FLUVOXAMINE

Body System:

Manner of administration:Oral

General Schedule

Restricted Benefit

Indication: Major depressive disorders

Indication: Obsessive-compulsive 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: 60	# of repeats: 2	DPMQ: $25.12	Max safety net: $25.00	General Patient Charge: $25.00
Available brands
APO-Fluvoxamine
FLUVOXAMINE-WGR
Faverin 50
Movox 50
Luvox *Additional charge for this brand is $7.00			DPMQ: $32.12	Max safety net: $25.00	General Patient Charge: $32.00

Body System:

Manner of administration:Oral

General Schedule

Restricted Benefit

Indication: Major depressive disorders

Indication: Obsessive-compulsive 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: 30	# of repeats: 5	DPMQ: $19.45	Max safety net: $20.93	General Patient Charge: $23.72
Available brands
APO-Fluvoxamine
FLUVOXAMINE-WGR
Faverin 50
Movox 50
Luvox *Additional charge for this brand is $3.50			DPMQ: $22.95	Max safety net: $20.93	General Patient Charge: $27.22

FLUVOXAMINE (14488M)