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PEG-3350, ELECTROLYTES, AND ASCORBATE Kit
Also known as Polyethylene Glycol 3350, Sodium Sulfate, Sodium Chloride, Potassium Chloride, Sodium Ascorbate, And Ascorbic Acid. Coverage in Guam (CMS PDP Region 36).
Not on any stand-alone Part D formulary in Guam
None of the 1 stand-alone Part D (PDP) plans in CMS PDP Region 36 list this drug. On one of those plans the patient would pay the full retail price, or you would need a formulary exception.