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Non-expansion

Florida Prior Authorization Requirements

Medicare AdvantageMedicare TraditionalDual-EligibleMedicaid MCOPart DMedicaid FFSCommercial (employer / fully-insured)

PA required

43%

1,090 verified rules

Verified Jun 8, 2026

Service category PA

All programs combined
Specialty Drugs
5/6Conditional
Durable Medical Equipment
5/6Conditional
Outpatient Surgery
4/6Conditional
Home Health
4/6Conditional
Inpatient Hospital
4/6Conditional
Mental Health — Inpatient
4/6Conditional
Skilled Nursing Facility
4/6Conditional
Occupational Therapy
3/6Conditional
Substance Use Treatment
3/6Conditional
Speech Therapy
3/6Conditional
Diagnostic Imaging
3/6Conditional
Physical Therapy
3/6Conditional
Ambulance Transport
3/6Conditional
advanced_imaging
3/6Conditional
Laboratory
0/6No PA

Drug class PA

Part D federal protections flagged
Oral Oncology
10/12Conditional
ADHD Stimulants
10/12Conditional
jak_inhibitors
7/7Full PA
Immunosuppressants
7/9Conditional
antifungals_systemic
7/8Conditional
tnf_inhibitors
7/7Full PA
growth_hormone
7/7Full PA
glp1_agonists
7/7Full PA
hereditary_angioedema
7/7Full PA
pulmonary_arterial_hypertension
7/7Full PA
Rare Disease / Orphan
6/7Conditional
testosterone_androgens
6/7Conditional
asthma_copd_biologics
6/6Full PA
il_inhibitors_biologics
6/6Full PA
hepatitis_c_daa
6/6Full PA
migraine_cgrp
6/6Full PA
Specialty Non-Biologic
5/6Conditional
Controlled — Schedule III–V
5/6Conditional
opioid_analgesics
5/6Conditional
Diabetes — Non-Insulin
5/6Conditional
Brand (Generic Available)
5/6Conditional
Diabetes — Insulin
5/6Conditional
Brand (No Generic)
5/6Conditional
Specialty Biologics
5/6Conditional
Hepatitis C
5/6Conditional
Biosimilars
5/6Conditional
Controlled — Schedule II
5/6Conditional
Antipsychotics
5/7Conditional
pcsk9_inhibitors
5/6Conditional
anticonvulsants
5/7Conditional
ms_disease_modifying
5/5Full PA
other_antidepressants
5/7Conditional
Antidepressants
4/6Conditional
wakefulness_agents
4/4Full PA
atypical_antipsychotics
4/5Conditional
HIV Antiretrovirals
3/12Conditional
enzyme_replacement
3/3Full PA
vmat2_inhibitors
3/3Full PA
hemophilia_factors
3/3Full PA
inhaled_respiratory
3/7Conditional
weight_loss_agents
3/3Full PA
nsaids
3/6Conditional
oral_retinoids
2/5Conditional
dermatology_biologics
2/2Full PA
GLP-1 (Weight Loss)
2/6Conditional
anxiolytics_benzodiazepines
2/7Conditional
oxybate_salts
2/2Full PA
sglt2_inhibitors
2/6Conditional
insulins
2/6Conditional
cannabidiol
2/2Full PA
ppi_acid_reducers
2/6Conditional
antiplatelets
2/7Conditional
oncology_supportive
2/2Full PA
cystic_fibrosis_modulators
2/2Full PA
hematopoietic_growth_factors
2/2Full PA
dalfampridine
2/2Full PA
erectile_dysfunction
2/2Full PA
immunoglobulins
2/2Full PA
cns_miscellaneous
1/1Full PA
ophthalmic_dry_eye_misc
1/1Full PA
glp1_diabetes
1/1Full PA
pulmonary_fibrosis
1/1Full PA
dpp4_inhibitors
1/5Conditional
antivirals_other
1/2Conditional
