Interchangeable Grouping
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28:00 CENTRAL NERVOUS SYSTEM DRUGS
Therapeutic Note(s)
28:08:08 ANALGESICS OPIATE AGONISTS
LU Criteria Text
FENTANYL TRANSDERMAL SYSTEM
50mcg/hr Trans Patch
Interchangeables found: 7
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DIN/ PIN/ NPN
Brand Name
Drug Benefit Price or Unit Price
Amount MOH Pays:
02386879
Co Fentanyl Matrix Patch
6.8838
6.8838
02275821
Duragesic
(Not a Benefit)
N/A
N/A
01937391
Duragesic 50
(Not a Benefit)
N/A
N/A
02341395
PMS-Fentanyl MTX
6.8838
6.8838
02330121
Ran-Fentanyl Matrix Patch
6.8838
6.8838
02327147
Sandoz Fentanyl Patch
6.8838
6.8838
02282968
Teva-Fentanyl
6.8838
6.8838
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