UPMC Health Plan

Submitted by Admin on
States
Oasis Wound Matrix Q4102

Commercial - DFU/VLU/Burns/Full Thickness Wounds
Medicare Advantage - DFU/VLU/DLEU/Other wounds based on medical necessity
Managed Medicaid Follows Fee-for-Service Medicaid

Oasis Burn Matrix Q4103

Commercial - DFU/VLU/Burns/Full Thickness Wounds
Medicare Advantage - DFU/VLU/DLEU/Other wounds based on medical necessity
Managed Medicaid Follows Fee-for-Service Medicaid

Oasis Ultra Q4124

Commercial - DFU/VLU/Burns/Full Thickness Wounds
Medicare Advantage - DFU/VLU/DLEU/Other wounds based on medical necessity
Managed Medicaid Follows Fee-for-Service Medicaid