States
Oasis Wound Matrix Q4102
In Network – Covered Based on Medical Necessity - DFU/VLU/DLEU/Other Wounds
Non-Kaiser – PA Required with Kaiser PCP Referral - DFU/VLU/DLEU/Other Wounds
Oasis Burn Matrix Q4103
Not Covered
Oasis Ultra Q4124
In Network – Covered Based on Medical Necessity - DFU/VLU/DLEU/Other Wounds
Non-Kaiser – PA Required with Kaiser PCP Referral - DFU/VLU/DLEU/Other Wounds