JOURNAL TRANSCRIPT

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Ostomy Catalog 2017-2018

Focused Care, Trusted Service

Call us toll free! 1-877-902-9726 Visit us online: www.byramhealthcare.com ■

Wound Care

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Diabetes

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Urology

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Ostomy

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Incontinence

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Enteral Nutrition

©2017 Byram Healthcare Centers, Inc. All rights reserved. Printed in the United States.

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Breast Pumps

Ostomy Program

Byram Healthcare has been helping improve the quality of life of people with ostomies since 1968. Today we are a market leader, providing quality products and services to people living with ostomies across the nation. We remain committed to helping people manage their ostomy so they can enjoy a healthy and productive lifestyle. Program Features: n

Extensive Inventory: We carry virtually every one and two-piece appliance and a wide variety of accessory items

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Custom Cutting Service: A service exclusive to Byram, ostomy skin barriers are custom cut to the patient’s stoma size

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Ostomy Education: Customized educational materials offer day to day advice as well as information regarding new products

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Latino Program: Eiminates language barriers and improve access to care; all labels, printed material and phone lines are available in Spanish

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Product Support CareLine: 1-877-902-9726 ext. 43333

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Clinical Support Careline: 1-877-902-9726 ext. 43312

Visit us online: www.byramhealthcare.com ■

Wound Care

■

Diabetes

■

Urology

■

Ostomy

■

Incontinence

■

Enteral Nutrition

©2017 Byram Healthcare Centers, Inc. All rights reserved. Printed in the United States.

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Breast Pumps

Ostomy

1-877-902-9726

Medicare Allowable Supplies ............................................................ 3 Ostomy Manufacturer Programs ...................................................... 4 Ordering Guide..................................................................................... 5 Pouching System Quiz ........................................................................ 6 Getting to Know your Ostomy.......................................................... 8 Custom Cutting Program ................................................................... 11 Problem Solving ................................................................................... 13 Foods and Stoma Function ............................................................... 16 Travel Tips.............................................................................................. 18 Ostomy Information Sheet ................................................................ 21

Ostomy Products COLOPLAST .......................................................................................... 22 CONVATEC ............................................................................................ 76 HOLLISTER ............................................................................................ 109 NU-HOPE ............................................................................................... 141 Ostomy Care Accessories .................................................................. 156 SAFE N SIMPLE ................................................................. Accessories

Disclaimer: The reimbursement information provided by Byram Healthcare is intended to provide general information relevant to coding and reimbursement of Byram Healthcare’s products only. Coverage and payment policies for the same insurer can vary from one region to another and may change from time to time because of ongoing changes in government and insurance industry rules and regulations. Therefore, please confirm HCPCS Codes with your local DME-MAC, private insurer, or Medicaid agency before processing claims. Byram Healthcare does not guarantee coverage or payment of its products listed herein.

Visit us online: www.byramhealthcare.com ■

Wound Care

■

Diabetes

■

Urology

■

Ostomy

■

Incontinence

■

Enteral Nutrition

©2017 Byram Healthcare Centers, Inc. All rights reserved. Printed in the United States.

■

Breast Pumps

1

Ostomy MEDICARE ASSIGNMENT

CUSTOMER SERVICE

*No up-front out-of-pocket expense. If you have Medicare, Byram is a Medicare participating provider. Byram will also bill your secondary insurance for the remaining 20%. You can relax, knowing our reimbursement experts will handle all of the paperwork and obtain prescriptions from your physician.

Our ostomy specialists are committed to your satisfaction. Our representatives have extensive product and reimbursement knowledge to make ordering easy and convenient. If you do not see the product you are looking for in the catalog, or have any questions, contact our customer service department for assistance toll-free at 1-877-902-9726.

*On assigned items when billing co-payment to secondary insurance for full payment.

SHIPPING

M

Items marked with “M” are Medicare Reimbursable.

PRIVATE INSURANCE AND MANAGED CARE Byram will work directly with your insurance company to ensure that you receive your full benefits. Since medical supply coverage and reimbursement varies by health plan, we will be happy to investigate your supply coverage with your insurance company.

MEDICAID

There is no charge for shipping on insurance covered orders. Most orders will ship the same day by FedEx Ground or through local regional couriers. This provides you with prompt, reliable nationwide delivery. Express shipping options are available.

PRIVACY POLICY Byram adheres to state and federal laws complying with the confidentiality of business and customer privacy, including the federal HIPAA (Health Insurance Portability and Accountability Act) regulations. If you would like a copy of our Privacy Policy, please visit our website or contact us and we will gladly mail you our policy.

Byram participates in a growing number of state Medicaid programs. Our customer service representatives will be happy to discuss your particular state’s coverage of medical supplies.

Call us toll free! 1-877-902-9726

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Ostomy

1-877-902-9726

How many supplies will my insurance company pay for? The table below outlines the quantity of supplies that Medicare will reimburse for in a given amount of time. Many health plans also follow Medicare’s guidelines. Higher quantities may be available, depending on specific medical reasons documented by your physician. Please contact your Byram Healthcare ostomy specialist at 1-877-902-9726 for questions specific to your insurance.

Item Wafer with Flange Pouches-Drainable Pouches-Closed End Stoma Cap Paste Barrier Wipes Skin Barrier Sheets Skin Barrier Rings Skin Barrier Spray Skin Barrier Strips Liquid Adhesive Adhesive Remover Wipes Tape 1" X 10 yards Tape 2" X 10 yards Deodorant, Liquid Deodorant, Tablet Ostomy Belt Convex Inserts Irrigation Sleeves Irrigation Bags Irrigation Cone Irrigation Catheter Lubricant

Unit Ea Ea Ea Ea Oz Ea Ea Ea Oz Ea Oz Box/50 Ea Ea Oz Ea Ea Ea Ea Ea Ea Ea Oz

Allowable Amount 30 Days 90 Days 20 60 20 60 60 180 31 93 4 oz 12 oz 25 75 20 60 AMN 2 oz 6 oz 20 60 4 12 AMN 2 6 1 3 AMN AMN 1 3 10 30 4 12 1 1 1 AMN

AMN=As Medically Necessary. Byram Healthcare has interpreted Medicare policy in order to create the above reference information and assumes no responsibility for inconsistencies in the policy. All medical and claims determinations will be made by Medicare or your insurance plan.

M

Items marked with “M” are Medicare Reimbursable.

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

3

Ostomy

Ostomy Manufacturer Programs Before you left the hospital, your ostomy nurse may have enrolled you in a program to receive product samples and ongoing clinical support from one of the following manufacturers: • Coloplast • Convatec • Hollister Byram Healthcare participates in all of these programs. Even if you are enrolled in one of these programs, you still have the right to choose your own supplier like Byram Healthcare to provide and bill your ostomy supplies to your insurance. To do so, just tell your ostomy product manufacturer when they call that you would like Byram Healthcare as your provider and they will transfer you directly to one of our ostomy specialists to place your order!

How Manufacturer Support Programs Work 1. Your stoma care nurse enrolls you in a manufacturer support program. 2. The manufacturer ships a sample kit to you within a few days and contacts you about their program. 3. You can specify Byram Healthcare as your medical supplier and they will transfer you directly to an ostomy specialist to place your order. 4. Byram Healthcare will ship supplies directly to your door and bill your insurance.

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Reorder your supplies online at

www.mybyramhealthcare.com

Shop conveniently from your home. Four easy ways to order: 1. CALL Byram Healthcare:

1-877-902-9726

Monday - Friday, 8:30 AM to 7:00 PM Local Time Saturday, 9:00 AM to 1:00 PM Local Time

2. ONLINE – Reorder your supplies at:

www.mybyramhealthcare.com

24 hours a day, 7 days a week

3. FAX us your order:

1-866-811-4500

4. MAIL your order form:

Byram Healthcare Centers, Inc. Attention: Customer Service 3010 Woodcreek Drive - Suite A Downers Grove, IL 60515

Please be sure to indicate your method of payment, if applicable, and your daytime phone number.

Visit us online: www.byramhealthcare.com ■

Wound Care

■

Diabetes

■

Urology

■

Ostomy

■

Incontinence

■

Enteral Nutrition

©2017 Byram Healthcare Centers, Inc. All rights reserved. Printed in the United States.

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Breast Pumps

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Ostomy Pouching System Quiz This quiz will help reinforce what you have learned about your pouching system. Please answer true or false for each statement. Closed T/F: Convenient because they can be thrown away when it’s about half filled T/F: Good option for colostomies of the lower intestinal region, where output is thicker T/F: Can be used along with drainable pouches

Drainable T/F: Opened at one end, can be emptied, rinsed, securely closed and reused T/F: Best used for ileostomies and colostomies of the higher intestinal regions, which produce a more frequent, liquid or paste-like output T/F: Available in different lengths T/F: May have a built-in or separate tail closure

Urostomy T/F: Designed for urinary stomas T/F: Have a valve opening for faster, more convenient draining of urine and mucus T/F: Can be attached to a drainage container at night

Disclaimer: The recommendations and information above should not be considered a substitute for personal medical advice or diagnosis. Before making any changes, consult your

health care professional.

Visit us online: www.byramhealthcare.com ■

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Wound Care

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Diabetes

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Urology

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Ostomy

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Incontinence

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Enteral Nutrition

©2017 Byram Healthcare Centers, Inc. All rights reserved. Printed in the United States.

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Breast Pumps

Ostomy

1-877-902-9726 One-Piece System T/F: Skin barrier and pouch are attached to skin together T/F: No assembly and fewer steps to apply; generally more flexible T/F: One connection point means fewer places for possible leakage

Two-Piece Systems T/F: The barrier is attached to the skin, and the pouch connects to the barrier T/F: Easier to switch to a different type of pouch T/F: Easier to clean pouch T/F: Less skin irritation from changing barriers T/F: Allows stoma to be visible, making it easier to center the skin barrier

Opaque/Transparent Pouches T/F: An opaque pouch is more discreet T/F: Transparent material in a one-piece system can help you center the wafer onto the stoma

Cut-to-Fit/Precut Barriers T/F: Cut-to-fit barriers allow you to customize the skin barrier opening to fit your stoma T/F: Pre-cut barriers provide a consistent fit around the stoma T/F: Pre-cut barriers perform best when used after your stoma has stabilized in shape

Filtered T/F: Releases gas, but not odor T/F: Prevents the pouch from ballooning and the need to “burp” the pouch T/F: Good choice for colostomies with thicker output or when eating gas-causing foods

If you answered True to all of these statements, you are correct!

Visit us online: www.byramhealthcare.com ■

Wound Care

■

Diabetes

■

Urology

■

Ostomy

■

Incontinence

■

Enteral Nutrition

©2017 Byram Healthcare Centers, Inc. All rights reserved. Printed in the United States.

■

Breast Pumps

7

Getting to Know Your Ostomy STOMA Colostomy: Your large intestine has been re-routed so that your body wastes now exit through a stoma on your abdominal wall. Urostomy: A small segment of your small intestine has been used to re-route urine through a stoma on your abdominal wall. Ileostomy: Your large intestine has been removed and your small intestine re-routed so that your body wastes now exit through a stoma on your abdominal wall. All stomas are basically the same, with the exception of size and shape. Your stoma should be red or pink. It is full of blood vessels, which are right on the surface. Your stoma should always be moist, similar to the inside lining of your mouth. It is a mucus membrane that has its own natural lubrication. Your stoma may bleed as it contains many blood vessels. At times when changing the appliance, you may see some blood; do not worry. Your stoma will mend itself, very much the same as when you bite the inside lining of your cheek or mouth. Your stoma has no feeling because it doesn’t have nerve endings. The slight movement of the stoma is called peristaltic action. Your stoma will be swollen following surgery and may take from six to eight weeks to shrink. Measure your stoma at each appliance change during this initial period. The appliance must fit properly to protect the skin and to ensure a leak-proof seal.

