CITALOPRAM

citalopram 20 mg tablet, 28

CITALOPRAM (8220P)

citalopram 20 mg tablet, 28
8220P
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: 1 Max qty units: 28 # of repeats: 5 DPMQ: $17.10 Max safety net: $18.64 General Patient Charge: $21.43
Available brands
APO-Citalopram
APX-Citalopram
CITALOPRAM-WGR
Celapram
Citalopram Sandoz
Talam
Cipramil
*Additional charge for this brand is $12.64
 DPMQ: $29.74 Max safety net: $18.64 General Patient Charge: $34.07