immunological_immunomodulators
1/1Full PA
metabolic_bone_other
1/1Full PA
ophthalmic_anti_inflammatory_anti_infective
1/1Full PA
sexual_dysfunction_agents
1/1Full PA
respiratory_allergy_cough_cold
1/1Full PA
gi_bowel_motility
1/1Full PA
electrolytes_vitamins
1/1Full PA
bisphosphonates
1/6Conditional
thyroid_agents
1/3Conditional
osteoporosis_anabolics
1/1Full PA
sleep_and_wakefulness_agents
1/1Full PA
sedative_hypnotics
1/5Conditional
ssri_antidepressants
1/5Conditional
anticoagulants_doac
1/6Conditional
statins
1/6Conditional
overactive_bladder
1/6Conditional
mucolytics
1/1Full PA
dipeptidyl_peptidase_1_dpp1_inhibitor
1/1Full PA
vitamin_a_preparations
1/1Full PA
lhrh_gnrh_antagonist_pituitary_suppressant_agents
1/1Full PA
calcium_channel_blocking_agents
1/1Full PA
general_inhalation_agents
1/1Full PA
pulmonary_fibrosis_systemic_enzyme_inhibitors
1/1Full PA
other_antidiabetics
1/7Conditional
sedative_hypnotics_non_barbiturate
1/1Full PA
tx_for_attention_deficit_hyperact_adhd_nri_type
1/1Full PA
dietary_supplement_miscellaneous
1/1Full PA
pku_tx_agent_cofactor_of_phenylalanine_hydroxylase
1/1Full PA
pancreatic_enzymes
1/1Full PA
antipsoriatics_agents
1/1Full PA
sickle_cell_anemia_agents
1/1Full PA
cytochrome_p450_inhibitors
1/1Full PA
ammonia_inhibitors
1/1Full PA
skeletal_muscle_relaxants
1/5Conditional
irritants_counter_irritants
1/1Full PA
adrenocorticotrophic_hormones
1/1Full PA
ibs_c_cic_agents_guanylate_cyclase_c_agonist
1/1Full PA
laxatives_and_cathartics
1/1Full PA
opioid_use_disorder
1/7Conditional
mu_opioid_receptor_antagonists_peripherally_acting
1/1Full PA
hydroxyphenyl_pyruvate_dioxygenase_hppd_inhibitor
1/1Full PA
bipolar_disorder_drugs
1/1Full PA
antidiarrheal_microorganisms_agents
1/1Full PA
antiemetic_antivertigo_agents
1/1Full PA
lhrh_gnrh_agonist_analog_pituitary_suppressants
1/1Full PA
acne_agents_systemic
1/1Full PA
glucocorticoids
1/2Conditional
antipruritics_topical
1/1Full PA
herbal_drugs
1/1Full PA
antiretroviral_integrase_inhibitor_and_nrti_comb
1/1Full PA
lhrh_gnrh_antagonist_estrogen_and_progestin_comb
1/1Full PA
topical_local_anesthetics
1/1Full PA
thrombopoietin_receptor_agonists
1/1Full PA
artv_nucleoside_nucleotide_non_nucleoside_rti_comb
1/1Full PA
lhrh_gnrh_agnst_pit_sup_central_precocious_puberty
1/1Full PA
antineoplastic_lhrh_gnrh_agonist_pituitary_suppr
1/1Full PA
bone_resorption_inhibitors
1/1Full PA
topical_antineoplastic_premalignant_lesion_agents
1/1Full PA
antivirals_hiv_specific_non_nucleoside_rti
1/1Full PA
anti_inflammatory_phosphodiesterase_4_pde4_inhib
1/1Full PA
antiretroviral_nucleoside_nucleotide_protease_inh
1/1Full PA
antivirals_hiv_spec_nucleoside_analog_rti_comb
1/1Full PA
top_anti_inflam_phosphodiesterase_4_pde4_inhib
1/1Full PA
antiretroviral_anti_cd4_domain_2_monoclonal_ab
1/1Full PA
antivirals_hiv_specific_fusion_inhibitors
1/1Full PA
ophthalmic_anti_vegf
1/2Conditional
antiretroviral_capsid_inhibitors
1/1Full PA
antivirals_hiv_spec_non_peptidic_protease_inhib
