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 |
|---|---|---|---|---|
| Sodium Bicarbonate SODIUM BICARBONATE | — Medicare Part D | — | — | — |
| Doxorubicin Hydrochloride DOXORUBICIN HYDROCHLORIDE | — Medicare Part D | — | — | — |
| PRASUGREL prasugrel hydrochloride | — Medicare Part D | — | — | — |
| timolol maleate ophthalmic gel forming solution | — Medicare Part D | — | — | — |
| Nisoldipine nisoldipine | — Medicare Part D | — | — | — |
| CTEXLI chenodiol | — Medicare Part D | — | — | — |
| Avaclyr ACYCLOVIR | — Medicare Part D | — | — | — |
| Syeda Drospirenone and Ethinyl Estradiol | — Medicare Part D | — | — | — |
| Buspirone HCL Buspirone HCL | — Medicare Part D | — | — | — |
| Adapalene and Benzoyl Peroxide Gel, 0.1%/2.5% | — Medicare Part D | — | — | — |
| PROMACTA eltrombopag olamine | — Medicare Part D | — | — | — |
| Zonegran Zonisamide | — Medicare Part D | — | — | — |
| OSENI alogliptin and pioglitazone | — Medicare Part D | — | — | — |
| Malathion Malathion | — Medicare Part D | — | — | — |
| Dapsone Dapsone | — Medicare Part D | — | — | — |
| OLINVYK OLICERIDINE | — Medicare Part D | — | — | — |
| Travoprost Ophthalmic Solution, 0.004% | — Medicare Part D | — | — | — |
| Sodium Fluoride 1.1% Dental Gel MINT | — Medicare Part D | — | — | — |
| SYMBRAVO meloxicam, rizatriptan | — Medicare Part D | — | — | — |
| Sodium Sulfacetamide 10 % and Sulfur 2 % Cleanser Sodium Sulfacetamide and Sulfur | — Medicare Part D | — | — | — |
| Enalapril Maleate Oral Solution Enalapril Maleate | — Medicare Part D | — | — | — |
| Fluocinolone Acetonide Oil Fluocinolone Acetonide | — Medicare Part D | — | — | — |
| Nebivolol nebivolol | — Medicare Part D | — | — | — |
| Lidocaine Patch Lidocaine HCl, Menthol | — Medicare Part D | — | — | — |
| ILEVRO nepafenac | — Medicare Part D | Yes | — | — |
| DEXAMETHASONE Dexamethasone | — Medicare Part D | — | — | — |
| Lyrica PREGABALIN | — Medicare Part D | — | — | — |
| Azelaic Acid Azelaic Acid | — Medicare Part D | — | — | — |
| Breo Ellipta fluticasone furoate and vilanterol trifenatate | — Medicare Part D | — | — | — |
| Corphena Dexchlorpheniramine Maleate | — Medicare Part D | — | — | — |
| Bryhali halobetasol propionate | — Medicare Part D | — | — | — |
| Omnipaque Iohexol | — Medicare Part D | — | — | — |
| ACETYLCYSTEINE ACETYLCYSTEINE | — Medicare Part D | — | — | — |
| Benazepril Hydrochloride and Hydrochlorothiazide Benazepril Hydrochloride and Hydrochlorothiazide | — Medicare Part D | — | — | — |
| TADALAFIL Tadalafil | — Medicare Part D | — | — | — |
| Bosentan Bosentan | — Medicare Part D | — | — | — |
| HEATHER Norethindrone | — Medicare Part D | — | — | — |
| Calcium Gluconate in Sodium Chloride Calcium Gluconate | — Medicare Part D | — | — | — |
| TobraDex tobramycin and dexamethasone | — Medicare Part D | — | — | — |
| NAPROXEN Naproxen | — Medicare Part D | — | — | — |
| TERBINAFINE HYDROCHLORIDE Terbinafine Hydrochloride | — Medicare Part D | — | — | — |
| Zurnai NALMEFENE HYDROCHLORIDE | — Medicare Part D | Yes | — | — |
| Vyndaqel, Vyndamax | — Medicare Part D | — | — | — |
| METHYLPREDNISOLONE ACETATE Methylprednisolone acetate | — Medicare Part D | — | — | — |
| Methergine Methylergonovine maleate | — Medicare Part D | — | — | — |
| ORACEA DOXYCYCLINE | — Medicare Part D | — | — | — |
| Loestrin Fe 28 Day, Loestrin 21 Day | — Medicare Part D | — | — | — |
| Kit for the Prepartion of Technetium Tc99m Sulfur Colloid Technetium Tc 99m Sulfur Colloid | — Medicare Part D | — | — | — |
| Methocarbamol Methocarbamol | — Medicare Part D | — | — | — |
| Proparacaine Hydrochloride Proparacaine Hydrochloride | — Medicare Part D | — | — | — |