Advanced Control Formulary drug list is changing on January 1, 2023. It’s important that you review the changes in the chart below. Talk to your health care provider about how these changes ... ©2022 Aetna Inc. Advanced Control – 12020700-01-02: Title: SOC-for-1.1.23-Advanced-Control-Plan Author: CQF Subject: Accessible PDFWe’ve got answers. Call us. Talk to a licensed agent at 1-855-335-1407 (TTY: 711) Monday to Friday, 8 AM to 8 PM. Medicare Part D FAQs. Find the answers to common questions about prescription drug coverage. View FAQs. Find a Medicare Part D plan in Kentucky to help cover your prescription drug costs.Expedited medical exceptions. In certain circumstances*, you or your prescriber can request a medical exception for a non-covered drug. To submit a request, call our Precertification Department at 1-855-582-2025 (TTY: 711), or fax a request to 1-855-330-1716.We would like to show you a description here but the site won’t allow us.This tool helps you find Part B drugs with utilization management requirements. Select a drug to find its HCPCS code (s), coverage criteria documents, step therapy documents and fax forms, if appilcable. search BRAND-NAME DRUGS. Notes. *FOR DRUG COVERAGE DETAILS: Universal Medicare coverage criteria will be used for this drug.In Maryland, by Aetna Health Inc., 151 Farmington Avenue, Hartford, CT 06156. Each insurer has sole financial responsibility for its own products. Pharmacy benefits are administered by an affiliated pharmacy benefit manager, CVS Caremark. Aetna is part of the CVS Health family of companies. Category.Talk to a licensed agent at 1-855-335-1407 (TTY: 711) Monday to Friday, 8 AM to 8 PM. Find the answers to common questions about prescription drug coverage. View FAQs. Find a Medicare Part D plan in New Jersey …For 2024, Aetna has raised prices for all of its plans. The high-end SilverScript Plus plan sees the biggest change — it’s over $25 per month more expensive than last year, on average. Average ...2023 List of Covered Drugs/Formulary Aetna Better HealthSM Premier Plan MMAI Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. For more recent information or other questions, contact us atHow Part D works with other insurance. Learn about how Medicare Part D (drug coverage) works with other coverage, like employer or union health coverage. Part D (Medicare drug coverage) helps cover cost of prescription drugs, may lower your costs and protect against higher costs.Jan 1, 2023 · Expedited medical exceptions. In certain circumstances*, you or your prescriber can request a medical exception for a non-covered drug. To submit a request, call our Precertification Department at 1-855-582-2025 (TTY: 711), or fax a request to 1-855-330-1716. We would like to show you a description here but the site won’t allow us. September 2022 29695 2. Emeriti Retirement Health Solutions. Aetna Medicare Rx offered by SilverScript Rx Standard. Benefits and Premiums are effective January 1, 2023 through December 31, 2023 SUMMARY OF BENEFITS PROVIDED BY SILVERSCRIPT INSURANCE COMPANY PHARMACY - PRESCRIPTION DRUG BENEFITS. Monthly Premium Please contact your former ... Aetna Medicare Advantage plans take a total, connected approach to your health. Our main goal is to help you live your healthiest life possible, body and mind. ... Page last updated: August 01, 2023 ©[current-year] Aetna Inc. Y0001_GRP_4006_3789. You are now leaving the Aetna Medicare website.Aetna Standard Plan drug list is changing on January 1, 2023. It’s important that you review ... Check your plan documents to find out if your plan has formulary exclusions, prior authorization, quantity limits or if you must first try certain drug(s) before another drug will be covered. ... 1/5/2023 11:03:19 AM ...Expedited medical exceptions. In certain circumstances*, you or your prescriber can request a medical exception for a non-covered drug. To submit a request, call our Precertification Department at 1-855-582-2025 (TTY: 711), or fax a request to 1-855-330-1716.Talk to a licensed agent at 1-855-335-1407 (TTY: 711) Monday to Friday, 8 AM to 8 PM. Find the answers to common questions about prescription drug coverage. View FAQs. Find a Medicare Part D plan in New …3.5 out of 5 stars* for plan year 2024. $32.50 Monthly Premium. Aetna Medicare Assure Plus (HMO D-SNP) is a HMO D-SNP Medicare Advantage (Medicare Part C) plan offered by Aetna Inc. Plan ID: H1609-043-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $32.50 