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
12184GMP	DRESSING FOAM WITH SILICONE HEAVY EXUDATER dressing foam with silicone heavy exudate 7.5 cm x 7.5 cm dressing, 10 (PI, CMI)
	Available brands
	Mepilex Border Flex 595211	1	1	0	$53.96	$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
4207KMP	DRESSING FOAM WITH SILICONE HEAVY EXUDATER dressing foam with silicone heavy exudate 7.5 cm x 7.5 cm dressing, 10 (PI, CMI)
	Available brands
	Allevyn Gentle Border 66800269	1	1	0	$67.37	$7.70	$7.70