LIFESTYLE TIPS Generally, the best time to change your appliance is in the morning before breakfast. Examine the peristomal skin (skin surrounding the stoma). It should be the same color and texture as the rest of the abdominal skin. Avoiding skin irritation is much better than treating it. You may take a bath or shower with your appliance on or off. Exposure to air, warm water and gentle soap is good for your skin. If you shower with your appliance on, the tape portion of the appliance will get wet. As the tape dries (you can blow dry with cool air or pat with a towel), it will remain secure on the skin.

Disclaimer: The recommendations and information above should not be considered a substitute for personal medical advice or diagnosis. Before making any changes, consult your

health care professional.

8

Ostomy

1-877-902-9726

Colostomy: Discharge from your colostomy can vary from a formed stool, pasty-like consistency or just liquid depending on where the stoma was fashioned in the large colon; ascending, transverse, or descending. Some stomas can be controlled through irrigation; some can be managed with a closed-end pouch while others require the use of a drainable-style appliance. There are no definite diet restrictions for colostomies, however some foods will cause excessive gas such as broccoli, cabbage, eggs, fish, beans. Other foods may be constipating and still others may produce odor while emptying. Experiment with one food at a time so problem foods can be identified easily. Urostomy: Using a night drainage system will assure a good night sleep! While some prefer to get up periodically throughout the night to empty, it is more convenient to hook up to bedside drainage. The pouch remains empty and you can rest without worry. There are no specific dietary restrictions for urostomates, but certain food such as asparagus will cause the urine to have more odor. Certain juices such as grapefruit and orange go into your system acidic but exit the body in an alkaline state. Too much alkalinity can cause crystals to build up around the stoma. Cranberry juice is very beneficial in keeping alkaline levels in check. Ileostomy: Chew all food thoroughly. Popcorn, peanuts, coconut and food with seeds or kernels should be eaten with discretion. Onions, cabbage, spicy foods, fish, garlic and beans may cause an odor when emptying the appliance. Green beans, broccoli, spinach, raw fruits and beer may cause diarrhea. Add one new food at a time so you can identify problems. Know what medications you are taking; avoid enteric coated pills and time release capsules. These medications are usually not absorbed due to their outer coating. They may exit into the pouch in their original state. Remind your physician that you have an Ileostomy, which may necessitate a different choice of drug. You may discuss this with your pharmacist as well. Disclaimer: The recommendations and information above should not be considered a substitute for personal medical advice or diagnosis. Before making any changes, consult your

health care professional.

M

Items marked with “M” are Medicare Reimbursable.

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

9

Ostomy MY OSTOMY INFORMATION Be prepared. Use this form to ensure you have all your ostomy information in one place. Surgery information: I have a: ____temporary ____ileostomy

____permanent

____colostomy

____urostomy

____other

Surgery was performed at: _____________________________________ Date of surgery: _____ /_____ /______ Surgeon’s name: ______________________________________________ Phone # ( ) _______-___________ WOC /Ostomy nurse’s name: ____________________________________ Phone # ( ) _______-___________ Home Health Agency information: I was discharged to: ________________________ Home Health Agency phone # ( ) _____- _________________________ Home Health Agency nurse: ________________ Date of Home Health discharge: ______ /______ / ________ Insurance information: Primary insurance: ____________________________________________ ID # ____________________ Secondary insurance: __________________________________________ ID # ____________________ Primary Doctor is: _____________________________________________ Phone # ( ) _______-___________ Ostomy product information: I use a: _____ 1-piece appliance _____ 2-piece appliance

Disclaimer: The recommendations and information above should not be considered a substitute for personal medical advice or diagnosis. Before making any changes, consult your

health care professional.

10

Reorder your supplies online at

www.mybyramhealthcare.com

Ostomy

1-877-902-9726

Custom Cutting Program What is custom cutting? Custom cutting is die-cutting the center opening of a wafer to fit the exact shape and size of your stoma. When is custom cutting recommended? Custom cutting is most beneficial six to eight weeks after surgery, once your stoma has shrunk and stabilized in size. Benefits of Byram’s custom cutting service: • Provides accurate sizing and proper fit so less time is spent changing the appliance. • A better fit translates into longer wear time. • Decrease leakage issues and skin irritation. • Less skin breakdown translates to fewer physician visits. • Assists persons with arthritis, vision impairment, or finger/hand dexterity problems.

Call our Ostomy Product Support CareLine: 1-877-902-9726 Ext. 43333

Disclaimer: The recommendations and information above should not be considered a substitute for personal medical advice or diagnosis. Before making any changes, consult your

health care professional.

M

Items marked with “M” are Medicare Reimbursable.

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

11

Ostomy Custom Cutting Program How to measure a stoma: 1. For oval stomas, the nurse/ostomate must provide the horizontal measurement. 2. The nurse/ostomate must also provide the vertical measurement. 3. The size now becomes, for example: f"v x 14"h Measure across (horizontal)

Measure down (vertical)

1 4"

f” To have your skin barriers custom cut, please contact Byram customer service: 1-877-902-9726

CUSTOM CUTTING ORDER GUIDE* ITEMS TO BE CUT: ___________________________ CUTTING SIZE Shape to be cut:



ROUND Size to be cut: ________________

(check one)



OVAL

Size to be cut: _______ X _______ vertical

horizontal

*Custom cut supplies are not returnable. Please allow an extra day for delivery.

Disclaimer: The recommendations and information above should not be considered a substitute for personal medical advice or diagnosis. Before making any changes, consult your

health care professional.

12

Ostomy

1-877-902-9726

Problem Solving: Colostomy and Ileostomy Many problems can be solved with simple home remedies or accessory products. Are you experiencing problems with excess gas? • Be careful with foods that are gaseous in nature: beans, cabbage, beer, etc. • If possible, select a pouch with a filter (most closed-end and some drainable models incorporate a filter) or add a filter to your current appliance. • Never puncture the material on the pouch, this destroys the odorproof film and allows odor to seep out at will. You can also add a gas vent tab to the top of your bag to release air. Are you experiencing problems with odor? • Everyone using the bathroom creates an odor. However, stool or fecal material that is contained in an appliance for several hours builds up bacteria and may be more offensive when emptying. • There are many good appliance deodorants on the market that can help neutralize odors within the pouch. • Certain foods may cause more odor. You may want to avoid these if you’ll be using a bathroom away from home. • Please refer to the section in this book labeled “Food Which May Influence Stoma Function.” • To order or inquire about appliance deodorant, please call a Byram Representative at 1-877-902-9726. Do you have difficulty in emptying or disposing of your pouch? • Always place some bathroom tissue in toilet prior to emptying pouch contents. This will eliminate back splash. • Place clip on the pouch so the end of the tail spout is facing upward (rather than under), this will allow easier emptying and directing into the toilet. • Clean tail spout inside and out with tissue prior to applying the clip or securing the “Velcro-like” closure.

Disclaimer: The recommendations and information above should not be considered a substitute for personal medical advice or diagnosis. Before making any changes, consult your

health care professional.

M

Items marked with “M” are Medicare Reimbursable.

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

13

Ostomy Problem Solving: Colostomy and Ileostomy Do you have difficulty with stool or fecal material not dropping down in pouch? • Leave a small amount of air in pouch when emptying; do not flatten pouch. • Before applying the clip or securing “Velcro-like” closure, pull walls of pouch apart to trap a small bubble of air. This will prevent clothing from pressing down on the appliance. • A lubricating deodorant can ease pouch emptying and help prevent pouch static and sticking. For more information regarding lubricating deodorant, please call Byram at 1-877-902-9726. • You may also want to talk to your doctor about using a stool softener to help thin out your stool. This may help stool fall into the bag more easily. Are you experiencing problems with liquid drainage? • Use a jelling agent to solidify drainage - contents will slide out easily. A Byram Representative can assist you in choosing a jelling agent to help thicken liquid stool. This will decrease noise and allow the contents to slide out more easily. • Single use packets make gelling agents easy to use with each pouch change. You may want to wear an ostomy belt to help hold the wafer on more securely. • Remember to place toilet paper into the toilet first to decrease splashing.

Disclaimer: The recommendations and information above should not be considered a substitute for personal medical advice or diagnosis. Before making any changes, consult your

health care professional.

14

Reorder your supplies online at

www.mybyramhealthcare.com

Ostomy

1-877-902-9726

Problem Solving: Urostomy Do you have problems with mucous clogging the valves? • Mucous cannot be avoided since the urostomy is fashioned from the small intestine. Call Byram customer service for assistance at 1-877-902-9726. Are you experiencing problems with your night drainage tube? • Always keep a small amount of urine in your pouch prior to connecting to night drainage. This will give an immediate flow of urine down the tube and break any air pockets. • Be sure that the tubing is straight down the bed, or with a curl if placed on the side of the bed. Using a leg strap will prevent twisting and kinking of tube. How can you wash pouches and night bag? • There are a variety of appliance cleaners available for urinary systems. For ordering information, call Byram at 1-877-902-9726. • In a pinch, white vinegar and water can also be used to rinse out urinary pouches, and a baking soda and water solution is effective in night bags. Does your tubing become discolored? • Most night drainage bottles or bags are disposable in nature because they are very difficult to clean with long usage. • To discuss available urinary appliance cleaners and decrystalizers call Byram custom service today for assistance at 1-877-902-9726.

Byram has the ostomy accessories you may need to manage your ostomy easily and effectively.

To reach our Ostomy Center of Excellence, please call: 1-800-308-9445 Disclaimer: The recommendations and information above should not be considered a substitute for personal medical advice or diagnosis. Before making any changes, consult your

health care professional.

M

Items marked with “M” are Medicare Reimbursable.

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

15

Ostomy Food Which May Influence Stoma Function Foods Which May Thicken Stool May decrease stomal output and help in managing diarrhea. Applesauce Bananas Milk, Boiled Cheese Chocolate Peanut Butter

Potatoes Rice Tapioca Whole wheat bread

Foods Which May Increase Stomal Output May cause an increase in peristalsis and may also be used as a means to relieve constipation. Alcohol Beans Beer Broccoli Cabbage Coffee Cucumbers Figs Fried Foods

Fruit, Raw Fruit Juice Iced Beverages Milk, Fresh Onions Prunes Plums Rhubarb Spicy Foods

Vegetables, Leafy

Foods Which May Discolor Fecal Output If you notice a discoloration of the stool, think back to what you have eaten to note if food may be the cause. Call your doctor when stool discoloration is not food related. Beets Food Dye Iron Pill Kool-Aid

Licorice Red Jello Spinach Strawberries

Tomato Juice Vitamins w/Iron Watermelon

Disclaimer: The recommendations and information above should not be considered a substitute for personal medical advice or diagnosis. Before making any changes, consult your

health care professional.

16

Ostomy

1-877-902-9726

Food Which May Influence Stoma Function Foods Which May Produce Gas Cheese, Strong Chewing Gum Cucumbers Eggs Fish Fruit Juice Melon Mushroom Nuts Onions

Apple Juice Asparagus Beans Beer Broccoli Brussel Sprouts Cabbage Family Carbonated Beverages Cauliflower

Peas Radishes Spices Spinach Sprouts Sweet Potato Vegetable Juice Yeast

Foods Which May Inhibit Gas Apple Juice Buttermilk

Cranberry Juice Yogurt

Foods Which May Produce Odor Ileostomy Alcohol Beverages Asparagus Baked Beans Broccoli Cabbage Cheese Eggs

Fish Garlic Mushrooms Nuts Onions Pears Vitamins

Urostomy Asparagus Fish Onions

Colostomy Asparagus Baked Beans Broccoli Fish Onions Pears

Foods Which May Inhibit Odor Parsley Spinach

Buttermilk Cranberry Juice Lettuce

Tomato Juice Yogurt

Disclaimer: The recommendations and information above should not be considered a substitute for personal medical advice or diagnosis. Before making any changes, consult your

health care professional.

M

Items marked with “M” are Medicare Reimbursable.

