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 |
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 |
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 |
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 |
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 |
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 |
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 |
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 |
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 |
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 |
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 |
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 |
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 |
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 |
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 |
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 |
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 |
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 |
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 |
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 |
|---|---|---|---|---|---|---|---|
| 12474MMPNP | FENTANYLP fentanyl 75 microgram/hour patch, 5 (PI, CMI) |
2 | 10 | 0 | $65.16 | $31.60 | $31.60 |
| Available brands | |||||||
| APO-Fentanyla | |||||||
| Fentanyl Sandoza |
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 |
|---|---|---|---|---|---|---|---|
| 12477QMPNP | FENTANYLP fentanyl 50 microgram/hour patch, 5 (PI, CMI) |
2 | 10 | 0 | $52.78 | $31.60 | $31.60 |
| Available brands | |||||||
| APO-Fentanyla | |||||||
| Fentanyl Sandoza |
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 |
|---|---|---|---|---|---|---|---|
| 12504DMPNP | FENTANYLP fentanyl 25 microgram/hour patch, 5 (PI, CMI) |
2 | 10 | 0 | $37.54 | $31.60 | $31.60 |
| Available brands | |||||||
| APO-Fentanyla | |||||||
| Fentanyl Sandoza |
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 |
|---|---|---|---|---|---|---|---|
| 12509JMPNP | FENTANYLP fentanyl 100 microgram/hour patch, 5 (PI, CMI) |
2 | 10 | 0 | $76.22 | $31.60 | $31.60 |
| Available brands | |||||||
| APO-Fentanyla | |||||||
| Fentanyl Sandoza |
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 |
|---|---|---|---|---|---|---|---|
| 12541CMPNP | FENTANYLP fentanyl 12 microgram/hour patch, 5 (PI, CMI) |
2 | 10 | 0 | $33.62 | $31.60 | $31.60 |
| Available brands | |||||||
| APO-Fentanyla | |||||||
| Fentanyl Sandoza |
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 |
|---|---|---|---|---|---|---|---|
| 5401GMPNP | FENTANYLP fentanyl 200 microgram lozenge, 9 (PI, CMI) |
1 | 9 | 0 | $90.86 | $31.60 | $31.60 |
| Available brands | |||||||
| Actiq |
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 |
|---|---|---|---|---|---|---|---|
| 5402HMPNP | FENTANYLP fentanyl 400 microgram lozenge, 9 (PI, CMI) |
1 | 9 | 0 | $90.86 | $31.60 | $31.60 |
| Available brands | |||||||
| Actiq |
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 |
|---|---|---|---|---|---|---|---|
| 5407NMPNP | FENTANYLP fentanyl 200 microgram lozenge, 30 (PI, CMI) |
2 | 60 | 0 | $515.24 | $31.60 | $31.60 |
| Available brands | |||||||
| Actiq |
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 |
|---|---|---|---|---|---|---|---|
| 5408PMPNP | FENTANYLP fentanyl 400 microgram lozenge, 30 (PI, CMI) |
2 | 60 | 0 | $515.24 | $31.60 | $31.60 |
| Available brands | |||||||
| Actiq |
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 |
|---|---|---|---|---|---|---|---|
| 5409QMPNP | FENTANYLP fentanyl 600 microgram lozenge, 30 (PI, CMI) |
2 | 60 | 0 | $378.04 | $31.60 | $31.60 |
| Available brands | |||||||
| Actiq |
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 |
|---|---|---|---|---|---|---|---|
| 5410RMPNP | FENTANYLP fentanyl 800 microgram lozenge, 30 (PI, CMI) |
2 | 60 | 0 | $378.04 | $31.60 | $31.60 |
| Available brands | |||||||
| Actiq |
FENTANYL
| Source | General Schedule |
| 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 |
|---|---|---|---|---|---|---|---|
| 8878GMPNP | FENTANYL fentanyl 12 microgram/hour patch, 5 (PI, CMI) |
1 | 5 | 0 | $26.45 | $27.93 | $31.38 |
| Available brands | |||||||
| APO-Fentanyla | |||||||
| Fentanyl Sandoza |
FENTANYL
| Source | General Schedule |
| 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 |
|---|---|---|---|---|---|---|---|
| 8891YMPNP | FENTANYL fentanyl 25 microgram/hour patch, 5 (PI, CMI) |
1 | 5 | 0 | $28.41 | $29.89 | $31.60 |
| Available brands | |||||||
| APO-Fentanyla | |||||||
| Fentanyl Sandoza |
FENTANYL
| Source | General Schedule |
| 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 |
|---|---|---|---|---|---|---|---|
| 8892BMPNP | FENTANYL fentanyl 50 microgram/hour patch, 5 (PI, CMI) |
1 | 5 | 0 | $36.03 | $31.60 | $31.60 |
| Available brands | |||||||
| APO-Fentanyla | |||||||
| Fentanyl Sandoza |
FENTANYL
| Source | General Schedule |
| 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 |
|---|---|---|---|---|---|---|---|
| 8893CMPNP | FENTANYL fentanyl 75 microgram/hour patch, 5 (PI, CMI) |
1 | 5 | 0 | $42.22 | $31.60 | $31.60 |
| Available brands | |||||||
| APO-Fentanyla | |||||||
| Fentanyl Sandoza |
FENTANYL
| Source | General Schedule |
| 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 |
|---|---|---|---|---|---|---|---|
| 8894DMPNP | FENTANYL fentanyl 100 microgram/hour patch, 5 (PI, CMI) |
1 | 5 | 0 | $47.75 | $31.60 | $31.60 |
| Available brands | |||||||
| APO-Fentanyla | |||||||
| Fentanyl Sandoza |
- Legend
- PPalliative care items
- aBrand equivalent a
- MPMedical Practitioner
- NPNurse Practitioner