1/1Full PA
anti_cd20_b_lymphocyte_monoclonal_antibody
1/1Full PA
antibiotic_antineoplastics
1/1Full PA
antimalarial_drugs
1/1Full PA
arv_nucleoside_nucleotide_rti_integrase_inhibitors
1/1Full PA
antineoplast_hum_vegf_inhibitor_recomb_mc_antibody
1/1Full PA
antivirals_hiv_specific_protease_inhibitors
1/1Full PA
antivirals_hiv_specific_nucleoside_analog_rti
1/1Full PA
immunomodulators
1/2Conditional
antivirals_hiv_specific_ccr5_co_receptor_antag
1/1Full PA
arginine_vasopressin_avp_receptor_antagonists
1/1Full PA
aminoglycoside_antibiotics
1/1Full PA
antiretroviral_nrtis_and_integrase_inhibitors_comb
1/1Full PA
neuromuscular_blocking_agents
1/1Full PA
antiretroviral_integrase_inhibitor_and_nnrti_comb
1/1Full PA
antivirals_hiv_specific_protease_inhibitor_comb
1/1Full PA
antineoplastic_immunomodulator_agents
1/1Full PA
glucosylceramide_synthase_gcs_inhibitor
1/1Full PA
antivirals_hiv_specific_cd4_attachment_inhibitor
1/1Full PA
antifibrotic_therapy_pyridone_analogs
1/1Full PA
antivirals_hiv_spec_nucleoside_nucleotide_analog
1/1Full PA
antivirals_hiv_1_integrase_strand_transfer_inhibtr
1/1Full PA
systemic_enzyme_inhibitors
1/1Full PA
antibacterials_systemic
1/1Full PA
antiparasitics
1/1Full PA
gi_other
1/1Full PA
allergen_immunotherapy
1/1Full PA
continuous_glucose_monitors
1/1Full PA
il1_other_immunomodulators
1/1Full PA
diuretics
1/3Conditional
gnrh_oncology_hormonal
1/1Full PA
arbs
1/5Conditional
cough_cold
1/1Full PA
ophthalmic_agents
1/1Full PA
other_cardiovascular
1/1Full PA
infertility_agents
1/1Full PA
miscellaneous_specialty
1/1Full PA
estrogens_hrt
1/1Full PA
transplant_immunosuppressants
1/1Full PA
other_lipid_agents
1/1Full PA
antibiotics_general
1/1Full PA
parkinsons_agents
1/1Full PA
viscosupplements
1/1Full PA
als_agents
1/1Full PA
vasopressins
1/1Full PA
calcium_receptor_agonists
1/1Full PA
myasthenia_gravis_agents
1/1Full PA
polyneuropathy_agents
1/1Full PA
botulinum_toxins
1/1Full PA
narcolepsy_cataplexy_agents
1/1Full PA
cortisol_synthesis_inhibitors
1/1Full PA
hereditary_tyrosinemia
1/1Full PA
oncology_hormonal
1/2Conditional
bleeding_disorders_agents
1/1Full PA
urea_cycle_disorder
1/1Full PA
uterine_fibroids
1/1Full PA
multiple_sclerosis_agents
1/1Full PA
central_precocious_puberty
1/1Full PA
paroxysmal_nocturnal_hemoglobinuria
1/1Full PA
chelating_agents
1/1Full PA
acromegaly_agents
1/1Full PA
growth_improvement_agents
1/1Full PA
calcium_regulators_misc
1/1Full PA
endometriosis_agents
1/1Full PA
carnitine_deficiency_agents
1/1Full PA
movement_disorders
1/1Full PA
fertility_regulators
1/1Full PA
sickle_cell_disease
1/1Full PA
platelet_disorders
1/1Full PA
autoimmune_physician_administered
1/1Full PA
dermatology_antipsoriatics
1/1Full PA
immunologic_misc
1/1Full PA
pulmonary_fibrosis_agents
1/1Full PA
alpha1_antitrypsin_deficiency
1/1Full PA
pde4_inhibitors_inflammatory
1/1Full PA
antiparkinson_agents
1/1Full PA
calcimimetics
1/1Full PA
il_inhibitors_ibd
1/1Full PA
cough_cold_allergy
1/1Full PA
