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New Image 2-Piece High Output Drainable Pouch 4", Ultra Clear 1 × $92.17
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Premier Ceraplus 1-Piece Urostomy Pouch Soft Convex Tape, Cut-to-Fit 2-1/8" (55mm) 1 × $59.95
Subtotal: $152.12
Weight | 0.51 lbs |
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Dimensions | 8.5 × 6.06 × 2.13 in |
package | Box – 5 pcs |
HCPCS Code | A4393 |
Medicare Qty | 5 |
$59.27
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