Medicare Part D coverage · dibasic potassium phosphate · RxCUI 800812

dibasic potassium phosphate 0.26 MG/ML / glucose 50 MG/ML / magnesium chloride 0.00373 MEQ/ML / potassium chloride 0.00174 MEQ/ML / sodium acetate 0.039 MEQ/ML Injectable Solution [Isolyte P]

Per the CMS 2026 Part D formulary file, dibasic potassium phosphate 0.26 MG/ML / glucose 50 MG/ML / magnesium chloride 0.00373 MEQ/ML / potassium chloride 0.00174 MEQ/ML / sodium acetate 0.039 MEQ/ML Injectable Solution [Isolyte P] is covered by 3,506 Medicare Part D plans (69.4% of enrollable products), averaging Tier 3.4, with prior authorization required on 1.9% of covering formularies.

69.4%
Plan coverage
3,506
Plans covering
T3.4
Avg tier
1.9%
Prior auth required

Verify with CMS →

Important: Drug coverage and costs vary by plan and location. Verify coverage directly with your Medicare plan before filling a prescription. This is informational data only and should not replace advice from your healthcare provider or pharmacist.

What the CMS Formulary Data Shows for dibasic potassium phosphate 0.26 MG/ML / glucose 50 MG/ML / magnesium chloride 0.00373 MEQ/ML / potassium chloride 0.00174 MEQ/ML / sodium acetate 0.039 MEQ/ML Injectable Solution [Isolyte P]

Per the CMS 2026 Part D formulary file, dibasic potassium phosphate 0.26 MG/ML / glucose 50 MG/ML / magnesium chloride 0.00373 MEQ/ML / potassium chloride 0.00174 MEQ/ML / sodium acetate 0.039 MEQ/ML Injectable Solution [Isolyte P] (RxNorm concept RXCUI 800812, generic name dibasic potassium phosphate) appears on 158 distinct formulary files spanning 3,506 Medicare Part D plan offerings - 69.4% of enrollable Part D products, mid-range placement; shopping across contracts changes access. Tier placement ranges from Tier 1 to Tier 6, with a cross-plan average of Tier 3.4.

Real-world access to dibasic potassium phosphate 0.26 MG/ML / glucose 50 MG/ML / magnesium chloride 0.00373 MEQ/ML / potassium chloride 0.00174 MEQ/ML / sodium acetate 0.039 MEQ/ML Injectable Solution [Isolyte P] depends on utilization management as much as tier placement: 1.9% of covering formularies require prior authorization. 0% require step therapy. 0% apply quantity limits.

Medicare Part D spending dashboard figures are not published for this drug. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry dibasic potassium phosphate 0.26 MG/ML / glucose 50 MG/ML / magnesium chloride 0.00373 MEQ/ML / potassium chloride 0.00174 MEQ/ML / sodium acetate 0.039 MEQ/ML Injectable Solution [Isolyte P] today.

Coverage Details

Formularies covering
158
Plans covering
3,506
Coverage rate
69.4%
Tier range
Tier 1 – Tier 6
Average tier
Tier 3, Preferred Brand

Restrictions

Prior authorization required
1.9% of formularies
Step therapy required
0% of formularies
Quantity limits
0% of formularies

Tier Distribution Across Plans

48 plans
Tier 1, Preferred Generic
44 plans
Tier 2, Generic
8 plans
Tier 3, Preferred Brand

Medicare Advantage Plans (MA-PD) Covering dibasic potassium phosphate 0.26 MG/ML / glucose 50 MG/ML / magnesium chloride 0.00373 MEQ/ML / potassium chloride 0.00174 MEQ/ML / sodium acetate 0.039 MEQ/ML Injectable Solution [Isolyte P]

