Description - DE Medical Assistance Program

A4427 OST PCH DRAIN/BARR LK FLNG/F 3 $2.78
A4428 URINE OST POUCH W FAUCET/TAP 3 $6.51
A4429 URINE OST POUCH W BLTINCONV 3 $8.25
A4430 OST URINE PCH W B/BLTIN CONV 3 $8.52
A4431 OST PCH URINE W BARRIER/TAPV 3 $6.22
A4432 OS PCH URINE W BAR/FANGE/TAP 3 $3.59
A4433 URINE OST PCH BAR W LOCK FLN 3 $3.34
A4434 OST PCH URINE W LOCK FLNG/FT 3 $3.76
A4450 NON-WATERPROOF TAPE 3 $0.09
A4452 WATERPROOF TAPE 3 $0.36
A4454 TAPE ALL TYPES ALL SIZES O $0.00
A4455 ADHESIVE REMOVER PER OUNCE 3 $1.33
A4456 ADHESIVE REMOVER, WIPES 6 $0.00
A4458 REUSABLE ENEMA BAG 5 $0.00
A4460 ELASTIC COMPRESSION BANDAGE O $0.00
A4461 SURGICL DRESS HOLD NON-REUSE 6 $0.00
A4462 ABDMNL DRSSNG HOLDER/BINDER O $0.00
A4463 SURGICAL DRESS HOLDER REUSE 6 $0.00
A4464 JOINT SUPPORT DEVICE/GARMENT O $0.00
A4465 NON-ELASTIC EXTREMITY BINDER 9 $0.00
A4466 ELASTIC GARMENT/COVERING 6 $0.00
A4470 GRAVLEE JET WASHER 5 $0.00
A4480 VABRA ASPIRATOR 3 $20.00
A4481 TRACHEOSTOMA FILTER 9 $0.00
A4483 MOISTURE EXCHANGER 3 $2.86
A4490 ABOVE KNEE SURGICAL STOCKING 3 $60.00
A4495 THIGH LENGTH SURG STOCKING 3 $60.00
A4500 BELOW KNEE SURGICAL STOCKING 3 $30.00
A4510 FULL LENGTH SURG STOCKING 3 $60.00
A4520 INCONTINENCE GARMENT ANYTYPE 9 $0.00
A4521 ADULT SIZE DIAPER SM EACH O $0.00
A4522 ADULT SIZE DIAPER MED EACH O $0.00
A4523 ADULT SIZE DIAPER LG EACH O $0.00
A4524 ADULT SIZE DIAPER XL EACH O $0.00
A4525 ADULT SIZE BRIEF SM EACH O $0.00
A4526 ADULT SIZE BRIEF MED EACH O $0.00
A4527 ADULT SIZE BRIEF LG EACH O $0.00
A4528 ADULT SIZE BRIEF XL EACH O $0.00
A4529 CHILD SIZE DIAPER SM/MED EA O $0.00
A4530 CHILD SIZE DIAPER LG EACH O $0.00
A4531 CHILD SIZE BRIEF SM/MED EACH O $0.00
A4532 CHILD SIZE BRIEF LG EACH O $0.00
A4533 YOUTH SIZE DIAPER EACH O $0.00
A4534 YOUTH SIZE BRIEF EACH 9 $0.00
A4535 DISP INCONT LINER/SHIELD EA O $0.00
A4536 PROT UNDERWR WSHBL ANY SZ EA O $0.00
A4537 UNDER PAD REUSABLE ANY SZ EA O $0.00
A4538 REUSABLE DIAPER FROM DPR SVC O $0.00
A4550 SURGICAL TRAYS 9 $0.00