This information is listed for claims purposes only.

UPC/GTINHCPCS CodeBrand NameProduct DescriptionSKUStrength / Package SizeBilling Units
860471002503Q4180RevitaRevita Intact Human Placental Membrane 15 mmRV-00151.767 sq cm2
869457000304Q4180RevitaRevita Intact Human Placental Membrane 2x2 cmRV-20204 sq cm4
869457000311Q4180RevitaRevita Intact Human Placental Membrane 2x3 cmRV-20306 sq cm6
869457000328Q4180RevitaRevita Intact Human Placental Membrane 4x4 cmRV-404016 sq cm16
869457000397Q4180RevitaRevita Intact Human Placental Membrane 2x12 cmRV-021224 sq cm24
869457000335Q4180RevitaRevita Intact Human Placental Membrane 4x6 cmRV-406024 sq cm24
869457000342Q4180RevitaRevita Intact Human Placental Membrane 6x6 cmRV-606036 sq cm36
869457000359Q4180RevitaRevita Intact Human Placental Membrane 6x8 cmRV-608048 sq cm48
850039927294Q4258EnverseEnverse Human Placental Membrane Allograft 15 mmEN-00151.767 sq cm2
860471002589Q4258EnverseEnverse Human Placental Membrane Allograft 2x3 cmEN-20306 sq cm6
850039927256Q4258EnverseEnverse Human Placental Membrane Allograft 4x4 cmEN-404016 sq cm16
850039927263Q4258EnverseEnverse Human Placental Membrane Allograft 4x6 cmEN-406024 sq cm24
850039927270Q4258EnverseEnverse Human Placental Membrane Allograft 6x8 cmEN-608048 sq cm48
850039927287Q4258EnverseEnverse Human Placental Membrane Allograft 9x15 cmEN-0915135 sq cm135
860471002510Q4232CorplexCorplex Dehydrated Human Umbilical Cord Sheet 15 mmCX-00151.767 sq cm2
860471002527Q4232CorplexCorplex Dehydrated Human Umbilical Cord Sheet 2x2 cmCX-20204 sq cm4
860471002534Q4232CorplexCorplex Dehydrated Human Umbilical Cord Sheet 2x3 cmCX-20306 sq cm6
860471002541Q4232CorplexCorplex Dehydrated Human Umbilical Cord Sheet 3x5 cmCX-305015 sq cm15
860471002558Q4231Corplex PCorplex P Dehydrated Human Umbilical Cord 1 ccCP-00101 cc1
860471002565Q4231Corplex PCorplex P Dehydrated Human Umbilical Cord 2 ccCP-00202 cc2
860471002572Q4231Corplex PCorplex P Dehydrated Human Umbilical Cord 4 ccCP-00404 cc4
860471002596Q4229CogenexCogenex Human Placental Membrane 2x3 cmCG-20306 sq cm6
860007909801Q4229CogenexCogenex Human Placental Membrane 4x4 cmCG-404016 sq cm16
860007909818Q4229CogenexCogenex Human Placental Membrane 6x8 cmCG-608048 sq cm48