fentanyl pt72

Generic: fentanyl pt72 12mcg/hr, 25mcg/hr, 50mcg/hr,

37.5mcg

Also known as: fentanyl pt72 12mcg/hr, 25mcg/hr, 50mcg/hr, 75mcg/hr fentanyl pt72 37.5mcg/hr, 62.5mcg/hr, 87.5mcg/hr, 100mcg/hr fentanyl pt72 12mcg/hr, 25mcg/hr, 37.5mcg/hr, 50mcg/hr, 62.5mcg/hr, 75mcg/hr, 87.5mcg/hr, 100mcg/hr fentanyl pt72 12mcg/hr, 25mcg/hr, 50mcg/hr, fentanyl pt72 37.5mcg/hr, 62.5mcg/hr,

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Coverage by Insurer

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

Blue Cross Blue Shield Federal

3 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 5 hours, 56 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBS Federal Standard Option 2026	Tier 1 - Generic	—	—	✓	QL
BCBS Federal Basic Option 2026	Tier 1 - Generic	—	—	✓	QL
BCBS Federal Focus 2026	Tier 1 - Generic	—	—	✓	QL

NC State Health Plan

3 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 5 hours, 55 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC State Health Plan - 80/20 Plus PPO 2026	Tier 2 - Non-Preferred Generic	✓	✓	✓	PA \| ST \| QL
NC State Health Plan - 70/30 Standard PPO 2026	Tier 2 - Non-Preferred Generic	✓	✓	✓	PA \| ST \| QL
NC State Health Plan - HDHP 2026	Tier 2 - Non-Preferred Generic	✓	✓	✓	PA \| ST \| QL