Sharp Health Plan
dexmethylphenidate (dexmethylphenidate)
Drugs for the Nervous System : Drugs for Attention Deficit Disorder
  • Quantity Limit: limit maximum 3 EA PER fill retail
  • Available only through Specialty Pharmacy;
    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; Dosing Limit: 60 mg/kg once per week;
  • Prior Authorization: Metastatic Castrate-Sensitive Prostate Cancer (mCSPC), Metastatic Prostate Cancer:
    Documented Diagnosis: Yes
    Duration: 1 year(s)

    Non-Metastatic Prostate Cancer:
    Documented Diagnosis: Yes
    Medical Test Required: Yes
    Duration: 1 year(s)