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 |
|---|---|---|---|---|
| Glycine Glycine | — Medicare Part D | — | — | — |
| Epinephrine Pediatrics Epinephrine 0.15 Pediatrics | — Medicare Part D | — | — | — |
| HYCAMTIN topotecan | — Medicare Part D | — | — | — |
| BONJESTA doxylamine succinate and pyridoxine hydrochloride | — Medicare Part D | — | — | — |
| dapagliflozin and metformin hydrochloride dapagliflozin and metformin hydrochloride | — Medicare Part D | — | — | — |
| Nortrel 28 Day Norethindrone and Ethinyl Estradiol | — Medicare Part D | — | — | — |
| Cialis Tadalafil | — Medicare Part D | — | — | — |
| Omega-3-Acid Ethyl Esters OMEGA-3-ACID ETHYL ESTERS | — Medicare Part D | — | — | — |
| Propofol propofol | — Medicare Part D | — | — | — |
| Norgestimate and Ethinyl Estradiol Norgestimate and Ethinyl Estradiol | — Medicare Part D | — | — | — |
| Omlonti omidenepag isopropyl | — Medicare Part D | — | — | — |
| NUZOLVENCE | — Medicare Part D | — | — | — |
| Plegridy Pen, Plegridy | — Medicare Part D | Yes | — | — |
| Fluticasone Propionate spray, metered | — Medicare Part D | — | — | — |
| ENSKYCE desogestrel and ethinyl estradiol | — Medicare Part D | — | — | — |
| CROMOLYN SODIUM Cromolyn Sodium | — Medicare Part D | — | — | — |
| phenylephrine hydrochloride, Phenylephrine Hydrochloride Phenylephrine Hydrochloride | — Medicare Part D | — | — | — |
| Naltrexone Hydrochloride Naltrexone Hydrochloride | — Medicare Part D | — | — | — |
| Ocrevus ocrelizumab | — Medicare Part D | — | — | — |
| Albuterol Sulfate Inhalation Solution Albuterol Sulfate | — Medicare Part D | — | — | — |
| Timoptic in Ocudose Timolol Maleate | — Medicare Part D | — | — | — |
| CARBIDOPA AND LEVODOPA Carbidopa and Levodopa | — Medicare Part D | — | — | — |
| PERPHENAZINE perphenazine | — Medicare Part D | — | — | — |
| PALIPERIDONE paliperidone | — Medicare Part D | Yes | — | — |
| Thallium metallicum THALLIUM | — Medicare Part D | — | — | — |
| Norgestimate and Ethinyl Estradiol Norgestimate and Ethinyl Estradiol | — Medicare Part D | — | — | — |
| IBANDRONATE SODIUM Ibandronate sodium | — Medicare Part D | — | — | — |
| Haloperidol haloperidol | — Medicare Part D | — | — | — |
| OXAYDO OXYCODONE HYDROCHLORIDE | — Medicare Part D | — | — | — |
| SOLU-CORTEF hydrocortisone sodium succinate | — Medicare Part D | — | — | — |
| Atropine Atropine Sulfate | — Medicare Part D | — | — | — |
| Trelegy Ellipta fluticasone furoate, umeclidinium bromide and vilanterol trifenatate | — Medicare Part D | — | — | — |
| Isosorbide Dinitrate Isosorbide Dinitrate | — Medicare Part D | — | — | — |
| Marvona-25 SUIK Bupivacaine Hydrochloride | — Medicare Part D | — | — | — |
| Depo-SubQ Provera medroxyprogesterone acetate | — Medicare Part D | — | — | — |
| METFORMIN HYDROCHLORIDE EXTENDED RELEASE METFORMIN HYDROCHLORIDE | — Medicare Part D | — | — | — |
| ATORVALIQ ATORVALIQ | — Medicare Part D | — | — | — |
| VYTORIN ezetimibe and simvastatin | — Medicare Part D | — | — | — |
| camrese Lo Levonorgestrel/Ethinyl Estradiol and Ethinyl Estradiol | — Medicare Part D | — | — | — |
| IBTROZI taletrectinib | — Medicare Part D | — | — | — |
| Kitabis Pak Tobramycin | — Medicare Part D | — | — | — |
| PROMETHAZINE HYDROCHLORIDE Promethazine Hydrochloride | — Medicare Part D | — | — | — |
| Clindacin P clindamycin phosphate | — Medicare Part D | — | — | — |
| Azulfidine Sulfasalazine | — Medicare Part D | — | — | — |
| PENMENVY Meningococcal (Groups A, B, C, W and Y) | — Medicare Part D | — | — | — |
| Oxistat oxiconazole nitrate | — Medicare Part D | — | — | — |
| TRICITRATES Tricitrates | — Medicare Part D | — | — | — |
| Norepinephrine Bitartrate Norepinephrine bitartrate | — Medicare Part D | — | — | — |
| CHLORDIAZEPOXIDE HYDROCHLORIDE AND CLIDINIUM BROMIDE Chlordiazepoxide Hydrochloride and Clidinium Bromide | — Medicare Part D | — | — | — |
| Bacteriostatic Sodium Chloride SODIUM CHLORIDE | — Medicare Part D | — | — | — |