Interchangeable Grouping
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28:00 CENTRAL NERVOUS SYSTEM DRUGS
Therapeutic Note(s)
28:08:08 ANALGESICS OPIATE AGONISTS
ACETYLSALICYLIC ACID & BUTALBITAL & CAFFEINE & CODEINE PHOSPHATE
330mg & 50mg & 40mg & 15mg Cap
Interchangeables found: 3
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DIN/ PIN/ NPN
Brand Name
Drug Benefit Price or Unit Price
Amount MOH Pays:
02554615
Apo-Butalbital-ASA-Caffeine-Codeine-C1/4
(Off-Formulary Interchangeable)
1.7363
N/A
00176192
Fiorinal C1/4
(Off-Formulary Interchangeable)
N/A
N/A
00608203
Ratio-Tecnal C1/4
(Off-Formulary Interchangeable)
1.7363
N/A
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