Q4 |
Svc exempt - ordrg/rfrng md |
Service for ordering/referring physician qualifies as a service exemption |
Q4001 |
Cast sup body cast plaster |
Casting supplies, body cast adult, with or without head, plaster |
Q4002 |
Cast sup body cast fiberglas |
Cast supplies, body cast adult, with or without head, fiberglass |
Q4003 |
Cast sup shoulder cast plstr |
Cast supplies, shoulder cast, adult (11 years +), plaster |
Q4004 |
Cast sup shoulder cast fbrgl |
Cast supplies, shoulder cast, adult (11 years +), fiberglass |
Q4005 |
Cast sup long arm adult plst |
Cast supplies, long arm cast, adult (11 years +), plaster |
Q4006 |
Cast sup long arm adult fbrg |
Cast supplies, long arm cast, adult (11 years +), fiberglass |
Q4007 |
Cast sup long arm ped plster |
Cast supplies, long arm cast, pediatric (0-10 years), plaster |
Q4008 |
Cast sup long arm ped fbrgls |
Cast supplies, long arm cast, pediatric (0-10 years), fiberglass |
Q4009 |
Cast sup sht arm adult plstr |
Cast supplies, short arm cast, adult (11 years +), plaster |
Q4010 |
Cast sup sht arm adult fbrgl |
Cast supplies, short arm cast, adult (11 years +), fiberglass |
Q4011 |
Cast sup sht arm ped plaster |
Cast supplies, short arm cast, pediatric (0-10 years), plaster |
Q4012 |
Cast sup sht arm ped fbrglas |
Cast supplies, short arm cast, pediatric (0-10 years), fiberglass |
Q4013 |
Cast sup gauntlet plaster |
Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster |
Q4014 |
Cast sup gauntlet fiberglass |
Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass |
Q4015 |
Cast sup gauntlet ped plster |
Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster |
Q4016 |
Cast sup gauntlet ped fbrgls |
Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass |
Q4017 |
Cast sup lng arm splint plst |
Cast supplies, long arm splint, adult (11 years +), plaster |
Q4018 |
Cast sup lng arm splint fbrg |
Cast supplies, long arm splint, adult (11 years +), fiberglass |
Q4019 |
Cast sup lng arm splnt ped p |
Cast supplies, long arm splint, pediatric (0-10 years), plaster |
Q4020 |
Cast sup lng arm splnt ped f |
Cast supplies, long arm splint, pediatric (0-10 years), fiberglass |
Q4021 |
Cast sup sht arm splint plst |
Cast supplies, short arm splint, adult (11 years +), plaster |
Q4022 |
Cast sup sht arm splint fbrg |
Cast supplies, short arm splint, adult (11 years +), fiberglass |
Q4023 |
Cast sup sht arm splnt ped p |
Cast supplies, short arm splint, pediatric (0-10 years), plaster |
Q4024 |
Cast sup sht arm splnt ped f |
Cast supplies, short arm splint, pediatric (0-10 years), fiberglass |
Q4025 |
Cast sup hip spica plaster |
Cast supplies, hip spica (one or both legs), adult (11 years +), plaster |
Q4026 |
Cast sup hip spica fiberglas |
Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass |
Q4027 |
Cast sup hip spica ped plstr |
Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster |
Q4028 |
Cast sup hip spica ped fbrgl |
Cast supplies, hip spica (one or both legs), pediatric (0-10 years), fiberglass |
Q4029 |
Cast sup long leg plaster |
Cast supplies, long leg cast, adult (11 years +), plaster |
Q4030 |
Cast sup long leg fiberglass |
Cast supplies, long leg cast, adult (11 years +), fiberglass |