100 Medicare Advantage plans with Part D drug coverage include this drug.

Plan Insurer Tier PA Premium States
Sentara Community Complete Select (HMO D-SNP) Sentara Health Plans T1 No $0 VA
Sentara Community Complete (HMO D-SNP) Sentara Health Plans T1 No $0 VA
Florida Complete Care-Duals VIP (HMO-POS D-SNP) Hpmp OF Florida, Inc. T1 No $0 FL
ElderServe MAP (HMO D-SNP) Elderserve Health, Inc. T1 No $0 NY
Cooperative Advantage (HMO D-SNP) Group Health Cooperative OF EAU Claire T1 No $0 WI
Longevity Health Plan (PPO I-SNP) Longevity Health Plan OF NEW Jersey Insurance Comp T1 No $0 NJ
Mercy Care Advantage (HMO D-SNP) Mercy Care T1 No $0 AZ
Mercy Care Advantage (HMO D-SNP) Mercy Care T1 No $0 AZ
Mercy Care Advantage (HMO D-SNP) Mercy Care T1 No $0 AZ
Elderplan Plus Long-Term Care (HMO-POS D-SNP) Elderplan, Inc. T1 No $0 NY
Health Choice Pathway (HMO D-SNP) Health Choice Arizona, Inc. T1 No $0 AZ
Healthfirst CompleteCare (HMO D-SNP) Healthfirst Health Plan, Inc. T1 No $0 NY
IMCare Classic (HMO D-SNP) Itasca Medical Care T1 No $0 MN
Johns Hopkins Advantage MD D-SNP (HMO D-SNP) Hopkins Health Advantage, Inc. T1 No $0 MD
MetroPlus UltraCare (HMO D-SNP) Metroplus Health Plan, Inc. T1 No $0 NY
Upper Peninsula Health Plan MI Coordinated Health (HMO D-SNP) Upper Peninsula Health Plan, LLC T1 No $0 MI
CareSource Dual Advantage (HMO D-SNP) Caresource Georgia Co. T1 No $0 GA
Senior Whole Health SCO (HMO D-SNP) Senior Whole Health, LLC T1 No $0 MA
Senior Whole Health SCO NHC (HMO D-SNP) Senior Whole Health, LLC T1 No $0 MA
Molina One Care (HMO D-SNP) Senior Whole Health, LLC T1 No $0 MA
Show the next 30 plans
HAP CareSource MI Coordinated Health (HMO D-SNP) HAP Caresource T1 No $0 MI
NaviCare (HMO D-SNP) Fallon Community Health Plan T1 No $0 MA
SeniorCare Complete (HMO D-SNP) South Country Health Alliance T1 No $0 MN
AbilityCare (HMO D-SNP) South Country Health Alliance T1 No $0 MN
Alameda Alliance Wellness (HMO D-SNP) Alameda Alliance FOR Health T1 No $0 CA
CCA One Care (HMO D-SNP) Commonwealth Care Alliance, Inc. T1 No $0 MA
CCA Senior Care Options (HMO D-SNP) Commonwealth Care Alliance, Inc. T1 No $0 MA
Community Care's Partnership Program (HMO D-SNP) Community Care Health Plan, Inc. T1 No $0 WI
Mass General Brigham SCO (HMO D-SNP) Mass General Brigham Health Plan, Inc T1 No $0 MA
Mass General Brigham One Care (HMO D-SNP) Mass General Brigham Health Plan, Inc T1 No $0 MA
Florida Complete Care (HMO I-SNP) Hpmp OF Florida, Inc. T1 No $4.80 FL
Florida Complete Care- In The Community (HMO-POS I-SNP) Hpmp OF Florida, Inc. T1 No $4.80 FL
Longevity Health Plan (HMO I-SNP) Longevity Health Plan OF Florida, Inc. T1 No $4.80 FL
Gold Dialysis & Kidney Complete (HMO-POS C-SNP) Gold Kidney OF Florida Inc T1 No $4.80 FL
Longevity Health Plan (HMO I-SNP) Longevity Health Plan OF Michigan, Inc. T1 No $8.80 MI
Longevity Health Plan (HMO I-SNP) Longevity Health Plan OF Illinois, Inc. T1 No $15.20 IL
Gold Dialysis & Kidney Complete (HMO-POS C-SNP) Gold Kidney OF Arizona T1 No $17.00 AZ
WellSense Added Value (HMO) Boston Medical Center Health Plan, Inc. T1 No $21.70 NH
Elderplan For Medicaid Beneficiaries (HMO-POS D-SNP) Elderplan, Inc. T1 No $22.70 NY
VIVA Medicare Extra Value (HMO D-SNP) Viva Health, Inc. T1 No $27.70 AL
VIVA Medicare Extra Care (HMO D-SNP) Viva Health, Inc. T1 No $27.70 AL
Longevity Health Plan (HMO I-SNP) Longevity Health Plan OF Colorado, Inc. T1 No $35.20 CO
Longevity Health Plan (HMO I-SNP) Longevity Health Plan OF North Carolina, Inc. T1 No $36.20 NC
Longevity Health Plan (PPO I-SNP) Longevity Health Plan OF NEW Jersey Insurance Comp T1 No $40.00 NJ
Elderplan Advantage For Nursing Home Residents (HMO-POS I-SNP) Elderplan, Inc. T1 No $44.80 NY
ElderServe Star (HMO I-SNP) Elderserve Health, Inc. T1 No $58.80 NY
Longevity Health Plan (HMO I-SNP) Longevity Health Plan OF NEW York, Inc. T1 No $58.80 NY
MetroPlus Platinum Plan (HMO) Metroplus Health Plan, Inc. T1 No $58.80 NY
Freedom VIP Care (HMO C-SNP) Freedom Health, Inc. T2 No $0 FL
Freedom VIP Savings (HMO C-SNP) Freedom Health, Inc. T2 No $0 FL