Monthly Premium. Drug tier copay levels. This 2023 comprehensive formulary is a listing of brand-name and generic drugs. Aetna® Medicare’s 2023 formulary covers most drugs identified by Medicare as Part D drugs. Tier 1 Generic drugs $0 copay. Tier 1 Brand name drugs $0 copay. We’ve got answers. Call us. Talk to a licensed agent at 1-855-335-1407 (TTY: 711) Monday to Friday, 8 AM to 8 PM. Medicare Part D FAQs. Find the answers to common questions about prescription drug coverage. View FAQs. Find a Medicare Part D plan in Kentucky to help cover your prescription drug costs.Precertification of pembrolizumab (Keytruda) is required of all Aetna participating providers and members in applicable plan designs. For precertification, call (866) 752-7021 or fax (888) 267-3277. For Statement of Medical Necessity (SMN) precertification forms, see Specialty Pharmacy Precertification.Here’s a summary of the services we cover from January 1, 2023 through December 31, 2023. Keep in mind: This is just a summary. Need a complete list of what …Talk to a licensed agent at 1-855-335-1407 (TTY: 711) Monday to Friday, 8 AM to 8 PM. Find the answers to common questions about prescription drug coverage. View FAQs. Find a Medicare Part D plan in Connecticut to help …conditions of coverage. Plan features and availability may vary by service area. The formulary and/or pharmacy network may change at any time. You will receive notice when necessary. ©2023 Aetna Inc. Y0001_NR_36870_2024_CYou can find your Evidence of Coverage (EOC), Summary of Benefits, Star Ratings, Formulary — Prescription Drug Coverage, Over-the-counter (OTC) benefit catalog, and more. If you’re in a Medicare Advantage plan, your plan name is listed on your member ID card. If you’re in a plan with prescription drug coverage only (PDP), look at the “S ...Aetna made major changes to our formularies (drug lists) for 2023 to remove many cost and access obstacles and help our members be more adherent with their …OTC benefit questions. Call OTC Health Solutions at 1-833-331-1573 (TTY: 711). You can speak with an agent 9 AM to 8 PM local time, Monday through Friday. Order a catalog. Call Member Services to order a printed copy of your OTC catalog or call the number on your Aetna member ID card. Contact Member Services.Medicare Part D drugs; ... Drugs on the List of Drugs (Formulary) are covered when you use our network pharmacies or mail order program for maintenance drugs. Maintenance drugs are drugs you take for a chronic or long-term condition. Some drugs we cover have limits or other rules. ... H0480_WEBSITE_2024 Pending Accepted …We’ve got answers. Talk to a licensed agent at 1-855-335-1407 (TTY: 711) Monday to Friday, 8 AM to 8 PM. Find the answers to common questions about prescription drug coverage. View FAQs. Find a Medicare Part D plan in Texas to help cover your prescription drug costs.Jan 1, 2023 · Expedited medical exceptions In certain circumstances*, you or your prescriber can request a medical exception for a non-covered drug. To submit a request, call our Precertification Department at 1-855-582-2025 (TTY: 711), or fax a request to 1-855-330-1716. Call us. Talk to a licensed agent at 1-855-335-1407 (TTY: 711) Monday to Friday, 8 AM to 8 PM. Medicare Part D FAQs. Find the answers to common questions about prescription drug coverage. View FAQs. Find a Medicare Part D plan in South Carolina to help cover your prescription drug costs.1-855-335-1407 (TTY: 711) Monday to Friday, 8 AM to 8 PM. Medicare FAQs. Get answers to common Medicare questions. With Aetna Medicare Advantage PPO plans, you can visit any doctor in or out of our provider network who accepts Medicare and our plan terms. Learn more about our Medicare Advantage PPO plans.Only 7% of Medicare Advantage members will have access to new benefits like transportation to appointments, home-delivered meals, ramps, etc By clicking "TRY IT", I agree to receiv...That’s why almost 75 percent of people who are on Medicare — or more than 47 million people 2 — are enrolled in a plan with prescription drug coverage. Forty-one percent of those over 65 take five or more medications a day. 1. As you figure out the best plan for your needs, here’s what you need to know about prescription drug coverage.OTC benefit questions. Call OTC Health Solutions at 1-833-331-1573 (TTY: 711). You can speak with an agent 9 AM to 8 PM local time, Monday through Friday. Order a catalog. Call Member Services to order a printed copy of your