ESCITALOPRAM

escitalopram 20 mg tablet, 28

ESCITALOPRAM (14415Q)

escitalopram 20 mg tablet, 28
14415Q
Body System:
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: Major depressive disorders
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 56 # of repeats: 2 DPMQ: $19.84 Max safety net: $21.38 General Patient Charge: $24.17
Available brands
APO-Escitalopram
APX-Escitalopram
Blooms Escitalopram
Cilopam-S
ESCIT
ESCITALOPRAM-WGR
Escitalopram GH
Escitalopram Sandoz
Lexam 20
LoxaLate
Lexapro
*Additional charge for this brand is $27.96
 DPMQ: $47.80 Max safety net: $21.38 General Patient Charge: $52.13