lidocaine 0.018 MG/MG Medicated Patch [ZTlido]

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lidocaine

RxCUI: 2001439

Important: Drug coverage and costs vary by plan and location. Verify coverage directly with your Medicare plan before filling a prescription. This is informational data only and should not replace advice from your healthcare provider or pharmacist.
9.5%
Plan Coverage
483
Plans Covering
T2.8
Avg Tier
93.9%
Prior Auth Required

What the CMS Formulary Data Shows for lidocaine 0.018 MG/MG Medicated Patch [ZTlido]

Per the CMS 2026 Part D formulary file, lidocaine 0.018 MG/MG Medicated Patch [ZTlido] (RxNorm concept RXCUI 2001439, generic name lidocaine) appears on 82 distinct formulary files spanning 483 Medicare Part D plan offerings - 9.5% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.8.

Real-world access to lidocaine 0.018 MG/MG Medicated Patch [ZTlido] depends on utilization management as much as tier placement: 93.9% of covering formularies require prior authorization. 0% require step therapy. 100% apply quantity limits.

Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 481,042 Part D beneficiaries filled lidocaine 0.018 MG/MG Medicated Patch [ZTlido] in 2023, with total plan-and-beneficiary spending of $179,454,361 and an average per-beneficiary annual cost of $373.05. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry lidocaine 0.018 MG/MG Medicated Patch [ZTlido] today.

Coverage Details

Formularies covering
82
Plans covering
483
Coverage rate
9.5%
Tier range
Tier 1 – Tier 4
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
93.9% of formularies
Step therapy required
0% of formularies
Quantity limits
100% of formularies

2023 Medicare Spending

Beneficiaries
481,042
Total spending
$179,454,361
Avg per beneficiary
$373.05

Tier Distribution Across Plans

30 plans
Tier 1, Preferred Generic
4 plans
Tier 2, Generic
66 plans
Tier 3, Preferred Brand

Medicare Advantage Plans (MA-PD) Covering lidocaine 0.018 MG/MG Medicated Patch [ZTlido]