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

17

Ostomy Travel Tips Travel plans do not need any special attention other than careful preparation. However you travel, be sure to anticipate your needs. Here are some travel tips to keep your journey relaxing. 3 Create a detailed list of all the supplies you use; catalog numbers, sizes, description, cut size (a copy of your last Byram invoice will do the trick). Pack extra supplies but do not overload. 3 While traveling, should an emergency arise, simply call us at 1-877-902-9726 for assistance. You can also look in the yellow pages under “Surgical Supplies.” Do not panic if you cannot find the model of appliance you are currently using; many brands are similar and can get you through this time. 3 Always pack your supplies in a separate suitcase or carry-on and never allow this bag to leave your side. When traveling by car, avoid leaving supplies in your trunk, as excessive heat may cause wafers or other items to melt. 3 Appliance wear-time may shorten in hot climates, so be prepared to change more frequently if needed. 3 When traveling on planes, remember the restrictions on liquids for carry-on luggage. Put liquid deodorants or adhesives in your checked baggage or put some into less than 3 oz. travel containers. 3 If you are going to be swimming, you may need to change your wafer more frequently. You may secure your wafer by “window framing” it with waterproof tape. 3 The Transportation Security Administration offers a helpline to assist travelers with disabilities and medical conditions. TSA Cares can be reached toll free at 1-855-787-2227 prior to traveling with questions about screening policies, procedures and what to expect at the security checkpoint. The most common complaint of all travelers is a change in bowel habits due to different foods, unfamiliar water, schedule and time changes. Ask your physician for a prescription for diarrhea before leaving home. Drink only bottled water if possible and try new foods one day at a time.

Disclaimer: The recommendations and information above should not be considered a substitute for personal medical advice or diagnosis. Before making any changes, consult your

health care professional.

18

Reorder your supplies online at

www.mybyramhealthcare.com

Ostomy

1-877-902-9726

TRAVEL COMMUNICATION CARD

Compliments of the UNited Ostomy Associations of America, Inc. This is provided to travelers in order to simplify communication with federal Transportation Security personnel and airline flight attendants, at those times when you wish or need to communicate in a non-verbal way, as is your legal right. This is not a “certificate” and it is not a “pass” to help you avoid screening. Please trim to wallet-size and laminate if desired. The blue color is important, as it is a “flash-card” developed by the TSA so their own officers will recognize it and be guided to treat the traveler with discretion and sensitivity. If laminated in a double-side manner, it can be used ‘blue side out’ during security screening, and the white side out when communicating non-verbally with airline personnel. JUST CUT OUT, FOLD AND PUT WITH TRAVEL DOCUMENTS NEWS: As of January 2011 - You may always have a travel companion with you during a private screening - TSA officers should NOT ask you to show your pouch—you may be asked to rub over your pouch outside your clothing so they can test your hand to rule out explosive residue. - To file a complaint, send an email to [email protected] (with a copy to [email protected], please)

M

Items marked with “M” are Medicare Reimbursable.

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

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OUTSIDE RIGHT

INSIDE RIGHT

United Ostomy Associations of America www.ostomy.org 1-800-826-0826

Provided by the UOAA, a volunteer-based health organization dedicated to providing education, support and advocacy for people who have or will have intestinal or urinary diversions.

TRAVELER’S COMMUNICATION CARD

INSIDE LEFT - this is designed to show in the event it is needed while in flight and the pilot has chosen to limit restroom access—or when passengers are supposed to be belted in during turbulence. You might wish to show it

The cardholder contains body waste in an OSTOMY POUCH (stool/urine) and/or carries pouches and related supplies and/or a catheter to manage personal hygiene. S/he needs access to the restroom now in order to empty the pouch — this is critical for the cardholder’s well-being and for public sanitation.

~ ~ GOTTA GO NOW ~ ~ RESTROOM ACCESS

L I N E

F O L D

being patted-down or entering a full-body scanner. The TSO may not take it from you to read, since the distinctive blue color makes it like a ‘flash card’.

Ostomy

1-877-902-9726

My Ostomy Supplies PRODUCT TYPE

Qty. Needed

Brand / Item # / Description

DRAIN POUCHES WAFERS/ FLANGES CLOSED POUCHES BARRIERS/ RINGS PASTE SKIN BARRIER STRIPS SKIN BARRIER WIPES ADH. REMOVER WIPES DEODORANT, LIQUID OSTOMY BELT OSTOMY POWDER OTHER OTHER

M

Items marked with “M” are Medicare Reimbursable.

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

21

Ostomy

COLOPLAST SENSURA® MIO FLEX TWO-PIECE SYSTEM

This flexible adhesive coupling fits to individual body contours and maintains a secure seal over uneven abdomens caused by scarring, skin folds, hernias, and other pouching challenges. The system features an elastic barrier to fit real body shapes and a full-circle filter to reduce ballooning. This product has a neutral gray textile for discretion. After selecting the appropriate barrier, select the matching pouch by color i.e., “red” barrier matches a “red” pouch. SENSURA® MIO FLEX SKIN BARRIERS SenSura® Mio Flex Standard Wear Barrier

M

Flat.

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Item 5/Box HCPCS: A4414 HCPCS: A4415

Order # CT10551 CT10561 CT10571

Cut-to-Fit 3⁄8”–1 5⁄16” 3⁄8”-1 7⁄8” 3⁄8”-2 11⁄16”

Color Code

Item 5/Box HCPCS: HCPCS: HCPCS: HCPCS: HCPCS: HCPCS: HCPCS: HCPCS: HCPCS:

Order #

Pre-Cut

Color Code

CT10562 CT10566 CT10563 CT10567 CT10564 CT10568 CT10565 CT10572 CT10573

1” 1 1⁄8” 1 3⁄16” 1 ¼” 1 3⁄8” 1 ½” 1 9⁄16” 1 ¾” 2”

A4414 A4414 A4414 A4414 A4414 A4414 A4414 A4415 A4415

SenSura® Mio Flex Convex Light Barrier Standard wear. Convex with belt tabs.

22

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Item 5/Box HCPCS: A4373

Order # CT16471 CT16481 CT16483 CT16491

Cut-to-Fit 3⁄8”– ¾”” 5⁄8”- 1 3⁄16” 5⁄8” – 1 9⁄16” 5⁄8”-2 1⁄16”

Color Code

Item 5/Box HCPCS: A4373

Order # CT16472 CT16484 CT16485 CT16486 CT16487 CT16488 CT16493 CT16494

Pre-Cut 11⁄16” 13⁄16” 1” 1 1⁄8” 1 ¼” 1 3⁄8” 1 ½” 1 5⁄8”

Color Code

M

Ostomy

COLOPLAST

1-877-902-9726

SENSURA® MIO FLEX DRAINABLE POUCHES SenSura® Mio Flex EasiClose™ WIDE Outlet Drainable Pouch Full-circle filter. Neutral gray, water-resistant textile. Opaque pouches feature peek-a-boo inspection window for easy application. Item MAXI 11” 10/Box HCPCS: A4425

Order # CT12262 CT12272 CT12282 CT12273 CT12283

Style Opaque Opaque Opaque Transparent Transparent

Without filter. Neutral gray, water-resistant textile. Item Order # Style MAXI 11” CT12274 Transparent 10/Box CT12284 Transparent HCPCS: A5063

M

•• •• • ••

Color Code

Color Code

Full-circle filter. Neutral gray, water-resistant textile. Opaque pouches feature peek-a-boo inspection window for easy application. Item Order # Style Color Code MIDI 10 ¼” CT12281 Opaque 10/Box HCPCS: A4425

•

SENSURA® MIO FLEX CLOSED POUCHES SenSura® Mio Flex MAXI Closed Pouch

Full-circle filter. Neutral gray, water-resistant textile. Opaque pouches feature peek-a-boo inspection window for easy application. Item MAXI 8 ¼ ” 30/Box HCPCS: A4419

Order # CT12202 CT12213 CT12222 CT12203 CT12216 CT12223

Style Opaque Opaque Opaque Transparent Transparent Transparent

M

•• •• ••

Color Code

Clinical CareMail

Have a question? E-mail one of our clinicians at [email protected]

M

Items marked with “M” are Medicare Reimbursable.

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

23

Ostomy

COLOPLAST SENSURA® MIO FLEX MAXI UROSTOMY POUCHES SenSura Mio Flex Maxi Urostomy Pouch

Multi-chambers minimize sloshing. Wider anti-reflux valves prevent urine from washing over stoma. Soft outlet can be connected to urostomy night bag. Neutral gray water-resistant textile. Opaque pouches feature peek-a-boo inspection window for easy application.

M

Item MAXI 10 ½” 10/Box HCPCS: A5073

Order # CT12291 CT12292 CT12297 CT12298

Style Opaque Transparent Opaque Transparent

SENSURA® FLEX TWO-PIECE SYSTEM

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Color Code

SenSura® Flex is a unique combination of security and flexibility. A reinforced adhesive ring maintains a secure seal across the entire coupling surface. Integrated security channel offers extra protection against leakage. Complete conformability allows freedom of movement. Minimal application pressure provides for an excellent post-op solution. After selecting the appropriate barrier, select the matching pouch by color i.e., “red” barrier matches a “red” pouch. SENSURA® FLEX SKIN BARRIERS SenSura® Flex Flat Skin Barrier

Standard wear barrier. Match barrier and pouch color codes for proper fit. Item 10/Box HCPCS: A4414 HCPCS: A4414 HCPCS: A4415 HCPCS: A4415

Order #

Cut-to-Fit

CT10101 CT10102 CT10103 CT10108

s" - 15⁄16" s" - 17⁄8" s" - 2¾" s” - 3½”

Color Code

•• ••

SenSura® Flex Xpro Flat Skin Barrier

Extended wear barrier. Match barrier and pouch color codes for proper fit. Item 10/Box HCPCS: A4409 HCPCS: A4409 HCPCS: A4410

24

Order #

Cut-to-Fit

CT10104 CT10105 CT10106

3⁄8” – 1 5⁄16” 3⁄8” – 1 7⁄8” 3⁄8” – 2 ¾”

Reorder your supplies online at

M

M

Color Code

•• •

www.mybyramhealthcare.com

Ostomy

COLOPLAST

1-877-902-9726

SENSURA® FLEX SKIN BARRIERS SenSura® Flex Convex Light Barrier with Belt Tabs

Standard wear barrier. Match barrier and pouch color codes for proper fit.

M

•• •• •• ••

Item 5/Box HCPCS: A4373

Order # CT11301 CT11302 CT11303 CT11307

Cut-to-Fit 5⁄8” – 15⁄16” 5⁄8” – 1 5⁄16” 5⁄8” – 1 11⁄16” 5⁄8” – 2”

Color Code

Item 5/Box HCPCS: A4373

Order # CT11312 CT11313 CT11314 CT11315

Pre-Cut 7⁄8” 1” 1 1⁄8” 1 ¼”

Color Code

SenSura® Flex Xpro Convex Light Barrier with Belt Tabs

Extended wear barrier. Match barrier and pouch color codes for proper fit. Item 5/Box HCPCS: A4407 HCPCS: A4407 HCPCS: A4407 HCPCS: A4408

Order #

Cut-to-Fit

CT11304 CT11305 CT11306 CT11308

5⁄8” – 15⁄16” 5⁄8” – 1 5⁄16” 5⁄8” – 1 11⁄16” 5⁄8” – 2”

SENSURA® FLEX DRAINABLE POUCHES

Color Code

•• ••

SenSura® Flex EasiClose™ WIDE Outlet Drainable Pouch

Drainable pouch with and without filter. Soft cloth on back (and front of opaque). Match barrier and pouch color codes for proper fit. With filter. Maxi, 11½” Length. Item Order # 20/Box CT11512 HCPCS: A4425 CT11517 CT11590

Style Transparent Transparent Transparent

Color Code

With filter. Maxi, 11½” Length. Item Order # 20/Box CT11514 HCPCS: A4425 CT11515 CT11518 CT11591

Style Opaque Opaque Opaque Opaque

Color Code

Without filter. Maxi, 11½” Length. Item Order # Style 20/Box CT11612 Transparent HCPCS: A5063 CT11690 Transparent

M

Items marked with “M” are Medicare Reimbursable.

