Plasma-Lyte A
Generic: Sodium Chloride, Sodium Gluconate, Sodium Acetate, Potassium Chloride and Magnesium Chloride
- Manufacturer
- Baxter
- NDC
- 0338-9591
- RxCUI
- 801109
- Route
- INTRAVENOUS
- ICD-10 indication
- E87.8
Affordability Check
How much will you actually pay for Plasma-Lyte A?
In 30 seconds, see every legitimate way to afford Plasma-Lyte A — Medicare copay, manufacturer copay card, Patient Assistance Program, grants, or cash.
About Plasma-Lyte A
What is this medication?
Plasma-Lyte A is a sterile, nonpyrogenic isotonic solution intended for intravenous administration. It is a specific type of electrolyte replacement fluid that contains a balanced mixture of sodium chloride, potassium chloride, magnesium chloride, sodium acetate, and sodium gluconate. Because its chemical composition and pH level are designed to closely resemble the natural makeup of human blood plasma, it is often referred to as a balanced crystalloid solution.
Medical professionals typically prescribe this medication to restore fluid and electrolyte balance in patients who are dehydrated or undergoing surgery. It is commonly used as a source of water and electrolytes or as an alkalinizing agent to treat conditions like metabolic acidosis. By providing necessary minerals and helping to stabilize the body's acid-base balance, it supports vital physiological functions during periods of physical stress or illness.
Copay & patient assistance
Detailed copay and financial assistance information is not publicly available for this medication at this time. Please consult your pharmacist or the manufacturer's official patient support program for more details.
External links go directly to the manufacturer's portal. RxCopays does not receive compensation for referrals.
Compare pricing elsewhere
RxCopays doesn't sell drugs or take referral fees. Here are the transparent-pricing directories we recommend checking alongside your insurance formulary.
Cost Plus Drug Company
Mark Cuban's transparent-pricing pharmacy — manufacturer cost + 15% markup + $5 dispensing fee. No insurance needed. Search alphabetically for Sodium Chloride, Sodium Gluconate, Sodium Acetate, Potassium Chloride and Magnesium Chloride.
Browse Cost Plus medications →
GoodRx
Compare local pharmacy prices with GoodRx coupons. Use the price with your insurance or without — whichever is cheaper.
Lookup Plasma-Lyte A →
NeedyMeds
Independent nonprofit directory of patient assistance programs, copay cards, and charity co-pay foundations.
Search for Sodium Chloride, Sodium Gluconate, Sodium Acetate, Potassium Chloride and Magnesium Chloride →
RxAssist
PAP directory maintained by Volunteers in Health Care at Brown University. Free, no ads.
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Conditions we've indexed resources for
Click a condition to see copay cards, grants, and PA rules specific to it. For the full list of FDA-approved indications, see Prescribing information above.
Medicare Part D coverage
How Plasma-Lyte A appears across Medicare Part D plan formularies nationally. Source: CMS monthly Prescription Drug Plan file (2026-04-30).
Covered by plans
21%
1,161 of 5,509 plans
Most common tier
Tier 4
On 46% of covering formularies
Prior authorization required
9%
of covering formularies
| Tier | Formularies on this tier | Share |
|---|---|---|
| Tier 1 (preferred generic) | 3 | 9% |
| Tier 2 (generic) | 5 | 14% |
| Tier 3 (preferred brand) | 11 | 31% |
| Tier 4 (non-preferred brand) | 16 | 46% |
Step therapy: 0% of formularies
Quantity limits: 0% of formularies
Coverage breadth: 35 of 65 formularies
How to read this:plans on the same formulary share tier + PA rules. Your specific plan's copay depends on (a) the tier above, (b) your plan's cost-share for that tier, (c) whether you're in the initial coverage phase or past the 2026 $2,000 out-of-pocket cap. For your exact plan, check its Summary of Benefits or log in to your Medicare.gov account. Copay cards don't apply to Medicare (federal law).
Prior authorization & coverage
| Payer | PA | Step therapy | Copay tier |
|---|---|---|---|
— Medicare Part D | — | — | — |
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How this page is sourced
- Drug identity verified against openFDA NDC Directory.
- Label text (when shown) originates from NLM DailyMed.
- Copay and assistance URLs verified periodically; if you hit a broken link, tell us.