DRESSING FOAM WITH SILVER

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
4252TMP DRESSING FOAM WITH SILVERR
dressing foam with silver 7.5 cm x 7.5 cm dressing, 10 (PI, CMI)
Available brands
Allevyn Ag Adhesive 66800073 1 1 0 $161.72 $6.80 $6.80
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DRESSING FOAM WITH SILVER

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
4263JMP DRESSING FOAM WITH SILVERR
dressing foam with silver 7.5 cm x 7.5 cm dressing, 10 (PI, CMI)
Available brands
Allevyn Ag Gentle Border 66800460 1 1 0 $161.72 $6.80 $6.80
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  • Legend
  • RRepatriation Care items
  • MPMedical Practitioner