Byram is a Medicare participating provider.

M

•• • •• •• ••

Color Code

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

25

COLOPLAST

Ostomy

SENSURA® FLEX CLOSED POUCHES SenSura® Flex Closed Pouch

Soft, moisture-absorbent backing, filter for odor control. Match barrier and pouch color codes for proper fit.

•• • •• •

Item Maxi 82" Length 30/Box HCPCS: A4419

Order # CT10911 CT10912 CT10917

Style Transparent Transparent Transparent

Color Code

Item Maxi 82" Length 30/Box HCPCS: A4419

Order # CT10914 CT10915 CT10918

Style Opaque Opaque Opaque

Color Code

Reordering supplies online is simple! Visit the improved www.mybyramhealthcare.com and sign up today!

26

M

Ostomy

COLOPLAST

1-877-902-9726

SENSURA® MIO CLICK TWO-PIECE SYSTEM The new SenSura® Mio is based on our human-centered approach to innovation; it’s designed with individual bodies in mind. The system features an elastic barrier to fit real body shapes, flexible coupling for security and a full-circle filter to reduce ballooning. This product has a neutral gray textile for discretion. After selecting the appropriate barrier, select the matching pouch by color i.e., “blue” barrier matches a “blue” pouch. SENSURA® MIO SKIN BARRIERS SenSura® Mio Click Standard Wear Barrier

M

Flat with belt tabs. Item 5/Box HCPCS: A4414 HCPCS: A4414 HCPCS: A4414 HCPCS: A4415 Item 5/Box HCPCS: A4414

Order #

Cut-to-Fit

CT10502 CT10512 CT10522 CT10531

3⁄8 – 1 3⁄8” 3⁄8 – 1 ¾” 3⁄8 – 2 1⁄8” 3⁄8 – 2 9⁄16”

Order # CT10503 CT10506 CT10504 CT10505 CT10513 CT10514 CT10515 CT10516 CT10523 CT10524 CT10525

Pre-Cut ¾” 7⁄8” 1” 1 1⁄8” 1 3⁄16” 1 ¼” 1 3⁄8” 1 ½” 1 9⁄16” 1 ¾” 2”

Color Code

•• •• •• •• •• •• •• •

Color Code

SenSura® Mio Click Convex Light Barrier

M

Standard wear. Convex with belt tabs. Item 5/Box HCPCS: A4373

M

Items marked with “M” are Medicare Reimbursable.

Order # CT16901 CT16911 CT16921 CT16931

Cut-to-Fit 3⁄8”– ¾”” 5⁄8”- 1 3⁄16” 5⁄8” – 1 9⁄16” 5⁄8”-2 1⁄16”

•• ••

Color Code

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

27

Ostomy

COLOPLAST SENSURA® MIO SKIN BARRIERS SenSura® Mio Click Convex Light Barrier (cont)

M

Standard wear. Convex with belt tabs. Item 5/Box HCPCS: A4373

Order # CT16903 CT16913 CT16914 CT16915 CT16923 CT16924 CT16933 CT16934

Pre-Cut 11⁄16” 13⁄16” 1” 1 1⁄8” 1 ¼” 1 3⁄8” 1 ½” 1 5⁄8”

SenSura® Mio Click Deep Convex Barrier

•• •• •• ••

Color Code

Standard wear. Convex with belt tabs.

28

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Item 5/Box HCPCS: A4373

Order # CT16941 CT16951 CT16961 CT16971

Cut-to-Fit 3⁄8”– ¾”” 5⁄8”- 1 3⁄16” 5⁄8” – 1 9⁄16” 5⁄8”-2 1⁄16”

Color Code

Item 5/Box HCPCS: A4373

Order # CT16942 CT16953 CT16954 CT16955 CT16963 CT16964 CT16973 CT16974

Pre-Cut 11⁄16” 13⁄16” 1” 1 1⁄8” 1 ¼” 1 3⁄8” 1 ½” 1 5⁄8”

Color Code

Reorder your supplies online at

M

www.mybyramhealthcare.com

Ostomy

COLOPLAST

1-877-902-9726

SENSURA® MIO DRAINABLE POUCHES SenSura® Mio Click EasiClose™ WIDE Outlet Drainable Pouch Neutral gray water-resistant textile. Opaque pouches feature peek-a-boo inspection window for easy application. Full-circle filter Item MAXI 11” 10/Box HCPCS: A4427

M

•• •• •• •• •• • ••

Order # CT11462 CT11472 CT11482 CT11486 CT11463 CT11473 CT11483 CT11487

Style Opaque Opaque Opaque Opaque Transparent Transparent Transparent Transparent

Color Code

Without filter Item MAXI 11” 10/Box HCPCS: A4426

Order # CT11474 CT11484 CT11488

Style Transparent Transparent Transparent

Color Code

Full-circle filter Item MIDI 10 ¼” 10/Box HCPCS: A4427

Order # CT11461 CT11471

Style Opaque Opaque

Color Code

SENSURA® MIO CLOSED POUCHES SenSura® Mio Click Closed Pouch

Full-circle filter. Neutral gray water-resistant textile. Opaque pouches feature peek-a-boo inspection window for easy application.

M

Items marked with “M” are Medicare Reimbursable.

M

•• •• • •• •

Item MAXI 8 ¼” 30/Box HCPCS: A4423

Order # CT11402 CT11413 CT11422 CT11425 CT11426

Style Opaque Opaque Opaque Opaque Transparent

Color Code

Item MIDI 7 ¼” 30/Box HCPCS: A4423

Order # CT11401 CT11412 CT11421

Style Opaque Opaque Opaque

Color Code

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

29

Ostomy

COLOPLAST SENSURA® MIO UROSTOMY POUCHES SenSura® Mio Click MAXI Urostomy Pouch

Multi-chambers minimize sloshing. Wider anti-reflux valves prevent urine from washing over stoma. Soft outlet can be connected to urostomy night bag. Neutral gray water-resistant textile. Item MAXI 10 ½” 10/Box HCPCS: A4433

Order # CT11491 CT11492 CT11497 CT11498

Style Opaque Transparent Opaque Transparent

•• ••

M

Color Code

SENSURA® CLICK TWO-PIECE SYSTEM The SenSura® Click combines the revolutionary double-layer adhesive with our secure click-lock technology. Patented click-lock coupling is leak-proof and secure. Audible click reassures that the system is locked in place. Easy-to-use coupling ring can be turned while unlocked. While unlocked, the pouch can be repositioned as well as the locking system. Application requires minimal pressure and can be removed with an “up and over” motion. After selecting the appropriate barrier, select the matching pouch by color i.e., “blue” barrier matches a “blue” pouch. SENSURA® SKIN BARRIERS SenSura® Click Flat Skin Barrier with Belt Tabs Standard wear barrier. Item 5/Box HCPCS: A4414 Item 5/Box HCPCS: A4414

30

Order # CT10011 CT10021 CT10031 CT10041 Order # CT10012 CT10013 CT10022 CT10023 CT10032

Cut-to-Fit s"-1s" s"-1w" s"-24" s”-22” Pre-Cut 13⁄16" 1" 13⁄16" 1s" 19⁄16"

•• •• •• •• •

Color Code

Color Code

M

Ostomy

COLOPLAST

1-877-902-9726

SENSURA® SKIN BARRIERS SenSura® Click Convex Light Skin Barrier with Belt Tabs Standard wear barrier.

•• •• •• •• •

Item 5/Box HCPCS: A4373

Order # CT11011 CT11021 CT11031 CT11041

Cut-to-Fit d"-f" d"-15⁄16" d"-111⁄16" d”-21⁄16”

Color Code

Item 5/Box HCPCS: A4372 HCPCS: A4373 HCPCS: A4373 HCPCS: A4373 HCPCS: A4373

Order #

Pre-Cut

Color Code

CT11012 CT11022 CT11023 CT11024 CT11032

f" 1" 8" 14" 1s"

SenSura® Click Xpro Flat Barrier with Belt Tabs Extended wear barrier. Item 5/Box HCPCS: A4409 HCPCS: A4409 HCPCS: A4409 HCPCS: A4410 Item 5/Box HCPCS: A4409

M

Items marked with “M” are Medicare Reimbursable.

Order #

Cut-to-Fit

CT10015 CT10025 CT10035 CT10045

3⁄8” – 1 3⁄8” 3⁄8” – 1 ¾” 3⁄8” – 2 ¼” 3⁄8” – 2 ½”

Order # CT10016 CT10017 CT10026 CT10027 CT10036

Pre-Cut 13⁄16” 1” 1 3⁄16” 1 3⁄8” 1 9⁄16”

M

M

Color Code

•• •• •• •• •

Color Code

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

31

Ostomy

COLOPLAST SENSURA® SKIN BARRIERS

SenSura® Click Xpro Convex-Light Convex Light Barrier with Belt Tabs Extended wear barrier. Item 5/Box HCPCS: A4407 HCPCS: A4407 HCPCS: A4407 HCPCS: A4408 Item 5/Box HCPCS: A4407

Order #

Cut-to-Fit

CT11015 CT11025 CT11035 CT11045

5⁄8 “– 7⁄8” 5⁄8 “ – 1 5⁄16” 5⁄8 “– 1 11⁄16” 5⁄8 “ – 2 1⁄16”

Order # CT11016 CT11026 CT11027 CT11028 CT11036

Pre-Cut 7⁄8” 1” 1 1⁄8” 1 ¼” 1 3⁄8”

Color Code

•• •• •• •• •

Color Code

SENSURA® CLICK TWO-PIECE DRAINABLE POUCHES

SenSura® Click Drainable EasiClose™ WIDE Outlet Midi Pouch with Filter Two-sided comfort panels. Opaque. Item Midi 10 2" Length 20/Box HCPCS: A4427

Order # CT11114 CT11115

Color Opaque Opaque

••

Two-sided comfort panels. Choose opaque or transparent. Order # CT11124 CT11125 CT11126 CT11127

One-sided comfort panel. Item Order # Maxi CT11194 112" Length CT11195 20/Box CT11196 HCPCS: A4427 CT11197

32

Reorder your supplies online at

M

Color Code

SenSura® Click EasiClose™ Drainable WIDE Outlet Maxi Pouch with Filter Item Maxi 112" Length 20/Box HCPCS: A4427

M

M

•• •• •• ••

Color Opaque Opaque Opaque Opaque

Color Code

Color Transparent Transparent Transparent Transparent

Color Code

www.mybyramhealthcare.com

Ostomy

COLOPLAST

1-877-902-9726

SENSURA® CLICK TWO-PIECE DRAINABLE POUCHES SenSura® Click EasiClose™ WIDE Outlet Drainable Maxi Pouch. No filter Two-sided comfort panels. Choose opaque or transparent. Item Order # Maxi CT11135 112" Length CT11136 20/Box HCPCS: A4426 One-sided comfort panel. Item Order # Maxi CT11185 112" Length CT11186 20/Box HCPCS: A4426

••

Color Opaque Opaque

Color Code

Color Transparent Transparent

Color Code

••

SenSura® Click Magnum High Output Drainable Pouch with Filter Soft cloth on back (and front of opaque). Item 12 ½” Length 10/Box HCPCS: A4413

Order # CT19040 CT19041 CT19042 CT19050 CT19051 CT19052

Color Opaque Opaque Opaque Transparent Transparent Transparent

SenSura® Click Closed End Pouches with Filter

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Order # CT10154 CT10155 CT10156

Two-sided. Item Order # Maxi, 8½" Length, 30/Box HCPCS: A4423 CT10164 CT10165 CT10166 CT10167 One sided comfort panel. Item Order # Maxi, 8½” Length, 30/Box HCPCS: A4423 CT10187

M

Items marked with “M” are Medicare Reimbursable.

