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 |
|---|---|---|---|---|
| LACTATED RINGERS AND DEXTROSE SODIUM CHLORIDE, SODIUM LACTATE, POTASSIUM CHLORIDE, CALCIUM CHLORIDE, and DEXTROSE MONOHYDRATE | — Medicare Part D | — | — | — |
| AZELASTINE HYDROCHLORIDE AND FLUTICASONE PROPIONATE Azelastine hydrochloride and Fluticasone propionate | — Medicare Part D | — | — | — |
| Dihydroergotamine Mesylate Nasal Dihydroergotamine Mesylate Nasal | — Medicare Part D | — | — | — |
| TELMISARTAN AND HYDROCHLOROTHIAZIDE Telmisartan and Hydrochlorothiazide | — Medicare Part D | — | — | — |
| Ioflupane I 123 IOFLUPANE I-123 | — Medicare Part D | — | — | — |
| Nexplanon etonogestrel | — Medicare Part D | Yes | — | — |
| IBU Ibuprofen | — Medicare Part D | — | — | — |
| Activella Estradiol/norethindrone acetate | — Medicare Part D | — | — | — |
| Aurovela 1.5/30 Norethindrone Acetate and Ethinyl Estradiol | — Medicare Part D | — | — | — |
| Beyaz Drospirenone/ethinyl estradiol/levomefolate calcium and levomefolate calcium | — Medicare Part D | — | — | — |
| Levocarnitine Levocarnitine | — Medicare Part D | — | — | — |
| TWYNEO Benzoyl Peroxide and Tretinoin | — Medicare Part D | — | — | — |
| Ergomar Sublingual Ergotamine Tartrate | — Medicare Part D | — | — | — |
| Bufo rana BUFO BUFO CUTANEOUS GLAND | — Medicare Part D | — | — | — |
| AcetaZOLAMIDE acetazolamide | — Medicare Part D | — | — | — |
| Retin-A MICRO Tretinoin | — Medicare Part D | — | — | — |
| NUPRO Chlorhexidine Gluconate CHLORHEXIDINE GLUCONATE | — Medicare Part D | — | — | — |
| TOBI Podhaler Tobramycin | — Medicare Part D | — | — | — |
| OVACE PLUS SULFACETAMIDE SODIUM | — Medicare Part D | — | — | — |
| Fragmin Dalteparin Sodium | — Medicare Part D | Yes | — | — |
| Atracurium Besylate ATRACURIUM BESYLATE | — Medicare Part D | — | — | — |
| Clotrimazole Topical Solution USP, 1% | — Medicare Part D | — | — | — |
| Memantine Hydrochloride Memantine Hydrochloride | — Medicare Part D | — | — | — |
| Phentermine Hydrochloride PHENTERMINE HYDROCHLORIDE | — Medicare Part D | — | — | — |
| Meropenem Meropenem | — Medicare Part D | — | — | — |
| Cardizem Diltiazem Hydrochloride | — Medicare Part D | — | — | — |
| FEIBA anti-inhibitor coagulant complex | — Medicare Part D | — | — | — |
| OHM-REN Apis Mellifica, Aranea Diadema, Berberis Vulgaris, Cantharis, Equisetum Hyemale, Hydrastis Canadensis, Juglans Regia, Kali Bichromicum, Mercurius Solubilis, Sarsaparilla, Solidago Virgaurea | — Medicare Part D | — | — | — |
| Sodium Sulfacetamide 10 Sulfur 2 cream Sulfacetamide Sodium and Sulfur | — Medicare Part D | — | — | — |
| Sevelamer Hydrochloride Sevelamer Hydrochloride | — Medicare Part D | — | — | — |
| Methyltestosterone METHYLTESTOSTERONE | — Medicare Part D | — | — | — |
| Diclogen Diclofenac Sodium, Camphor and Menthol | — Medicare Part D | — | — | — |
| Dopamine Hydrochloride in Dextrose Dopamine Hydrochloride in Dextrose | — Medicare Part D | — | — | — |
| AMLODIPINE BESYLATE Amlodipine Besylate | — Medicare Part D | — | — | — |
| Selenious Acid Selenious Acid | — Medicare Part D | — | — | — |
| Ethacrynic Acid Ethacrynic Acid | — Medicare Part D | — | — | — |
| Doxorubicin Hydrochloride DOXORUBICIN HYDROCHLORIDE | — Medicare Part D | — | — | — |
| Etoposide Etoposide | — Medicare Part D | — | — | — |
| VERQUVO vericiguat | — Medicare Part D | — | — | — |
| Pantoprazole PANTOPRAZOLE | — Medicare Part D | — | — | — |
| Lithostat acetohydroxamic acid | — Medicare Part D | — | — | — |
| Cefepime Hydrochloride CEFEPIME HYDROCHLORIDE | — Medicare Part D | — | — | — |
| Conjugated Estrogens CONJUGATED ESTROGENS | — Medicare Part D | — | — | — |
| KISQALI FEMARA CO-PACK letrozole and ribociclib | — Medicare Part D | — | — | — |
| Sodium Sulfacetamide 9% - Sulfur 4% SULFACETAMIDE SODIUM, SULFUR | — Medicare Part D | — | — | — |
| Onpattro patisiran | — Medicare Part D | — | — | — |
| SOTALOL HYDROCHLORIDE Sotalol Hydrochloride | — Medicare Part D | — | — | — |
| MYCOPHENOLATE MOFETIL Mycophenolate Mofetil | — Medicare Part D | — | — | — |
| Ribavirin Ribavirin | — Medicare Part D | — | — | — |
| Xylocaine, Xylocaine MPF | — Medicare Part D | — | — | — |