hematopoietic_esa
1/1Full PA
neuro_psych_misc
1/1Full PA
dermatology_topical_other
1/1Full PA
metabolic_disorder_agents
1/1Full PA
ophthalmic_anti_inflammatory
1/1Full PA
antibiotics_misc
1/1Full PA
hepatitis_b_agents
1/1Full PA
immunosuppressants_misc
1/1Full PA
ovulation_stimulants
1/1Full PA
antidementia_alzheimers
0/1No PA
Opioid Treatment (MOUD)
0/6No PA
Compounded Medications
0/6No PA
vaccines
0/2No PA
otic_agents
0/4No PA
leukotriene_modifiers
0/5No PA
roflumilast
0/2No PA
bph_agents
0/2No PA
oral_corticosteroids
0/1No PA
anaphylaxis_epinephrine
0/1No PA
digitalis_glycosides
0/2No PA
xanthines
0/2No PA
inotropic_drugs
0/1No PA
antiarrhythmics
0/3No PA
expectorants
0/1No PA
heart_rate_reducing_sa_selective_i_f_current_inh
0/1No PA
non_opioid_antitus_1st_gen_antihistamine_decongest
0/1No PA
antianginal_anti_ischemic_agents_non_hemodynamic
0/1No PA
non_opioid_antitussive_and_expectorant_combination
0/1No PA
antihypertensives_vasodilators
0/1No PA
opioid_antitussive_anticholinergic_combinations
0/1No PA
antihypertensives_sympatholytic
0/1No PA
non_opioid_antitussive_1st_gen_antihistamine_comb
0/1No PA
antihypertensives_ace_inhibitors
0/1No PA
antihypertensives_angiotensin_receptor_antagonist
0/1No PA
angiotensin_receptor_blockr_calcium_channel_blockr
0/1No PA
water
0/1No PA
angiotensin_receptor_antag_thiazide_diuretic_comb
0/1No PA
anti_alcoholic_preparations
0/1No PA
iv_solutions_dextrose_saline
0/1No PA
ace_inhibitor_thiazide_or_thiazide_like_diuretic
0/1No PA
bicarbonate_producing_containing_agents
0/1No PA
ace_inhibitor_calcium_channel_blocker_combination
0/1No PA
electrolyte_depleters
0/1No PA
angiotensin_recept_neprilysin_inhibitor_comb_arni
0/1No PA
sodium_saline_preparations
0/1No PA
periodontal_collagenase_inhibitors
0/1No PA
estrogen_androgen_combinations
0/1No PA
angioten_receptr_antag_calcium_chanl_blkr_thiazide
0/1No PA
potassium_replacement
0/1No PA
vitamin_b_preparations
0/1No PA
dental_aids_and_preparations
0/1No PA
progestational_agents
0/1No PA
beta_adrenergic_agents
0/1No PA
iv_fat_emulsions
0/1No PA
eye_mast_cell_stabilizers
0/1No PA
vasodilators_coronary
0/1No PA
calcium_replacement
0/1No PA
vitamin_c_preparations
0/1No PA
fluoride_preparations
0/1No PA
bradykinin_b2_receptor_antagonists
0/1No PA
magnesium_salts_replacement
0/1No PA
vitamin_d_preparations
0/1No PA
antacids
0/1No PA
contraceptives_oral
0/1No PA
analgesic_antipyretics_salicylates
0/1No PA
smoking_deterrents_other
0/1No PA
phosphate_replacement
0/1No PA
prenatal_vitamin_preparations
0/1No PA
electrolyte_maintenance
0/1No PA
pediatric_vitamin_preparations
0/1No PA
anti_ulcer_preparations
0/1No PA
contraceptives_transdermal
0/1No PA
antipsychotics_dopamine_antagonists_thioxanthenes
0/1No PA
iron_replacement
0/1No PA
vitamin_k_preparations
0/1No PA
anti_ulcer_h_pylori_agents
0/1No PA
contraceptives_intravaginal
0/1No PA
analgesic_non_salicylate_and_barbiturate_combinat
0/1No PA
antipsych_dopamine_antag_diphenylbutylpiperidines
