etodolac 400 MG Oral Tablet [Lodine]
etodolac
RxCUI: 206812
What the CMS Formulary Data Shows for etodolac 400 MG Oral Tablet [Lodine]
Per the CMS 2026 Part D formulary file, etodolac 400 MG Oral Tablet [Lodine] (RxNorm concept RXCUI 206812, generic name etodolac) appears on 1 distinct formulary file spanning 74 Medicare Part D plan offerings - 1.5% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 2 to Tier 2, with a cross-plan average of Tier 2.
Real-world access to etodolac 400 MG Oral Tablet [Lodine] depends on utilization management as much as tier placement: 0% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 99,162 Part D beneficiaries filled etodolac 400 MG Oral Tablet [Lodine] in 2023, with total plan-and-beneficiary spending of $12,880,856 and an average per-beneficiary annual cost of $129.90. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry etodolac 400 MG Oral Tablet [Lodine] today.
Coverage Details
- Formularies covering
- 1
- Plans covering
- 74
- Coverage rate
- 1.5%
- Tier range
- Tier 2, Generic
- Average tier
- Tier 2, Generic
Restrictions
- Prior authorization required
- 0% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 0% of formularies
2023 Medicare Spending
- Beneficiaries
- 99,162
- Total spending
- $12,880,856
- Avg per beneficiary
- $129.90
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering etodolac 400 MG Oral Tablet [Lodine]
74 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| SCAN Connections (HMO D-SNP) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Connections at Home (HMO D-SNP) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN NEVADA, INC. | T2 | No | $0 | NV |
| SCAN Balance (HMO C-SNP) | SCAN HEALTH PLAN NEVADA, INC. | T2 | No | $0 | NV |
| SCAN Strive (HMO C-SNP) | SCAN HEALTH PLAN NEVADA, INC. | T2 | No | $0 | NV |
| SCAN MyChoice (HMO) | SCAN HEALTH PLAN NEVADA, INC. | T2 | No | $0 | NV |
| SCAN Classic (HMO) | SCAN DESERT HEALTH PLAN, INC. | T2 | No | $0 | AZ |
| SCAN Balance (HMO C-SNP) | SCAN DESERT HEALTH PLAN, INC. | T2 | No | $0 | AZ |
| SCAN Embrace (HMO-POS I-SNP) | SCAN DESERT HEALTH PLAN, INC. | T2 | No | $0 | AZ |
| SCAN Strive (HMO C-SNP) | SCAN DESERT HEALTH PLAN, INC. | T2 | No | $0 | AZ |
| SCAN MyChoice (HMO) | SCAN DESERT HEALTH PLAN, INC. | T2 | No | $0 | AZ |
| SCAN Classic WA (HMO) | SCAN HEALTH PLAN (WA) | T2 | No | $0 | WA |
| SCAN MyChoice WA (HMO) | SCAN HEALTH PLAN (WA) | T2 | No | $0 | WA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN (NM) | T2 | No | $0 | NM |
| SCAN Balance (HMO C-SNP) | SCAN HEALTH PLAN (NM) | T2 | No | $0 | NM |
| SCAN Strive (HMO C-SNP) | SCAN HEALTH PLAN (NM) | T2 | No | $0 | NM |
| SCAN MyChoice (HMO) | SCAN HEALTH PLAN (NM) | T2 | No | $0 | NM |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Balance (HMO C-SNP) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Prime (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Balance (HMO C-SNP) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Balance (HMO C-SNP) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Alta (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Venture (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Venture (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Embrace (HMO I-SNP) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Embrace (HMO I-SNP) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Embrace (HMO-POS I-SNP) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Affirm partnered with Included LGBTQ+ Health (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Affirm partnered with Included LGBTQ+ Health (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Strive (HMO C-SNP) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Strive (HMO C-SNP) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Inspired by women for women (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Classic (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Balance (HMO C-SNP) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Balance (HMO C-SNP) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Balance (HMO C-SNP) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Balance (HMO C-SNP) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN Affirm partnered with Included LGBTQ+ Health (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN MyChoice (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN MyChoice (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
| SCAN MyChoice (HMO) | SCAN HEALTH PLAN | T2 | No | $0 | CA |
Frequently Asked Questions
Is etodolac 400 MG Oral Tablet [Lodine] covered by Medicare Part D?
Yes, etodolac 400 MG Oral Tablet [Lodine] is covered by 74 Medicare Part D plans (1.5% of all Part D formularies).
What tier is etodolac 400 MG Oral Tablet [Lodine] on Medicare Part D plans?
etodolac 400 MG Oral Tablet [Lodine] averages Tier 2 across Part D plans, ranging from Tier 2 to Tier 2.
Does etodolac 400 MG Oral Tablet [Lodine] require prior authorization?
0% of Part D formularies require prior authorization for etodolac 400 MG Oral Tablet [Lodine]. Step therapy: 0%. Quantity limits: 0%.
How much does Medicare spend on etodolac 400 MG Oral Tablet [Lodine]?
In 2023, total Medicare Part D spending on etodolac 400 MG Oral Tablet [Lodine] was $12,880,856, covering 99,162 beneficiaries. The average spend per beneficiary was $129.90.
Read our methodology - how this data is sourced, computed, and verified.