ASCOMP WITH CODEINE 50/325/40/30 mg Capsule
Also known as Butalbital, Aspirin, Caffeine And Codeine Phosphate. Coverage in Connecticut, Massachusetts, Rhode Island and Vermont (CMS PDP Region 02).
Not on any stand-alone Part D formulary in Connecticut, Massachusetts, Rhode Island and Vermont
None of the 11 stand-alone Part D (PDP) plans in CMS PDP Region 02 list this drug. On one of those plans the patient would pay the full retail price, or you would need a formulary exception.