Color Code

Color

Color Code

Color Transparent

Byram is a Medicare participating provider.

M

•• •

Color Opaque Opaque Opaque

Opaque Opaque Opaque Opaque

M

Color Code

Two-sided comfort panels. Opaque. Item Midi 7" Length 30/Box HCPCS: A4423

M

•• ••

Color Code

•

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

33

Ostomy

COLOPLAST SENSURA® CLICK TWO-PIECE DRAINABLE POUCHES SenSura® Multi-Chamber Click Urostomy Pouch

Multi-chambers minimize sloshing. Wider anti-reflux valves prevent urine from washing over stoma. Soft outlet can be connected to urostomy night bag. Soft cloth on back. Item Order # MIDI 9 ½” Length CT11851 10/Box CT11841 HCPCS: A4433 Soft cloth on back. Item Order # MAXI 10 3⁄8” Length 10/Box CT11854 HCPCS: A4433 CT11855 CT11856 Soft cloth on front and back. Item Order # MAXI 10 3⁄8” Length 10/Box CT11844 HCPCS: A4433 CT11845 CT11846

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••

Color Transparent Opaque

Color Code

Color

Color Code

Transparent Transparent Transparent Color Opaque Opaque Opaque

•• •

Color Code

•• •

M

Ostomy

COLOPLAST

1-877-902-9726

SENSURA® MIO ONE-PIECE POUCH The SenSura® Mio one-piece pouch is an innovative new product from Coloplast, designed to fit the body’s shape, providing a comfortable and secure experience. This product offers three brand new features: • Elastic Barrier: SenSura® Mio was created using BodyFit Technology, and features an elastic barrier that fits to the shape of the body, providing a secure fit. The SenSura® Mio one-piece product allows for movement, because the barrier is able to stretch and move with the body without lifting from the skin or digging in to the skin. • Neutral Gray Textile: This new pouch material is made of a real woven textile, providing a comfortable feel against the body. This textile was designed in a neutral gray color, which is very discreet under clothing – even under a white shirt. • Full-Circle Filter: With a brand new filter design, the SenSura® Mio product now includes a full-circle shape with a large “pre-filter”. This pre-filter reduces clogging of the filter, and allows consistent air-flow to prevent “ballooning” of the pouch. SENSURA® MIO DRAINABLE POUCHES SenSura® Mio EasiClose™ WIDE Outlet Standard Wear Drainable Pouch Flat. Neutral gray, water-resistant textile. Opaque pouches feature peek-a-boo inspection window for easy application.

M

Items marked with “M” are Medicare Reimbursable.

Transparent, Full-circle filter. Item Order # MAXI 11” CT10481 10/Box CT10482 HCPCS: A4424 CT10488 CT10483 CT10490 CT10484 CT10491 CT10487 CT10485 CT10486

Cut Cut-to-fit Pre-cut Pre-cut Pre-cut Pre-cut Pre-cut Pre-cut Pre-cut Pre-cut Pre-cut

Stoma Size 3⁄8” – 2 1⁄8” 1” 1 1⁄8” 1 3⁄16” 1 ¼” 1 3⁄8” 1 ½” 1 9⁄16” 1 ¾” 2”

Opaque, Full circle filter. Item Order # MAXI 11” CT10471 10/Box CT10472 HCPCS: A4424 CT10473 CT10474 CT10475 CT10476 CT10480 CT10479 CT10477 CT10478

Cut Cut-to-fit Pre-cut Pre-cut Pre-cut Pre-cut Pre-cut Pre-cut Pre-cut Pre-cut Pre-cut

Stoma Size 3⁄8” -2 1⁄8” 1” 1 1⁄8” 1 3⁄16” 1 ¼” 1 3⁄8” 1 ½” 1 9⁄16” 1 ¾” 2”

M

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

35

Ostomy

COLOPLAST SENSURA® MIO DRAINABLE POUCHES

SenSura® Mio EasiClose™ WIDE Outlet Standard Wear Drainable Pouch (Cont.) Flat. Neutral gray, water-resistant textile. Opaque pouches feature peek-a-boo inspection window for easy application. Opaque, Full-circle filter. Item Order # MIDI 10 ¼” CT10461 10/Box HCPCS: A4424 Transparent, without filter. Item Order # MAXI 11” CT10489 10/Box CT10492 HCPCS: A5061 CT10493 CT10494 CT10495 CT10496

Cut Cut-to-fit

Stoma Size 3⁄8” – 1 ¾”

Cut Cut-to-fit Pre-cut Pre-cut Pre-cut Pre-cut Pre-cut

Stoma Size 3⁄8” – 2 1⁄8” 1” 1 1⁄8” 1 ¼” 1 3⁄8” 1 ½”

M

SenSura® Mio EasiClose™ Soft Convex MAXI Standard Wear Drainable Pouch

Belt tabs. Neutral gray, water-resistant textile. Opaque pouches feature peeka-boo inspection window for easy application. Full-circle filter. Opaque, Full-circle filter. Item Order # MAXI 11” CT16715 10/Box CT16716 HCPCS: A4389 CT16705 CT16706

Style Transparent Transparent Opaque Opaque

Cut Cut-to-fit Cut-to-fit Cut-to-fit Cut-to-fit

M

Stoma Size 5⁄8” – 1 5⁄16” 3⁄8” – 2” 5⁄8” – 1 5⁄16” 3⁄8” – 2”

SenSura® Mio EasiClose™ Convex Light MAXI Standard Wear Drainable Pouch

Belt tabs. Neutral gray, water-resistant textile. Opaque pouches feature peeka-boo inspection window for easy application. Full-circle filter. Opaque, Full-circle filter. Item Order # MAXI 11” CT16737 10/Box CT16738 HCPCS: A4389 CT16739 CT16740 CT16741 CT16742 CT16725

36

Reorder your supplies online at

Style Transparent Transparent Transparent Transparent Transparent Transparent Opaque

Cut Cut-to-fit Cut-to-fit Cut-to-fit Pre-cut Pre-cut Pre-cut Cut-to-fit

M

Stoma Size 3⁄8” – 7⁄8” 5⁄8” – 1 5⁄16” 3⁄8” – 1 11⁄16” 13⁄16” 1” 1 1⁄8” 3⁄8” – 7⁄8”

www.mybyramhealthcare.com

Ostomy

COLOPLAST

1-877-902-9726

SENSURA® MIO DRAINABLE POUCHES SenSura® Mio EasiClose™ Convex Light MAXI Standard Wear Drainable Pouch (Cont.)

Belt tabs. Neutral gray, water-resistant textile. Opaque pouches feature peeka-boo inspection window for easy application. Full-circle filter. Opaque, Full-circle filter. Item Order # MAXI 11” CT16726 10/Box CT16730 HCPCS: A4389 CT16731 CT16732 CT16727 CT16734 CT16735

Style Opaque Opaque Opaque Opaque Opaque Opaque Opaque

Cut Cut-to-fit Pre-cut Pre-cut Pre-cut Pre-cut Pre-cut Pre-cut

Stoma Size 5⁄8” – 1 5⁄16” 13⁄16” 1” 1 1⁄8” 1 ¼” 1 3⁄8” 1 ½”

SenSura® Mio EasiClose™ Convex Light MAXI Standard Wear Drainable Pouch Belt tabs. Neutral gray, water-resistant textile. Without filter. Opaque, Full-circle filter. Item Order # MAXI 11” CT16748 10/Box HCPCS: A4389

Style Transparent

Cut Cut-to-fit

M

M

Stoma Size 3⁄8” – 1 11⁄16”

SenSura® Mio EasiClose™ Deep Convex MAXI Standard Wear Drainable Pouch

Belt tabs. Neutral gray, water-resistant textile. Opaque pouches feature peeka-boo inspection window for easy application. Full-circle filter. Opaque, Full-circle filter. Item Order # MAXI 11” CT16765 10/Box CT16766 HCPCS: A4389 CT16767 CT16770 CT16771 CT16772 CT16773 CT16755 CT16756 CT16760 CT16761 CT16762 CT16757 CT16763 CT16764

M

Items marked with “M” are Medicare Reimbursable.

Style Transparent Transparent Transparent Transparent Transparent Transparent Transparent Opaque Opaque Opaque Opaque Opaque Opaque Opaque Opaque

Cut Cut-to-fit Cut-to-fit Cut-to-fit Pre-cut Pre-cut Pre-cut Pre-cut Cut-to-fit Cut-to-fit Pre-cut Pre-cut Pre-cut Pre-cut Pre-cut Pre-cut

M

Stoma Size 3⁄8” – 7⁄8” 5⁄8” – 1 5⁄16” 3⁄8” – 1 11⁄16” 13⁄16” 1” 1 1⁄8” 1 ¼” 3⁄8” – 7⁄8” 5⁄8” – 1 5⁄16” 13⁄16” 1” 1 1⁄8” 1 ¼” 1 3⁄8” 1 ½”

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

37

Ostomy

COLOPLAST SENSURA® MIO DRAINABLE POUCHES

SenSura® Mio EasiClose™ Deep Convex MAXI Standard Wear Drainable Pouch Belt tabs. Neutral gray, water-resistant textile. Without filter. Opaque, Full-circle filter. Item Order # MAXI 11” CT16778 10/Box HCPCS: A4389

Style Transparent

Cut Cut-to-fit

M

Stoma Size 3⁄8” – 1 11⁄16”

SENSURA MIO ONE-PIECE CLOSED POUCHES SenSura® Mio Standard Wear Closed Pouch

Flat. Full-circle filter. Neutral gray, water-resistant textile. Peek-a-boo inspection window for easy application. Opaque. Item MAXI 8 ¼” 30/Box HCPCS: A4416

Order # CT10881 CT10885* CT10883 CT10884 CT10885*

Cut Cut-to-fit Cut-to-fit Pre-cut Pre-cut Pre-cut

Stoma Size 5⁄8” – 1 ¾” 1 9⁄16” – 2 1⁄8” 1 3⁄16” 1 3⁄8” 1 9⁄16”

Item MIDI 7 ¼” 30/Box HCPCS: A4416

Order # CT10871 CT10872 CT10873 CT10874

Cut Cut-to-fit Pre-cut Pre-cut Pre-cut

Stoma Size 5⁄8” – 1 ¾” 1” 1 3⁄16” 1 3⁄8”

Comfortable and discreet stoma cap alternative. Item Order # Cut MINI 5 ¼” CT10870 Cut-to-fit 30/Box HCPCS: A4416

M

Stoma Size 5⁄8” – 1 ¾”

*Because of its larger starter hole, 10885 functions as both a pre-cut and cut-to-fit solution.

Experience the Byram Difference

Byram offers reliable, accurate service nationwide to home care agencies, managed care organizations, healthcare professionals and the patient at home.

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Ostomy

COLOPLAST

1-877-902-9726

SENSURA MIO ONE-PIECE CLOSED POUCHES SenSura® Mio Soft Convex MAXI Standard Wear Closed Pouch

Belt tabs. Neutral gray, water-resistant textile. Opaque pouches feature peeka-boo inspection window for easy application. Full-circle filter. Item MAXI 8 ¼” 10/Box HCPCS: A4417

Order # CT16315 CT16305 CT16306 CT16310 CT16311 CT16312 CT16313

Style Transparent Opaque Opaque Opaque Opaque Opaque Opaque

Cut Cut-to-fit Cut-to-fit Cut-to-fit Pre-cut Pre-cut Pre-cut Pre-cut

M

Stoma Size 3⁄8” – 2” 5⁄8” – 1 5⁄16” 3⁄8” – 2” 1” 1 1⁄8” 1 ¼” 1 3⁄8”

SenSura® Mio Soft Convex MIDI Standard Wear Closed Pouch

Belt tabs. Neutral gray, water-resistant textile. Opaque pouches feature peeka-boo inspection window for easy application. Full-circle filter. Item MIDI 7 ¼” 10/Box HCPCS: A4417

Order # CT16301

Style Opaque

Cut Cut-to-fit

M

Stoma Size 5⁄8” – 1 5⁄16”

SenSura® Mio Convex Light MAXI Standard Wear Closed Pouch

Belt tabs. Neutral gray, water-resistant textile. Opaque pouches feature peeka-boo inspection window for easy application. Full-circle filter. Item MAXI 8 ¼” 10/Box HCPCS: A4417

Order # CT16335 CT16325 CT16326 CT16330 CT16331 CT16327 CT16333 CT16334

Style Transparent Opaque Opaque Opaque Opaque Opaque Opaque Opaque

Cut Pre-cut Cut-to-fit Cut-to-fit Pre-cut Pre-cut Pre-cut Pre-cut Pre-cut

M

Stoma Size 3⁄8” – 1 11⁄16” 3⁄8” – 7⁄8” 5⁄8” – 1 5⁄16” 1” 1 1⁄8” 1 ¼” 1 3⁄8” 1 ½”

SenSura® Mio Convex Light MIDI Standard Wear Closed Pouch

Belt tabs. Neutral gray, water-resistant textile. Opaque pouches feature peeka-boo inspection window for easy application. Full-circle filter. Item MIDI 7 ¼” 10/Box HCPCS: A4417

M

Items marked with “M” are Medicare Reimbursable.

