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 |
|---|---|---|---|---|
| JOURNAVX Suzetrigine | — Medicare Part D | — | — | — |
| Icosapent Ethyl icosapent ethyl | — Medicare Part D | — | — | — |
| Diclolidol Kit Lidocaine HCl, Diclofenac Sodium | — Medicare Part D | — | — | — |
| Pristiq Extended-Release desvenlafaxine succinate | — Medicare Part D | — | — | — |
| Dipentum olsalazine sodium | — Medicare Part D | — | — | — |
| Insulin glargine U-300 Max, Insulin glargine U-300 | — Medicare Part D | Yes | — | — |
| ERYTHROMYCIN ERYTHROMYCIN | — Medicare Part D | — | — | — |
| Warfarin Sodium Warfarin Sodium | — Medicare Part D | — | — | — |
| Sertraline HCL Sertraline | — Medicare Part D | — | — | — |
| Liothyronine Sodium liothyronine sodium | — Medicare Part D | — | — | — |
| Charlotte 24Fe norethindrone acetate and ethinyl estradiol and ferrous fumarate | — Medicare Part D | — | — | — |
| Promethazine Hydrochloride and Dextromethorphan Hydrobromide Promethazine Hydrochloride and Dextromethorphan Hydrobromide | — Medicare Part D | — | — | — |
| Oxygen Carbon Dioxide Oxygen Carbon Dioxide | — Medicare Part D | — | — | — |
| Paricalcitol Paricalcitol | — Medicare Part D | — | — | — |
| Isoniazid Isoniazid | — Medicare Part D | — | — | — |
| TECENTRIQ atezolizumab | — Medicare Part D | — | — | — |
| Foliflex Ferrous Fumarate, Folic Acid | — Medicare Part D | — | — | — |
| Lodosyn carbidopa | — Medicare Part D | — | — | — |
| Simulect basiliximab | — Medicare Part D | — | — | — |
| ALDURAZYME laronidase | — Medicare Part D | — | — | — |
| ATACAND HCT Candesartan Cilexetil and Hydrochlorothiazide | — Medicare Part D | — | — | — |
| NESTABS Prenatal Multi-vitamin/Mineral Supplement Multi-vitamin/Mineral Supplement with Sodium Ascorbate, Cholecalciferol, di-alpha-Tocopheryl Acetate, Thiamine Mononitrate, Riboflavin, Niacinamide, Pyridoxine HCL, Folic Acid, Cyanocobalamin, Calcium Formate, Calcium Carbonate, Ferrous (II) bis-Glycinate Chelate, Potassium Iodide, Zinc Oxide, and Choline Bitartrate | — Medicare Part D | — | — | — |
| Imatinib imatinib mesylate | — Medicare Part D | — | — | — |
| HYDROCORTISONE, IODOQUINOL hydrocortisone, iodoquinol | — Medicare Part D | — | — | — |
| ESTERIFIED ESTROGENS AND METHYLTESTOSTERONE ESTERIFIED ESTROGENS, METHYLTESTOSTERONE | — Medicare Part D | — | — | — |
| TAZORAC tazarotene | — Medicare Part D | — | — | — |
| CARDENE IV nicardipine hydrochloride | — Medicare Part D | — | — | — |
| KIDS CHOICE STANNOUS FLUORIDE | — Medicare Part D | — | — | — |
| Flurandrenolide Flurandrenolide | — Medicare Part D | — | — | — |
| TrophAmine ISOLEUCINE, LEUCINE, LYSINE ACETATE, METHIONINE, PHENYLALANINE, THREONINE, TRYPTOPHAN, VALINE, CYSTEINE HYDROCHLORIDE, HISTIDINE, TYROSINE, N-ACETYL-TYROSINE, ALANINE, ARGININE, PROLINE, SERINE, GLYCINE, ASPARTIC ACID, GLUTAMIC ACID, and TAURINE | — Medicare Part D | Yes | — | — |
| Albuterol ALBUTEROL SULFATE | — Medicare Part D | — | — | — |
| Junel 21 Day Norethindrone Acetate and Ethinyl Estradiol | — Medicare Part D | — | — | — |
| COMBOGESIC IV ACETAMINOPHEN and IBUPROFEN | — Medicare Part D | — | — | — |
| Revcovi elapegademase-lvlr | — Medicare Part D | Yes | — | — |
| YUVEZZI carbachol and brimonidine tartrate | — Medicare Part D | — | — | — |
| Mycapssa Octreotide | — Medicare Part D | — | — | — |
| Cyclobenzaprine HCL ER Cyclobenzaprine HCL | — Medicare Part D | — | — | — |
| Ixinity coagulation factor IX (recombinant) | — Medicare Part D | — | — | — |
| INLEXZO gemcitabine intravesical | — Medicare Part D | — | — | — |
| Spritam levetiracetam | — Medicare Part D | — | — | — |
| DELFLEX Dextrose Monohydrate, Sodium Chloride, Sodium Lactate, Calcium Chloride, Magnesium Chloride | — Medicare Part D | — | — | — |
| BETASEPT Antiseptic Surgical Scrub | — Medicare Part D | — | — | — |
| LEXISCAN regadenoson | — Medicare Part D | — | — | — |
| Venoforce II Collinsonia Canadensis, Hamamelis Virginiana, Aesculus Hippocastanum, Belladonna, Calcarea Fluorica, Carduus Marianus, Pulsatilla (Pratensis), Secale Cornutum, Vipera Berus | — Medicare Part D | — | — | — |
| BRIDION sugammadex | — Medicare Part D | — | — | — |
| ZOLADEX goserelin | — Medicare Part D | — | — | — |
| Bijuva estradiol and progesterone | — Medicare Part D | — | — | — |
| 3% Sodium Chloride 3% Sodium Chloride | — Medicare Part D | — | — | — |
| MEDROXYPROGESTERONE ACETATE Medroxyprogesterone acetate | — Medicare Part D | — | — | — |
| Xenon Xenon XE-133 | — Medicare Part D | — | — | — |