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