Order # CT16321 CT16322 CT16323

Style Opaque Opaque Opaque

Cut Cut-to-fit Cut-to-fit Cut-to-fit

M

Stoma Size 3⁄8” – 7⁄8” 5⁄8” – 1 5⁄16” 1 ¼” – 1 11⁄16”

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

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Ostomy

COLOPLAST SENSURA MIO ONE-PIECE CLOSED POUCHES

SenSura® Mio Deep Convex MAXI Standard Wear Closed Pouch

Belt tabs. Neutral gray, water-resistant textile. Opaque pouches feature peeka-boo inspection window for easy application. Full-circle filter. Item MAXI 8 ¼” 10/Box HCPCS: A4417

Order # CT16355 CT16345 CT16346 CT16350 CT16351 CT16347 CT16353 CT16354

Style Transparent Opaque Opaque Opaque Opaque Opaque Opaque Opaque

Cut Cut-to-fit Cut-to-fit Cut-to-fit Pre-cut Pre-cut Pre-cut Pre-cut Pre-cut

M

Stoma Size 3⁄8” – 1 11⁄16” 3⁄8” – 7⁄8” 5⁄8” – 1 5⁄16” 1” 1 1⁄8” 1 ¼” 1 3⁄8” 1 ½”

SenSura® Mio Deep Convex MIDI Standard Wear Closed Pouch

Belt tabs. Neutral gray, water-resistant textile. Opaque pouches feature peeka-boo inspection window for easy application. Full-circle filter. Item MIDI 7 ¼” 10/Box HCPCS: A4417

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Order # CT16341 CT16342 CT16343

Reorder your supplies online at

Style Opaque Opaque Opaque

Cut Cut-to-fit Cut-to-fit Cut-to-fit

M

Stoma Size 3⁄8” – 7⁄8” 5⁄8” – 1 5⁄16” 1 ¼” – 1 11⁄16”

www.mybyramhealthcare.com

Ostomy

COLOPLAST

1-877-902-9726

SENSURA MIO ORIGINAL ONE-PIECE CLOSED POUCHES SenSura® Mio Original Closed Pouch with Filter “Peek-a-boo” inspection window for easy placement. Soft cloth on front and back.

M

Item Order # MAXI 8 ½” Length CT10831 30/Box CT10835* HCPCS: A4416

Cut-to-Fit 5⁄8” – 1 ¾” 1 9⁄16” – 2 ¼”

Style Opaque Opaque

Item MAXI 8 ½” Length 30/Box HCPCS: A4416

Order # CT10833 CT10834 CT10835*

Pre-Cut 1 3⁄16” 1 3⁄8” 1 9⁄16”

Style Opaque Opaque Opaque

Item MIDI 7” Length 30/Box HCPCS: A4416

Order # CT10821

Cut-to-Fit 5⁄8” – 1 ¾”

Style Opaque

Item MIDI 7” Length 30/Box HCPCS: A4416

Order # CT10822 CT10823 CT10824

Pre-Cut 1” 1 3⁄16” 1 3⁄8”

Style Opaque Opaque Opaque

Cut-to-Fit 5⁄8” – 1 ¾”

Style Opaque

Item Order # MINI 5 1/2” Length CT10811 30/Box HCPCS: A4416

*Because of its larger starter hole, 10835 functions as both a pre-cut and cut-to-fit solution.

SenSura® Mio Standard Wear MAXI Urostomy Pouch

Neutral gray, water-resistant textile on back. Flat. Multi-chambers minimize sloshing. Anti-reflux valves prevent urine from washing over the stoma. Soft outlet can be connected to urostomy night bag. Transparent. Item 10 ½” 10/Box HCPCS: A5071

Order # CT10586

Cut Cut-to-fit

M

Stoma Size 3⁄8” – 1 ¾”

To reach our Ostomy Center of Excellence, please call: 1-800-308-9445

M

Items marked with “M” are Medicare Reimbursable.

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

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COLOPLAST

Ostomy

SENSURA MIO ORIGINAL ONE-PIECE CLOSED POUCHES SenSura® Mio Soft Convex MAXI Urostomy Pouch

Standard wear. Multi-chambers minimize sloshing. Wider anti-reflux valves prevent urine from washing over stoma. Soft outlet can be connected to urostomy night bag. Neutral gray water-resistant textile. Opaque pouches feature peek-a-boo inspection window for easy application.

M

Item MAXI 10 ½’ 10/Box HCPCS: A4392

Order # CT16810 CT16805

Style Transparent Opaque

Cut Cut-to-fit Cut-to-fit

Stoma Size 3⁄8” – 2” 3⁄8” – 1 5⁄16”

SenSura® Mio Soft Convex MIDI Urostomy Pouch

Standard wear. Belt tabs. Multi-chambers minimize sloshing. Wider anti-reflux valves prevent urine from washing over stoma. Soft outlet can be connected to urostomy night bag. Neutral gray water-resistant textile. Item MAXI 9 ½’ 10/Box HCPCS: A4392

Order # CT16801

Style Opaque

Cut Cut-to-fit

M

Stoma Size 3⁄8” –1 5⁄16”

SenSura® Mio Convex Light MAXI Urostomy Pouch

Standard wear. Belt tabs. Multi-chambers minimize sloshing. Wider anti-reflux valves prevent urine from washing over stoma. Soft outlet can be connected to urostomy night bag. Neutral gray water-resistant textile. Item MAXI 10 ½’ 10/Box HCPCS: A4392

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Order # CT16835 CT16837 CT16836 CT16840 CT16841 CT16842 CT16825 CT16826 CT16830 CT16831 CT16832 CT16833 CT16827

Style Transparent Transparent Transparent Transparent Transparent Transparent Opaque Opaque Opaque Opaque Opaque Opaque Opaque

Cut Cut-to-fit Cut-to-fit Cut-to-fit Pre-cut Pre-cut Pre-cut Cut-to-fit Cut-to-fit Pre-cut Pre-cut Pre-cut Pre-cut Pre-cut

Stoma Size 3⁄8” –7⁄8” 3⁄8” – 1 11⁄16” 5⁄8” – 1 5⁄16” 13⁄16” 1” 1 1⁄8” 3⁄8” – 7⁄8” 5⁄8” – 1 5⁄16” 11⁄16” 13⁄16” 1” 1 1⁄8” 1 ¼”

M

Ostomy

COLOPLAST

1-877-902-9726

SENSURA MIO ORIGINAL ONE-PIECE CLOSED POUCHES SenSura® Mio Convex Light MIDI Urostomy Pouch

Standard wear. Belt tabs. Multi-chambers minimize sloshing. Wider anti-reflux valves prevent urine from washing over stoma. Soft outlet can be connected to urostomy night bag. Neutral gray water-resistant textile. Item MAXI 9 ½’ 10/Box HCPCS: A4392

Order # CT16821 CT16822 CT16823

Style Opaque Opaque Opaque

Cut Cut-to-fit Cut-to-fit Pre-cut

M

Stoma Size 3⁄8” –7⁄8” 5⁄8” – 1 5⁄16” 1¼

SenSura® Mio Deep Convex MAXI Urostomy Pouch

Standard wear. Belt tabs. Multi-chambers minimize sloshing. Wider anti-reflux valves prevent urine from washing over stoma. Soft outlet can be connected to urostomy night bag. Neutral gray water-resistant textile. Item MAXI 10 ½’ 10/Box HCPCS: A4392

M

Items marked with “M” are Medicare Reimbursable.

Order # CT16865 CT16866 CT16867 CT16870 CT16871 CT16872 CT16855 CT16856 CT16860 CT16861 CT16862 CT16863 CT16857

Style Transparent Transparent Transparent Transparent Transparent Transparent Opaque Opaque Opaque Opaque Opaque Opaque Opaque

Cut Cut-to-fit Cut-to-fit Cut-to-fit Pre-cut Pre-cut Pre-cut Cut-to-fit Cut-to-fit Pre-cut Pre-cut Pre-cut Pre-cut Pre-cut

M

Stoma Size 3⁄8” –7⁄8” 5⁄8” – 1 5⁄16” 3⁄8” – 1 11⁄16” 13⁄16” 1” 1 1⁄8” 3⁄8” – 7⁄8” 5⁄8” – 1 5⁄16” 11⁄16” 13⁄16” 1” 1 1⁄8” 1 ¼”

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

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SenSura® One-Piece Systems offer a unique double-layer adhesive. The lower layer provides absorption and moisture balance. The upper layer provides erosion resistance. SenSura® also provides optimal adhesion, flexibility and ease of removal. All SenSura® products are latex free. SENSURA® ONE-PIECE CLOSED END POUCHES SenSura® Closed End Maxi Pouch with Integrated Filter, Flat Skin Barrier Closed-end maxi pouch with integrated filter. Two-sided comfort panels. Standard wear, flat skin barrier. Cut-to-Fit or Pre-Cut. Item 8½" Length 30/Box HCPCS: A4416

Order # CT15480

Cut-to-Fit s"-3"

Style Opaque

Item 8½" Length 30/Box HCPCS: A4416

Order # CT15484

Pre-Cut 1s"

Style Opaque

M

SENSURA® ONE-PIECE DRAINABLE POUCHES SenSura® EasiClose™ WIDE Outlet Maxi Pouch with Integrated Filter, Flat Skin Barrier EasiClose™ WIDE outlet drainable pouch with integrated filter. One-sided comfort panel. Standard wear, flat skin barrier. Cut-to-Fit or Pre-Cut. Item 112" Length 20/Box HCPCS: A4424

Order # CT15521

Cut-to-Fit s"-3"

Style Transparent

Item 112" Length 20/Box HCPCS: A4424

Order # CT15522 CT15523 CT15524

Pre-Cut 1" 13⁄16" 1s"

Style Transparent Transparent Transparent

M

SenSura® EasiClose™ WIDE Outlet Maxi Pouch without Filter, Flat Skin Barrier

EasiClose™ WIDE outlet drainable pouch. No Filter. One-sided comfort panel. Standard wear, flat skin barrier. Cut-to-Fit or Pre-Cut. Item 112" Length 20/Box HCPCS: A5061

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Order # CT15821

Reorder your supplies online at

Cut-to-Fit s"-3"

M

Style Transparent

www.mybyramhealthcare.com

Ostomy

COLOPLAST

1-877-902-9726

SENSURA® ONE-PIECE DRAINABLE POUCHES SenSura® EasiClose™ WIDE Outlet Maxi Pouch with Integrated Filter, Flat Skin Barrier EasiClose™ WIDE outlet drainable pouch with integrated filter. Soft cloth on front and back. Standard wear, flat skin barrier. Cut-to-Fit or Pre-Cut. Item 112" Length 20/Box HCPCS: A4424

Order # CT15531

Cut-to-Fit s"-3"

Style Opaque

Item 112" Length 20/Box HCPCS: A4424

Order # CT15532 CT15533 CT15534

Pre-Cut 1" 13⁄16" 1s"

Style Opaque Opaque Opaque

M

SenSura® Xpro EasiClose™ WIDE Outlet Maxi Pouch with Integrated Filter, Flat Skin Barrier Filter EasiClose™ WIDE outlet drainable pouch with integrated filter. Soft cloth front and back. Extended wear, flat skin barrier. Soft cloth on back. Item Order # 11 ½” Length CT15981 10/Box HCPCS: A5056 Soft cloth on front and back. Item Order # 11 ½” Length CT15991 10/Box CT15992 HCPCS: A5056 CT15993 CT15994

Cut-to-Fit 3⁄8” – 3”

Style Transparent

Pre-Cut 1” 1 3⁄16” 1 ¼” 1 ½”

Style Opaque Opaque Opaque Opaque

M

Our Latino Program is designed to provide our Spanish speaking customers with a comfortable communication environment and access to customized support for ostomy management Call: 1-866-302-4295

M

Items marked with “M” are Medicare Reimbursable.

