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acetaminophen/codeine phosphate 120-12mg/5ml oral soln

Tier: 1

Prior Authorization: No

Category: ANALGESICS - OPIOID

Sub Category: OPIOID COMBINATIONS

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SECUR, Inc d/b/a SECUR Health Plan is an HMO I-SNP with a Medicare contract. Enrollment in SECUR Health Plan depends on contract renewal. SECUR Health Plan complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sexual orientation, gender identity or sex. SECUR Health plan does not exclude people or treat them differently because of race, color, national origin, age, disability, sexual orientation, gender identity or sex. ©2026 SECUR | Date Last Updated: August 9, 2026 | H3048_SECURWebsite_M_2026

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