| NAME |
AMPHETAMINE/DEXTROAMPHETAMINE 25MG TRIPHASIC CAP,SA |
| VA GENERIC NAME |
AMPHETAMINE/DEXTROAMPHETAMINE |
| DOSAGE FORM |
CAP,SA |
| FDA MED GUIDE |
Amphetamine-Dextroamphetamine_SA_(Generic)_(2021).pdf |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Schedule II Non-Narcotics |
| STRENGTH |
25 |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| UNITS |
MG |
| NATIONAL FORMULARY NAME |
AMPHETAMINE/DEXTROAMPHETAMINE CAP,SA |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2017-09-01 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
AMPHET/D-AMPHET 25MG TRIPHASIC SA CAP |
| VA PRODUCT IDENTIFIER |
A1943 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
CAP |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4036814 |
| EFFECTIVE DATE/TIME |
-
- 2017-07-18 00:00:00
- STATUS: ACTIVE
|
