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 |
|---|---|---|---|---|
| Brevital Sodium methohexital sodium | — Medicare Part D | — | — | — |
| VALSARTAN valsartan | — Medicare Part D | — | — | — |
| Mitoxantrone Mitoxantrone | — Medicare Part D | — | — | — |
| Estradiol Vaginal Estradiol | — Medicare Part D | — | — | — |
| Progesterone Progesterone | — Medicare Part D | — | — | — |
| FAMOTIDINE FAMOTIDINE | — Medicare Part D | — | — | — |
| Lofexidine Lofexidine | — Medicare Part D | — | — | — |
| Oxygen Compressed Oxygen, Compressed U.S.P. | — Medicare Part D | — | — | — |
| Volumex Iodinated I-131 Albumin | — Medicare Part D | — | — | — |
| Menostar estradiol | — Medicare Part D | — | — | — |
| MALARONE atovaquone and proguanil hydrochloride | — Medicare Part D | — | — | — |
| Ritonavir film coated ritonavir 100 mg | — Medicare Part D | — | — | — |
| Aspirin and Extended - Release Dipyridamole Capsules, 25 mg / 200 mg | — Medicare Part D | — | — | — |
| Nascobal cyanocobalamin | — Medicare Part D | — | — | — |
| Evamist Estradiol | — Medicare Part D | — | — | — |
| EnBrace HR LEVOMEFOLATE MAGNESIUM, LEUCOVORIN, FOLIC ACID, FERROUS CYSTEINE GLYCINATE, MAGNESIUM ASCORBATE, ZINC ASCORBATE, COCARBOXYLASE, FLAVIN ADENINE DINUCLEOTIDE, NADH, PYRIDOXAL PHOSPHATE ANHYDROUS, COBAMAMIDE, BETAINE, MAGNESIUM L-THREONATE, 1,2-DOCOSAHEXANOYL-SN-GLYCERO-3-PHOSPHOSERINE CALCIUM, 1,2-ICOSAPENTOYL-SN-GLYCERO-3-PHOSPHOSERINE CALCIUM, and PHOSPHATIDYL SERINE | — Medicare Part D | — | — | — |
| Imipramine Hydrochloride Imipramine Hydrochloride | — Medicare Part D | — | — | — |
| BUPROPION HYDROCHLORIDE Bupropion hydrochloride | — Medicare Part D | — | — | — |
| Felbamate Felbamate | — Medicare Part D | — | — | — |
| LYFGENIA lovotibeglogene autotemcel | — Medicare Part D | — | — | — |
| NITROSTAT nitroglycerin | — Medicare Part D | — | — | — |
| psorcon Diflorasone Diacetate | — Medicare Part D | — | — | — |
| Losartan potassium Tablets, 25 mg, Losartan potassium Tablets, 50 mg, Losartan potassium Tablets, 100 mg | — Medicare Part D | — | — | — |
| Anticoagulant Citrate Phosphate Dextrose (CPD) Blood-Pack Units in PL 146 Plastic | — Medicare Part D | — | — | — |
| ZEMBRACE SYMTOUCH Sumatriptan Succinate | — Medicare Part D | — | — | — |
| Nexletol Bempedoic Acid | — Medicare Part D | — | — | — |
| ENSTILAR calcipotriene and betamethasone dipropionate | — Medicare Part D | — | — | — |
| ENTYVIO, ENTYVIO Pen, Entyvio | — Medicare Part D | Yes | — | — |
| Cabenuva cabotegravir and rilpivirine | — Medicare Part D | — | — | — |
| IGALMI DEXMEDETOMIDINE | — Medicare Part D | — | — | — |
| FENOPROFEN CALCIUM FENOPROFEN CALCIUM | — Medicare Part D | — | — | — |
| Medical Air AIR | — Medicare Part D | — | — | — |
| Omega-3-Acid Ethyl Esters OMEGA-3-ACID ETHYL ESTERS | — Medicare Part D | — | — | — |
| Cardura doxazosin | — Medicare Part D | — | — | — |
| CardioGen-82 Rubidium Chloride RB-82 | — Medicare Part D | — | — | — |
| ZOLINZA vorinostat | — Medicare Part D | — | — | — |
| PROPECIA finasteride | — Medicare Part D | — | — | — |
| METOPROLOL SUCCINATE Metoprolol succinate | — Medicare Part D | — | — | — |
| STIMUFEND pegflilgrastim-fpgk | — Medicare Part D | Yes | — | — |
| Aztreonam AZTREONAM | — Medicare Part D | — | — | — |
| Ryaltris olopatadine hydrochloride and mometasone furoate | — Medicare Part D | — | — | — |
| Ramipril Ramipril | — Medicare Part D | — | — | — |
| ACTEMRA, Actemra, Actemra ACTPen | — Medicare Part D | Yes | — | — |
| CIPRO HC ciprofloxacin hydrochloride and hydrocortisone | — Medicare Part D | — | — | — |
| Ziprasidone Mesylate ZIPRASIDONE MESYLATE | — Medicare Part D | — | — | — |
| Succinylcholine Chloride Succinylcholine Chloride | — Medicare Part D | — | — | — |
| INDERAL LA propranolol hydrochloride | — Medicare Part D | — | — | — |
| Desonide Desonide | — Medicare Part D | — | — | — |
| Triumeq, Triumeq PD | — Medicare Part D | — | — | — |
| Atorvastatin Calcium Atorvastatin Calcium | — Medicare Part D | — | — | — |