injection | — Medicare Part D | — | — | — |
| LOTEPREDNOL ETABONATE Loteprednol Etabonate | — Medicare Part D | — | — | — |
| Tiotropium Bromide tiotropium bromide | — Medicare Part D | — | — | — |
| AcetaZOLAMIDE acetazolamide | — Medicare Part D | — | — | — |
| NEOMYCIN AND POLYMYXIN B SULFATES AND HYDROCORTISONE neomycin sulfate, polymyxin b sulfate and hydrocortisone | — Medicare Part D | — | — | — |
| MESNA MESNA | — Medicare Part D | — | — | — |
| Proparacaine Hydrochloride Proparacaine Hydrochloride | — Medicare Part D | — | — | — |