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 |
|---|---|---|---|---|
| Irinotecan hydrochloide Irinotecan hydrochloide | — Medicare Part D | — | — | — |
| Morphine Sulfate, Morphine sulfate | — Medicare Part D | — | — | — |
| Omnitrope Somatropin | — Medicare Part D | Yes | — | — |
| Provigil modafinil | — Medicare Part D | — | — | — |
| ADRENALIN (EPINEPHRINE) epinephrine | — Medicare Part D | — | — | — |
| Vyvanse lisdexamfetamine dimesylate | — Medicare Part D | — | — | — |
| PERSERIS Risperidone | — Medicare Part D | — | — | — |
| LEUCOVORIN CALCIUM Leucovorin Calcium | — Medicare Part D | — | — | — |
| Biktarvy bictegravir sodium, emtricitabine, and tenofovir alafenamide fumarate | — Medicare Part D | — | — | — |
| Oxygen/Helium 25/75 Oxygen/Helium 25/75 | — Medicare Part D | — | — | — |
| SIVEXTRO tedizolid phosphate | — Medicare Part D | Yes | — | — |
| VASOPRESSIN Vasopressin | — Medicare Part D | — | — | — |
| Cortrosyn Cosyntropin | — Medicare Part D | — | — | — |
| PALONOSETRON Palonosetron Hydrochloride | — Medicare Part D | — | — | — |
| Sandostatin octreotide acetate | — Medicare Part D | — | — | — |
| ELEVIDYS delandistrogene moxeparvovec-rokl | — Medicare Part D | — | — | — |
| EPKINLY epcoritamab-bysp | — Medicare Part D | — | — | — |
| Butrans buprenorphine | — Medicare Part D | — | — | — |
| Lenvima Lenvatinib | — Medicare Part D | — | — | — |
| Treximet Sumatriptan Succinate and Naproxen Sodium | — Medicare Part D | — | — | — |
| Methylphenidate Transdermal System methylphenidate | — Medicare Part D | — | — | — |
| Ondansetron Hydrochloride Ondansetron Hydrochloride | — Medicare Part D | — | — | — |
| Jentadueto linagliptin and metformin hydrochloride | — Medicare Part D | — | — | — |
| Labetalol Hydrochloride Labetalol Hydrochloride | — Medicare Part D | — | — | — |
| SOTALOL HYDROCHLORIDE Sotalol Hydrochloride | — Medicare Part D | — | — | — |
| ASMANEX HFA MOMETASONE FUROATE | — Medicare Part D | — | — | — |
| ACTIMMUNE Interferon gamma-1b | — Medicare Part D | Yes | — | — |
| Deferoxamine Mesylate Deferoxamine mesylate | — Medicare Part D | — | — | — |
| Taytulla norethindrone acetate and ethinyl estradiol, and ferrous fumarate | — Medicare Part D | — | — | — |
| Nystop Nystatin | — Medicare Part D | — | — | — |
| Latanoprost Latanoprost | — Medicare Part D | — | — | — |
| IPRATROPIUM BROMIDE AND ALBUTEROL SULFATE Ipratropium Bromide and Albuterol Sulfate | — Medicare Part D | — | — | — |
| Buspirone HCL Buspirone HCL | — Medicare Part D | — | — | — |
| Clindamycin Phosphate and Tretinoin clindamycin phosphate and tretinoin | — Medicare Part D | — | — | — |
| CHLORTHALIDONE Chlorthalidone | — Medicare Part D | — | — | — |
| Voydeya Danicopan | — Medicare Part D | — | — | — |
| Naprotin Naproxen , Capsaicin | — Medicare Part D | — | — | — |
| BRIMONIDINE brimonidine | — Medicare Part D | — | — | — |
| ATNAA atropine and pralidoxime chloride Auto-Injector atropine and pralidoxime chloride | — Medicare Part D | — | — | — |
| EMTRICITABINE AND TENOFOVIR DISOPROXIL FUMARATE Emtricitabine and Tenofovir Disoproxil Fumarate | — Medicare Part D | — | — | — |
| EVOTAZ atazanavir and cobicistat | — Medicare Part D | — | — | — |
| Mitomycin Mitomycin | — Medicare Part D | — | — | — |
| AZELASTINE HYDROCHLORIDE Azelastine Hydrochloride | — Medicare Part D | — | — | — |
| CLINDAMYCIN HYDROCHLORIDE Clindamycin Hydrochloride | — Medicare Part D | — | — | — |
| NALBUPHINE HCI NALBUPHINE HCI | — Medicare Part D | — | — | — |
| Syfovre Pegcetacoplan | — Medicare Part D | — | — | — |
| Butalbital And Acetaminophen, ALLZITAL, Butalbital and Acetaminophen | — Medicare Part D | — | — | — |
| Riomet Metformin Hydrochloride | — Medicare Part D | — | — | — |
| PROMETHAZINE HYDROCHLORIDE Promethazine Hydrochloride | — Medicare Part D | — | — | — |
| Minocycline Hydrochloride minocycline hydrochloride | — Medicare Part D | — | — | — |