BUTALBITAL, ACETAMINOPHEN, CAFFEINE, AND CODEINE PHOSPHATE 50/300/40/30 mg Capsule
Coverage in Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming (CMS PDP Region 25).
Not on any stand-alone Part D formulary in Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming
None of the 11 stand-alone Part D (PDP) plans in CMS PDP Region 25 list this drug. On one of those plans the patient would pay the full retail price, or you would need a formulary exception.