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 |
|---|---|---|---|---|
| MESNEX mesna | — Medicare Part D | — | — | — |
| Promethazine Hydrochloride and Dextromethorphan Hydrobromide Oral Solution Promethazine Hydrochloride and Dextromethorphan Hydrobromide | — Medicare Part D | — | — | — |
| ENALAPRILAT Enalaprilat | — Medicare Part D | — | — | — |
| IPRATROPIUM BROMIDE Ipratropium Bromide | — Medicare Part D | — | — | — |
| ETHYNODIOL DIACETATE AND ETHINYL ESTRADIOL Ethynodiol Diacetate and Ethinyl Estradiol | — Medicare Part D | — | — | — |
| CELESTONE SOLUSPAN Betamethasone Acetate and Betamethasone Sodium Phosphate | — Medicare Part D | — | — | — |
| Zirabev bevacizumab-bvzr | — Medicare Part D | — | — | — |
| DAWNZERA donidalorsen | — Medicare Part D | Yes | — | — |
| NYVEPRIA pegfilgrastim-apgf | — Medicare Part D | Yes | — | — |
| Rykindo extended-release microspheres Risperidone | — Medicare Part D | — | — | — |
| Tolvaptan Tolvaptan | — Medicare Part D | — | — | — |
| Folvitra Folic Acid, Vitamin D3 | — Medicare Part D | — | — | — |
| Dupixent Dupilumab | — Medicare Part D | Yes | — | — |
| Vitamin C 15 % L-Ascorbic Acid | — Medicare Part D | — | — | — |
| Timolol Maleate Timolol Maleate Ophthalmic | — Medicare Part D | — | — | — |
| DROSPIRENONE AND ETHINYL ESTRADIOL Drospirenone and Ethinyl Estradiol | — Medicare Part D | — | — | — |
| Azopt brinzolamide | — Medicare Part D | — | — | — |
| Bacitracin Zinc and Polymyxin B Sulfate Bacitracin Zinc and Polymyxin B Sulfate | — Medicare Part D | — | — | — |
| Ondansetron HCL Ondansetron HCL | — Medicare Part D | — | — | — |
| QuilliChew ER methylphenidate hydrochloride | — Medicare Part D | — | — | — |
| Phenylephrine Hydrochloride Phenylephrine Hydrochloride | — Medicare Part D | — | — | — |
| TARGADOX doxycycline hyclate | — Medicare Part D | — | — | — |
| AZITHROMYCIN Azithromycin | — Medicare Part D | — | — | — |
| Ciprofloxacin and Dexamethasone Ciprofloxacin and Dexamethasone | — Medicare Part D | — | — | — |
| Clonidine clonidine transdermal system | — Medicare Part D | — | — | — |
| Impoyz clobetasol propionate | — Medicare Part D | — | — | — |
| ORLYNVAH sulopenem etzadroxil and probenecid | — Medicare Part D | — | — | — |
| Derma-Smoothe/FS fluocinolone acetonide | — Medicare Part D | — | — | — |
| ROFLUMILAST roflumilast | — Medicare Part D | — | — | — |
| Dolobid Diflunisal | — Medicare Part D | — | — | — |
| VIGABATRIN vigabatrin | — Medicare Part D | — | — | — |
| Dihydroergotamine Mesylate Dihydroergotamine mesylate | — Medicare Part D | — | — | — |
| Phentermine and Topiramate Extended-Release Phentermine and Topiramate Extended-Release | — Medicare Part D | — | — | — |
| Pretrate Ferrous Fumarate, Folic Acid | — Medicare Part D | — | — | — |
| PHYRAGO dasatinib | — Medicare Part D | — | — | — |
| CYCLOSET bromocriptine mesylate | — Medicare Part D | — | — | — |
| Nilotinib Nilotinib | — Medicare Part D | — | — | — |
| QUELICIN Succinylcholine Chloride | — Medicare Part D | — | — | — |
| Terazosin Hydrochloride Terazosin Hydrochloride | — Medicare Part D | — | — | — |
| DermacinRx Clorhexacin Mupirocin Ointment | — Medicare Part D | — | — | — |
| CaroSpir CaroSpir | — Medicare Part D | — | — | — |
| polycin bacitracin zinc and polymyxin b sulfates | — Medicare Part D | — | — | — |
| RIVAROXABAN Rivaroxaban | — Medicare Part D | — | — | — |
| Dexlido Kit Dexamethasone Sodium Phosphate, Lidocaine Hydrochloride, Povidine Iodine | — Medicare Part D | — | — | — |
| Prucalopride succinate Prucalopride Succinate | — Medicare Part D | — | — | — |
| FLOVENT DISKUS fluticasone propionate | — Medicare Part D | — | — | — |
| Gavreto Pralsetinib | — Medicare Part D | — | — | — |
| Lidothol Patch lidocaine and menthol | — Medicare Part D | — | — | — |
| Jesduvroq daprodustat | — Medicare Part D | — | — | — |
| IMIQUIMOD Imiquimod | — Medicare Part D | — | — | — |