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
11715NMP	DRESSING NON-ADHERENT ABSORBENTR dressing non-adherent absorbent 22 cm x 22 cm hydroactive dressing, 10 (PI, CMI)
	Available brands
	Vliwasorb Pro 32643	1	1	0	$38.84	$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
11717QMP	DRESSING NON-ADHERENT ABSORBENTR dressing non-adherent absorbent 12.5 cm x 12.5 cm hydroactive dressing, 10 (PI, CMI)
	Available brands
	Vliwasorb Pro 32641	1	1	0	$27.98	$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
11718RMP	DRESSING NON-ADHERENT ABSORBENTR dressing non-adherent absorbent 22 cm x 32 cm hydroactive dressing, 10 (PI, CMI)
	Available brands
	Vliwasorb Pro 32644	1	1	0	$51.42	$7.70	$7.70

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

Note

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
12593TMP	DRESSING NON-ADHERENT ABSORBENTR dressing non-adherent absorbent 10 cm x 20 cm hydroactive dressing, 10 (PI, CMI)
	Available brands
	Zetuvit Plus 413711	1	1	0	$46.11	$7.70	$7.70

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

Note

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
12599DMP	DRESSING NON-ADHERENT ABSORBENTR dressing non-adherent absorbent 20 cm x 40 cm hydroactive dressing, 10 (PI, CMI)
	Available brands
	Zetuvit Plus 413715	1	1	0	$97.83	$7.70	$7.70

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

Note

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
12600EMP	DRESSING NON-ADHERENT ABSORBENTR dressing non-adherent absorbent 10 cm x 10 cm hydroactive dressing, 10 (PI, CMI)
	Available brands
	Zetuvit Plus 413710	1	1	0	$39.65	$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
12824YMP	DRESSING NON-ADHERENT ABSORBENTR dressing non-adherent absorbent 23 cm x 25 cm dressing, 30 (PI, CMI)
	Available brands
	Mesorb 677701	1	1	0	$101.85	$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
12825BMP	DRESSING NON-ADHERENT ABSORBENTR dressing non-adherent absorbent 10 cm x 23 cm dressing, 50 (PI, CMI)
	Available brands
	Mesorb 677401	1	1	0	$78.84	$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
12832JMP	DRESSING NON-ADHERENT ABSORBENTR dressing non-adherent absorbent 10 cm x 13 cm dressing, 50 (PI, CMI)
	Available brands
	Mesorb 677001	1	1	0	$58.41	$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
12833KMP	DRESSING NON-ADHERENT ABSORBENTR dressing non-adherent absorbent 22.5 cm x 32.5 cm hydroactive dressing, 10 (PI, CMI)
	Available brands
	Mextra Superabsorbent 610500	1	1	0	$91.20	$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
12834LMP	DRESSING NON-ADHERENT ABSORBENTR dressing non-adherent absorbent 17.5 cm x 22.5 cm hydroactive dressing, 10 (PI, CMI)
	Available brands
	Mextra Superabsorbent 610300	1	1	0	$53.57	$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
12837PMP	DRESSING NON-ADHERENT ABSORBENTR dressing non-adherent absorbent 12.5 cm x 12.5 cm hydroactive dressing, 10 (PI, CMI)
	Available brands
	Mextra Superabsorbent 610000	1	1	0	$34.54	$7.70	$7.70