$6.00
Box of 25 · FSA/HSA

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FSA / HSA accepted
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Product Details
Specifications
TypeIV/drain split sponge
Pack SizeBox of 25, 1 Pack, or Case of 300
Ply6
Size4 x 4"
How it compares
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|---|---|---|---|---|
| FSA / HSA | Eligible | Eligible | Eligible | Eligible |
| Prescription | Not required | Not required | Not required | Not required |
| HCPCS code | — | A6253, A6402 | A6266 | A6219 |
| Type | IV/drain split sponge | Wound drainage pack | Iodoform packing strips | Gauze dressing |
| Pack Size | Box of 25, 1 Pack, or Case of 300 | — | 1 Each or Case of 12 | 1 Each or Box of 10 |
| Sterility | — | Sterile | Sterile | — |


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