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Coverage / Medica / Lidoderm (lidocaine 5% patch) / Neuropathic pain

Lidoderm (lidocaine 5% patch) — Medica

Neuropathic pain

Initial criteria

Diagnosis of neuropathic pain other than radiculopathy or sciatica

Approval duration

1 year

Provenance

View official policy PDF

Plan: Medica
Drug: Lidoderm (lidocaine 5% patch)
Indication: Neuropathic pain
Last seen: 2025-10-06
Hash: 2095825cd186…

Disclaimer: Educational only. Coverage varies by employer group and formulary. Always verify with the plan.

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Disclaimer: Educational use only. Coverage varies by employer group and formulary. Always verify with the plan.

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