Showing top 50 of 100 plans.

Frequently Asked Questions

Is dibasic potassium phosphate 0.26 MG/ML / glucose 50 MG/ML / magnesium chloride 0.00373 MEQ/ML / potassium chloride 0.00174 MEQ/ML / sodium acetate 0.039 MEQ/ML Injectable Solution [Isolyte P] covered by Medicare Part D?

Yes, dibasic potassium phosphate 0.26 MG/ML / glucose 50 MG/ML / magnesium chloride 0.00373 MEQ/ML / potassium chloride 0.00174 MEQ/ML / sodium acetate 0.039 MEQ/ML Injectable Solution [Isolyte P] is covered by 3,506 Medicare Part D plans (69.4% of all Part D formularies).

What tier is dibasic potassium phosphate 0.26 MG/ML / glucose 50 MG/ML / magnesium chloride 0.00373 MEQ/ML / potassium chloride 0.00174 MEQ/ML / sodium acetate 0.039 MEQ/ML Injectable Solution [Isolyte P] on Medicare Part D plans?

dibasic potassium phosphate 0.26 MG/ML / glucose 50 MG/ML / magnesium chloride 0.00373 MEQ/ML / potassium chloride 0.00174 MEQ/ML / sodium acetate 0.039 MEQ/ML Injectable Solution [Isolyte P] averages Tier 3.4 across Part D plans, ranging from Tier 1 to Tier 6.

Does dibasic potassium phosphate 0.26 MG/ML / glucose 50 MG/ML / magnesium chloride 0.00373 MEQ/ML / potassium chloride 0.00174 MEQ/ML / sodium acetate 0.039 MEQ/ML Injectable Solution [Isolyte P] require prior authorization?

1.9% of Part D formularies require prior authorization for dibasic potassium phosphate 0.26 MG/ML / glucose 50 MG/ML / magnesium chloride 0.00373 MEQ/ML / potassium chloride 0.00174 MEQ/ML / sodium acetate 0.039 MEQ/ML Injectable Solution [Isolyte P]. Step therapy: 0%. Quantity limits: 0%.

Nationwide similar Part D drugs

Data-derived peers across the CMS Part D formulary extract: nearest average tier placement and nearest prior-authorization rate. Not therapeutic alternatives or same-generic strengths.

Data sourced from the Centers for Medicare & Medicaid Services (CMS). See our methodology for details. Retrieved and formatted by PlainMedicare