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 |
|---|---|---|---|---|
| Fluoxetine HCL fluoxetine hcl | — Medicare Part D | — | — | — |
| HALOPERIDOL LACTATE HALOPERIDOL LACTATE | — Medicare Part D | — | — | — |
| DEXTROAMPHETAMINE SULFATE DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE MONOHYDRATE, DEXTROAMPHETAMINE SULFATE, AMPHETAMINE SULFATE | — Medicare Part D | — | — | — |
| Dextrose Magnesium Sulfate Heptahydrate | — Medicare Part D | — | — | — |
| Hydroxocobalamin Hydroxocobalamin | — Medicare Part D | — | — | — |
| LEFLUNOMIDE Leflunomide | — Medicare Part D | — | — | — |
| NALOXONE HYDROCHLORIDE Naloxone Hydrochloride | — Medicare Part D | — | — | — |
| Evekeo Amphetamine Sulfate | — Medicare Part D | — | — | — |
| Clindamycin Palmitate Hydrochloride Clindamycin Palmitate Hydrochloride | — Medicare Part D | — | — | — |
| Ursodiol URSODIOL | — Medicare Part D | — | — | — |
| Flarex fluorometholone acetate | — Medicare Part D | Yes | — | — |
| Teglutik Riluzole | — Medicare Part D | — | — | — |
| DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE MONOHYDRATE, DEXTROAMPHETAMINE SULFATE AND AMPHETAMINE SULFATE Dextroamphetamine Saccharate, Amphetamine Aspartate Monohydrate, Dextroamphetamine Sulfate, and Amphetamine Sulfate | — Medicare Part D | — | — | — |
| olmesartan medoxomil and amlodipine besylate and hydrochlorothiazide olmesartan medoxomil and amlodipine besylate and hydrochlorothiazide | — Medicare Part D | — | — | — |
| LEROCHOL lerodalcibep-liga | — Medicare Part D | — | — | — |
| DEXMETHYLPHENIDATE HYDROCHLORIDE Dexmethylphenidate Hydrochloride | — Medicare Part D | — | — | — |
| IHEEZO chloroprocaine hydrochloride ophthalmic gel | — Medicare Part D | — | — | — |
| VISTOGARD uridine triacetate | — Medicare Part D | — | — | — |
| Ergocalciferol (Vitamin D2) ergocalciferol | — Medicare Part D | — | — | — |
| CitraNatal Assure ascorbic acid, calcium citrate, iron, vitamin d, dl- alpha- tocopherol acetate, thiamine, riboflavin, niacinamide, pyridoxine hydrochloride, folic acid, iodine, zinc, copper, docusate sodium, doconexent and icosapent | — Medicare Part D | — | — | — |
| Caldolor ibuprofen | — Medicare Part D | — | — | — |
| METOPROLOL SUCCINATE Metoprolol succinate | — Medicare Part D | — | — | — |
| Rosuvastatin Rosuvastatin | — Medicare Part D | — | — | — |
| CITALOPRAM HYDROBROMIDE CITALOPRAM HYDROBROMIDE | — Medicare Part D | — | — | — |
| FINGOLIMOD HYDROCHLORIDE fingolimod hydrochloride | — Medicare Part D | — | — | — |
| Xenical orlistat | — Medicare Part D | — | — | — |
| Carbamazepine Carbamazepine | — Medicare Part D | — | — | — |
| Miglustat miglustat | — Medicare Part D | — | — | — |
| Phenoxybenzamine Hydrochloride PHENOXYBENZAMINE HYDROCHLORIDE | — Medicare Part D | — | — | — |
| QVAR REDIHALER Beclomethasone Dipropionate HFA | — Medicare Part D | — | — | — |
| SOMAVERT pegvisomant | — Medicare Part D | Yes | — | — |
| EOVIST Gadoxetate Disodium | — Medicare Part D | — | — | — |
| Hydrocortisone Hydrocortisone | — Medicare Part D | — | — | — |
| TORSEMIDE Torsemide | — Medicare Part D | — | — | — |
| CLINDAMYCIN PHOSPHATE AND BENZOYL PEROXIDE CLINDAMYCIN PHOSPHATE AND BENZOYL PEROXIDE | — Medicare Part D | — | — | — |
| Bosentan Bosentan | — Medicare Part D | — | — | — |
| Mupirocin Mupirocin | — Medicare Part D | — | — | — |
| Exforge HCT amlodipine valsartan and hydrochlorothiazide | — Medicare Part D | — | — | — |
| Midazolam Hydrochloride MIDAZOLAM HYDROCHLORIDE | — Medicare Part D | — | — | — |
| Sodium Sulfacetamide 9 Sulfur 4.5 Wash Sulfacetamide Sodium and Sulfur | — Medicare Part D | — | — | — |
| ALYFTREK vanzacaftor, tezacaftor, and deutivacaftor | — Medicare Part D | — | — | — |
| TOBRAMYCIN Tobramycin | — Medicare Part D | — | — | — |
| Eletriptan Hydrobromide Eletriptan Hydrobromide | — Medicare Part D | — | — | — |
| SELEGILINE HYDROCHLORIDE Selegiline Hydrochloride | — Medicare Part D | — | — | — |
| TOTAL FEM BAL Adrenalinum, Cholesterinum, Folliculinum, Hypothalamus, Oophorinum, Pulsatilla | — Medicare Part D | — | — | — |
| Dorzolamide and Timolol Dorzolamide Hydrochloride and Timolol Maleate Ophthalmic Solution | — Medicare Part D | — | — | — |
| LODOCO Colchicine Tablets 0.5 mg | — Medicare Part D | — | — | — |
| BUPROPION HYDROCHLORIDE Bupropion hydrochloride | — Medicare Part D | — | — | — |
| ESTRADIOL AND NORETHINDRONE ACETATE estradiol and norethindrone acetate | — Medicare Part D | — | — | — |
| ZYKADIA ceritinib | — Medicare Part D | — | — | — |