SKIN EMOLLIENT

SKIN EMOLLIENT (4107E)

SKIN EMOLLIENT Lotion 500 mL, 1
4107E
Body System:
Manner of administration:Application
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: 2 DPMQ: - Max safety net: - General Patient Charge: -
Available brands
Alpha Keri Lotion DPMQ: $23.29 Max safety net: $7.70 General Patient Charge: $7.70

SKIN EMOLLIENT (4122Y)

SKIN EMOLLIENT Bath oil 500 mL, 1
4122Y
Body System:
Manner of administration:Application
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: 2 DPMQ: - Max safety net: - General Patient Charge: -
Available brands
Alpha Keri Bath Oil DPMQ: $23.29 Max safety net: $7.70 General Patient Charge: $7.70
Hamilton Skin Therapy Oil DPMQ: $25.47 Max safety net: $7.70 General Patient Charge: $7.70
QV Bath Oil DPMQ: $25.39 Max safety net: $7.70 General Patient Charge: $7.70