Tetrahydrozoline hydrochloride, dextran 70, polyethylene glycol 400, povidone 1 mg/mL / 10 mg/mL / 10 mg/mL / .5 mg/mL Medicare Part D Coverage
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Frequently Asked Questions about Tetrahydrozoline hydrochloride, dextran 70, polyethylene glycol 400, povidone
0% of Medicare Part D plans cover Tetrahydrozoline hydrochloride, dextran 70, polyethylene glycol 400, povidone. 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 Tetrahydrozoline hydrochloride, dextran 70, polyethylene glycol 400, povidone varies by plan. Compare plans to find the best tier for your medication.
0% of plans require prior authorization for Tetrahydrozoline hydrochloride, dextran 70, polyethylene glycol 400, povidone. 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 →