Clickable Table
Generic Name | Brand Name | Strength | Dosing | 90 Day Cost | Coverage | Comments | Category 1 | Category 2 |
---|---|---|---|---|---|---|---|---|
Risperidone | Risperdal | 1 mg | QD | $35 | BC / NIHB - Covered | G Psychiatry | Antipsychotics | |
Quetiapine | Seroquel | 25 mg | HS | $20 | BC / NIHB - Covered | G Psychiatry | Antipsychotics | |
Quetiapine | Seroquel XR | 300 mg | QD | $110 | BC / NIHB - Covered | G Psychiatry | Antipsychotics | |
Olanzapine | Zyprexa | 5 mg, 10 mg | QD | $85 | BC / NIHB - Covered | G Psychiatry | Antipsychotics | |
Lorazepam | Ativan | 1 mg | PRN | $20 | BC / NIHB - Covered |
90 tablets |
G Psychiatry | Anxiolytic Sedative |
Trazodone | Desyrel | 50 mg | PRN | $20 | BC / NIHB - Covered |
90 tablets |
G Psychiatry | Anxiolytic Sedative |
Zopiclone | Imovane | 7.5 mg | PRN | $25 | BC - Covered / NIHB - NC |
90 tablets |
G Psychiatry | Anxiolytic Sedative |
Temazepam | Restoril | 30 mg | PRN | $45 | BC / NIHB - Covered |
90 tablets |
G Psychiatry | Anxiolytic Sedative |
Amphetamines, Mixed Salts | Adderall XR | 10 mg | QD | $295 | BC - Restricted / NIHB - Covered | G Psychiatry | Stimulants (ADHD) | |
Methylphenidate | Concerta | 36 mg | QD | $445 | BC - Restricted / NIHB - Covered | G Psychiatry | Stimulants (ADHD) | |
Methylphenidate | Ritalin | 10 mg | BID | $60 | BC / NIHB - Covered | G Psychiatry | Stimulants (ADHD) | |
Lisdexamfetamine | Vyvanse | 20 mg | QD | $295 | BC - Restricted / NIHB - Covered | G Psychiatry | Stimulants (ADHD) | |
Citalopram | Celexa | 20 mg | QD | $25 | BC / NIHB - Covered | G Psychiatry | Antidepressants | |
Escitalopram | Cipralex | 10 mg | QD | $45 | BC / NIHB - Covered | G Psychiatry | Antidepressants | |
Duloxetine | Cymbalta | 30 mg | QD | $50 | BC / NIHB - Covered | G Psychiatry | Antidepressants | |
Venlafaxine | Effexor XR | 75 mg | QD | $30 | BC / NIHB - Covered | G Psychiatry | Antidepressants | |
Paroxetine | Paxil | 20 mg | QD | $45 | BC / NIHB - Covered | G Psychiatry | Antidepressants | |
Desvenlafaxine | Pristiq | 50 mg | QD | $255 | BC - NC / NIHB - SA | G Psychiatry | Antidepressants | |
Fluoxetine | Prozac | 20 mg | QD | $45 | BC / NIHB - Covered | G Psychiatry | Antidepressants | |
Mirtazapine | Remeron | 30 mg | HS | $35 | BC / NIHB - Covered | G Psychiatry | Antidepressants | |
Vortioxetine | Trintellix | 20 mg | QD | $340 | BC / NIHB - Covered | G Psychiatry | Antidepressants | |
Bupropion | Wellbutrin XL | 150 mg | QD | $45 | BC / NIHB - Covered | G Psychiatry | Antidepressants | |
Sertraline | Zoloft | 50 mg | QD | $45 | BC / NIHB - Covered | G Psychiatry | Antidepressants | |
Aripiprazole | Abilify | 15 mg | QD | $140 | BC - Restricted / NIHB - Covered | G Psychiatry | Antipsychotics |