ANTIDEPRESSANTS: SSRIs | Vendor Drug Program

Brand Name/Generic Name	NDC/Manufacturer	FFS Clinical Prior Auth Required	PDL Prior Auth Required	Programs
CITALOPRAM HBR 10 MG TABLET citalopram hydrobromide	42806001910 EPIC PHARMA LLC	No	No	Medicaid CHIP CSHCN HTW
CITALOPRAM HBR 10 MG TABLET citalopram hydrobromide	13668000901 TORRENT PHARMAC	No	No	Medicaid CHIP CSHCN HTW
CITALOPRAM HBR 10 MG TABLET citalopram hydrobromide	69097082207 CIPLA USA, INC.	No	No	Medicaid CHIP CSHCN
CITALOPRAM HBR 10 MG TABLET citalopram hydrobromide	13668000905 TORRENT PHARMAC	No	No	Medicaid CHIP CSHCN HTW
CITALOPRAM HBR 10 MG TABLET citalopram hydrobromide	69097082212 CIPLA USA, INC.	No	No	Medicaid CHIP CSHCN
CITALOPRAM HBR 10 MG TABLET citalopram hydrobromide	13668000909 TORRENT PHARMAC	No	No	Medicaid CHIP CSHCN HTW
CITALOPRAM HBR 10 MG TABLET citalopram hydrobromide	00904608461 MAJOR PHARMACEU	No	No	Medicaid CHIP CSHCN HTW KHC
CITALOPRAM HBR 10 MG TABLET citalopram hydrobromide	65862000501 AUROBINDO PHARM	No	No	Medicaid CHIP CSHCN HTW KHC
CITALOPRAM HBR 10 MG TABLET citalopram hydrobromide	65862000505 AUROBINDO PHARM	No	No	Medicaid CHIP CSHCN HTW KHC
CITALOPRAM HBR 10 MG TABLET citalopram hydrobromide	13107000501 AUROBINDO PHARM	No	No	Medicaid CHIP CSHCN HTW KHC