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Ascomp With Codeine - Butalbital, Aspirin, Cafeine, And Codeine Phosphate capsule
Trillium Community Health Plan
Trillium Community Health Plan Coverage for Ascomp With Codeine - Butalbital, Aspirin, Cafeine, And Codeine Phosphate capsule
All
1
Managed Medicaid
1
Managed Medicaid
Managed Medicaid - HMO - Medicaid
PA Required
No Step Therapy
Quantity Limit
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Support for Getting Your Patient on Ascomp With Codeine - Butalbital, Aspirin, Cafeine, And Codeine Phosphate capsule
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