DRESSING HYDROGEL AMORPHOUS

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
4599CMP DRESSING HYDROGEL AMORPHOUSR
dressing hydrogel amorphous gel, 50 g (PI, CMI)
Available brands
SoloSite Gel 36361338 3 3 3 $39.17 $6.80 $6.80
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DRESSING HYDROGEL AMORPHOUS

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
4894NMP DRESSING HYDROGEL AMORPHOUSR
dressing hydrogel amorphous gel, 25 g (PI, CMI)
Available brands
Intrasite Gel 7313 4 4 3 $80.42 $6.80 $6.80
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DRESSING HYDROGEL AMORPHOUS

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
4912MMP DRESSING HYDROGEL AMORPHOUSR
dressing hydrogel amorphous gel, 10 x 15 g (PI, CMI)
Available brands
Comfeel Purilon Gel 3900 1 1 1 $71.84 $6.80 $6.80
DuoDERM Gel 187990 1 1 1 $64.92 $6.80 $6.80
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DRESSING HYDROGEL AMORPHOUS

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
4913NMP DRESSING HYDROGEL AMORPHOUSR
dressing hydrogel amorphous gel, 3 x 30 g (PI, CMI)
Available brands
DuoDERM Gel H7987 3 3 1 $94.58 $6.80 $6.80
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DRESSING HYDROGEL AMORPHOUS

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
4914PMP DRESSING HYDROGEL AMORPHOUSR
dressing hydrogel amorphous gel, 50 g (PI, CMI)
Available brands
Solugel 10336 3 3 3 $35.36 $6.80 $6.80
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  • Legend
  • RRepatriation Care items
  • MPMedical Practitioner