$69.00
1/2 in · FSA/HSA

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FSA / HSA accepted
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Product Details
Specifications
TypeOne-piece urostomy pouch
Dimensions1/2 in, 5/8 in, 7/8 in, 1 in, 1-1/8 in, 1-1/4 in, 1-3/8 in, 1-1/2 in, or 1-3/4 in
Ostomy SystemOne-piece
Pouch DrainUrostomy (tap)
Barrier ProfileConvex
HCPCS CodeA4430
BarrierFlextend
FitPre-sized
Opening1/2" (13 mm) for 84890; 5/8" (16 mm) for 84891; 7/8" (22 mm) for 84893; 1" (25 mm) for 84894; 1-1/8" (29 mm) for 84895; 1-1/4" (32 mm) for 84896; 1-3/8" (35 mm) for 84897; 1-1/2" (38 mm) for 84898; 1-3/4" (44 mm) for 84899
ColorUltra-clear
Length9" (23 cm)
Tape borderYes
Belt tabsYes
In the box
- Premier one-piece urostomy pouch (5)
- Urostomy adapter (1 per box)
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|---|---|---|---|---|
| FSA / HSA | Eligible | Eligible | Eligible | Eligible |
| Prescription | Not required | Not required | Not required | Not required |
| HCPCS code | A4430 | A4375 | A4393 | A4390 |
| Type | One-piece urostomy pouch | One-piece ostomy pouch | Ostomy pouch | Ostomy pouch |
| Dimensions | 1/2 in, 5/8 in, 7/8 in, 1 in, 1-1/8 in, 1-1/4 in, 1-3/8 in, 1-1/2 in, or 1-3/4 in | — | 1" or 1-1/4" | 1-1/8 in, 1-1/4 in, or 1-1/2 in |
| Ostomy System | One-piece | — | One-piece | One-piece |
| Pouch Drain | Urostomy (tap) | — | Urostomy (tap) | Drainable |
| Barrier Profile | Convex | — | Convex | Convex |
| Fit | Pre-sized | — | Pre-cut | — |
| Opening | 1/2" (13 mm) for 84890; 5/8" (16 mm) for 84891; 7/8" (22 mm) for 84893; 1" (25 mm) for 84894; 1-1/8" (29 mm) for 84895; 1-1/4" (32 mm) for 84896; 1-3/8" (35 mm) for 84897; 1-1/2" (38 mm) for 84898; 1-3/4" (44 mm) for 84899 | — | 1-1/4 inch | 1-1/8" (53529), 1-1/4" (53532) or 1-1/2" (53538) |
| Color | Ultra-clear | — | — | Opaque |
| Profile | — | — | Shallow convex | Shallow convex |


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