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 Idaho and Utah (CMS PDP Region 31).
Not on any stand-alone Part D formulary in Idaho and Utah
None of the 10 stand-alone Part D (PDP) plans in CMS PDP Region 31 list this drug. On one of those plans the patient would pay the full retail price, or you would need a formulary exception.
28 Medicare Advantage plans in ID, UT do cover it
Medicare Advantage plans carry their own formularies, separate from stand-alone Part D. A patient on an MA-PD plan may have coverage even where no PDP lists the drug. ID: 12 plans · UT: 16 plans.