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 |
|---|---|---|---|---|
| SABRIL vigabatrin | — Medicare Part D | — | — | — |
| ZALEPLON Zaleplon | — Medicare Part D | — | — | — |
| Fluoride SODIUM MONOFLUOROPHOSPHATE | — Medicare Part D | — | — | — |
| LAMIVUDINE AND ZIDOVUDINE Lamivudine and Zidovudine | — Medicare Part D | — | — | — |
| Cipro ciprofloxacin hydrochloride | — Medicare Part D | — | — | — |
| NYPOZI filgrastim-txid | — Medicare Part D | — | — | — |
| Rufinamide rufinamide | — Medicare Part D | — | — | — |
| Savella milnacipran hydrochloride | — Medicare Part D | — | — | — |
| Denti-Care Denti-Rinse Chlorhexidine Gluconate Oral Rinse | — Medicare Part D | — | — | — |
| PROCHLORPERAZINE EDISYLATE Prochlorperazine Edisylate | — Medicare Part D | — | — | — |
| Rocuronium ROCURONIUM BROMIDE | — Medicare Part D | — | — | — |
| Dexlansoprazole delayed release dexlansoprazole | — Medicare Part D | — | — | — |
| EluRyng Etonogestrel and Ethinyl Estradiol | — Medicare Part D | — | — | — |
| AZITHROMYCIN DIHYDRATE Azithromycin dihydrate | — Medicare Part D | — | — | — |
| Daypro oxaprozin | — Medicare Part D | — | — | — |
| LIDOCAINE HYDROCHLORIDE AND DEXTROSE LIDOCAINE HYDROCHLORIDE ANHYDROUS and DEXTROSE MONOHYDRATE | — Medicare Part D | — | — | — |
| ERIVEDGE vismodegib | — Medicare Part D | — | — | — |
| Revatio sildenafil citrate | — Medicare Part D | — | — | — |
| Myrbetriq mirabegron | — Medicare Part D | — | — | — |
| Palynziq pegvaliase-pqpz | — Medicare Part D | Yes | — | — |
| Zenzedi Dextroamphetamine Sulfate | — Medicare Part D | — | — | — |
| DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE MONOHYDRATE, DEXTROAMPHETAMINE SULFATE AND AMPHETAMINE SULFATE Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate | — Medicare Part D | — | — | — |
| Cholesterinum Boldo, Cholesterinum, Taraxacum officinale, Lycopodium clavatum, Podophyllum peltatum | — Medicare Part D | — | — | — |
| Prenatryl, Prometa | — Medicare Part D | — | — | — |
| Alfuzosin Hydrochloride Alfuzosin Hydrochloride | — Medicare Part D | — | — | — |
| Sevenfact Coagulation Factor VIIa Recombinant Human | — Medicare Part D | — | — | — |
| PYZCHIVA ustekinumab-ttwe | — Medicare Part D | — | — | — |
| BRAFTOVI Encorafenib | — Medicare Part D | — | — | — |
| Clomiphene Citrate Clomiphene citrate | — Medicare Part D | — | — | — |
| DICYCLOMINE HYDROCHLORIDE Dicyclomine Hydrochloride | — Medicare Part D | — | — | — |
| Sodium Phenylbutyrate Sodium Phenylbutyrate | — Medicare Part D | — | — | — |
| Azithromycin monohydrate Azithromycin monohydrate | — Medicare Part D | — | — | — |
| PROPAFENONE HYDROCHLORIDE Propafenone Hydrochloride | — Medicare Part D | — | — | — |
| CISPLATIN CISplatin | — Medicare Part D | — | — | — |
| Tri-Vite Drops with Fluoride | — Medicare Part D | — | — | — |
| Epinephrine EPINEPHRINE | — Medicare Part D | — | — | — |
| Buprenorphine HCl Buprenorphine HCl | — Medicare Part D | — | — | — |
| Gemfibrozil Gemfibrozil | — Medicare Part D | — | — | — |
| ADVAIR DISKUS fluticasone propionate and salmeterol | — Medicare Part D | — | — | — |
| Pantoprazole Sodium PANTOPRAZOLE | — Medicare Part D | — | — | — |
| LONSURF trifluridine and tipiracil | — Medicare Part D | — | — | — |
| Jadenu deferasirox | — Medicare Part D | — | — | — |
| RASAGILINE Rasagiline mesylate | — Medicare Part D | — | — | — |
| SECUADO ASENAPINE | — Medicare Part D | — | — | — |
| Haldol Decanoate Haloperidol Decanoate | — Medicare Part D | — | — | — |
| FLUCONAZOLE, fluconazole | — Medicare Part D | — | — | — |
| Sitagliptin and Metformin Hydrochloride SITAGLIPTIN and METFORMIN HYDROCHLORIDE | — Medicare Part D | — | — | — |
| Fondaparinux Sodium Fondaparinux Sodium | — Medicare Part D | — | — | — |
| LENMELDY atidarsagene autotemcel | — Medicare Part D | — | — | — |
| Tranexamic Acid, TRANEXAMIC ACID | — Medicare Part D | — | — | — |