POTASSIUM CHLORIDE IN LACTATED RINGERS AND DEXTROSE 5/600/310/179/20 g/100mL/mg/100mL Injection, Solution
Also known as Dextrose Monohydrate, Sodium Chloride, Sodium Lactate, Potassium Chloride, Calcium Chloride. Coverage in Florida (CMS PDP Region 11).
2 of 10 stand-alone Part D plans in Florida cover this drug on tier 4.
No plan applies a prior authorization, step therapy or quantity limit.
335 Medicare Advantage plans in FL 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. FL: 335 plans.
Every plan that covers it
| Plan | Tier | 30-day preferred | 90-day mail | Unit cost | Est. 30-day fill | Restrictions |
|---|---|---|---|---|---|---|
| AARP Medicare Rx Saver from UHC (PDP)$98.70/mo premium · $615.00 deductible | 4Non-Preferred Drug | 35% | — | $0.0104 | — | None |
| AARP Medicare Rx Preferred from UHC (PDP)$119.10/mo premium · $130.00 deductible | 4Non-Preferred Drug | 34% | — | $0.0104 | — | None |
Cost-sharing is the initial coverage phase at a preferred pharmacy; a percentage is coinsurance of the plan’s negotiated price, and the deductible may apply first. CMS publishes a negotiated price per unit, so the 30-day fill is shown only where the plan’s own quantity limit supplies the quantity.