Source	Repatriation Pharmaceutical Benefits
Body System	VARIOUS > ALL OTHER NON-THERAPEUTIC PRODUCTS > ALL OTHER NON-THERAPEUTIC PRODUCTS

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
10832DMP	DRESSING HYDROFIBRE ALTERNATE TO ALGINATESR dressing hydrofibre alternate to alginates 12.5 cm x 12.5 cm dressing, 10 (PI, CMI)
	Available brands
	Aquacel Foam Adhesive	1	10	0	$119.71	$7.70	$7.70

Source	Repatriation Pharmaceutical Benefits
Body System	VARIOUS > ALL OTHER NON-THERAPEUTIC PRODUCTS > ALL OTHER NON-THERAPEUTIC PRODUCTS

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
10837JMP	DRESSING HYDROFIBRE ALTERNATE TO ALGINATESR dressing hydrofibre alternate to alginates 10 cm x 10 cm dressing, 10 (PI, CMI)
	Available brands
	Aquacel Foam Non-Adhesive	1	10	0	$123.36	$7.70	$7.70

Source	Repatriation Pharmaceutical Benefits
Body System	VARIOUS > ALL OTHER NON-THERAPEUTIC PRODUCTS > ALL OTHER NON-THERAPEUTIC PRODUCTS

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
2797FMP	DRESSING HYDROFIBRE ALTERNATE TO ALGINATESR dressing hydrofibre alternate to alginates 10 cm x 10 cm dressing, 10 (PI, CMI)
	Available brands
	Aquacel Extra 420672	1	1	1	$99.75	$7.70	$7.70

Source	Repatriation Pharmaceutical Benefits
Body System	VARIOUS > ALL OTHER NON-THERAPEUTIC PRODUCTS > ALL OTHER NON-THERAPEUTIC PRODUCTS

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
2803MMP	DRESSING HYDROFIBRE ALTERNATE TO ALGINATESR dressing hydrofibre alternate to alginates 15 cm x 15 cm dressing, 5 (PI, CMI)
	Available brands
	Aquacel Extra 420673	2	2	1	$202.28	$7.70	$7.70

Source	Repatriation Pharmaceutical Benefits
Body System	VARIOUS > ALL OTHER NON-THERAPEUTIC PRODUCTS > ALL OTHER NON-THERAPEUTIC PRODUCTS

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
4698GMP	DRESSING HYDROFIBRE ALTERNATE TO ALGINATESR dressing hydrofibre alternate to alginates 2 cm x 45 cm ribbon, 5 (PI, CMI)
	Available brands
	Aquacel 403770	1	1	1	$84.05	$7.70	$7.70