METHYLPHENIDATE 15MG/9HR PATCH (17620)    VA PRODUCT (50.68)

Name Value
NAME METHYLPHENIDATE 15MG/9HR PATCH
VA GENERIC NAME METHYLPHENIDATE
DOSAGE FORM PATCH
FDA MED GUIDE Methylphenidate_Patch_(Daytrana)_(2019).pdf
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Schedule II Non-Narcotics
STRENGTH 15
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS MG/9HR
NATIONAL FORMULARY NAME METHYLPHENIDATE PATCH
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   3
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
    COPAY END DATE:   2022-07-06 00:00:00
  • COPAY TIER LEVEL:   2
    COPAY EFFECTIVE DATE:   2022-07-07 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME METHYLPHENIDATE 15MG/9HR PATCH
VA PRODUCT IDENTIFIER M0674
TRANSMIT TO CMOP NO
VA DISPENSE UNIT PATCH
MASTER ENTRY FOR VUID YES
VUID 4025152
EFFECTIVE DATE/TIME
  • 2006-05-22 00:00:00
    STATUS:   ACTIVE