$1.19
Pack of 10 · FSA/HSA

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Product Details
Specifications
TypeWoven gauze sponge
Pack SizePack of 10 or Case of 1280
Material100% cotton
Size4" x 4"
Ply16-ply
SterilitySterile
HCPCS CodeA6402
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|---|---|---|---|---|
| FSA / HSA | Eligible | Eligible | Eligible | Eligible |
| Prescription | Not required | Not required | Not required | Not required |
| HCPCS code | A6402 | A6216 | A6402 | — |
| Type | Woven gauze sponge | Woven gauze sponge | Woven gauze sponge | Gauze sponge (X-ray detectable) |
| Pack Size | Pack of 10 or Case of 1280 | Bag of 200 or Case of 4000 | Box of 100, Case of 2400, or Case of 1200 | 1 Tray or Case of 48 |
| Material | 100% cotton | 100% cotton | 100% cotton | — |
| Size | 4" x 4" | 4" x 4" | 2" x 2", 4" x 4" | 4 x 8" |
| Ply | 16-ply | 8-ply | 12-ply | 12-Ply or 16-Ply |
| Sterility | Sterile | Non-sterile | Sterile | — |


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