Adenosinum Triphosphoricum Dinatrum, Benzoicum Acidum, Cholinum, Cinnamic Acid, Eugenol, Folic Acid, Formalinum, Histaminum Hydrochloricum, L-Asparagine (Monohydrate), Lac Defloratum, Lac Vaccinum, Me 8 [hp_X]/mL / 6 [hp_C]/mL / 4 [hp_X]/mL / 6 [hp_X]/mL / 6 [hp_X]/mL / 6 [hp_C]/mL / 6 [hp_C]/mL / 6 Medicare Part D Coverage
cover Adenosinum Triphosphoricum Dinatrum, Benzoicum Acidum, Cholinum, Cinnamic Acid, Eugenol, Folic Acid, Formalinum, Histaminum Hydrochloricum, L-Asparagine (Monohydrate), Lac Defloratum, Lac Vaccinum, Me
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Frequently Asked Questions about Adenosinum Triphosphoricum Dinatrum, Benzoicum Acidum, Cholinum, Cinnamic Acid, Eugenol, Folic Acid, Formalinum, Histaminum Hydrochloricum, L-Asparagine (Monohydrate), Lac Defloratum, Lac Vaccinum, Me
0% of Medicare Part D plans cover Adenosinum Triphosphoricum Dinatrum, Benzoicum Acidum, Cholinum, Cinnamic Acid, Eugenol, Folic Acid, Formalinum, Histaminum Hydrochloricum, L-Asparagine (Monohydrate), Lac Defloratum, Lac Vaccinum, Me. Coverage varies by plan and geographic area.
Costs vary by plan. Enter your ZIP code above to see exact prices for plans in your area.
The tier placement for Adenosinum Triphosphoricum Dinatrum, Benzoicum Acidum, Cholinum, Cinnamic Acid, Eugenol, Folic Acid, Formalinum, Histaminum Hydrochloricum, L-Asparagine (Monohydrate), Lac Defloratum, Lac Vaccinum, Me varies by plan. Compare plans to find the best tier for your medication.
0% of plans require prior authorization for Adenosinum Triphosphoricum Dinatrum, Benzoicum Acidum, Cholinum, Cinnamic Acid, Eugenol, Folic Acid, Formalinum, Histaminum Hydrochloricum, L-Asparagine (Monohydrate), Lac Defloratum, Lac Vaccinum, Me. Prior authorization means your doctor must confirm the drug is medically necessary before the plan will cover it.
Coverage statistics based on CMS formulary data for plan year 2026. Data updated regularly. Methodology →