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 |
|---|---|---|---|---|
| DALBAVANCIN HYDROCHLORIDE dalbavancin hydrochloride | — Medicare Part D | — | — | — |
| AMLODIPINE AND OLMESARTAN MEDOXOMIL Amlodipine and Olmesartan Medoxomil | — Medicare Part D | — | — | — |
| Divalproex Sodium Divalproex Sodium | — Medicare Part D | — | — | — |
| Tizanidine tizanidine | — Medicare Part D | — | — | — |
| ZINC Titanium Dioxide and Zinc Oxide | — Medicare Part D | — | — | — |
| Cystografin Dilute diatrizoate meglumine | — Medicare Part D | — | — | — |
| DARIFENACIN Darifenacin Hydrobromide | — Medicare Part D | — | — | — |
| Ruxience rituximab-pvvr | — Medicare Part D | — | — | — |
| RECARBRIO imipenem anhydrous, cilastatin, and relebactam anhydrous | — Medicare Part D | — | — | — |
| SODIUM NITROPRUSSIDE Sodium Nitroprusside | — Medicare Part D | — | — | — |
| MOVANTIK naloxegol oxalate | — Medicare Part D | — | — | — |
| NYSTATIN AND TRIAMCINOLONE ACETONIDE nystatin and triamcinolone acetonide | — Medicare Part D | — | — | — |
| THEOPHYLLINE Theophylline | — Medicare Part D | — | — | — |
| Tirofiban Hydrochloride Tirofiban Hydrochloride | — Medicare Part D | — | — | — |
| Lofexidine hydrochloride Lofexidine Hydrochloride | — Medicare Part D | — | — | — |
| KYXATA CARBOplatin | — Medicare Part D | — | — | — |
| Jolessa Levonorgestrel / Ethinyl Estradiol | — Medicare Part D | — | — | — |
| Enalapril Maleate Oral Solution Enalapril Maleate | — Medicare Part D | — | — | — |
| Tenofovir Disoproxil Fumarate TENOFOVIR DISOPROXIL FUMARATE | — Medicare Part D | — | — | — |
| Galantamine Galantamine | — Medicare Part D | — | — | — |
| Promethazine Hydrochloride and Dextromethorphan Hydrobromide Oral Promethazine Hydrochloride and Dextromethorphan Hydrobromide | — Medicare Part D | — | — | — |
| LACOSAMIDE lacosamide | — Medicare Part D | — | — | — |
| Valrubicin Intravesical Solution Valrubicin Intravesical Solution | — Medicare Part D | — | — | — |
| Lanthanum Carbonate Lanthanum carbonate | — Medicare Part D | — | — | — |
| Maxitrol neomycin sulfate, polymyxin b sulfate and dexamethasone | — Medicare Part D | — | — | — |
| Carnitor SF levocarnitine | — Medicare Part D | — | — | — |
| Matzim LA Diltiazem Hydrochloride | — Medicare Part D | — | — | — |
| PANTOPRAZOLE SODIUM DELAYED-RELEASE delayed release pantoprazole sodium granules | — Medicare Part D | — | — | — |
| SENSORCAINE MPF, SENSORCAINE | — Medicare Part D | — | — | — |
| LEFLUNOMIDE Leflunomide | — Medicare Part D | — | — | — |
| Amikacin Sulfate AMIKACIN SULFATE | — Medicare Part D | — | — | — |
| Lidocaine Hydrochloride and Epinephrine LIDOCAINE HYDROCHLORIDE and EPINEPHRINE | — Medicare Part D | — | — | — |
| XIAFLEX collagenase clostridium histolyticum | — Medicare Part D | — | — | — |
| Nitrofurantoin Mono NITROFURANTOIN MONOHYDRATE | — Medicare Part D | — | — | — |
| Trilocaine Lidocaine Hydrochloride | — Medicare Part D | — | — | — |
| Gemmily norethindrone acetate and ethinyl estradiol, and ferrous fumarate | — Medicare Part D | — | — | — |
| USTEKINUMAB-TTWE ustekinumab-ttwe | — Medicare Part D | — | — | — |
| Diflunisal Diflunisal | — Medicare Part D | — | — | — |
| Se-Natal 19 Chewable Vitamins and Minerals | — Medicare Part D | — | — | — |
| DOCIVYX docetaxel | — Medicare Part D | — | — | — |
| EPLERENONE eplerenone | — Medicare Part D | — | — | — |
| Apri 28 Day Desogestrel and Ethinyl Estradiol | — Medicare Part D | — | — | — |
| Sodium Bicarbonate SODIUM BICARBONATE | — Medicare Part D | — | — | — |
| Tetrabenazine Tetrabenazine | — Medicare Part D | — | — | — |
| Norethindrone and ethinyl estradiol and ferrous fumarate norethindrone and ethinyl estradiol and ferrous fumarate | — Medicare Part D | — | — | — |
| Meloxicam meloxicam | — Medicare Part D | — | — | — |
| NUZYRA omadacycline | — Medicare Part D | Yes | — | — |
| Sulfamethoxazole and Trimethoprim DS Sulfamethoxazole and Trimethoprim | — Medicare Part D | — | — | — |
| ZYPREXA Relprevv Olanzapine pamoate | — Medicare Part D | — | — | — |
| Etyqa ESTRADIOL AND NORETHINDRONE ACETATE | — Medicare Part D | — | — | — |