OTC catalog or call the number on your Aetna member ID card. Contact Member Services.Asking for coverage of a drug that is not on the formulary (drug list) is sometimes called asking for a formulary exception. In certain cases we make a formulary exception to cover a drug not on our formulary. If we do, you will need to pay the cost-share that applies to drugs in Tier 4 (Non-preferred drug).Call us. Talk to a licensed agent at 1-855-335-1407 (TTY: 711) Monday to Friday, 8 AM to 8 PM. Medicare Part D FAQs. Find the answers to common questions about prescription drug coverage. View FAQs. Find a Medicare Part D plan in Georgia to help cover your prescription drug costs.For 2023, Aetna is offering Medicare Advantage Prescription Drug (MAPD) plans in 46 states plus Washington, D.C. Aetna added 141 new counties across the country, providing 1 million more Medicare beneficiaries access to an Aetna plan. In total, Aetna will offer MAPD plans in 2,014 counties in 2023, accessible by 55 million Medicare beneficiaries. 2Aetna Medicare Advantage plans take a total, connected approach to your health. Our main goal is to help you live your healthiest life possible, body and mind. ... Page last updated: October 31, 2023 ©[current-year] Aetna Inc. Y0001_GRP_4006_3911. You are now leaving the Aetna Medicare website.Or visit our online formulary to find less-costly alternatives. ... 2023 by the American Medical Association (AMA). ... See CMS's Medicare Coverage Center. Please ... We would like to show you a description here but the site won’t allow us. This website provides you with tools and resources that can help you get the most value out of your group Medicare Advantage plan. Since retiree plans vary, it’s important to review the information from your former employer or plan sponsor. – Medicare Advantage plans can be medical only (MA) or include prescription drug coverage (MAPD).We would like to show you a description here but the site won’t allow us.Expedited medical exceptions. In certain circumstances*, you or your prescriber can request a medical exception for a non-covered drug. To submit a request, call our Precertification Department at 1-855-582-2025 (TTY: 711), or fax a request to 1-855-330-1716.You also can mail a written request to Aetna PA, 1300 E. Campbell Rd., Richardson, TX 75081.Apr 15, 2024 · Review our Medicare Supplement Insurance plans. 87% of Aetna® Medicare Advantage members are in 4-star plans or higher for 2024. Every year, Medicare evaluates plans based on a 5-star rating system. Read the latest press release on our Star Ratings for 2024 and our ongoing commitment to improving health outcomes for members. CVS Health (CVS 1.85%) Q1 2024 Earnings Call May 01, 2024, 8:00 a.m. ET. Contents: Prepared Remarks; Questions and Answers; Call Participants; Prepared …Jan 1, 2023 · Expedited medical exceptions. In certain circumstances*, you or your prescriber can request a medical exception for a non-covered drug. To submit a request, call our Precertification Department at 1-855-582-2025 (TTY: 711), or fax a request to 1-855-330-1716. Updated 12/01/2023 3. What is the Aetna Medicare Comprehensive Formulary? A formulary is a list of covered drugs selected by our plan in consultation with a team of health care providers, which represents the prescription therapies believed to be a necessary part of a quality treatment program. We will generally cover the drugs listed onFor 2024, Aetna has raised prices for all of its plans. The high-end SilverScript Plus plan sees the biggest change — it’s over $25 per month more expensive than last year, on average. Average ...Jan 1, 2023 · We are working to update the information on this website to reflect your 2023 benefits. Please check back mid-October for updates. And watch your mail for more plan information coming from Aetna over the next several weeks. In the meantime, our representatives are available to answer your questions. They can reached at 1-855-223-4807 (TTY: 711 ... With Aetna Medicare Advantage PPO plans, you can visit any doctor in or out of our provider network who accepts Medicare and our plan terms. Learn more about our Medicare Advantage PPO plans. ... Page last updated: November 17, 2023 ©[current-year] Aetna Inc. Y0001_34893_2024_M. You are leaving AetnaMedicare.com for …Aetna made major changes to our formularies (drug lists) for 2023 to remove many cost and access obstacles and help our members be more adherent with their …If you’re a Medicare