Wound cleansers, any type, any size
Wound filler, gel/paste, per fluid ounce, not otherwise specified
Wound filler, dry form, per gram, not otherwise specified
Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing
Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing
Gauze, non-impregnated, sterile, pad size more than 48 sq. in., without adhesive border, each dressing
Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard
Eye pad, non-sterile, each
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