LISDEXAMFETAMINE

LISDEXAMFETAMINE (10474G)

lisdexamfetamine dimesilate 50 mg capsule, 30
10474G
Body System:
Manner of administration:Oral
General Schedule
Authority Required

Restriction

Indication: Attention deficit hyperactivity disorder
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 30 # of repeats: 5 DPMQ: $46.11 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Vyvanse

LISDEXAMFETAMINE (10486X)

lisdexamfetamine dimesilate 30 mg capsule, 30
10486X
Body System:
Manner of administration:Oral
General Schedule
Authority Required

Restriction

Indication: Attention deficit hyperactivity disorder
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 30 # of repeats: 5 DPMQ: $46.11 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Vyvanse

LISDEXAMFETAMINE (10492F)

lisdexamfetamine dimesilate 70 mg capsule, 30
10492F
Body System:
Manner of administration:Oral
General Schedule
Authority Required

Restriction

Indication: Attention deficit hyperactivity disorder
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 30 # of repeats: 5 DPMQ: $46.11 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Vyvanse

LISDEXAMFETAMINE (11884L)

lisdexamfetamine dimesilate 20 mg capsule, 30
11884L
Body System:
Manner of administration:Oral
General Schedule
Authority Required

Restriction

Indication: Attention deficit hyperactivity disorder
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 30 # of repeats: 5 DPMQ: $46.11 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Vyvanse

LISDEXAMFETAMINE (11897E)

lisdexamfetamine dimesilate 60 mg capsule, 30
11897E
Body System:
Manner of administration:Oral
General Schedule
Authority Required

Restriction

Indication: Attention deficit hyperactivity disorder
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 30 # of repeats: 5 DPMQ: $46.11 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Vyvanse

LISDEXAMFETAMINE (11898F)

lisdexamfetamine dimesilate 40 mg capsule, 30
11898F
Body System:
Manner of administration:Oral
General Schedule
Authority Required

Restriction

Indication: Attention deficit hyperactivity disorder
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 30 # of repeats: 5 DPMQ: $46.11 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
Vyvanse