| NAME |
LISDEXAMFETAMINE DIMESYLATE 10MG CAP,ORAL |
| VA GENERIC NAME |
LISDEXAMFETAMINE |
| DOSAGE FORM |
CAP,ORAL |
| FDA MED GUIDE |
Lisdexamfetamine_(Vyvanse)_(Oct_2021).pdf |
| FORMULARY DESIGNATOR |
PA-F |
| ACTIVE INGREDIENTS |
|
| NATIONAL FORMULARY INDICATOR |
YES |
| CS FEDERAL SCHEDULE |
Schedule II Non-Narcotics |
| STRENGTH |
10 |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| UNITS |
MG |
| NATIONAL FORMULARY NAME |
LISDEXAMFETAMINE CAP,ORAL |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
LISDEXAMFETAMINE DIMESYLATE 10MG CAP |
| VA PRODUCT IDENTIFIER |
L0647 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
CAP |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4034098 |
| EFFECTIVE DATE/TIME |
-
- 2015-01-26 00:00:00
- STATUS: ACTIVE
|
