DESVENLAFAXINE

desvenlafaxine 100 mg modified release tablet, 28

DESVENLAFAXINE (9367B)

desvenlafaxine 100 mg modified release tablet, 28
9367B
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: - Max safety net: - General Patient Charge: -
Available brands
Pristiq
*Additional charge for this brand is $4.50
 DPMQ: $26.81 Max safety net: $23.79 General Patient Charge: $29.50