FENTANYL

Source Palliative Care
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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 $31.60 $31.60
Available brands
Abstral
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FENTANYL

Source Palliative Care
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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 $31.60 $31.60
Available brands
Abstral
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FENTANYL

Source Palliative Care
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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 $31.60 $31.60
Available brands
Abstral
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FENTANYL

Source Palliative Care
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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 $31.60 $31.60
Available brands
Abstral
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FENTANYL

Source Palliative Care
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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 $31.60 $31.60
Available brands
Abstral
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FENTANYL

Source Palliative Care
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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 $31.60 $31.60
Available brands
Abstral
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FENTANYL

Source Palliative Care
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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 $31.60 $31.60
Available brands
Abstral
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FENTANYL

Source Palliative Care
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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 $31.60 $31.60
Available brands
Abstral
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FENTANYL

Source Palliative Care
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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 $31.60 $31.60
Available brands
Abstral
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FENTANYL

Source Palliative Care
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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 $31.60 $31.60
Available brands
Abstral
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FENTANYL

Source Palliative Care
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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 $31.60 $31.60
Available brands
Abstral
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FENTANYL

Source Palliative Care
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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 $31.60 $31.60
Available brands
Abstral
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FENTANYL

Source Palliative Care
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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 $31.60 $31.60
Available brands
Fentora
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FENTANYL

Source Palliative Care
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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 $31.60 $31.60
Available brands
Fentora
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FENTANYL

Source Palliative Care
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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 $31.60 $31.60
Available brands
Fentora
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FENTANYL

Source Palliative Care
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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 $31.60 $31.60
Available brands
Fentora
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FENTANYL

Source Palliative Care
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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 $31.60 $31.60
Available brands
Fentora
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FENTANYL

Source Palliative Care
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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 $31.60 $31.60
Available brands
Fentora
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FENTANYL

Source Palliative Care
Body System NERVOUS SYSTEM > ANALGESICS > OPIOIDS
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 $31.60 $31.60
Available brands
Fentora
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