0/1No PA
beta_adrenergic_blocking_agents
0/1No PA
thrombolytic_enzymes
0/1No PA
zinc_replacement
0/1No PA
vitamin_b12_preparations
0/1No PA
contraceptives_intravaginal_systemic
0/1No PA
analgesic_non_salicylate_barbiturate_xanthine_comb
0/1No PA
beta_blockers_and_thiazide_thiazide_like_diuretics
0/1No PA
heparin_and_related_preparations
0/1No PA
hyperparathyroid_tx_agents_vitamin_d_analog_type
0/1No PA
appetite_stim_for_anorexia_cachexia_wasting_synd
0/1No PA
bile_salt_sequestrants
0/1No PA
cholinesterase_inhibitors
0/1No PA
antiseborrheic_agents
0/1No PA
iodine_containing_agents
0/1No PA
folic_acid_preparations
0/1No PA
antidiarrheals
0/2No PA
local_anesthetics
0/1No PA
opioid_non_salicyl_analgesic_barbiturate_xanthine
0/1No PA
intestinal_motility_stimulants
0/1No PA
anticoagulants_coumarin_type
0/1No PA
mineral_replacement_miscellaneous
0/1No PA
vitamin_b6_preparations
0/1No PA
drug_tx_chronic_inflam_colon_dx_5_aminosalicylat
0/1No PA
analgesic_salicylate_barbiturate_xanthine_comb
0/1No PA
hypnotics_melatonin_mt1_mt2_receptor_agonists
0/1No PA
antipsoriatic_agents_systemic
0/1No PA
anti_anxiety_drugs
0/1No PA
antiparkinsonism_drugs_other
0/1No PA
belladonna_alkaloids
0/1No PA
rectal_lower_bowel_prep_glucocort_non_hemorr
0/1No PA
iv_solutions_dextrose_water
0/1No PA
antipsychotics_phenothiazines
0/1No PA
antiparkinsonism_drugs_anticholinergic
0/1No PA
anticholinergics_quaternary_ammonium
0/1No PA
rosacea_agents_topical
0/1No PA
iv_solutions_dextrose_and_lactated_ringers
0/1No PA
antidotes_miscellaneous
0/1No PA
smoking_deterrent_agents_ganglionic_stim_others
0/1No PA
vaginal_antifungals
0/1No PA
diluent_solutions
0/1No PA
parenteral_amino_acid_solutions_and_combinations
0/1No PA
estrogenic_agents
0/1No PA
amyotrophic_lateral_sclerosis_agents
0/1No PA
smoking_deterrent_nicotinic_recept_partial_agonist
0/1No PA
vitamin_b1_preparations
0/1No PA
agts_tx_neuromusc_transmission_dis_pot_chan_blkr
0/1No PA
opioid_antagonists
0/1No PA
multivitamin_preparations
0/1No PA
alzheimer_s_therapy_nmda_receptor_antagonists
0/1No PA
pseudobulbar_affect_pba_agents_nmda_antagonists
0/1No PA
emollients
0/1No PA
hyperuricemia_tx_xanthine_oxidase_inhibitors
0/1No PA
bile_salts
0/1No PA
metabolic_deficiency_agents
0/1No PA
barbiturates
0/1No PA
parasympathetic_agents
0/1No PA
keratolytics
0/1No PA
platelet_reducing_agents
0/1No PA
metallic_poison_agents_to_treat
0/1No PA
prenatal_vitamins_with_low_or_no_iron
0/1No PA
antitussives_non_opioid
0/1No PA
anticholinergics_antispasmodics
0/1No PA
acne_agents_topical
0/1No PA
somatostatic_agents
0/1No PA
contraceptives_injectable
0/1No PA
analgesic_antipyretics_non_salicylate
0/1No PA
antipsychotics_dopamine_antagonists_butyrophenones
0/1No PA
alpha_beta_adrenergic_blocking_agents
0/1No PA
antidiuretic_and_vasopressor_hormones
0/1No PA
oxytocics
0/1No PA
analgesics_non_opioid
0/1No PA
snri_antidepressants
0/2No PA
anaphylaxis_therapy_agents
0/1No PA
adrenergics_aromatic_non_catecholamine
