Coloplast Ostomy Pouch Assura® EasiClose™ 14174 One-Piece System 11 Inch Length, Maxi Convex, Pre-Cut 1 Inch Stoma Drainable Ostomy Irrigation Kits Manufacturer # 00798716162302 Country of

Manufacturer # 00798716162302 Country of Origin Unknown Administration Method Tube Application Tube Feeding Formula Calories per Serving 500 Calories Calories per Serving Range 401 to 500 Calories Container Type Carton Container Type Range Cartons & Pouches Dietary Restrictions Galactosemia Flavor Unflavored Flavor Range Unflavored HCPCS B4152 (Disclaimer) Ingredients WATER

(4) Glucose Gel Packets

Manufacturer # 304918 Brand Advance Lubricath® Manufacturer Bard Country of Origin Unknown Application Indwelling Catheter Tray Collection Type 350 mL Urine Meter Contents 1 60 Inch Drainage Tube

Manufacturer # 16964 Brand SenSura® Mio Click Manufacturer Coloplast Country of Origin Denmark Adhesive Type Elastic Adhesive Application Ostomy Barrier Barrier Depth Deep Convex Depth Barrier Shape Deep Convex Shape Barrier Type Extended Wear Color Gray Flange Size 60 mm Flange HCPCS A4407 Opening Size 1-3/8 Inch Opening System Match Blue Code System UNSPSC Code 42312105

Coloplast Ostomy Pouch Assura® EasiClose™ 14174 One-Piece System 11 Inch Length, Maxi Convex, Pre-Cut 1 Inch Stoma Drainable Ostomy Irrigation Kits Manufacturer # 00798716162302 Country ofUOM BOX 10 UNITS PER BOX Features 2 Sided Comfort Panel Skin friendly adhesive No clips or clamps to lose Odor filter in every pouch Manufacturer # 14174 Brand Assura EasiClose Manufacturer Coloplast Country of Origin Hungary Application Ostomy Pouch Barrier Style Convex, Pre Cut Capacity 530 mL Color Opaque Drain Type Drainable FSA Eligible Buy UOM Yes FSA Eligible Primary UOM Yes FSA Eligible Sell UOM Yes Filtered Pouch Yes HCPCS A4389 Length 11