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 |
|---|---|---|---|---|
| Epinephrine 0.15 Pediatrics Epinephrine 0.15 Pediatrics | — Medicare Part D | — | — | — |
| Adrenalin (epinephrine in sodium chloride) epinephrine | — Medicare Part D | — | — | — |
| TISSUEBLUE Brilliant Blue G | — Medicare Part D | — | — | — |
| LUXTURNA voretigene neparvovec-rzyl | — Medicare Part D | — | — | — |
| FORMOTEROL FUMARATE Formoterol Fumarate | — Medicare Part D | — | — | — |
| Deferasorox Deferasirox | — Medicare Part D | — | — | — |
| Vyalev foscarbidopa/foslevodopa | — Medicare Part D | — | — | — |
| BUPROPION HYDROCHLORIDE (SR) Bupropion hydrochloride | — Medicare Part D | — | — | — |
| Methamphetamine Hydrochloride METHAMPHETAMINE HYDROCHLORIDE | — Medicare Part D | — | — | — |
| Evenity romosozumab-aqqg | — Medicare Part D | — | — | — |
| Clozaril clozapine | — Medicare Part D | — | — | — |
| DEXMEDETOMIDINE HYDROCHLORIDE dexmedetomidine hydrochloride | — Medicare Part D | — | — | — |
| LITHOBID lithium carbonate | — Medicare Part D | — | — | — |
| DIFFERIN Adapalene | — Medicare Part D | — | — | — |
| QUETIAPINE FUMARATE Quetiapine Fumarate | — Medicare Part D | — | — | — |
| AMLODIPINE, VALSARTAN, HYDROCHLOROTHIAZIDE amlodipine besylate valsartan hydrochlorothiazide | — Medicare Part D | — | — | — |
| Medical Gasseous Oxygen Cylinders OXYGEN | — Medicare Part D | — | — | — |
| Femynor norgestimate and ethinyl estradiol | — Medicare Part D | — | — | — |
| Cromolyn Sodium Inhalation Solution Cromolyn Sodium Inhalation | — Medicare Part D | — | — | — |
| Oxygen/Helium 30/70 Oxygen/Helium 30/70 | — Medicare Part D | — | — | — |
| SOLIFENACIN SUCCINATE Solifenacin Succinate | — Medicare Part D | — | — | — |
| Fluoxetine Fluoxetine Hydrochloride | — Medicare Part D | — | — | — |
| DORZOLAMIDE HYDROCHLORIDE AND TIMOLOL MALEATE Dorzolamide Hydrochloride and Timolol Maleate | — Medicare Part D | — | — | — |
| Micafungin Micafungin | — Medicare Part D | — | — | — |
| Colestipol Hydrochloride Colestipol Hydrochloride | — Medicare Part D | — | — | — |
| Fosinopril Sodium Fosinopril Sodium | — Medicare Part D | — | — | — |
| Norvasc amlodipine besylate | — Medicare Part D | — | — | — |
| Nitrofurantoin Macrocrystals nitrofurantoin macrocrystals | — Medicare Part D | — | — | — |
| IQIRVO elafibranor | — Medicare Part D | — | — | — |
| PROMETHAZINE HCI PROMETHAZINE HCI | — Medicare Part D | — | — | — |
| Oziltus denosumab-mobz | — Medicare Part D | — | — | — |
| ARIKAYCE Amikacin | — Medicare Part D | Yes | — | — |
| ELCYS Cysteine Hydrochloride | — Medicare Part D | — | — | — |
| Bystolic nebivolol hydrochloride | — Medicare Part D | — | — | — |
| BYFAVO remimazolam besylate | — Medicare Part D | — | — | — |
| Allday 5000 Sensitive 1.1% Sodium Fluoride Toothpaste | — Medicare Part D | — | — | — |
| TOBRAMYCIN Tobramycin | — Medicare Part D | — | — | — |
| bromfenac ophthalmic solution Bromfenac Sodium | — Medicare Part D | — | — | — |
| IVABRADINE Ivabradine | — Medicare Part D | — | — | — |
| Sinuva mometasone furoate | — Medicare Part D | — | — | — |
| DISKETS Methadone Hydrochloride | — Medicare Part D | — | — | — |
| DUVYZAT givinostat | — Medicare Part D | Yes | — | — |
| METHYLPREDNISOLONE ACETATE Methylprednisolone acetate | — Medicare Part D | — | — | — |
| Fluocinolone Acetonide fluocinolone acetonide | — Medicare Part D | — | — | — |
| Silenor doxepin hydrochloride | — Medicare Part D | — | — | — |
| Dexamethasone Intensol, Dexamethasone | — Medicare Part D | — | — | — |
| Diclofenac Sodium Delayed Release Diclofenac Sodium | — Medicare Part D | — | — | — |
| Pindolol Pindolol | — Medicare Part D | — | — | — |
| ERLOTINIB Erlotinib Hydrochloride | — Medicare Part D | — | — | — |
| INZIRQO hydrochlorothiazide | — Medicare Part D | — | — | — |