LAMOTRIGINE

lamotrigine 100 mg tablet, 56

LAMOTRIGINE (15343M)

lamotrigine 100 mg tablet, 56
15343M
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: 1 Max qty units: 56 # of repeats: 5 DPMQ: $22.54 Max safety net: $24.08 General Patient Charge: $25.00
Available brands
Lamotrigine GH
Sandoz Lamotrigine
Lamictal
*Additional charge for this brand is $3.45
 DPMQ: $25.99 Max safety net: $24.08 General Patient Charge: $28.45