Source	Repatriation Pharmaceutical Benefits
Body System	VARIOUS > ALL OTHER NON-THERAPEUTIC PRODUCTS > ALL OTHER NON-THERAPEUTIC PRODUCTS

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
11715NMP	DRESSING NON-ADHERENT ABSORBENTR dressing non-adherent absorbent 22 cm x 22 cm hydroactive dressing, 10 (PI, CMI)
	Available brands
	Vliwasorb Pro 32643	1	1	0	$38.51	$7.70	$7.70

Source	Repatriation Pharmaceutical Benefits
Body System	VARIOUS > ALL OTHER NON-THERAPEUTIC PRODUCTS > ALL OTHER NON-THERAPEUTIC PRODUCTS

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
11717QMP	DRESSING NON-ADHERENT ABSORBENTR dressing non-adherent absorbent 12.5 cm x 12.5 cm hydroactive dressing, 10 (PI, CMI)
	Available brands
	Vliwasorb Pro 32641	1	1	0	$27.65	$7.70	$7.70

Source	Repatriation Pharmaceutical Benefits
Body System	VARIOUS > ALL OTHER NON-THERAPEUTIC PRODUCTS > ALL OTHER NON-THERAPEUTIC PRODUCTS

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
11718RMP	DRESSING NON-ADHERENT ABSORBENTR dressing non-adherent absorbent 22 cm x 32 cm hydroactive dressing, 10 (PI, CMI)
	Available brands
	Vliwasorb Pro 32644	1	1	0	$51.09	$7.70	$7.70