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

Authority Required

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
12772FMP	DRESSING ALGINATE WITH SILVER DEEP WOUNDR dressing alginate with silver deep wound 5 cm x 5 cm dressing, 10 (PI, CMI)
	Available brands
	Melgisorb Ag 256055	1	1	0	$136.82	$7.70	$7.70

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

Authority Required

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
12801RMP	DRESSING ALGINATE WITH SILVER DEEP WOUNDR dressing alginate with silver deep wound 10 cm x 10 cm dressing, 10 (PI, CMI)
	Available brands
	Melgisorb Ag 256105	1	1	0	$237.41	$7.70	$7.70