Kcl/D5W/Nacl

0.9% — Injection

.25%, .5%

Also known as: KCL/D5W/NACL INJ KCL/D5W/NACL INJ 0.3/0.9% KCL/D5W/NACL INJ 0.15/0.2 KCL/D5W/NACL INJ 0.15/0.9 KCL/D5W/NACL INJ 0.3/0.45

Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 20 hours, 34 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 80/20 Plus PPO 2026 Tier 3 - Non-Preferred Brand None
NC State Health Plan - 70/30 Standard PPO 2026 Tier 3 - Non-Preferred Brand None
NC State Health Plan - HDHP 2026 Tier 3 - Non-Preferred Brand None
Something not right?