METHYLPHENIDATE HCL (ADHANSIA XR) 70MG CAP,SA (29348)    VA PRODUCT (50.68)

Name Value
NAME METHYLPHENIDATE HCL (ADHANSIA XR) 70MG CAP,SA
VA GENERIC NAME METHYLPHENIDATE
DOSAGE FORM CAP,SA
FDA MED GUIDE Methylphenidate_SA_Cap_(Generic)_(2020).pdf
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Schedule II Non-Narcotics
STRENGTH 70
SINGLE/MULTI SOURCE PRODUCT Single source
INACTIVATION DATE 2023-01-17 00:00:00
UNITS MG
NATIONAL FORMULARY NAME METHYLPHENIDATE CAP,SA
CREATE DEFAULT POSSIBLE DOSAGE NO
POSSIBLE DOSAGES TO CREATE 1x Possible Dosage
PACKAGE Both Inpatient and Outpatient
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   3
    COPAY EFFECTIVE DATE:   2019-06-27 00:00:00
    COPAY END DATE:   2022-10-12 00:00:00
  • COPAY TIER LEVEL:   2
    COPAY EFFECTIVE DATE:   2022-10-13 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME METHYLPHENIDATE (ADHANSIA XR)70MG SA CAP
VA PRODUCT IDENTIFIER M1219
TRANSMIT TO CMOP NO
VA DISPENSE UNIT CAP
MASTER ENTRY FOR VUID YES
VUID 4038501
EFFECTIVE DATE/TIME
  • 2019-06-27 00:00:00
    STATUS:   ACTIVE
  • 2019-06-27 00:00:00
    STATUS:   ACTIVE
  • 2023-01-17 00:00:00
    STATUS:   INACTIVE