0/1No PA
vaginal_antibiotics
0/1No PA
eye_sulfonamides
0/1No PA
urinary_ph_modifiers
0/1No PA
tx_for_adhd_selective_alpha_2_receptor_agonist
0/1No PA
hemorrheologic_agents
0/1No PA
topical_antiparasitics
0/1No PA
ophthalmic_anti_inflammatory_immunomodulator_type
0/1No PA
topical_antivirals
0/1No PA
anti_mycobacterium_agents
0/1No PA
adrenergic_vasopressor_agents
0/1No PA
lipotropics
0/1No PA
topical_anti_inflammatory_nsaids
0/1No PA
ophthalmic_antibiotics
0/1No PA
urinary_tract_anesthetic_analgesic_agnt_azo_dye
0/1No PA
antineoplastic_egf_receptor_blocker_mclon_antibody
0/1No PA
oxazolidinone_antibiotics
0/1No PA
antivirals_general
0/1No PA
mast_cell_stabilizers_orally_inhaled
0/1No PA
alpha_adrenergic_blocking_agents
0/1No PA
antifibrinolytic_agents
0/1No PA
thyroid_hormones
0/1No PA
nasal_antihistamine_and_anti_inflam_steroid_comb
0/1No PA
nsaids_cyclooxygenase_inhibitor_type_analgesics
0/1No PA
antineoplastic_topoisomerase_i_inhibitors
0/1No PA
vitamin_a_derivatives
0/1No PA
pituitary_suppressive_agents
0/1No PA
vaginal_estrogen_preparations
0/1No PA
eye_antihistamines
0/1No PA
uricosuric_agents
0/1No PA
ophthalmic_cystine_depleting_agents
0/1No PA
eye_vasoconstrictors
0/1No PA
thiazide_and_related_diuretics
0/1No PA
antineoplastic_antimetabolites
0/1No PA
antiretroviral_capsid_inhibitors_prep
0/1No PA
antibiotic_antibacterial_misc
0/1No PA
leukotriene_receptor_antagonists
0/1No PA
topical_preparations_antibacterials
0/1No PA
eye_antivirals
0/1No PA
kidney_stone_agents
0/1No PA
polymyxin_antibiotics_and_derivatives
0/1No PA
antithyroid_preparations
0/1No PA
topical_immunosuppressive_agents
0/1No PA
nasal_anti_inflammatory_steroids
0/1No PA
anti_inflammatory_pyrimidine_synthesis_inhibitor
0/1No PA
carbapenem_penem_antibiotics
0/1No PA
antivirals_hiv_specific_nucleotide_analog_rti
0/1No PA
mast_cell_stabilizers
0/2No PA
otic_preparations_anti_inflammatory_antibiotics
0/1No PA
nsaids_cyclooxygenase_2_cox_2_selective_inhibitor
0/1No PA
cephalosporin_antibiotics_2nd_generation
0/1No PA
calcimimetic_parathyroid_calcium_enhancer
0/1No PA
topical_anti_inflammatory_steroidal
0/1No PA
ear_preparations_anti_inflammatory
0/1No PA
cephalosporin_antibiotics_3rd_generation
0/1No PA
1st_gen_antihistamine_and_decongestant_combination
0/1No PA
mineralocorticoids
0/1No PA
topical_sulfonamides
0/1No PA
benign_prostatic_hypertrophy_micturition_agents
0/1No PA
absorbable_sulfonamide_antibacterial_agents
0/1No PA
antihistamines_1st_generation
0/1No PA
topical_antibiotics
0/1No PA
carbonic_anhydrase_inhibitors
0/1No PA
antineoplastic_alkylating_agents
0/1No PA
nitrofuran_derivatives_antibacterial_agents
0/1No PA
chronic_inflam_colon_dx_5_a_salicylat_rectal_tx
0/1No PA
eye_antibiotic_and_glucocorticoid_combinations
0/1No PA
potassium_sparing_diuretics_in_combination
0/1No PA
tetracycline_antibiotics
0/1No PA
hemorrhoid_prep_anti_inflam_steroid_local_anesthet
0/1No PA
mydriatics
0/1No PA
loop_diuretics
0/1No PA
