METHYLPHENIDATE
methylphenidate hydrochloride 27 mg modified release tablet, 30
METHYLPHENIDATE (15169J)
15169J
Manner of administration:Oral
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: $174.54 | Max safety net: $25.00 | General Patient Charge: $25.00 |
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