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 |
|---|---|---|---|---|
| Timolol Hemihydrate TIMOLOL HEMIHYDRATE | — Medicare Part D | — | — | — |
| Fluphenazine Hydrochloride fluphenazine hydrochloride | — Medicare Part D | — | — | — |
| SODIUM SULFACETAMIDE, SULFUR sodium sulfacetamide, sulfur | — Medicare Part D | — | — | — |
| Clindamycin Clindamycin Phosphate | — Medicare Part D | — | — | — |
| Conjupri levamlodipine | — Medicare Part D | — | — | — |
| Abiraterone Abiraterone | — Medicare Part D | — | — | — |
| Simpesse Levonorgestrel and Ethinyl Estradiol and Ethinyl Estradiol | — Medicare Part D | — | — | — |
| IVERMECTIN ivermectin | — Medicare Part D | — | — | — |
| Butalbital/Acetaminophen/Caffeine Butalbital, Acetaminophen, Caffeine, and Codeine Phosphate | — Medicare Part D | — | — | — |
| Methylphenidate Hydrochloride Extended-Release methylphenidate hydrochloride | — Medicare Part D | — | — | — |
| Desvenlafaxine Desvenlafaxine | — Medicare Part D | — | — | — |
| FLUTICASONE PROPIONATE DISKUS fluticasone propionate | — Medicare Part D | — | — | — |
| AZITHROMYCIN Azithromycin | — Medicare Part D | — | — | — |
| CLOMIPRAMINE HYDROCHLORIDE Clomipramine Hydrochloride | — Medicare Part D | — | — | — |
| ORENCIA abatacept | — Medicare Part D | Yes | — | — |
| Candesartan Candesartan Cilexetil and Hydrochlorothiazide | — Medicare Part D | — | — | — |
| IVABRADINE Ivabradine | — Medicare Part D | — | — | — |
| BAFIERTAM monomethyl fumarate | — Medicare Part D | — | — | — |
| Maxitrol neomycin sulfate, polymyxin b sulfate and dexamethasone | — Medicare Part D | — | — | — |
| Axumin Fluciclovine F-18 | — Medicare Part D | — | — | — |
| Phenobarbital Sodium Phenobarbital Sodium | — Medicare Part D | — | — | — |
| ACCRUFER Ferric Maltol | — Medicare Part D | — | — | — |
| Carbidopa Carbidopa and Levodopa | — Medicare Part D | — | — | — |
| Keppra XR levetiracetam | — Medicare Part D | — | — | — |
| AMLODIPINE BESYLATE 2.5 mg AMLODIPINE BESYLATE | — Medicare Part D | — | — | — |
| Memantine HCL Memantine HCl | — Medicare Part D | — | — | — |
| EMGALITY galcanezumab-gnlm | — Medicare Part D | Yes | — | — |
| Prazosin HCL Prazosin HCL | — Medicare Part D | — | — | — |
| Gallium Ga-68 PSMA-11 GALLIUM GA-68 GOZETOTIDE | — Medicare Part D | — | — | — |
| Glycopyrrolate Glycopyrrolate | — Medicare Part D | — | — | — |
| Betaxolol Hydrochloride Betaxolol hydrochloride | — Medicare Part D | — | — | — |
| Pitavastatin pitavastatin | — Medicare Part D | — | — | — |
| Empaveli Pegcetacoplan | — Medicare Part D | Yes | — | — |
| Epinephrine Convenience Kit Epinephrine | — Medicare Part D | — | — | — |
| Absorica LD, Absorica | — Medicare Part D | — | — | — |
| HYDROXYCHLOROQUINE SULFATE Hydroxychloroquine Sulfate | — Medicare Part D | — | — | — |
| Cefuroxime Cefuroxime Axetil | — Medicare Part D | — | — | — |
| LISINOPRIL AND HYDROCHLOROTHIAZIDE Lisinopril and Hydrochlorothiazide Tablets | — Medicare Part D | — | — | — |
| NICARDIPINE HYDROCHLORIDE Nicardipine Hydrochloride | — Medicare Part D | — | — | — |
| FLUOXETINE HYDROCHLORIDE Fluoxetine Hydrochloride | — Medicare Part D | — | — | — |
| Super Chocolate Prescription Anticavity Toothpaste | — Medicare Part D | — | — | — |
| Clofenax Diclofenac Sodium, Kinesiology tape | — Medicare Part D | — | — | — |
| Colestipol Hydrochloride Colestipol Hydrochloride | — Medicare Part D | — | — | — |
| Nitroglycerin In Dextrose Nitroglycerin | — Medicare Part D | — | — | — |
| BRIVARACETAM brivaracetam | — Medicare Part D | — | — | — |
| Chloroquine Phosphate CHLOROQUINE PHOSPHATE | — Medicare Part D | — | — | — |
| Terconazole Terconazole | — Medicare Part D | — | — | — |
| Juluca dolutegravir sodium and rilpivirine hydrochloride | — Medicare Part D | Yes | — | — |
| IOPIDINE 1% apraclonidine hydrochloride ophthalmic solution | — Medicare Part D | — | — | — |
| CISPLATIN CISplatin | — Medicare Part D | — | — | — |