steroid_antineoplastics
0/1No PA
macrolide_antibiotics
0/1No PA
anaerobic_antiprotozoal_antibacterial_agents
0/1No PA
topical_antifungals
0/1No PA
nasal_antihistamine
0/1No PA
colchicine
0/1No PA
betalactams
0/1No PA
histamine_h2_receptor_inhibitors
0/1No PA
topical_antifungal_anti_inflammatory_steroid_agent
0/1No PA
ear_preparations_misc_anti_infectives
0/1No PA
cephalosporin_antibiotics_1st_generation
0/1No PA
miotics_and_other_intraocular_pressure_reducers
0/1No PA
potassium_sparing_diuretics
0/1No PA
antineoplastic_vinca_alkaloids
0/1No PA
penicillin_antibiotics
0/1No PA
diagnostic_preparations_miscellaneous
0/1No PA
eye_anti_inflammatory_agents
0/1No PA
antineoplastics_miscellaneous
0/1No PA
2nd_gen_anaerobic_antiprotozoal_antibacterial
0/1No PA
ear_preparations_antibiotics
0/1No PA
cephalosporin_antibiotics_4th_generation
0/1No PA
2nd_gen_antihistamine_and_decongestant_combination
0/1No PA
cystine_depleting_agents_nephropathic_cystinosis
0/1No PA
lincosamide_antibiotics
0/1No PA
antitubercular_antibiotics
0/1No PA
antiprotozoal_drugs_miscellaneous
0/1No PA
antineoplastics_antibody_antibody_drug_complexes
0/1No PA
vancomycin_antibiotics_and_derivatives
0/1No PA
anthelmintics
0/3No PA
quinolone_antibiotics
0/1No PA
hepatitis_b_treatment_agents
0/1No PA
immunosuppressives
0/1No PA
antileprotics
0/1No PA
antihistamines_2nd_generation
0/1No PA
irrigants
0/1No PA
triptans
0/6No PA
cannabinoid_antiemetics
0/2No PA
bipolar_agents_lithium
0/1No PA
antigout_agents
0/1No PA
antimyasthenic_agents
0/1No PA
dental_oral_agents
0/1No PA
antimycobacterials_tb
0/1No PA
topical_steroids
0/3No PA
inflammatory_bowel_disease
0/2No PA
antihistamines
0/4No PA
alzheimers_agents
0/2No PA
contraceptives
0/3No PA
beta_blockers
0/5No PA
calcium_channel_blockers
0/5No PA
hepatitis_b_antivirals
0/1No PA
dental_products
0/1No PA
feminine_products
0/1No PA
ace_inhibitors
0/5No PA
nutritional_dietary
0/1No PA
vitamins
0/2No PA
smoking_cessation
0/1No PA
gout_agents
0/1No PA
non_opioid_analgesics
0/2No PA
salicylates
0/1No PA
antimalarials
0/2No PA
cephalosporins
0/1No PA
tetracyclines
0/1No PA
antilipemics_misc
0/1No PA
direct_renin_inhibitors
0/1No PA
vaginal_anti_infectives
0/2No PA
vitamin_d_analogs
0/1No PA
rectal_corticosteroids
0/1No PA
antibacterials_misc
0/1No PA
macrolides
0/1No PA
cns_misc
0/1No PA
gi_anticholinergics
0/1No PA
ulcer_therapy_combinations
0/1No PA
fluoroquinolones
0/1No PA
antidementia_agents
0/1No PA
fibromyalgia_agents
0/1No PA
diabetic_supplies
0/1No PA
smoking_deterrents
0/1No PA
gi_antispasmodics
0/1No PA
genitourinary_misc
0/1No PA
antitubercular_agents
0/1No PA
aldosterone_antagonists
0/1No PA
endocrine_metabolic_misc
0/1No PA
antilipemics_fibrates
0/1No PA
antivirals_systemic
0/1No PA
anti_infectives_misc
0/1No PA
alcohol_deterrents
0/1No PA
glucose_elevating_agents
0/1No PA
h2_receptor_antagonists
0/1No PA
musculoskeletal_therapy_agents
0/1No PA
phosphate_binders
0/1No PA
alpha_blockers
0/1No PA
