DRESSING FOAM WITH SILICONE HEAVY EXUDATE

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
4196WMP DRESSING FOAM WITH SILICONE HEAVY EXUDATER
dressing foam with silicone heavy exudate 10 cm x 10 cm dressing, 10 (PI, CMI)
Available brands
Allevyn Gentle 66800248 1 1 0 $84.02 $6.60 $6.60
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DRESSING FOAM WITH SILICONE HEAVY EXUDATE

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
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 $60.02 $6.60 $6.60
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DRESSING FOAM WITH SILICONE HEAVY EXUDATE

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
4230PMP DRESSING FOAM WITH SILICONE HEAVY EXUDATER
dressing foam with silicone heavy exudate 10 cm x 10 cm dressing, 10 (PI, CMI)
Available brands
Allevyn Gentle Border 66800270 1 1 0 $84.02 $6.60 $6.60
space

DRESSING FOAM WITH SILICONE HEAVY EXUDATE

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
4642HMP DRESSING FOAM WITH SILICONE HEAVY EXUDATER
dressing foam with silicone heavy exudate 7.5 cm x 7.5 cm dressing, 5 (PI, CMI)
Available brands
Mepilex Border 295200 1 1 0 $33.19 $6.60 $6.60
space

DRESSING FOAM WITH SILICONE HEAVY EXUDATE

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
4643JMP DRESSING FOAM WITH SILICONE HEAVY EXUDATER
dressing foam with silicone heavy exudate 10 cm x 10 cm dressing, 5 (PI, CMI)
Available brands
Mepilex Border 295300 1 1 0 $43.78 $6.60 $6.60
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  • Legend
  • RRepatriation Care items
  • MPMedical Practitioner