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

Note

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
12629QMP	DRESSING HYDROACTIVE DEBRIDEMENTR dressing hydroactive debridement 5.5 cm dressing, 10 (PI, CMI)
	Available brands
	HydroClean Plus 609606	1	1	0	$148.59	$7.70	$7.70

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

Note

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
12636CMP	DRESSING HYDROACTIVE DEBRIDEMENTR dressing hydroactive debridement 4 cm dressing, 10 (PI, CMI)
	Available brands
	HydroClean Plus Cavity 609622	1	1	0	$93.38	$7.70	$7.70

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

Note

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
12637DMP	DRESSING HYDROACTIVE DEBRIDEMENTR dressing hydroactive debridement 4 cm dressing, 10 (PI, CMI)
	Available brands
	HydroClean Plus 609602	1	1	0	$89.55	$7.70	$7.70

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

Note

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
12660HMP	DRESSING HYDROACTIVE DEBRIDEMENTR dressing hydroactive debridement 7.5 cm x 7.5 cm dressing, 10 (PI, CMI)
	Available brands
	HydroClean Plus 609608	1	1	0	$197.64	$7.70	$7.70

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

Note

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
4948KMP	DRESSING HYDROACTIVE DEBRIDEMENTR dressing hydroactive debridement 5.5 cm dressing, 10 (PI, CMI)
	Available brands
	TenderWet Active Cavity 609272	1	1	0	$86.65	$7.70	$7.70

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

Note

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
4949LMP	DRESSING HYDROACTIVE DEBRIDEMENTR dressing hydroactive debridement 4 cm dressing, 10 (PI, CMI)
	Available brands
	TenderWet 24 Active 609210	1	1	0	$84.79	$7.70	$7.70

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

Note

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
4950MMP	DRESSING HYDROACTIVE DEBRIDEMENTR dressing hydroactive debridement 7.5 cm x 7.5 cm dressing, 10 (PI, CMI)
	Available brands
	TenderWet 24 Active 609213	1	1	0	$112.39	$7.70	$7.70