cardiovascular_misc
0/1No PA
mood_stabilizers
0/1No PA
progestins
0/1No PA
benign_prostatic_hyperplasia
0/1No PA
antilipemics_bile_acid_resins
0/1No PA
postherpetic_neuralgia
0/1No PA
laxatives
0/2No PA
nitrates
0/1No PA
psychotherapeutic_misc
0/1No PA
antilipemics_cholesterol_absorption
0/1No PA
antiparkinsonian_agents
0/1No PA
migraine_ergotamines
0/1No PA
menopausal_symptom_agents
0/1No PA
gastrointestinal_misc
0/1No PA
dermatology_scabicides_pediculicides
0/1No PA
prenatal_vitamins
0/1No PA
ophthalmic_anti_inflammatories
0/1No PA
mouth_throat_dental_agents
0/1No PA
ophthalmic_carbonic_anhydrase_inhibitors
0/1No PA
dermatology_acne
0/1No PA
ophthalmic_antiallergics
0/1No PA
dermatology_actinic_keratosis
0/1No PA
allergenic_extracts
0/1No PA
respiratory_misc
0/1No PA
dermatology_antifungals
0/1No PA
dermatology_misc
0/1No PA
dermatology_antipruritic
0/1No PA
dermatology_rosacea
0/1No PA
dmards
0/1No PA
ophthalmic_rho_kinase_inhibitors
0/1No PA
nutritional_misc
0/1No PA
ophthalmic_anti_infectives
0/1No PA
ophthalmic_sympathomimetics
0/1No PA
dermatology_antiseborrheics
0/1No PA
cold_cough
0/1No PA
dermatology_wound_care
0/1No PA
ophthalmic_other
0/1No PA
ophthalmic_antiglaucoma_beta_blockers
0/1No PA
ophthalmic_misc
0/1No PA
anaphylaxis_treatment_agents
0/1No PA
ophthalmic_antiglaucoma_combinations
0/1No PA
ophthalmic_prostaglandins
0/1No PA
electrolytes
0/1No PA
ophthalmic_anti_infective_anti_inflammatory
0/1No PA
dermatology_antibiotics
0/1No PA
dermatology_local_anesthetics
0/1No PA
antianginal_nitrates
0/1No PA
anticoagulants_heparins
0/1No PA
anticoagulants_warfarin
0/1No PA
antimycobacterial
0/1No PA
serms
0/1No PA
hematinics_other
0/1No PA
ophthalmic_glaucoma
0/1No PA
opioid_reversal_antidotes
0/1No PA
corticosteroids_systemic
0/1No PA
antipsoriatics_topical
0/1No PA
fibromyalgia_snri
0/1No PA
vitamins_minerals
0/1No PA
antiemetics
0/1No PA
other_antihyperlipidemics
0/1No PA
antimyasthenic_cholinergic
0/1No PA
cardiotonics
0/1No PA
digestive_enzymes
0/1No PA
estrogens_progestins
0/1No PA
arni_sacubitril
0/1No PA
vasopressin_desmopressin
0/1No PA
interstitial_cystitis
0/1No PA
hemostatics
0/1No PA
antidiarrheal_probiotic
0/1No PA
other_antihypertensives
0/1No PA
smoking_alcohol_deterrents
0/1No PA
vasopressors_anaphylaxis
0/1No PA
topical_anti_infectives
0/1No PA
nutritional_metabolic
0/1No PA
mouth_throat_dental
0/1No PA
vaccines_toxoids
0/1No PA
medical_supplies_devices
0/1No PA
anorectal_rectal
0/1No PA
pharmaceutical_adjuvants
0/1No PA

PA type breakdown

clinical_criteria
340
Conditional
80
Full PA
49

Federal protected classes requiring PA

ImmunosuppressantsPA required
AntidepressantsPA required
Oral OncologyPA required
AntidepressantsPA required
AntipsychoticsPA required
ImmunosuppressantsPA required
Oral OncologyPA required
AntipsychoticsPA required

State flags

Medicaid expansion state
WISeR pilot (high data quality)
FFS-dominant (minimal MCO)

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