DRESSING FOAM WITH SILICONE HEAVY EXUDATE

DRESSING FOAM WITH SILICONE HEAVY EXUDATE (12184G)

dressing foam with silicone heavy exudate 7.5 cm x 7.5 cm dressing, 10
12184G
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
Mepilex Border Flex 595211 DPMQ: $54.10 Max safety net: $7.70 General Patient Charge: $7.70

DRESSING FOAM WITH SILICONE HEAVY EXUDATE (12185H)

dressing foam with silicone heavy exudate 15 cm x 20 cm dressing, 10
12185H
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
Mepilex Border Flex 595611 DPMQ: $175.17 Max safety net: $7.70 General Patient Charge: $7.70

DRESSING FOAM WITH SILICONE HEAVY EXUDATE (12195W)

dressing foam with silicone heavy exudate 22 cm x 23 cm dressing, 6
12195W
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
Mepilex Border Heel 282750 DPMQ: $165.09 Max safety net: $7.70 General Patient Charge: $7.70

DRESSING FOAM WITH SILICONE HEAVY EXUDATE (12206K)

dressing foam with silicone heavy exudate 10 cm x 10 cm dressing, 10
12206K
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
Mepilex Border Flex 595311 DPMQ: $71.62 Max safety net: $7.70 General Patient Charge: $7.70

DRESSING FOAM WITH SILICONE HEAVY EXUDATE (12207L)

dressing foam with silicone heavy exudate 22 cm x 25 cm dressing, 5
12207L
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
Mepilex Border Sacrum 282450 DPMQ: $126.54 Max safety net: $7.70 General Patient Charge: $7.70

DRESSING FOAM WITH SILICONE HEAVY EXUDATE (12216Y)

dressing foam with silicone heavy exudate 16 cm x 20 cm dressing, 5
12216Y
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
Mepilex Border Sacrum 282050 DPMQ: $84.29 Max safety net: $7.70 General Patient Charge: $7.70

DRESSING FOAM WITH SILICONE HEAVY EXUDATE (4196W)

dressing foam with silicone heavy exudate 10 cm x 10 cm dressing, 10
4196W
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
Allevyn Gentle 66800248 DPMQ: $86.27 Max safety net: $7.70 General Patient Charge: $7.70

DRESSING FOAM WITH SILICONE HEAVY EXUDATE (4207K)

dressing foam with silicone heavy exudate 7.5 cm x 7.5 cm dressing, 10
4207K
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
Allevyn Gentle Border 66800269 DPMQ: $68.71 Max safety net: $7.70 General Patient Charge: $7.70

DRESSING FOAM WITH SILICONE HEAVY EXUDATE (4230P)

dressing foam with silicone heavy exudate 10 cm x 10 cm dressing, 10
4230P
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
Allevyn Gentle Border 66800270 DPMQ: $95.86 Max safety net: $7.70 General Patient Charge: $7.70