fentanyl patch 12mcg / 25mcg / 50mcg / 75mcg / 100mcg

12mcg / 25mcg / 50mcg / 75mcg / 100mcg

Also known as: Duragesic

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.

1 plan

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 3 hours, 35 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC Medicaid Preferred Drug List 2026	Preferred	✓	—	—	PA