CADEXOMER-IODINE

CADEXOMER-IODINE (4931M)

cadexomer-iodine 3 g powder, 7 sachets
4931M
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: 2 DPMQ: - Max safety net: - General Patient Charge: -
Available brands
Iodosorb Powder 66051070 DPMQ: $95.71 Max safety net: $7.70 General Patient Charge: $7.70

CADEXOMER-IODINE (4932N)

cadexomer-iodine 50% ointment, 4 x 10 g
4932N
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: 2 DPMQ: - Max safety net: - General Patient Charge: -
Available brands
Iodosorb Ointment 66051240 DPMQ: $152.58 Max safety net: $7.70 General Patient Charge: $7.70

CADEXOMER-IODINE (4933P)

cadexomer-iodine 50% ointment, 2 x 20 g
4933P
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: 2 DPMQ: - Max safety net: - General Patient Charge: -
Available brands
Iodosorb Ointment 66051230 DPMQ: $151.13 Max safety net: $7.70 General Patient Charge: $7.70

CADEXOMER-IODINE (4935R)

cadexomer-iodine 6 cm x 4 cm dressing, 5 x 5 g sheet
4935R
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: 2 DPMQ: - Max safety net: - General Patient Charge: -
Available brands
Iodosorb 66051330 DPMQ: $144.19 Max safety net: $7.70 General Patient Charge: $7.70

CADEXOMER-IODINE (4936T)

cadexomer-iodine 8 cm x 6 cm dressing, 3 x 10 g sheet
4936T
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: 2 DPMQ: - Max safety net: - General Patient Charge: -
Available brands
Iodosorb 66051340 DPMQ: $208.35 Max safety net: $7.70 General Patient Charge: $7.70

CADEXOMER-IODINE (4937W)

cadexomer-iodine 10 cm x 8 cm dressing, 2 x 17 g sheet
4937W
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
Iodosorb 66051360 DPMQ: $219.52 Max safety net: $7.70 General Patient Charge: $7.70