Q4031 |
Cast sup lng leg ped plaster |
Cast supplies, long leg cast, pediatric (0-10 years), plaster |
Q4032 |
Cast sup lng leg ped fbrgls |
Cast supplies, long leg cast, pediatric (0-10 years), fiberglass |
Q4033 |
Cast sup lng leg cylinder pl |
Cast supplies, long leg cylinder cast, adult (11 years +), plaster |
Q4034 |
Cast sup lng leg cylinder fb |
Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass |
Q4035 |
Cast sup lngleg cylndr ped p |
Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster |
Q4036 |
Cast sup lngleg cylndr ped f |
Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass |
Q4037 |
Cast sup shrt leg plaster |
Cast supplies, short leg cast, adult (11 years +), plaster |
Q4038 |
Cast sup shrt leg fiberglass |
Cast supplies, short leg cast, adult (11 years +), fiberglass |
Q4039 |
Cast sup shrt leg ped plster |
Cast supplies, short leg cast, pediatric (0-10 years), plaster |
Q4040 |
Cast sup shrt leg ped fbrgls |
Cast supplies, short leg cast, pediatric (0-10 years), fiberglass |
Q4041 |
Cast sup lng leg splnt plstr |
Cast supplies, long leg splint, adult (11 years +), plaster |
Q4042 |
Cast sup lng leg splnt fbrgl |
Cast supplies, long leg splint, adult (11 years +), fiberglass |
Q4043 |
Cast sup lng leg splnt ped p |
Cast supplies, long leg splint, pediatric (0-10 years), plaster |
Q4044 |
Cast sup lng leg splnt ped f |
Cast supplies, long leg splint, pediatric (0-10 years), fiberglass |
Q4045 |
Cast sup sht leg splnt plstr |
Cast supplies, short leg splint, adult (11 years +), plaster |
Q4046 |
Cast sup sht leg splnt fbrgl |
Cast supplies, short leg splint, adult (11 years +), fiberglass |
Q4047 |
Cast sup sht leg splnt ped p |
Cast supplies, short leg splint, pediatric (0-10 years), plaster |
Q4048 |
Cast sup sht leg splnt ped f |
Cast supplies, short leg splint, pediatric (0-10 years), fiberglass |
Q4049 |
Finger splint, static |
Finger splint, static |
Q4050 |
Cast supplies unlisted |
Cast supplies, for unlisted types and materials of casts |
Q4051 |
Splint supplies misc |
Splint supplies, miscellaneous (includes thermoplastics, strapping, fasteners, padding and other supplies) |
Q4074 |
Iloprost non-comp unit dose |
Iloprost, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 20 micrograms |
Q4081 |
Epoetin alfa, 100 units esrd |
Injection, epoetin alfa, 100 units (for esrd on dialysis) |
Q4082 |
Drug/bio noc part b drug cap |
Drug or biological, not otherwise classified, part b drug competitive acquisition program (cap) |
Q4100 |
Skin substitute, nos |
Skin substitute, not otherwise specified |
Q4101 |
Apligraf |
Apligraf, per square centimeter |
Q4102 |
Oasis wound matrix |
Oasis wound matrix, per square centimeter |
Q4103 |
Oasis burn matrix |
Oasis burn matrix, per square centimeter |
Q4104 |
Integra bmwd |
Integra bilayer matrix wound dressing (bmwd), per square centimeter |
Q4105 |
Integra drt or omnigraft |
Integra dermal regeneration template (drt) or integra omnigraft dermal regeneration matrix, per square centimeter |
Q4106 |
Dermagraft |
Dermagraft, per square centimeter |
Q4107 |
Graftjacket |
Graftjacket, per square centimeter |
Q4108 |
Integra matrix |
