DRESSING NON-ADHERENT ABSORBENT

DRESSING NON-ADHERENT ABSORBENT (12824Y)

dressing non-adherent absorbent 23 cm x 25 cm dressing, 30
12824Y
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: 0 DPMQ: - Max safety net: - General Patient Charge: -
Available brands
Mesorb 677701 DPMQ: $101.85 Max safety net: $7.70 General Patient Charge: $7.70

DRESSING NON-ADHERENT ABSORBENT (12825B)

dressing non-adherent absorbent 10 cm x 23 cm dressing, 50
12825B
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: 0 DPMQ: - Max safety net: - General Patient Charge: -
Available brands
Mesorb 677401 DPMQ: $78.84 Max safety net: $7.70 General Patient Charge: $7.70

DRESSING NON-ADHERENT ABSORBENT (12832J)

dressing non-adherent absorbent 10 cm x 13 cm dressing, 50
12832J
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: 0 DPMQ: - Max safety net: - General Patient Charge: -
Available brands
Mesorb 677001 DPMQ: $58.41 Max safety net: $7.70 General Patient Charge: $7.70

DRESSING NON-ADHERENT ABSORBENT (12833K)

dressing non-adherent absorbent 22.5 cm x 32.5 cm hydroactive dressing, 10
12833K
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: 0 DPMQ: - Max safety net: - General Patient Charge: -
Available brands
Mextra Superabsorbent 610500 DPMQ: $91.20 Max safety net: $7.70 General Patient Charge: $7.70

DRESSING NON-ADHERENT ABSORBENT (12834L)

dressing non-adherent absorbent 17.5 cm x 22.5 cm hydroactive dressing, 10
12834L
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: 0 DPMQ: - Max safety net: - General Patient Charge: -
Available brands
Mextra Superabsorbent 610300 DPMQ: $53.57 Max safety net: $7.70 General Patient Charge: $7.70

DRESSING NON-ADHERENT ABSORBENT (12837P)

dressing non-adherent absorbent 12.5 cm x 12.5 cm hydroactive dressing, 10
12837P
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: 0 DPMQ: - Max safety net: - General Patient Charge: -
Available brands
Mextra Superabsorbent 610000 DPMQ: $34.54 Max safety net: $7.70 General Patient Charge: $7.70