$373.00
3/4 in · FSA/HSA

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FSA / HSA accepted
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Product Details
Specifications
TypeOstomy pouch
Dimensions3/4 in, 7/8 in, or 12 in
Barrier ProfileConvex
HCPCS CodeA4390
DrainDrainable
WearExtended
ProfileConvex
FitPre-cut
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|---|---|---|---|---|
| FSA / HSA | Eligible | Eligible | Eligible | Eligible |
| Prescription | Not required | Not required | Not required | Not required |
| HCPCS code | A4390 | A4375 | A4393 | A4390 |
| Type | Ostomy pouch | One-piece ostomy pouch | Ostomy pouch | Ostomy pouch |
| Dimensions | 3/4 in, 7/8 in, or 12 in | — | 1" or 1-1/4" | 1-1/8 in, 1-1/4 in, or 1-1/2 in |
| Barrier Profile | Convex | — | Convex | Convex |
| Profile | Convex | — | Shallow convex | Shallow convex |
| Fit | Pre-cut | — | Pre-cut | — |
| Ostomy System | — | — | One-piece | One-piece |
| Pouch Drain | — | — | Urostomy (tap) | Drainable |
| Opening | — | — | 1-1/4 inch | 1-1/8" (53529), 1-1/4" (53532) or 1-1/2" (53538) |


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Urology
Ostomy
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