| NAME |
METHYLPHENIDATE HCL (ADHANSIA XR) 85MG 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 |
85 |
| 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 |
|
| 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)85MG SA CAP |
| VA PRODUCT IDENTIFIER |
M1220 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
CAP |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4038503 |
| 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
|
