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
4686PMP	DRESSING FILMR dressing film 6 cm x 7 cm dressing, 8 (PI, CMI)
	Available brands
	Nexcare Tegaderm Transparent H1624	1	1	0	$21.48	$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
4687QMP	DRESSING FILMR dressing film 10 cm x 12 cm dressing, 4 (PI, CMI)
	Available brands
	Nexcare Tegaderm Transparent H1626	1	1	0	$24.96	$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
4688RMP	DRESSING FILMR dressing film 15 cm x 20 cm dressing, 1 (PI, CMI)
	Available brands
	Tegaderm Transparent 1628	6	6	0	$34.53	$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
4893MMP	DRESSING FILMR dressing film 10 cm x 12 cm dressing, 10 (PI, CMI)
	Available brands
	Op-Site Flexigrid 4629	1	1	0	$45.71	$7.70	$7.70