Sutter Health Plus
Dyanavel XR (amphetamine)
Drugs for the Nervous System : Drugs for Attention Deficit Disorder
  • Quantity Limit: 2 pens per 28 day(s).
  • Breast Cancer: HR+ (HER2-):
    Duration: 1 year(s)


  • For FAX form click HERE
    Our electronic prior authorization (ePA) process is the preferred method for submitting pharmacy prior authorization requests. Creating an account is free, easy and helps patients get their medications sooner. You can complete the process through your current electronic health record/electronic medical record (EHR/EMR) system or by using one of these ePA sites:
     Log in to Surescripts
     Log in to CoverMyMeds; For details on drug coverage click HERE;
  • Quantity Limit: limit maximum 2.50 mL PER 30 day(s)