100 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
Gold Coast Health Plan Total Care Advantage (HMO D-SNP) Ventura County Medi-Cal Managed Care Commission T1 Yes $0 CA
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) Health Care Service Corporation T1 Yes $0 NM
Blue Cross MA Dual Care Plus Preferred (PPO D-SNP) Health Care Service Corporation T1 Yes $0 NM
SecureBlue (HMO D-SNP) HMO Minnesota T1 Yes $0 MN
Hamaspik Medicare Choice (HMO D-SNP) HAMASPIK, INC. T1 Yes $0 NY
SeniorCare Complete (HMO D-SNP) SOUTH COUNTRY HEALTH ALLIANCE T1 Yes $0 MN
AbilityCare (HMO D-SNP) SOUTH COUNTRY HEALTH ALLIANCE T1 Yes $0 MN
Alameda Alliance Wellness (HMO D-SNP) ALAMEDA ALLIANCE FOR HEALTH T1 Yes $0 CA
Elevate Medicare Choice (HMO D-SNP) DENVER HEALTH MEDICAL PLAN, INC. T1 Yes $0 CO
AllCare Advantage Redwood Rx (HMO D-SNP) ALLCARE HEALTH PLAN, INC. T1 Yes $0 OR
PrimeWest Senior Health Complete (HMO D-SNP) PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE T1 Yes $0 MN
Prime Health Complete (HMO D-SNP) PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE T1 Yes $0 MN
Alterwood Advantage Dual Secure (HMO D-SNP) ALTERWOOD ADVANTAGE, INC. T1 Yes $0 MD
Nascentia Dual Advantage (HMO D-SNP) VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK T1 Yes $0 NY
Abilis Health Community (HMO I-SNP) SIGNATURE ADVANTAGE, LLC T1 No $0 KY, TN
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) HCSC INSURANCE SERVICES COMPANY T1 Yes $4.80 TX
Gold Dialysis & Kidney Complete (HMO-POS C-SNP) GOLD KIDNEY OF FLORIDA INC T1 Yes $4.80 FL
Texas Independence Health Plan, Inc. (HMO I-SNP) TEXAS INDEPENDENCE HEALTH PLAN, INC. T1 No $4.80 TX
Texas Independence Community Plan (HMO I-SNP) TEXAS INDEPENDENCE HEALTH PLAN, INC. T1 No $4.80 TX
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) GHS INSURANCE COMPANY T1 Yes $5.00 OK
ATRIO Special Needs Plan (HMO D-SNP) ATRIO HEALTH PLANS T1 Yes $10.50 OR
ATRIO Special Needs Plan (HMO D-SNP) ATRIO HEALTH PLANS T1 Yes $10.50 OR
Gold Dialysis & Kidney Complete (HMO-POS C-SNP) GOLD KIDNEY OF ARIZONA T1 Yes $17.00 AZ
Alterwood Advantage Dual Value (HMO D-SNP) ALTERWOOD ADVANTAGE, INC. T1 Yes $31.20 MD
Valor Health Plan (HMO I-SNP) TSG GUARD, INC. T1 No $31.40 OH
WV Senior Advantage (HMO I-SNP) WEST VIRGINIA SENIOR ADVANTAGE, INC. T1 No $32.70 WV
Hamaspik Medicare Select (HMO D-SNP) HAMASPIK, INC. T1 Yes $34.50 NY
Abilis Health (HMO I-SNP) SIGNATURE ADVANTAGE, LLC T1 No $35.90 KY, TN
CommuniCare Advantage ISNP (HMO I-SNP) OH CHS SNP INC. T1 No $38.40 IN, MD, OH
Nascentia Skilled Nursing Facility (HMO I-SNP) VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK T1 Yes $58.80 NY
PHP (HMO C-SNP) AIDS HEALTHCARE FOUNDATION T2 Yes $0 CA
DualConnect (HMO D-SNP) SANTA CLARA COUNTY HEALTH AUTHORITY T2 Yes $0 CA
VNS Health Total (HMO D-SNP) VNS CHOICE T2 Yes $0 NY
VNS Health EasyCare Plus (HMO D-SNP) VNS CHOICE T2 Yes $51.60 NY
CenCal CareConnect (HMO D-SNP) SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA T3 Yes $0 CA
SummaCare Medicare Topaz (HMO) SUMMACARE INC. T3 Yes $0 OH
SummaCare Medicare Quartz (HMO) SUMMACARE INC. T3 Yes $0 OH
IEHP DualChoice (HMO D-SNP) Inland Empire Health Plan T3 Yes $0 CA
Astiva Health Savings Plan (HMO) ASTIVA HEALTH, INC. T3 Yes $0 CA
Astiva Health C-SNP Deluxe (HMO C-SNP) ASTIVA HEALTH, INC. T3 Yes $0 CA
Astiva Health Savings Plan - NorCal (HMO) ASTIVA HEALTH, INC. T3 Yes $0 CA
Astiva Health Premier Plan - NorCal (HMO) ASTIVA HEALTH, INC. T3 Yes $0 CA
Astiva Health Premier Plan (HMO) ASTIVA HEALTH, INC. T3 Yes $0 CA
ATRIO Prime Rx (HMO) ATRIO HEALTH PLANS T3 Yes $0 OR
ATRIO Choice Rx (PPO) ATRIO HEALTH PLANS T3 Yes $0 OR
ATRIO Choice Rx (PPO) ATRIO HEALTH PLANS T3 Yes $0 OR
ATRIO Prime Rx (PPO) ATRIO HEALTH PLANS T3 Yes $0 OR
ATRIO Prime Rx (PPO) ATRIO HEALTH PLANS T3 Yes $0 OR
ATRIO Prime Rx (PPO) ATRIO HEALTH PLANS T3 Yes $0 OR
ATRIO Choice Rx (PPO) ATRIO HEALTH PLANS T3 Yes $0 OR

Frequently Asked Questions

Is lidocaine 0.018 MG/MG Medicated Patch [ZTlido] covered by Medicare Part D?

Yes, lidocaine 0.018 MG/MG Medicated Patch [ZTlido] is covered by 483 Medicare Part D plans (9.5% of all Part D formularies).

What tier is lidocaine 0.018 MG/MG Medicated Patch [ZTlido] on Medicare Part D plans?

lidocaine 0.018 MG/MG Medicated Patch [ZTlido] averages Tier 2.8 across Part D plans, ranging from Tier 1 to Tier 4.

Does lidocaine 0.018 MG/MG Medicated Patch [ZTlido] require prior authorization?

93.9% of Part D formularies require prior authorization for lidocaine 0.018 MG/MG Medicated Patch [ZTlido]. Step therapy: 0%. Quantity limits: 100%.

How much does Medicare spend on lidocaine 0.018 MG/MG Medicated Patch [ZTlido]?

In 2023, total Medicare Part D spending on lidocaine 0.018 MG/MG Medicated Patch [ZTlido] was $179,454,361, covering 481,042 beneficiaries. The average spend per beneficiary was $373.05.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare Editorial