DRESSING FOAM HEAVY EXUDATE

DRESSING FOAM HEAVY EXUDATE (12760N)

dressing foam heavy exudate 10 cm x 10 cm dressing, 5
12760N
Body System:
Manner of administration:For External Use
Repatriation Pharmaceutical Benefits
Restricted Benefit

Restriction

Indication: Wounds
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 1 # of repeats: 0 DPMQ: - Max safety net: - General Patient Charge: -
Available brands
Mepilex XT 211100 DPMQ: $44.59 Max safety net: $7.70 General Patient Charge: $7.70

DRESSING FOAM HEAVY EXUDATE (12776K)

dressing foam heavy exudate 20 cm x 20 cm dressing, 5
12776K
Body System:
Manner of administration:For External Use
Repatriation Pharmaceutical Benefits
Restricted Benefit

Restriction

Indication: Wounds
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 1 # of repeats: 0 DPMQ: - Max safety net: - General Patient Charge: -
Available brands
Mepilex XT 211400 DPMQ: $132.19 Max safety net: $7.70 General Patient Charge: $7.70

DRESSING FOAM HEAVY EXUDATE (12797M)

dressing foam heavy exudate 5 cm x 5 cm dressing, 5
12797M
Body System:
Manner of administration:For External Use
Repatriation Pharmaceutical Benefits
Restricted Benefit

Restriction

Indication: Wounds
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 1 # of repeats: 0 DPMQ: - Max safety net: - General Patient Charge: -
Available brands
Mepilex XT 211015 DPMQ: $38.57 Max safety net: $7.70 General Patient Charge: $7.70

DRESSING FOAM HEAVY EXUDATE (4795J)

dressing foam heavy exudate 10 cm x 10 cm dressing, 10
4795J
Body System:
Manner of administration:For External Use
Repatriation Pharmaceutical Benefits
No restrictions
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 1 # of repeats: 1 DPMQ: - Max safety net: - General Patient Charge: -
Available brands
Allevyn 66007637 DPMQ: $179.16 Max safety net: $7.70 General Patient Charge: $7.70