subscriber and want to make changes to your coverage, open enrollment will allow you to do so. From October 15 to December 7, Medicare allows subscribers to ch...Aetna Value Plus Plan 2024 Susi Zilvia, Total number of formulary drugs: List of drugs change notice: Source: trixyqkelila.pages.dev Hospice Formulary List 2024 Candi …We would like to show you a description here but the site won’t allow us.If you're eligible for Medicare, you'll have a different enrollment period from everyone else. Here's the lowdown on when you should apply for Medicare... Calculators Helpful Guide...We would like to show you a description here but the site won’t allow us.Call us. Talk to a licensed agent at 1-855-335-1407 (TTY: 711) Monday to Friday, 8 AM to 8 PM. Medicare Part D FAQs. Find the answers to common questions about prescription drug coverage. View FAQs. Find a Medicare Part D plan in Missouri to help cover your prescription drug costs.Call us. Talk to a licensed agent at 1-855-335-1407 (TTY: 711) Monday to Friday, 8 AM to 8 PM. Medicare Part D FAQs. Find the answers to common questions about prescription drug coverage. View FAQs. Find a Medicare Part D plan in California to help cover your prescription drug costs.We’ve got answers. Call us. Talk to a licensed agent at 1-855-335-1407 (TTY: 711) Monday to Friday, 8 AM to 8 PM. Medicare Part D FAQs. Find the answers to common questions about prescription drug coverage. View FAQs. Find a Medicare Part D plan in Kentucky to help cover your prescription drug costs.Aetna is part of the CVS Health family of companies. Excluded drug name(s) Preferred option(s)*. butalbital-acetaminophen capsule, butalbital-acetaminophen tablet 25-325 mg, butalbital-acetaminophen tablet 50-300 mg, BUTALBITAL-ACETAMINOPHEN (NDC* 69499034230 only) diclofenac sodium, ibuprofen, naproxen (except naproxen CR or naproxen suspension)Check our formulary. Our Medicare prescription formulary (drug list) shows the drugs we cover, which tier a drug is on, limits or requirements and mail-order availability. Generally, the lower the tier, the less you pay. Your Summary of Benefits tells you the drug costs for tiers.October 2023 Drugs not covered — and their covered alternatives for the Aetna Standard Formulary 2023 Formulary Exclusions Drug List The drugs on this list have been removed from your plan’s formulary. If you continue using a drug listed under “formulary drug removals”, you may have to pay the full cost. Ask your doctor to choose one ofPharmacy Criteria. Search our Pharmacy Clinical Policy Bulletins for the following commercial formulary plans: Advanced Control Plans-Aetna, Aetna Health Exchange Plans, and Standard Opt Out Plans-Aetna. Pharmacy Clinical Policy Bulletins for all other formulary plans are available by calling the number on the back of the member’s ID card. Year.We’ve got answers. Connect with us. Talk to a licensed agent by calling 1-855-335-1407 (TTY: 711). They’re available Monday to Friday, 8 AM to 8 PM. Or, we’ll call you. Learn more about benefits Aetna Medicare may offer for your Medicare hearing aids, dental coverage, and eyewear needs.Please go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to get information on all of your options. TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the SilverScript SmartSaver (PDP) benefit details. — Medicare Plan Features —. Monthly Premium: $6.60 (see Plan Premium Details below) Annual ...Formulary Guidance. This page provides important information on prescription drug coverage policies under Medicare, the framework for CMS' review of Medicare prescription drug plan formularies, and instructions concerning formulary file uploads. Click the selection that best matches your informational needs.2023 Formulary (List of covered drugs) B2. PLEASE READ: THIS DOCUMENT CONTAINS INFORMATION ABOUT THE DRUGS WE COVER IN THIS PLAN. Formulary ID Number: 23016 Version 20. This formulary was updated on 12/01/2023. For more recent information or other questions, please contact Aetna Medicare Member Services at 1-855-463-0933 or for TTY users: 711,Call us. Talk to a licensed agent at 1-855-335-1407 (TTY: 711) Monday to Friday, 8 AM to 8 PM. Medicare Part D FAQs. Find the answers to common questions about prescription drug coverage. View FAQs. Find a Medicare Part D plan in Virginia to help cover your prescription drug costs.Know more about coverage for your current prescriptions. Search our Medicare Part D drug list (formulary) and find additional