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Ascomp With Codeine - Butalbital, Aspirin, Cafeine, And Codeine Phosphate capsule
St. Luke's Health Plan (MCO)
St. Luke's Health Plan (MCO) Coverage for Ascomp With Codeine - Butalbital, Aspirin, Cafeine, And Codeine Phosphate capsule
All
2
Health Exchange
2
Health Exchange
Health Exchange - POS - Health Insurance Exchange
No PA
No Step Therapy
Quantity Limit
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Health Exchange - HDHP - Health Insurance Exchange
No PA
No Step Therapy
Quantity Limit
See Details
Support for Getting Your Patient on Ascomp With Codeine - Butalbital, Aspirin, Cafeine, And Codeine Phosphate capsule
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