Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
10600XMPNP	FENTANYLP fentanyl 200 microgram sublingual tablet, 10 (PI, CMI)	2	20	0	$146.34	$25.00	$25.00
	Available brands
	Abstral

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
10601YMPNP	FENTANYLP fentanyl 100 microgram sublingual tablet, 10 (PI, CMI)	2	20	0	$146.34	$25.00	$25.00
	Available brands
	Abstral

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
10602BMPNP	FENTANYLP fentanyl 100 microgram sublingual tablet, 30 (PI, CMI)	2	60	0	$410.42	$25.00	$25.00
	Available brands
	Abstral

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
10603CMPNP	FENTANYLP fentanyl 400 microgram sublingual tablet, 10 (PI, CMI)	1	10	0	$82.17	$25.00	$25.00
	Available brands
	Abstral

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
10604DMPNP	FENTANYLP fentanyl 600 microgram sublingual tablet, 10 (PI, CMI)	1	10	0	$82.17	$25.00	$25.00
	Available brands
	Abstral

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
10606FMPNP	FENTANYLP fentanyl 300 microgram sublingual tablet, 10 (PI, CMI)	1	10	0	$82.17	$25.00	$25.00
	Available brands
	Abstral

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
10607GMPNP	FENTANYLP fentanyl 200 microgram sublingual tablet, 30 (PI, CMI)	2	60	0	$410.42	$25.00	$25.00
	Available brands
	Abstral

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
10608HMPNP	FENTANYLP fentanyl 400 microgram sublingual tablet, 30 (PI, CMI)	2	60	0	$410.42	$25.00	$25.00
	Available brands
	Abstral

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
10610KMPNP	FENTANYLP fentanyl 300 microgram sublingual tablet, 30 (PI, CMI)	2	60	0	$410.42	$25.00	$25.00
	Available brands
	Abstral

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
10611LMPNP	FENTANYLP fentanyl 800 microgram sublingual tablet, 30 (PI, CMI)	2	60	0	$410.42	$25.00	$25.00
	Available brands
	Abstral

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
10612MMPNP	FENTANYLP fentanyl 800 microgram sublingual tablet, 10 (PI, CMI)	1	10	0	$82.17	$25.00	$25.00
	Available brands
	Abstral

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
10613NMPNP	FENTANYLP fentanyl 600 microgram sublingual tablet, 30 (PI, CMI)	2	60	0	$410.42	$25.00	$25.00
	Available brands
	Abstral

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
10684HMPNP	FENTANYLP fentanyl 100 microgram orally disintegrating tablet, 28 (PI, CMI)	2	56	0	$444.20	$25.00	$25.00
	Available brands
	Fentora

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
10697BMPNP	FENTANYLP fentanyl 200 microgram orally disintegrating tablet, 4 (PI, CMI)	2	8	0	$77.80	$25.00	$25.00
	Available brands
	Fentora

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
10698CMPNP	FENTANYLP fentanyl 200 microgram orally disintegrating tablet, 28 (PI, CMI)	2	56	0	$444.20	$25.00	$25.00
	Available brands
	Fentora

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
10713WMPNP	FENTANYLP fentanyl 600 microgram orally disintegrating tablet, 28 (PI, CMI)	2	56	0	$285.82	$25.00	$25.00
	Available brands
	Fentora

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
10729QMPNP	FENTANYLP fentanyl 100 microgram orally disintegrating tablet, 4 (PI, CMI)	2	8	0	$77.80	$25.00	$25.00
	Available brands
	Fentora

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
10737DMPNP	FENTANYLP fentanyl 400 microgram orally disintegrating tablet, 28 (PI, CMI)	2	56	0	$285.82	$25.00	$25.00
	Available brands
	Fentora

Source	Palliative Care
Body System	NERVOUS SYSTEM > ANALGESICS > OPIOIDS

Caution

Note

Authority Required

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
10738EMPNP	FENTANYLP fentanyl 800 microgram orally disintegrating tablet, 28 (PI, CMI)	2	56	0	$285.82	$25.00	$25.00
	Available brands
	Fentora