Drug Coverage Lookup
See how a prescription drug is placed across Medicare Part D plan formularies — tier, prior authorization, step therapy, and quantity limits, counted per unique plan.
Accucaine (Lidocaine)
Amide Local Anesthetic
Found on the formularies of 5499 of 5499 Medicare Part D plans in this dataset · Tiers 1–4 · prior authorization on 4547 plans (83%) · quantity limits on 5352 (97%), counting a plan when at least one form/strength carries the flag.
This is dataset-wide formulary placement (data current through 2026-08-31) — check your specific plan for its current coverage and restrictions.
| Plan | Tier | Prior Auth | Step Therapy | Qty Limit |
|---|---|---|---|---|
| Hamaspik Medicare Choice (HMO D-SNP) (H0034-002) (NY) | Tier 1 | Yes | No | 90 per 30 days |
| UHC Dual Complete IA-S001 (HMO-POS D-SNP) (H0169-001) (IA) | Tiers 1–4 | Yes | No | 90 per 30 days |
| UHC Dual Complete MO-S001 (HMO-POS D-SNP) (H0169-002) (MO) | Tiers 1–4 | Yes | No | 90 per 30 days |
| UHC Dual Complete NE-S001 (HMO-POS D-SNP) (H0169-003) (NE) | Tiers 1–4 | Yes | No | 90 per 30 days |
| UHC Dual Complete KS-S001 (HMO-POS D-SNP) (H0169-004) (KS) | Tiers 1–4 | Yes | No | 90 per 30 days |
| UHC Dual Complete MO-S3 (HMO-POS D-SNP) (H0169-009) (MO) | Tiers 1–4 | Yes | No | 90 per 30 days |
| UHC Dual Complete KS-Q1 (HMO-POS D-SNP) (H0169-010) (KS) | Tiers 1–4 | Yes | No | 90 per 30 days |
| UHC Dual Complete TN-S001 (HMO-POS D-SNP) (H0251-002) (TN) | Tiers 1–4 | Yes | No | 90 per 30 days |
| UHC Dual Complete TN-Y001 (HMO-POS D-SNP) (H0251-004) (TN) | Tiers 1–4 | Yes | No | 90 per 30 days |
| UHC Dual Complete TN-Y2 (HMO-POS D-SNP) (H0251-008) (TN) | Tiers 1–4 | Yes | No | 90 per 30 days |
| UHC Complete Care WI-1 (PPO C-SNP) (H0294-002) (WI) | Tiers 1–4 | Yes | No | 90 per 30 days |
| AARP Medicare Advantage from UHC MI-0001 (PPO) (H0294-017) (MI) | Tiers 1–4 | Yes | No | 90 per 30 days |
| UHC Dual Complete NM-Y1 (PPO D-SNP) (H0294-049) (NM) | Tiers 1–4 | Yes | No | 90 per 30 days |
| UHC Dual Complete NM-S1 (PPO D-SNP) (H0294-050) (NM) | Tiers 1–4 | Yes | No | 90 per 30 days |
| UHC Dual Complete NM-V1 (PPO D-SNP) (H0294-051) (NM) | Tiers 1–4 | Yes | No | 90 per 30 days |
| UHC Dual Complete AZ-S001 (HMO-POS D-SNP) (H0321-002) (AZ) | Tiers 1–4 | Yes | No | 90 per 30 days |
| UHC Dual Complete AZ-Y001 (HMO-POS D-SNP) (H0321-004) (AZ) | Tiers 1–4 | Yes | No | 90 per 30 days |
| HealthSpring Preferred (HMO) (H0354-001) (AZ) | Tiers 1–4 | Yes | No | 90 per 30 days |
| HealthSpring Achieve (HMO C-SNP) (H0354-027) (AZ) | Tiers 1–4 | Yes | No | 90 per 30 days |
| HealthSpring Alliance (HMO) (H0354-028) (AZ) | Tiers 1–4 | Yes | No | 90 per 30 days |
| HealthSpring Preferred Savings (HMO) (H0354-029) (AZ) | Tiers 1–4 | Yes | No | 90 per 30 days |
| HealthSpring Preferred Full Savings (HMO) (H0354-030) (AZ) | Tiers 1–4 | Yes | No | 90 per 30 days |
| UHC Dual Complete VA-Y4 (PPO D-SNP) (H0421-001) (VA) | Tiers 1–4 | Yes | No | 90 per 30 days |
| MetroPlus UltraCare (HMO D-SNP) (H0423-007) (NY) | Tier 1 | Yes | No | 50 per 30 days |
| AARP Medicare Advantage from UHC AL-0001 (HMO-POS) (H0432-003) (AL) | Tiers 1–4 | Yes | No | 90 per 30 days |
One row per plan — showing 25 of 5499 plans; a Yes means the flag applies to at least one form/strength on that plan.
Acquisition cost (NADAC): $0.06882/unit — price effective 10/21/2026
Source: CMS Monthly Prescription Drug Plan Formulary and Pharmacy Network Information — data current through 2026-08-31 (CMS release 2026-08-26, refreshed monthly) · a newer CMS release may be available — this dataset is more than 2 months old · NADAC price effective 10/21/2026 (per-NDC last change, not a data-staleness date). Dataset-wide plan-year formulary placement, not a guarantee of your individual benefit — confirm with your plan or pharmacist.
Data: CMS Monthly Part D formulary files · FDA/RxNorm drug identity · CMS NADAC pricing — CMS Part D formulary data current through 2026-08-31 · source
GET https://insurewith.ai/tools/drug-coverage/data.json?drug=lidocaine