Integra matrix, per square centimeter |
Q4110 |
Primatrix |
Primatrix, per square centimeter |
Q4111 |
Gammagraft |
Gammagraft, per square centimeter |
Q4112 |
Cymetra injectable |
Cymetra, injectable, 1 cc |
Q4113 |
Graftjacket xpress |
Graftjacket xpress, injectable, 1 cc |
Q4114 |
Integra flowable wound matri |
Integra flowable wound matrix, injectable, 1 cc |
Q4115 |
Alloskin |
Alloskin, per square centimeter |
Q4116 |
Alloderm |
Alloderm, per square centimeter |
Q4117 |
Hyalomatrix |
Hyalomatrix, per square centimeter |
Q4118 |
Matristem micromatrix |
Matristem micromatrix, 1 mg |
Q4119 |
Matristem wound matrix |
Matristem wound matrix, per square centimeter |
Q4120 |
Matristem burn matrix |
Matristem burn matrix, per square centimeter |
Q4121 |
Theraskin |
Theraskin, per square centimeter |
Q4122 |
Dermacell, awm, porous sq cm |
Dermacell, dermacell awm or dermacell awm porous, per square centimeter |
Q4123 |
Alloskin |
Alloskin rt, per square centimeter |
Q4124 |
Oasis tri-layer wound matrix |
Oasis ultra tri-layer wound matrix, per square centimeter |
Q4125 |
Arthroflex |
Arthroflex, per square centimeter |
Q4126 |
Memoderm/derma/tranz/integup |
Memoderm, dermaspan, tranzgraft or integuply, per square centimeter |
Q4127 |
Talymed |
Talymed, per square centimeter |
Q4128 |
Flexhd/allopatchhd/sq cm |
Flex hd, or allopatch hd, per square centimeter |
Q4129 |
Unite biomatrix |
Unite biomatrix, per square centimeter |
Q4130 |
Strattice tm |
Strattice tm, per square centimeter |
Q4131 |
Epifix or epicord |
Epifix or epicord, per square centimeter |
Q4132 |
Grafix core, grafixpl core |
Grafix core and grafixpl core, per square centimeter |
Q4133 |
Grafix stravix prime pl sqcm |
Grafix prime, grafixpl prime, stravix and stravixpl, per square centimeter |
Q4134 |
Hmatrix |
Hmatrix, per square centimeter |
Q4135 |
Mediskin |
Mediskin, per square centimeter |
Q4136 |
Ezderm |
Ez-derm, per square centimeter |
Q4137 |
Amnioexcel biodexcel 1sq cm |
Amnioexcel, amnioexcel plus or biodexcel, per square centimeter |
Q4138 |
Biodfence dryflex, 1cm |
Biodfence dryflex, per square centimeter |
Q4139 |
Amnio or biodmatrix, inj 1cc |
Amniomatrix or biodmatrix, injectable, 1 cc |
Q4140 |
Biodfence 1cm |
Biodfence, per square centimeter |
Q4141 |
Alloskin ac, 1 cm |
Alloskin ac, per square centimeter |
Q4142 |
Xcm biologic tiss matrix 1cm |
Xcm biologic tissue matrix, per square centimeter |
Q4143 |
Repriza, 1cm |
Repriza, per square centimeter |
Q4145 |
Epifix, inj, 1mg |
Epifix, injectable, 1 mg |
Q4146 |
Tensix, 1cm |
Tensix, per square centimeter |
Q4147 |
Architect ecm px fx 1 sq cm |
Architect, architect px, or architect fx, extracellular matrix, per square centimeter |
Q4148 |
Neox neox rt or clarix cord |
Neox cord 1k, neox cord rt, or clarix cord 1k, per square centimeter |
Q4149 |
Excellagen, 0.1 cc |
Excellagen, 0.1 cc |
Q4150 |
Allowrap ds or dry 1 sq cm |
Allowrap ds or dry, per square centimeter |
Q4151 |
Amnioband, guardian 1 sq cm |
Amnioband or guardian, per square centimeter |
Q4152 |
Dermapure 1 square cm |
Dermapure, per square centimeter |
Q4153 |
Dermavest, plurivest sq cm |
Dermavest and plurivest, per square centimeter |
