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$41.00
1-3/4" / Green · FSA/HSA
Hollister
New Image Two-Piece Shape-to-Fit Flat FormaFlex Skin Barrier Size 5 Count
SKU: 14102
New Image Two-Piece Shape-to-Fit Flat FormaFlex Skin Barrier Size 5 Count
A Hollister New Image two-piece flat FormaFlex ostomy skin barrier, shape-to-fit, 44 mm flange (green code), extended wear.
FSA/HSA Eligible
This item can typically be purchased with an FSA or HSA card at checkout. Eligibility can vary by plan, so check with your plan administrator if you are unsure.
Regular price
$41.00
Regular price
Sale price
$41.00
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Product Details
Specifications
TypeSkin barrier (two-piece)
ProfileFlat
BarrierFormaFlex
WearExtended
Fitshape-to-fit
Flange44 mm (Green code)
HCPCS CodeA4409
How it compares
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| Product | This item 
Hollister
New Image Two-Piece Shape-to-Fit Flat FormaFlex Skin Barrier Size 5 Count
$41.003 options | Torbot Hypalon Face Plate Large/Mini 1-1/4" $79.00View → | Coloplast SenSura Mio Flex EasiClose WIDE Outlet Drainable Pouch Maxi Black With Window With Filter 10 Count $43.003 optionsView → | Safe N Simple Urostomy Two-Piece Pouch Beige Flange With Valve and Belt Tabs $44.003 optionsView → |
|---|---|---|---|---|
| FSA / HSA | Eligible | Eligible | Eligible | Eligible |
| Prescription | Not required | Not required | Not required | Not required |
| HCPCS code | A4409 | A4361 | A4425 | A4434 |
| Type | Skin barrier (two-piece) | Ostomy faceplate | Flat Drainable Ostomy Pouch | Ostomy pouch |
| Flange | 44 mm (Green code) | — | — | 45 mm (1-3/4") |