PLASMA-LYTE A 526/502/368/37/30 mg/100mL Injection, Solution
Also known as Sodium Chloride, Sodium Gluconate, Sodium Acetate, Potassium Chloride And Magnesium Chloride. Coverage in American Samoa (CMS PDP Region 35).
Not on any stand-alone Part D formulary in American Samoa
None of the 1 stand-alone Part D (PDP) plans in CMS PDP Region 35 list this drug. On one of those plans the patient would pay the full retail price, or you would need a formulary exception.