Q4154 |
Biovance 1 square cm |
Biovance, per square centimeter |
Q4155 |
Neoxflo or clarixflo 1 mg |
Neoxflo or clarixflo, 1 mg |
Q4156 |
Neox 100 or clarix 100 |
Neox 100 or clarix 100, per square centimeter |
Q4157 |
Revitalon 1 square cm |
Revitalon, per square centimeter |
Q4158 |
Kerecis omega3, per sq cm |
Kerecis omega3, per square centimeter |
Q4159 |
Affinity1 square cm |
Affinity, per square centimeter |
Q4160 |
Nushield 1 square cm |
Nushield, per square centimeter |
Q4161 |
Bio-connekt per square cm |
Bio-connekt wound matrix, per square centimeter |
Q4162 |
Wndex flw, bioskn flw, 0.5cc |
Woundex flow, bioskin flow, 0.5 cc |
Q4163 |
Woundex, bioskin, per sq cm |
Woundex, bioskin, per square centimeter |
Q4164 |
Helicoll, per square cm |
Helicoll, per square centimeter |
Q4165 |
Keramatrix, kerasorb sq cm |
Keramatrix or kerasorb, per square centimeter |
Q4166 |
Cytal, per square centimeter |
Cytal, per square centimeter |
Q4167 |
Truskin, per sq centimeter |
Truskin, per square centimeter |
Q4168 |
Amnioband, 1 mg |
Amnioband, 1 mg |
Q4169 |
Artacent wound, per sq cm |
Artacent wound, per square centimeter |
Q4170 |
Cygnus, per sq cm |
Cygnus, per square centimeter |
Q4171 |
Interfyl, 1 mg |
Interfyl, 1 mg |
Q4172 |
Puraply or puraply am |
Puraply or puraply am, per square centimeter |
Q4173 |
Palingen or palingen xplus |
Palingen or palingen xplus, per square centimeter |
Q4174 |
Palingen or promatrx |
Palingen or promatrx, 0.36 mg per 0.25 cc |
Q4175 |
Miroderm |
Miroderm, per square centimeter |
Q4176 |
Neopatch or therion, 1 sq cm |
Neopatch or therion, per square centimeter |
Q4177 |
Floweramnioflo, 0.1 cc |
Floweramnioflo, 0.1 cc |
Q4178 |
Floweramniopatch, per sq cm |
Floweramniopatch, per square centimeter |
Q4179 |
Flowerderm, per sq cm |
Flowerderm, per square centimeter |
Q4180 |
Revita, per sq cm |
Revita, per square centimeter |
Q4181 |
Amnio wound, per square cm |
Amnio wound, per square centimeter |
Q4182 |
Transcyte, per sq centimeter |
Transcyte, per square centimeter |
Q4183 |
Surgigraft, 1 sq cm |
Surgigraft, per square centimeter |
Q4184 |
Cellesta or duo per sq cm |
Cellesta or cellesta duo, per square centimeter |
Q4185 |
Cellesta flowab amnion 0.5cc |
Cellesta flowable amnion (25 mg per cc); per 0.5 cc |
Q4186 |
Epifix 1 sq cm |
Epifix, per square centimeter |
Q4187 |
Epicord 1 sq cm |
Epicord, per square centimeter |
Q4188 |
Amnioarmor 1 sq cm |
Amnioarmor, per square centimeter |
Q4189 |
Artacent ac, 1 mg |
Artacent ac, 1 mg |
Q4190 |
Artacent ac 1 sq cm |
Artacent ac, per square centimeter |
Q4191 |
Restorigin 1 sq cm |
Restorigin, per square centimeter |
Q4192 |
Restorigin, 1 cc |
Restorigin, 1 cc |
Q4193 |
Coll-e-derm 1 sq cm |
Coll-e-derm, per square centimeter |
Q4194 |
Novachor 1 sq cm |
Novachor, per square centimeter |
Q4195 |
Puraply 1 sq cm |
Puraply, per square centimeter |
Q4196 |
Puraply am 1 sq cm |
Puraply am, per square centimeter |
Q4197 |
Puraply xt 1 sq cm |
Puraply xt, per square centimeter |
Q4198 |
Genesis amnio membrane 1sqcm |
Genesis amniotic membrane, per square centimeter |
Q4199 |
Cygnus matrix, per sq cm |
Cygnus matrix, per square centimeter |
Q4200 |