information and resources.Precertification of pembrolizumab (Keytruda) is required of all Aetna participating providers and members in applicable plan designs. For precertification, call (866) 752-7021 or fax (888) 267-3277. For Statement of Medical Necessity (SMN) precertification forms, see Specialty Pharmacy Precertification.This is a pharmacy that has a contract with our plan to provide prescription drugs to members at a price negotiated by Aetna ® Medicare. This price is used to calculate your out-of-pocket cost. In most cases, your prescriptions are covered under our plan only if they’re filled: At a network retail pharmacy; Through CVS Caremark ® Mail ...Updates to the current formulary are posted monthly. Humana Medicare Advantage plans that offer prescription drug coverage may use a tiered drug list, which means that less expensive medications on a lower tier may be covered with lower copayments, coinsurance or deductibles. ... 2 96% of Humana’s Medicare Advantage … Want a full list of every drug covered by your plan? Download the formulary and find other important prescription drug information. Check the tier a drug is on, any limits or requirements and mail order availability. Generally, the lower the tier, the less you pay. Complete the steps below to get a full list of all covered drugs. Aetna Medicare Rx offered by SilverScript . 2023 Formulary (List of Covered Drugs) 5T Comprehensive+ Formulary. PLEASE READ: THIS DOCUMENT CONTAINS INFORMATION ABOUT THE DRUGS WE COVER IN THIS PLAN. This formulary was updated on 03/20/2023. For more recent information or other questions, please All covered Part D drugs on any tier of the plan's formulary would not be as effective for the enrollee as the requested formulary drug and/or would likely ...We would like to show you a description here but the site won’t allow us.Jan 1, 2023 · Expedited medical exceptions. In certain circumstances*, you or your prescriber can request a medical exception for a non-covered drug. To submit a request, call our Precertification Department at 1-855-582-2025 (TTY: 711), or fax a request to 1-855-330-1716. Insurance company and/or Aetna Life Insurance Company (Aetna). In Florida, by Aetna Health Inc. and/or Aetna. Life Insurance Company. In Utah and Wyoming by ...All covered Part D drugs on any tier of the plan's formulary would not be as effective for the enrollee as the requested formulary drug and/or would likely ...The Michigan Premier Plan formulary documents can be found below. Formulary. Formulary Updates. Prior Authorization Criteria. Step Therapy Criteria. Machine Readable Formulary File. Medicare Part B Step Therapy. Glucose Meters. The latest formulary, formulary updates, step therapy criteria, pa criteria.We would like to show you a description here but the site won’t allow us.Medicare Part D, the prescription drug component of Medicare, is optional insurance. Unlike with Medicare Part A and Part B, which the Social Security Administration manages, priva...The Michigan Premier Plan formulary documents can be found below. Formulary. Formulary Updates. Prior Authorization Criteria. Step Therapy Criteria. Machine Readable Formulary File. Medicare Part B Step Therapy. Glucose Meters. The latest formulary, formulary updates, step therapy criteria, pa criteria.We’ve got answers. Call us. Talk to a licensed agent at 1-855-335-1407 (TTY: 711) Monday to Friday, 8 AM to 8 PM. Medicare Part D FAQs. Find the answers to common questions about prescription drug coverage. View FAQs. Find a Medicare Part D plan in Illinois to help cover your prescription drug costs.We would like to show you a description here but the site won’t allow us.This tool helps you find Part B drugs with utilization management requirements. Select a drug to find its HCPCS code (s), coverage criteria documents, step therapy documents and fax forms, if appilcable. search BRAND-NAME DRUGS. Notes. *FOR DRUG COVERAGE DETAILS: Universal Medicare coverage criteria will be used for this drug.The formulary may change at any time. You will ... ©2023 Aetna Inc. Y0001_NR_36869_2024_C . Proprietary; Title: Medicare Part B preferred drug list — Aetna Medicare Advantage (MA) only plans Author: Aetna Subject: Medicare Part B preferred drug list Aetna Medicare Advantage \(MA\) only plans Keywords: WCAG 2.1 AA …Aetna made major changes to our formularies (drug lists) for 2023 to remove many cost and access obstacles and help our members be more adherent with their …It also