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
12mcg/hr Trans Patch
Interchangeables found: 3
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DIN/ PIN/ NPN
Brand Name
Drug Benefit Price or Unit Price
Amount MOH Pays:
02280345
Duragesic 12
(Not a Benefit)
N/A
N/A
02327112
Sandoz Fentanyl Patch
3.3200
3.3200
02311925
Teva-Fentanyl
3.3200
3.3200
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