Skin te 1 sq cm |
Skin te, per square centimeter |
Q4201 |
Matrion 1 sq cm |
Matrion, per square centimeter |
Q4202 |
Keroxx (2.5g/cc), 1cc |
Keroxx (2.5g/cc), 1cc |
Q4203 |
Derma-gide, 1 sq cm |
Derma-gide, per square centimeter |
Q4204 |
Xwrap 1 sq cm |
Xwrap, per square centimeter |
Q4205 |
Membrane graft or wrap sq cm |
Membrane graft or membrane wrap, per square centimeter |
Q4206 |
Fluid flow or fluid gf 1 cc |
Fluid flow or fluid gf, 1 cc |
Q4208 |
Novafix per sq cm |
Novafix, per square cenitmeter |
Q4209 |
Surgraft per sq cm |
Surgraft, per square centimeter |
Q4210 |
Axolotl graf dualgraf sq cm |
Axolotl graft or axolotl dualgraft, per square centimeter |
Q4211 |
Amnion bio or axobio sq cm |
Amnion bio or axobiomembrane, per square centimeter |
Q4212 |
Allogen, per cc |
Allogen, per cc |
Q4213 |
Ascent, 0.5 mg |
Ascent, 0.5 mg |
Q4214 |
Cellesta cord per sq cm |
Cellesta cord, per square centimeter |
Q4215 |
Axolotl ambient, cryo 0.1 mg |
Axolotl ambient or axolotl cryo, 0.1 mg |
Q4216 |
Artacent cord per sq cm |
Artacent cord, per square centimeter |
Q4217 |
Woundfix biowound plus xplus |
Woundfix, biowound, woundfix plus, biowound plus, woundfix xplus or biowound xplus, per square centimeter |
Q4218 |
Surgicord per sq cm |
Surgicord, per square centimeter |
Q4219 |
Surgigraft dual per sq cm |
Surgigraft-dual, per square centimeter |
Q4220 |
Bellacell hd, surederm sq cm |
Bellacell hd or surederm, per square centimeter |
Q4221 |
Amniowrap2 per sq cm |
Amniowrap2, per square centimeter |
Q4222 |
Progenamatrix, per sq cm |
Progenamatrix, per square centimeter |
Q4224 |
Hhf10-p per sq cm |
Human health factor 10 amniotic patch (hhf10-p), per square centimeter |
Q4225 |
Amnio or derma tl, per sq cm |
Amniobind or dermabind tl, per square centimeter |
Q4226 |
Myown harv prep proc sq cm |
Myown skin, includes harvesting and preparation procedures, per square centimeter |
Q4227 |
Amniocore per sq cm |
Amniocore, per square centimeter |
Q4228 |
Bionextpatch, per sq cm |
Bionextpatch, per square centimeter |
Q4229 |
Cogenex amnio memb per sq cm |
Cogenex amniotic membrane, per square centimeter |
Q4230 |
Cogenex flow amnion 0.5 cc |
Cogenex flowable amnion, per 0.5 cc |
Q4231 |
Corplex p, per cc |
Corplex p, per cc |
Q4232 |
Corplex, per sq cm |
Corplex, per square centimeter |
Q4233 |
Surfactor /nudyn per 0.5 cc |
Surfactor or nudyn, per 0.5 cc |
Q4234 |
Xcellerate, per sq cm |
Xcellerate, per square centimeter |
Q4235 |
Amniorepair or altiply sq cm |
Amniorepair or altiply, per square centimeter |
Q4236 |
Carepatch per sq cm |
Carepatch, per square centimeter |
Q4237 |
Cryo-cord, per sq cm |
Cryo-cord, per square centimeter |
Q4238 |
Derm-maxx, per sq cm |
Derm-maxx, per square centimeter |
Q4239 |
Amnio-maxx or lite per sq cm |
Amnio-maxx or amnio-maxx lite, per square centimeter |
Q4240 |
Corecyte topical only 0.5 cc |
Corecyte, for topical use only, per 0.5 cc |
Q4241 |
Polycyte, topical only 0.5cc |
Polycyte, for topical use only, per 0.5 cc |
Q4242 |
Amniocyte plus, per 0.5 cc |
Amniocyte plus, per 0.5 cc |
Q4244 |
Procenta, per 200 mg |
Procenta, per 200 mg |
Q4245 |
Amniotext, per cc |
Amniotext, per cc |
Q4246 |
