LAMOTRIGINE

lamotrigine 50 mg tablet, 56

LAMOTRIGINE (15342L)

lamotrigine 50 mg tablet, 56
15342L
Body System:
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: Bipolar disorder
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 112 # of repeats: 5 DPMQ: $24.26 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Lamotrigine GH
Sandoz Lamotrigine
Lamictal
*Additional charge for this brand is $6.88
 DPMQ: $31.14 Max safety net: $25.00 General Patient Charge: $31.88