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

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Ostomy

COLOPLAST SENSURA® ONE-PIECE DRAINABLE POUCHES

SenSura® EasiClose™ WIDE Outlet Maxi Pouch with Intergrated Filter, Convex Light Skin Barrier with Belt Tabs EasiClose™ WIDE outlet drainable pouch with integrated filter. Belt tabs and comfort panel. Standard wear convex light skin barrier. Cut-to-Fit or Pre-Cut. Soft cloth on back. Item Order # 112" Length CT15606 10/Box HCPCS: A4389 Item 112" Length 10/Box HCPCS: A4389

Order # CT15623 CT15624

Soft cloth front and back. Item Order # 112" Length CT15608 10/Box HCPCS: A4389 Item 112" Length 10/Box HCPCS: A4389

Order # CT15633 CT15634

Cut-to-Fit d"-111⁄16"

Style Transparent

Pre-Cut 1" 18"

Style Transparent Transparent

Cut-to-Fit d"-111⁄16"

Style Opaque

Pre-Cut 1" 18"

Style Opaque Opaque

SenSura® Xpro EasiClose™ WIDE Outlet Maxi Pouch with Intergrated Filter, Convex Light Skin Barrier with Belt Tabs

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Soft cloth on back. Item Order # 11 ½” Length CT15695 10/Box CT15696 HCPCS: A5057

Cut-to-Fit 5⁄8” – 1 5⁄16” 5⁄8” – 1 11⁄16”

Style Transparent Transparent

Soft cloth on front and back. Item Order # 11 ½” Length CT15697 10/Box CT15698 HCPCS:A5057

Pre-Cut 7⁄8” 1”

Style Opaque Opaque

M

M

Ostomy

COLOPLAST

1-877-902-9726

SENSURA® ONE-PIECE DRAINABLE POUCHES SenSura® Standard Wear MAXI Drainable Pouch

Flat. Soft outlet for liquid stool can connect to a drain bag. Filter. Soft cloth on front and back. Peek-a-boo inspection window allows easy application. Opaque. Item 12 ½” 30/Box HCPCS: A4424

Order # CT19004

Cut Cut-to-fit

M

Stoma Size 3⁄8” – 3”

SenSura® Multi-Chamber Urostomy Pouch

Multi-chambers minimize sloshing. Anti-reflux valve prevents urine from washing over stoma. Soft outlet can be connected to urostomy night bag. Standard wear. Soft cloth on back. Item Order # MIDI 9 ½” Length CT11803 10/Box HCPCS: A5071 Standard wear. Soft cloth on back. Item Order # MAXI 10 3⁄8” Length CT11804 10/Box HCPCS: A5071

Cut-to-Fit 3⁄8” – 2 ½”

Style Transparent

Cut-to-Fit 3⁄8” – 3”

Style Transparent

Xpro Extended Wear, Soft cloth on back Item Order # Cut-to-Fit MAXI 10 3⁄8” Length CT11809 3⁄8” – 3” 10/Box HCPCS: A4391 Xpro Extended Wear, Soft cloth on front and back. Item Order # Pre-Cut MAXI 10 3⁄8” Length CT11805 7⁄8” 10/Box CT11806 1” HCPCS: A4391 CT11807 1 3⁄16” CT11808 1 ¼”

M

Style Transparent

Style Opaque Opaque Opaque Opaque

Our ostomy specialists are commited to your satisfaction. Please call us with any questions. 1-877-902-9726

M

Items marked with “M” are Medicare Reimbursable.

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

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Ostomy

COLOPLAST SENSURA® ONE-PIECE POST-OP DRAINABLE POUCHES

SenSura® Convex Light Multi-Chamber Urostomy Pouch with Belt Tabs Multi-chambers minimizes sloshing. Anti-reflux valves prevent urine from washing over stoma. Soft outlet can be connected to urostomy night bag. Standard wear, soft cloth on back. Item Order # MAXI 10 3⁄8” Length CT11814 10/Box HCPCS: A4392

Cut-to-Fit 5⁄8” – 1 5⁄16”

M

Style Transparent

SenSura® Xpro Convex Light Multi-Chamber Urostomy Pouch with Belt Tabs Multi-chambers minimizes sloshing. Anti-reflux valves prevent urine from washing over stoma. Soft outlet can be connected to urostomy night bag. Xpro extended wear, soft cloth on back. Item Order # Cut-to-Fit MAXI 10 3⁄8” Length CT11819 5⁄8” – 1 5⁄16” 10/Box HCPCS: A4393 Xpro extended wear, soft cloth on front and back. Item Order # Pre-Cut MAXI 10 3⁄8” Length CT11816 7⁄8” 10/Box CT11817 1” HCPCS: A4393 CT11818 1 ¼”

Style Transparent

Style Opaque Opaque Opaque

SenSura® Drainable Post-Op Pouch with Window

Soft outlet can be connected to bed drain bag. Soft cloth on back.

M

Easy-to-open and -close access window attached to pouch. Item Order # Cut-to-Fit Style 13” Length CT19020 3⁄8” – 3” Transparent 5/Box CT19021 3⁄8” – 4 ½” Transparent HCPCS: A6154 STERILE. Easy-to-open and -close access window attached to pouch. Item Order # Cut-to-Fit Style 13” Length CT19010 3⁄8” – 3” Transparent 5/Box CT19011 3⁄8” – 4 ½” Transparent HCPCS: A6154 Effective for small fistulas. No access window. Item Order # Cut-to-Fit 12 ¼” Length CT19030 3⁄8” – 3” 5/Box HCPCS: A6154

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Reorder your supplies online at

Style Transparent

www.mybyramhealthcare.com

Ostomy

COLOPLAST

1-877-902-9726

ASSURA® TWO-PIECE OSTOMY SYSTEM The Assura® Two-Piece Ostomy System can be applied with minimal pressure to the barrier, and easily removed with just an "up and over" motion. When the system is locked, the pouch is safely and securely fastened to the barrier. Assura® skin barrier flanges come in three types: Flat, Convex Light and Convex. They are available in either cut-to-fit or pre-cut. Match the color code of the barrier you select to the color code of the pouch you will use.

ASSURA® SKIN BARRIERS Assura® Flat, Standard Wear Skin Barrier with Belt Tabs

Flat, flexible, spiral skin barrier, standard wear adhesive contains moistureabsorbing hydrocolloid. Lock-ring flange with attached belt tabs. Match barrier and pouch color codes for proper fit. Item 5/Box HCPCS: A4414

Order # CT2881 CT2882 CT2883

Item Order # 5/Box CT12841 HCPCS: A4414 CT12842 CT12844 CT12845 CT12847 CT12848

M

Items marked with “M” are Medicare Reimbursable.

M

•• • •• •• ••

Cut-to-Fit 3⁄8" to 13⁄8" 3⁄8" to 1w" 3⁄8" to 24"

Color Code

Pre-Cut Size 13⁄16" 1" 13⁄16" 13⁄8" 19⁄16" 1¾"

Color Code

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

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Ostomy

COLOPLAST ASSURA® SKIN BARRIERS

Assura® Flat, Extra-Extended Wear Skin Barrier Flange

Flat, flexible barrier. Extra extended wear adhesive with moisture absorbent hydrocolloid. Locking-ring flange with attached belt tabs. Match barrier and pouch color codes for proper fit.

M

•• • •• •• •• •

Item Order # 5/Box CT2831 HCPCS: A4409 CT2832 CT2833

Cut-to-Fit 3⁄8" to 13⁄8" 3⁄8" to 1w" 3⁄8" to 24"

Color Code

Item Order# 5/Box CT14250 HCPCS: A4409 CT14251 CT14252 CT14254 CT14255 CT14257 CT14258

Pre-Cut Size 5⁄8" 13⁄16" 1" 13⁄16" 13⁄8" 19⁄16" 1¾"

Color Code

Assura® Convex Light, Standard Wear Skin Barrier with Belt Tabs

Shallow convexity skin barrier for flush or slightly retracted stomas. Standard wear adhesive with moisture absorbing hydrocolloid. Locking-ring flange with attached belt tabs. Match barrier and pouch color codes for proper fit.

•• • •• •• •• ••

Item 5/Box HCPCS: A4373

Order # CT14261 CT14262 CT14263

Cut-to-Fit 5⁄8” to 15⁄16” 5⁄8” to 15⁄16” 5⁄8” to 111⁄16”

Color Code

Item 5/Box HCPCS: A4373

Order # CT14271 CT14272 CT14273 CT14274 CT14275 CT14276 CT14277 CT14278

Pre-Cut Size ¾" 7⁄8" 1" 11⁄8" 1¼" 13⁄8" 1½" 15⁄8"

Color Code

Reordering supplies online is simple! Visit the improved www.mybyramhealthcare.com and sign up today!

50

M

Ostomy

COLOPLAST

1-877-902-9726

ASSURA® SKIN BARRIERS Assura® Convex Light, Extra-Extended Wear, Skin Barrier with Belt Tabs

Shallow convexity skin barrier for flush or slightly retracted stomas. Extra-extended wear adhesive with moisture absorbing hydrocolloid. Locking-ring flange with attached belt tabs. Match barrier and pouch color codes for proper fit.

M

•• • •• •• •• ••

Item 5/Box HCPCS: A4407

Order# CT14281 CT14282 CT14283

Cut- to-Fit d” to 15⁄16” d” to 15⁄16” d” to 111⁄16”

Color Code

Item 5/Box HCPCS: A4407

Order# CT14291 CT14292 CT14293 CT14294 CT14295 CT14296 CT14297 CT14298

Pre-Cut Size w" f" 1" 18" 14" 1s" 12" 1d"

Color Code

Assura® Convex, Standard Wear Skin Barrier Flange

Convex, flexible, spiral skin barrier. Adhesive contains moisture-absorbing hydrocolloid. Lock-ring flange with attached belt tabs. Match barrier and pouch color codes for proper fit. Cut-to-Fit or Pre-Cut.

M

Items marked with “M” are Medicare Reimbursable.

M

•• •• •• •• •• •

Item 5/Box HCPCS: A4373

Order # CT12716 CT12719

Cut-to-Fit d" to 15⁄16" d" to 111⁄16"

Color Code

Item 5/Box HCPCS: A4373

Order #

Pre-Cut Size

Color Code

CT12701 CT12702 CT12703 CT12704 CT12705 CT12706 CT12707 CT12708 CT12709

d" w" f" 1" 18" 14" 1s" 12" 1d"

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

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Ostomy

COLOPLAST ASSURA® SKIN BARRIERS Assura® Convex, Extra-Extended Wear Skin Barrier Flange

Convex, flexible spiral skin barrier. Extra-extended wear adhesive with moistureabsorbent hydrocolloid. Locking-ring flange with attached belt loops. Match barrier and pouch color codes for proper fit. Cut-to-Fit or Pre-Cut.