Coretext or protext, per cc |
Coretext or protext, per cc |
Q4247 |
Amniotext patch, per sq cm |
Amniotext patch, per square centimeter |
Q4248 |
Dermacyte amn mem allo sq cm |
Dermacyte amniotic membrane allograft, per square centimeter |
Q4249 |
Amniply, per sq cm |
Amniply, for topical use only, per square centimeter |
Q4250 |
Amnioamp-mp per sq cm |
Amnioamp-mp, per square centimeter |
Q4251 |
Vim, per square centimeter |
Vim, per square centimeter |
Q4252 |
Vendaje, per square centimet |
Vendaje, per square centimeter |
Q4253 |
Zenith amniotic membrane psc |
Zenith amniotic membrane, per square centimeter |
Q4254 |
Novafix dl per sq cm |
Novafix dl, per square centimeter |
Q4255 |
Reguard, topical use per sq |
Reguard, for topical use only, per square centimeter |
Q4256 |
Mlg complet, per sq cm |
Mlg-complete, per square centimeter |
Q4257 |
Relese, per sq cm |
Relese, per square centimeter |
Q4258 |
Enverse, per sq cm |
Enverse, per square centimeter |
Q4259 |
Celera per sq cm |
Celera dual layer or celera dual membrane, per square centimeter |
Q4260 |
Signature apatch, per sq cm |
Signature apatch, per square centimeter |
Q4261 |
Tag, per square centimeter |
Tag, per square centimeter |
Q4262 |
Dual layer impax, per sq cm |
Dual layer impax membrane, per square centimeter |
Q4263 |
Surgraft tl, per sq cm |
Surgraft tl, per square centimeter |
Q4264 |
Cocoon membrane, per sq cm |
Cocoon membrane, per square centimeter |
Q4265 |
Neostim tl per sq cm |
Neostim tl, per square centimeter |
Q4266 |
Neostim per sq cm |
Neostim membrane, per square centimeter |
Q4267 |
Neostim dl per sq cm |
Neostim dl, per square centimeter |
Q4268 |
Surgraft ft per sq cm |
Surgraft ft, per square centimeter |
Q4269 |
Surgraft xt per sq cm |
Surgraft xt, per square centimeter |
Q4270 |
Complete sl per sq cm |
Complete sl, per square centimeter |
Q4271 |
Complete ft per sq cm |
Complete ft, per square centimeter |
Q4272 |
Esano a, per sq cm |
Esano a, per square centimeter |
Q4273 |
Esano aaa, per sq cm |
Esano aaa, per square centimeter |
Q4274 |
Esano ac, per sq cm |
Esano ac, per square centimeter |
Q4275 |
Esano aca, per sq cm |
Esano aca, per square centimeter |
Q4276 |
Orion, per sq cm |
Orion, per square centimeter |
Q4277 |
Woundplus e-grat, per sq cm |
Woundplus membrane or e-graft, per square centimeter |
Q4278 |
Epieffect, per sq cm |
Epieffect, per square centimeter |
Q4279 |
Vendaje ac, per sq cm |
Vendaje ac, per square centimeter |
Q4280 |
Xcell amnio matrix per sq cm |
Xcell amnio matrix, per square centimeter |
Q4281 |
Barrera slor dl per sq cm |
Barrera sl or barrera dl, per square centimeter |
Q4282 |
Cygnus dual per sq cm |
Cygnus dual, per square centimeter |
Q4283 |
Biovance tri or 3l, sq cm |
Biovance tri-layer or biovance 3l, per square centimeter |
Q4284 |
Dermabind sl, per sq cm |
Dermabind sl, per square centimeter |
Q4285 |
Nudyn dl or dl mesh pr sq cm |
Nudyn dl or nudyn dl mesh, per square centimeter |
Q4286 |
Nudyn sl or slw, per sq cm |
Nudyn sl or nudyn slw, per square centimeter |
Q4287 |
Dermabind dl, per sq cm |
Dermabind dl, per square centimeter |
Q4288 |
Dermabind ch, per sq cm |
Dermabind ch, per square centimeter |
