DRESSING HYDROGEL SHEET

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
4806YMP DRESSING HYDROGEL SHEETR
dressing hydrogel sheet 10 cm x 10 cm dressing, 5 (PI, CMI)
Available brands
Hydrosorb 900854 2 2 0 $54.38 $6.60 $6.60
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DRESSING HYDROGEL SHEET

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
4911LMP DRESSING HYDROGEL SHEETR
dressing hydrogel sheet 9.5 cm x 10.2 cm dressing, 5 (PI, CMI)
Available brands
Nu-Gel 2497 2 2 0 $81.82 $6.60 $6.60
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