ARIPIPRAZOLE

ARIPIPRAZOLE (8717T)

aripiprazole 10 mg tablet, 30
8717T
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 4246)

Indication: Schizophrenia
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: $39.11 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
APO-Aripiprazole
ARIPIPRAZOLE-WGR
ARIZOLE
Abilify
Abyraz
Aripiprazole GH
Aripiprazole Sandoz

ARIPIPRAZOLE (8718W)

aripiprazole 15 mg tablet, 30
8718W
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 4246)

Indication: Schizophrenia
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: $49.72 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
APO-Aripiprazole
ARIPIPRAZOLE-WGR
ARIZOLE
Abilify
Abyraz
Aripiprazole GH
Aripiprazole Sandoz

ARIPIPRAZOLE (8719X)

aripiprazole 20 mg tablet, 30
8719X
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 4246)

Indication: Schizophrenia
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: $57.53 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
APO-Aripiprazole
ARIPIPRAZOLE-WGR
ARIZOLE
Abilify
Abyraz
Aripiprazole GH
Aripiprazole Sandoz

ARIPIPRAZOLE (8720Y)

aripiprazole 30 mg tablet, 30
8720Y
Body System:
Manner of administration:Oral
General Schedule
Authority Required (STREAMLINED)

Restriction (Streamlined authority code: 4246)

Indication: Schizophrenia
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: $67.09 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
APO-Aripiprazole
ARIPIPRAZOLE-WGR
ARIZOLE
Abilify
Abyraz
Aripiprazole GH
Aripiprazole Sandoz