means you'll be able to enroll in Medicare prescription coverage. The SilverScript SmartSaver (PDP) plan offers the right balance between low monthly premiums and the flexible coverage you need. $5.92 national average monthly plan premium *. $0 annual deductible on Tier 1 drugs. $6 copays for a 90-day supply of Tier 1 drugs at preferred ...Some plans may have different pharmacy networks. So, it's always best to check which pharmacies are in your plan’s network. Use our find a pharmacy tool below to find network pharmacies in your area. To get started, just enter your ZIP code. ZIP CODE. Find a 2024 pharmacy in our network. We update our find a pharmacy tool every two weeks.The formulary and pharmacy network may change at any time. You will receive notice when necessary. ... Y0001_31186_2023_M. 1171350-22-01. You are leaving AetnaMedicare.com for InstaMed.com. ... Caremark.com is the secure website where Aetna Medicare SilverScript members can manage prescriptions, sign up for mail delivery, …
We would like to show you a description here but the site won’t allow us.. Stephanie olmo age
OTC benefit questions. Call OTC Health Solutions at 1-833-331-1573 (TTY: 711). You can speak with an agent 9 AM to 8 PM local time, Monday through Friday. Order a catalog. Call Member Services to order a printed copy of your OTC catalog or call the number on your Aetna member ID card. Contact Member Services.Find the Aetna Medicare forms you need to help you get started with claims reimbursements, Aetna Rx Home Delivery, filing an appeal and more.Call us. Talk to a licensed agent at 1-855-335-1407 (TTY: 711) Monday to Friday, 8 AM to 8 PM. Medicare Part D FAQs. Find the answers to common questions about prescription drug coverage. View FAQs. Find a Medicare Part D plan in Virginia to help cover your prescription drug costs.We would like to show you a description here but the site won’t allow us.We would like to show you a description here but the site won’t allow us.How Part D works with other insurance. Learn about how Medicare Part D (drug coverage) works with other coverage, like employer or union health coverage. Part D (Medicare drug coverage) helps cover cost of prescription drugs, may lower your costs and protect against higher costs.Call us. Talk to a licensed agent at 1-855-335-1407 (TTY: 711) Monday to Friday, 8 AM to 8 PM. Medicare Part D FAQs. Find the answers to common questions about prescription drug coverage. View FAQs. Find a Medicare Part D plan in Michigan to help cover your prescription drug costs.If you’re a Medicare subscriber and want to make changes to your coverage, open enrollment will allow you to do so. From October 15 to December 7, Medicare allows subscribers to ch...Find coverage and formulary details, check copays and estimate drug costs for your plan on your member website. Log in to member website. Looking for Medicare ...Living with a chronic condition can be challenging. From managing symptoms to finding the right treatments, it’s important to have access to the resources and support you need. Aet...We’ve got answers. Talk to a licensed agent at 1-855-335-1407 (TTY: 711) Monday to Friday, 8 AM to 8 PM. Find the answers to common questions about prescription drug coverage. View FAQs. Find a Medicare Part D plan in Texas to help cover your prescription drug costs.Call us. Talk to a licensed agent at. 1-855-335-1407 (TTY: 711) Monday to Friday, 8 AM to 8 PM. Medicare FAQs. Get answers to common Medicare questions. Aetna offers a few different Medicare Advantage plans, including HMO-POS plans, PPO plans, and Dual Special Needs Plans (DSNP). Learn more about your Medicare Advantage plan options. We would like to show you a description here but the site won’t allow us. Updated 12/01/2023 3. What is the Aetna Medicare Comprehensive Formulary? A formulary is a list of covered drugs selected by our plan in consultation with a team of health care providers, which represents the prescription therapies believed to be a necessary part of a quality treatment program. We will generally cover the drugs listed onAetna is part of the CVS Health family of companies. Excluded drug name(s) Preferred option(s)*. butalbital-acetaminophen capsule, butalbital-acetaminophen tablet 25-325 mg, butalbital-acetaminophen tablet 50-300 mg, BUTALBITAL-ACETAMINOPHEN (NDC* 69499034230 only) diclofenac sodium, ibuprofen, naproxen (except naproxen CR or naproxen suspension).
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