Skip to main content

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.

DrugPayerPAStep therapyTier
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