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Polyethylene glycol 400, Tetrahydrozoline HCl 1 g/100mL / .05 g/100mL Medicare Part D Coverage

Brand name: Code Red Eye Drops Redness Relief
Dosage form
SOLUTION/ DROPS
Route
OPHTHALMIC
0%
of Medicare Part D plans
cover Polyethylene glycol 400, Tetrahydrozoline HCl

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Frequently Asked Questions about Polyethylene glycol 400, Tetrahydrozoline HCl

0% of Medicare Part D plans cover Polyethylene glycol 400, Tetrahydrozoline HCl. 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 Polyethylene glycol 400, Tetrahydrozoline HCl varies by plan. Compare plans to find the best tier for your medication.

0% of plans require prior authorization for Polyethylene glycol 400, Tetrahydrozoline HCl. 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 →