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 |
|---|---|---|---|---|
| Norepinephrine Norepinephrine Bitartrate | — Medicare Part D | — | — | — |
| Lunesta ESZOPICLONE | — Medicare Part D | — | — | — |
| LYMPHIR denileukin diftitox-cxdl | — Medicare Part D | — | — | — |
| FENOFIBRATE Fenofibrate | — Medicare Part D | — | — | — |
| FOSAPREPITANT DIMEGLUMINE FOSAPREPITANT DIMEGLUMINE | — Medicare Part D | — | — | — |
| UNLOXCYT cosibelimab | — Medicare Part D | — | — | — |
| DAPAGLIFLOZIN DAPAGLIFLOZIN | — Medicare Part D | — | — | — |
| Prometrium Progesterone | — Medicare Part D | — | — | — |
| Thermazene Silver Sulfadiazine Silver Sulfadiazine | — Medicare Part D | — | — | — |
| Ziprasidone Hydrochloride Ziprasidone HCl | — Medicare Part D | — | — | — |
| ADAPALENE AND BENZOYL PEROXIDE adapalene and benzoyl peroxide topical | — Medicare Part D | — | — | — |
| Unituxin DINUTUXIMAB | — Medicare Part D | — | — | — |
| Venlafaxine Hydrochloride ER Venlafaxine Hydrochloride | — Medicare Part D | — | — | — |
| NALMEFENE HYDROCHLORIDE Nalmefene Hydrochloride | — Medicare Part D | Yes | — | — |
| SCENESSE afamelanotide | — Medicare Part D | — | — | — |
| TECHNETIUM Tc 99m MERTIATIDE Technetium Tc 99m Mertiatide | — Medicare Part D | — | — | — |
| VASOPRESSIN Vasopressin | — Medicare Part D | — | — | — |
| Relpax eletriptan hydrobromide | — Medicare Part D | — | — | — |
| PIOGLITAZONE HYDROCHLORIDE Pioglitazone Hydrochloride | — Medicare Part D | — | — | — |
| CARBIDOPA, LEVODOPA AND ENTACAPONE carbidopa, levodopa, and entacapone | — Medicare Part D | — | — | — |
| Plenvu POLYETHYLENE GLYCOL 3350, SODIUM SULFATE, SODIUM CHLORIDE, POTASSIUM CHLORIDE, ASCORBIC ACID, SODIUM ASCORBATE | — Medicare Part D | — | — | — |
| Diltiazem Hydrochloride diltiazem hydrochloride | — Medicare Part D | — | — | — |
| DORZOLAMIDE HYDROCHLORIDE AND TIMOLOL MALEATE Dorzolamide Hydrochloride and Timolol Maleate | — Medicare Part D | — | — | — |
| Bisoprolol Fumarate and Hydrochlorothiazide bisoprolol fumarate and hydrochlorothiazide | — Medicare Part D | — | — | — |
| Oxygen OXYGEN | — Medicare Part D | — | — | — |
| CEVIMELINE HYDROCHLORIDE cevimeline hydrochloride | — Medicare Part D | — | — | — |
| Enulose Lactulose | — Medicare Part D | — | — | — |
| Tolmetin Sodium tolmetin sodium | — Medicare Part D | — | — | — |
| Ionite R Sodium Fluoride | — Medicare Part D | — | — | — |
| Cortisone Acetate CORTISONE ACETATE | — Medicare Part D | — | — | — |
| Promethazine and Phenylephrine HCl, and Codeine Phosphate Promethazine, Phenylephrine, Codeine | — Medicare Part D | — | — | — |
| Xyliderm Lidocaine, Isopropyl Alcohol | — Medicare Part D | — | — | — |
| Meperidine Hydrochloride MEPERIDINE HYDROCHLORIDE | — Medicare Part D | — | — | — |
| GRANIX tbo-filgrastim | — Medicare Part D | Yes | — | — |
| COXANTO oxaprozin | — Medicare Part D | — | — | — |
| DICLOFENAC SODIUM diclofenac sodium | — Medicare Part D | — | — | — |
| Bendamustine BENDAMUSTINE HYDROCHLORIDE | — Medicare Part D | — | — | — |
| NITRO-BID Nitroglycerin | — Medicare Part D | — | — | — |
| Vosevi SOFOSBUVIR, VELPATASVIR, and VOXILAPREVIR | — Medicare Part D | — | — | — |
| Hemabate carboprost tromethamine | — Medicare Part D | — | — | — |
| Tri-Sprintec norgestimate and ethinyl estradiol | — Medicare Part D | — | — | — |
| ZAFEMY Norelgestromin and Ethinyl Estradiol | — Medicare Part D | — | — | — |
| Gentamicin GENTAMICIN SULFATE | — Medicare Part D | — | — | — |
| Rosyrah levonorgestrel and ethinyl estradiol and ethinyl estradiol | — Medicare Part D | — | — | — |
| Rezurock belumosudil | — Medicare Part D | — | — | — |
| Moxidectin Moxidectin | — Medicare Part D | — | — | — |
| Aralia Racemosa MT Aralia Racemosa | — Medicare Part D | — | — | — |
| YUSIMRY adalimumab-aqvh | — Medicare Part D | Yes | — | — |
| Paroxetine Hydrochloride paroxetine hydrochloride | — Medicare Part D | — | — | — |
| Top Quality Mfg APF Sodium Fluoride | — Medicare Part D | — | — | — |