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
13012WMP	DRESSING POLY-ABSORBENT FIBRE LIPIDOCOLLOID WITH SUCROSE OCTASULFATE MODERATE EXUDATER dressing poly-absorbent fibre lipidocolloid with sucrose octasulfate moderate exudate 15 cm x 20 cm dressing, 10 (PI, CMI)
	Available brands
	UrgoStart Plus Pad 100422	1	1	3	$475.32	$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
13025MMP	DRESSING POLY-ABSORBENT FIBRE LIPIDOCOLLOID WITH SUCROSE OCTASULFATE MODERATE EXUDATER dressing poly-absorbent fibre lipidocolloid with sucrose octasulfate moderate exudate 10 cm x 10 cm dressing, 10 (PI, CMI)
	Available brands
	UrgoStart Plus Pad 100421	1	1	3	$210.11	$7.70	$7.70