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$39.64
1-3/4 in / 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 flat FormaFlex extended wear skin barrier for a two-piece pouching system, shape-to-fit with a starter hole, tape border and beige floating flange.
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
$39.64
Regular price
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$39.64
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Product Details
Specifications
TypeSkin barrier (two-piece)
Dimensions1-3/4 in, 2-1/4 in, or 2-3/4 in
ColorGreen, Red, or Blue
HCPCS CodeA4409
ProfileFlat
BarrierFormaFlex
WearExtended
Fitshape-to-fit
Flange44 mm (Green code)
In the box
- Hollister New Image flat FormaFlex skin barrier (5)
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|---|---|---|---|---|
| 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 |
| Dimensions | 1-3/4 in, 2-1/4 in, or 2-3/4 in | — | — | 1-3/4 in or 2-1/4 in |
| Color | Green, Red, or Blue | — | Black | — |
| Flange | 44 mm (Green code) | — | — | 45 mm (1-3/4") |