MedicarePartD.guide

A non-government resource built from CMS public data

GOLYTELY 236/22.74/6.74/5.86/2.97 g/4L Powder, For Solution

Also known as Polyethylene Glycol 3350, Sodium Sulfate Anhydrous, Sodium Bicarbonate, Sodium Chloride, Potassium Chloride. Coverage in Hawaii (CMS PDP Region 33).

Not on any stand-alone Part D formulary in Hawaii

None of the 8 stand-alone Part D (PDP) plans in CMS PDP Region 33 list this drug. On one of those plans the patient would pay the full retail price, or you would need a formulary exception.

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