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 |
|---|---|---|---|---|
| Warfarin Sodium Warfarin Sodium | — Medicare Part D | — | — | — |
| Cefepime Cefepime | — Medicare Part D | — | — | — |
| DROSPIRENONE AND ETHINYL ESTRADIOL Drospirenone and Ethinyl Estradiol | — Medicare Part D | — | — | — |
| LIDOCAINE HYDROCHLORIDE Lidocaine Hydrochloride | — Medicare Part D | — | — | — |
| METHYLPHENIDATE HYDROCHLORIDE methylphenidate hydrochloride | — Medicare Part D | — | — | — |
| Normosol-R and Dextrose Dextrose, Sodium Chloride, Sodium Acetate Anhydrous, Sodium Gluconate, Potassium Chloride, and Magnesium Chloride | — Medicare Part D | — | — | — |
| Tuxarin codeine phosphate and chlorpheniramine maleate | — Medicare Part D | — | — | — |
| ESZOPICLONE Eszopiclone | — Medicare Part D | — | — | — |
| Diflorasone Diacetate DIFLORASONE DIACETATE | — Medicare Part D | — | — | — |
| ROMVIMZA Vimseltinib | — Medicare Part D | — | — | — |
| Juleber Desogestrel and Ethinyl Estradiol | — Medicare Part D | — | — | — |
| Oseltamivir Phosphate for Oral Suspension Oseltamivir Phosphate | — Medicare Part D | — | — | — |
| NEOMYCIN AND POLYMYXIN B SULFATES AND GRAMICIDIN neomycin sulfate, polymyxin b sulfate and gramicidin | — Medicare Part D | — | — | — |
| TOBRAMYCIN AND DEXAMETHASONE Tobramycin and dexamethasone | — Medicare Part D | — | — | — |
| Linagliptin and metformin hydrochloride linagliptin and metformin hydrochloride | — Medicare Part D | — | — | — |
| Pyridoxine Hydrochloride Pyridoxine Hydrochloride | — Medicare Part D | — | — | — |
| Miochol E acetylcholine chloride | — Medicare Part D | — | — | — |
| Incruse Ellipta umeclidinium | — Medicare Part D | — | — | — |
| Ciprofloxacin Ciprofloxacin Hydrochloride | — Medicare Part D | — | — | — |
| Sodium Fluoride 1.1% Gel Sodium Fluoride | — Medicare Part D | — | — | — |
| PERPHENAZINE perphenazine | — Medicare Part D | — | — | — |
| Methoxsalen Methoxsalen | — Medicare Part D | — | — | — |
| DEXMEDETOMIDINE Dexmedetomidine HCl | — Medicare Part D | — | — | — |
| Tasimelteon Tasimelteon | — Medicare Part D | — | — | — |
| FLUORIDEX Stannous Fluoride Rinse | — Medicare Part D | — | — | — |
| Hyoscyamine Sulfate Hyoscyamine Sulfate | — Medicare Part D | — | — | — |
| Flunisolide Flunisolide | — Medicare Part D | — | — | — |
| ERRIN NORETHINDRONE | — Medicare Part D | — | — | — |
| Imipenem and Cilastatin Imipenem and Cilastatin | — Medicare Part D | — | — | — |
| Arcalyst rilonacept | — Medicare Part D | Yes | — | — |
| Bupropion HCL ER (XL) Bupropion HCL ER (XL) | — Medicare Part D | — | — | — |
| Cyclobenzaprine HCL Cyclobenzaprine HCL | — Medicare Part D | — | — | — |
| Carboplatin CARBOPLATIN | — Medicare Part D | — | — | — |
| Lubiprostone Lubiprostone | — Medicare Part D | — | — | — |
| CYANOCOBALAMIN CYANOCOBALAMIN | — Medicare Part D | — | — | — |
| QUDEXY XR Topiramate | — Medicare Part D | — | — | — |
| Insulin Glargine Solostar insulin glargine | — Medicare Part D | Yes | — | — |
| LISDEXAMFETAMINE DIMESYLATE Lisdexamfetamine | — Medicare Part D | — | — | — |
| Tekturna aliskiren hemifumarate | — Medicare Part D | — | — | — |
| Iris tenax IRIS TENAX | — Medicare Part D | — | — | — |
| Eletriptan HBR Eletriptan HBR | — Medicare Part D | — | — | — |
| Ferric Citrate Ferric Citrate | — Medicare Part D | — | — | — |
| Sensorcaine MPF BUPIVACAINE HYDROCHLORIDE | — Medicare Part D | — | — | — |
| PreviDent 5000 Booster Plus Spearmint Sodium Fluoride | — Medicare Part D | — | — | — |
| RAPAFLO silodosin | — Medicare Part D | — | — | — |
| DOJOLVI Triheptanoin | — Medicare Part D | — | — | — |
| TARINA 24 FE Norethindrone Acetate and Ethinyl Estradiol and Ferrous Fumarate | — Medicare Part D | — | — | — |
| CHLOROTHIAZIDE SODIUM CHLOROTHIAZIDE SODIUM | — Medicare Part D | — | — | — |
| OSCIMIN Hyoscyamine Sulfate | — Medicare Part D | — | — | — |
| Ifosfamide ifosfamide | — Medicare Part D | — | — | — |