Q4289 |
Revoshield+ amnio, per sq cm |
Revoshield + amniotic barrier, per square centimeter |
Q4290 |
Membrane wrap hydr per sq cm |
Membrane wrap-hydro, per square centimeter |
Q4291 |
Lamellas xt, per sq cm |
Lamellas xt, per square centimeter |
Q4292 |
Lamellas, per sq cm |
Lamellas, per square centimeter |
Q4293 |
Acesso dl, per sq cm |
Acesso dl, per square centimeter |
Q4294 |
Amnio quad-core, per sq cm |
Amnio quad-core, per square centimeter |
Q4295 |
Amnio tri-core, per sq cm |
Amnio tri-core amniotic, per square centimeter |
Q4296 |
Rebound matrix, per sq cm |
Rebound matrix, per square centimeter |
Q4297 |
Emerge matrix, per sq cm |
Emerge matrix, per square centimeter |
Q4298 |
Amnicore pro, per sq cm |
Amnicore pro, per square centimeter |
Q4299 |
Amnicore pro+, per sq cm |
Amnicore pro+, per square centimeter |
Q4300 |
Acesso tl, per sq cm |
Acesso tl, per square centimeter |
Q4301 |
Activate matrix, per sq cm |
Activate matrix, per square centimeter |
Q4302 |
Complete aca, per sq cm |
Complete aca, per square centimeter |
Q4303 |
Complete aa, per sq cm |
Complete aa, per square centimeter |
Q4304 |
Grafix plus, per sq cm |
Grafix plus, per square centimeter |
Q4305 |
Amer am ac tri-lay per sq cm |
American amnion ac tri-layer, per square centimeter |
Q4306 |
Americ amnion ac per sq cm |
American amnion ac, per square centimeter |
Q4307 |
American amnion, per sq cm |
American amnion, per square centimeter |
Q4308 |
Sanopellis, per sq cm |
Sanopellis, per square centimeter |
Q4309 |
Via matrix, per sq cm |
Via matrix, per square centimeter |
Q4310 |
Procenta, per 100 mg |
Procenta, per 100 mg |
Q4311 |
Acesso, per sq cm |
Acesso, per square centimeter |
Q4312 |
Acesso ac, per sq cm |
Acesso ac, per square centimeter |
Q4313 |
Dermabind fm, per sq cm |
Dermabind fm, per square centimeter |
Q4314 |
Reeva, per sq cm |
Reeva ft, per square cenitmeter |
Q4315 |
Regenelink amniotic mem allo |
Regenelink amniotic membrane allograft, per square centimeter |
Q4316 |
Amchoplast, per sq cm |
Amchoplast, per square centimeter |
Q4317 |
Vitograft, per sq cm |
Vitograft, per square centimeter |
Q4318 |
E-graft, per sq cm |
E-graft, per square centimeter |
Q4319 |
Sanograft, per sq cm |
Sanograft, per square centimeter |
Q4320 |
Pellograft, per sq cm |
Pellograft, per square centimeter |
Q4321 |
Renograft, per sq cm |
Renograft, per square centimeter |
Q4322 |
Caregraft, per sq cm |
Caregraft, per square centimeter |
Q4323 |
Alloply, per sq cm |
Alloply, per square centimeter |
Q4324 |
Amniotx, per sq cm |
Amniotx, per square centimeter |
Q4325 |
Acapatch, per sq cm |
Acapatch, per square centimeter |
Q4326 |
Woundplus, per sq cm |
Woundplus, per square centimeter |
Q4327 |
Duoamnion, per sq cm |
Duoamnion, per square centimeter |
Q4328 |
Most, per sq cm |
Most, per square centimeter |
Q4329 |
Singlay, per sq cm |
Singlay, per square centimeter |
Q4330 |
Total, per sq cm |
Total, per square centimeter |
Q4331 |
Axolotl graft, per sq cm |
Axolotl graft, per square centimeter |
Q4332 |
Axolotl dualgraft, per sq cm |
Axolotl dualgraft, per square centimeter |
Q4333 |
Ardeograft, per sq cm |
Ardeograft, per square centimeter |