CITALOPRAM

citalopram 20 mg tablet, 28

CITALOPRAM (14490P)

citalopram 20 mg tablet, 28
14490P
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-Citalopram
APX-Citalopram
CITALOPRAM-WGR
Celapram
Citalopram Sandoz
Talam
Cipramil
*Additional charge for this brand is $25.28
 DPMQ: $45.12 Max safety net: $21.38 General Patient Charge: $49.45