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
4767XMP	GAUZE AND COTTON TISSUE COMBINE ROLLR gauze and cotton tissue combine roll 9 cm x 10 m wrapped pack roll, 1 (PI, CMI)
	Available brands
	BSN 2902165	1	1	0	$18.23	$7.70	$7.70