M

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•• • •• •• •• ••

Item 5/Box HCPCS: A4407

Order # CT14243 CT14246 CT14249

Cut-to-Fit d" to 15⁄16" d” to 15⁄16” d” to 111⁄16”

Color Code

Item 5/Box HCPCS: A4407

Order #

Pre-Cut Size

Color Code

CT14232 CT14233 CT14234 CT14235 CT14236 CT14237 CT14238 CT14239

w" f" 1" 18" 14" 1s" 12" 1d"

Reorder your supplies online at

www.mybyramhealthcare.com

Ostomy

COLOPLAST

1-877-902-9726

ASSURA® CLOSED POUCHES Assura® Drainable Pouch with EasiClose™ WIDE Outlet and Filter

The EasiClose WIDE outlet pouch is extremely hygienic and secure for those with colostomies and ileostomies. The WIDE outlet makes emptying easier for those with thicker output. Filter option enhances discretion while controlling odor. New slick interior pouch film also makes emptying easier and faster. Velcro® dots on outlet creates a hygienic pouching system.

M

Two-sided comfort panels, filter. Item Order # 102" Length CT15954 Midi CT15955 10/Box CT15956 HCPCS: A4427

Style Opaque Opaque Opaque

Color Code

One-sided comfort panel, filter. Item Order # 112" Length CT15974 Maxi CT15975 10/Box CT15976 HCPCS: A4427

Style Transparent Transparent Transparent

Color Code

Two-sided comfort panels, filter. Item Order # 112" Length CT15984 Maxi CT15985 10/Box CT15986 HCPCS: A4427

Style Opaque Opaque Opaque

Color Code

Style Opaque Opaque

Color Code

Two-sided comfort panels, no filter. Item Order # 112" Length CT15982 Maxi CT15983 10/Box HCPCS: A4426

•• • •• • •• • ••

Coloplast Assura® Fit Tip

To assure your system components will all fit together correctly, just match the colors on boxes of barriers, pouches, stoma caps and irrigation sleeves.

M

Items marked with “M” are Medicare Reimbursable.

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

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Ostomy

COLOPLAST ASSURA® DRAINABLE POUCHES

Assura® Drainable Pouch with EasiClose™ Outlet

Extremely hygienic and secure pouch for those with colostomies or ileostomies. Unique integrated Velcro® closure system and integrated charcoal filter. Low profile for maximum discretion. Odor barrier film. Secure locking mechanism. No clips or clamps required. Match pouch and barrier code colors for proper fit.

M

Mini Classic. Item 94" Length 10/Box HCPCS: A4427

Order # CT13924 CT13925

Style Opaque Opaque

Color Code

Midi Graphic Design. Item 102" Length 10/Box HCPCS: A4427

Order # CT13964 CT13965 CT13966

Style Opaque Opaque Opaque

Color Code

Maxi Classic. Item 112" Length 10/Box HCPCS: A4427

Order # CT13984 CT13985 CT13986

Style Opaque Opaque Opaque

Color Code

Order #

Style

Color Code

CT13974 CT13975 CT13976

Transparent Transparent Transparent

Maxi Transparent. Item 112" Length, 10/Box HCPCS: A4427

Assura® Drainable Pouch

•• •• • •• • •• •

Pouch with soft, moisture-absorbent backing and twist-tie or clip closure. Lock-ring attachment system produces an audible "click" when connection has been secured. 5 pouch clamps and 5 twist ties included. Match color code of skin barrier and pouch for proper fit.

M

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Item Midi 9w" Length 10/Box HCPCS: A4426

Order # CT12527 CT12528 CT12529

Style Opaque Opaque Opaque

Maxi 114" Length 10/Box HCPCS: A4426

CT12577 CT12578 CT12579

Opaque Opaque Opaque

•• • •• •

Color Code

Ostomy

COLOPLAST

1-877-902-9726

ASSURA® DRAINABLE POUCHES Assura® High Output Drainable Pouch with Filter

Soft outlet attaches to drain bag. Soft cloth on back (and front of opaque). Item 12 ½” Length 10/Box HCPCS:A4413

Order # CT8114 CT8115 CT8116 CT2846 CT2847

Style Transparent Transparent Transparent Opaque Opaque

M

•• •• •

Color code

Assura® Closed Pouch with Filter

Closed pouch has a soft, cloth front and back for comfort, odor-proof film, and secure lock-ring system that produces an audible "click" sound when pouch is securely attached to flange. Match pouch and barrier color codes for proper fit. Includes filter for odor control. Latex-free.

M

Items marked with “M” are Medicare Reimbursable.

•• • •• •

Item Mini 7" Length 30/Box HCPCS: A4423

Order # CT12344 CT12345 CT12346

Style Transparent Transparent Transparent

Color Code

Item Mini 7" Length 30/Box HCPCS: A4423

Order # CT12354 CT12355 CT12356

Style Opaque Opaque Opaque

Color Code

Item Order # Maxi, 82" Length, 30/Box HCPCS: A4423 CT12374 CT12375 CT12376

Style

Color Code

Item Maxi 82” Length 30/Box HCPCS: A4423

Style Opaque Opaque Opaque

Order # CT12384 CT12385 CT12386

Transparent Transparent Transparent

M

•• • •• •

Color Code

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

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Ostomy

COLOPLAST ASSURA® STOMA CAPS Assura® Stoma Cap with Filter

Stoma Cap has a soft, moisture-absorbent wicking material with odor-proof film and integrated filter. Match to system color codes for proper fit. Item 30/Box HCPCS: A5055

Order # CT2801 CT2802 CT2803

Style Opaque Opaque Opaque

M

•• •

Color Code

ASSURA® UROSTOMY POUCHES Assura® Multi-Chamber Urostomy Pouch

Soft, absorbent backing with anti-reflux valve. Pouch is divided into chambers for a more discreet and quiet pouch. Simple locking connector for night drainage attachment. Includes 3 adaptors.

M

56

•• • •• •

Item 102" length 10/Box HCPCS: A4433

Order # CT14224 CT14225 CT14226

Style Opaque Opaque Opaque

Color Code

Item 102" length 10/Box HCPCS: A4433

Order # CT14227 CT14228 CT14229

Style Transparent Transparent Transparent

Color Code

Reorder your supplies online at

www.mybyramhealthcare.com

Ostomy

COLOPLAST

1-877-902-9726

ASSURA® UROSTOMY POUCHES Assura® Urostomy Pouch

Urostomy pouch with soft, moisture-absorbent backing, odor-proof film and lockring attachment system which produces audible "click" when pouch is correctly attached. Match pouch and barrier color code for proper fit. Includes antireflux valve and 5 adaptors for night drainage bag attachment. Latex-free.

M

•• •• • •• •

Item 92" Length 10/Box HCPCS: A4433

Order # CT1751 CT1752

Style Transparent Transparent

Color Code

Item 10w" Length 10/Box HCPCS: A4433

Order # CT1757 CT1758 CT1759

Style Transparent Transparent Transparent

Color Code

Item 10w" Length 10/Box HCPCS: A4433

Order # CT1754 CT1755 CT1756

Style Opaque Opaque Opaque

Color Code

Assura® Urostomy Micro-Pouch

Soft, absorbent backing with anti-reflux valve. Pouch is small enough so it doesn’t twist like a standard urostomy pouch. Can be easily connected to the Assura® Urostomy Night Bag. No adaptors needed.

M

Item 6" Length 10/Box HCPCS: A4433

Order # CT14204 CT14205 CT14206

Style Transparent Transparent Transparent

•• •

Color Code

Clinical CareMail

Have a question? E-mail one of our clinicians at [email protected]

M

Items marked with “M” are Medicare Reimbursable.

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

57

Ostomy

COLOPLAST ASSURA® AC TWO-PIECE SYSTEM ASSURA® AC 2-PIECE SYSTEM Assura® AC features a flexible, adhesive two-piece coupling system that conforms to the body and is easy to apply. This product offers the flexibility of a one-piece system and the convenience of a two-piece. To ensure the correct combination of two-piece barrier and pouches, match the baseplate color code to the color code of the pouch that will be used. Important: Patients with a clinical need for convexity, those with fistulas or skin folds that must be accommodated, and those who use an ostomy belt for support may not find this system to be appropriate for them.

NOTE: Items marked * have custom peel rings.

ASSURA® AC BASEPLATES Assura® AC Flat Barrier

Adhesive coupling offers the convenience of a 2-piece with greater flexibility. Cut-to-Fit ensures exact fit around stoma. Standard Wear Adhesive. Item Order # 10/Box HCPCS: A4414 CT14301 HCPCS: A4414 CT14302 HCPCS: A4415 CT14303 Standard Wear Adhesive. Item Order # 5/Box CT14309 HCPCS: A4415

Cut-to-Fit

Size

s"-15⁄16" s"-1f" s"- 2w"

Small Medium Large

Cut-to-Fit s"-32"

Size Color Code Extra Large

Extra-Extended Wear Adhesive. Item Order # Cut-to-Fit 10/Box HCPCS: A4409 CT14304 s"-15⁄16" HCPCS: A4409 CT14305 s"-1f" HCPCS: A4410 CT14306 s"-2w"

Size Small Medium Large

Color Code

•• • •

Color Code

•• •

Our Latino Program is designed to provide our Spanish speaking customers with a comfortable communication environment and access to customized support for ostomy management Call: 1-866-302-4295

58

M

Ostomy

COLOPLAST

1-877-902-9726

ASSURA® AC BASEPLATES Assura® AC Convex Light Barrier with Belt Tabs

Assura® AC baseplates are now available in the flexible convex light style. Adhesive baseplate, instead of a flange, eliminates locking problems. Choose Pre-cut or Cut-to-Fit. Attached belt tabs.

M

Standard Wear Adhesive. Cut-to-Fit Item Order # Cut-to-Fit 5/Box CT14401 d” - 15⁄16” HCPCS: A4373 CT14403 d"- 111⁄16" CT14406 d"- 23⁄8"

Size Small Medium Large

Color Code

Standard Wear Adhesive. Pre-Cut Item Order # Pre-Cut 5/Box CT14642 f” HCPCS: A4373 CT14643 1" CT14644 18" CT14645 14" CT14646 1s"

Size Small Medium Medium Medium Medium

Color Code

Extra-Extended Wear Adhesive. Cut-to-Fit Item Order # Cut-to-Fit 5/Box CT14601 d” - 15⁄16” HCPCS: A4407 CT14602 d” - 1 5⁄16” CT14603 d” - 1 11⁄16” HCPCS: A4408 CT14408 d” - 2 3⁄8”

Size Small Medium Medium Large

Color Code

ASSURA® AC DRAINABLE POUCHES

•• • •• •• • •• • •

Assura® AC Easiclose™ Drainable Pouches with Filter

Assura® AC drainable pouches attach to Assura AC barriers with an adhesive coupling system instead of the locking mechanism of a standard flange. Match color code of pouch to color code of selected barrier.

M

Opaque, two-sided comfort panels, filter. Item Order# Midi CT14346 104" Length CT14347 20/Box CT14349 HCPCS: A4425 Transparent, one-sided comfort panel, filter. Item Order# Midi CT14342* 104"Length CT14344 20/Box HCPCS:A4425

•• •

Color Code

••

Color Code

*Includes perforated rings providing the option of an exact fit around the stoma.

M

Items marked with “M” are Medicare Reimbursable.

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

59

Ostomy

COLOPLAST ASSURA® AC DRAINABLE POUCHES

Assura® AC Easiclose™ Drainable Pouches with Filter (Cont.)

Assura® AC drainable pouches attach to Assura AC barriers with an adhesive coupling system instead of the locking mechanism of a standard flange. Match color code of pouch to color code of selected barrier.

M

*Includes perforated rings providing the option of an exact fit around the stoma.

Opaque, two-sided cloth panels, filter. Item Order# Maxi CT14361 114" Length CT14362 20/Box CT14364 HCPCS: A4425 Transparent, one-sided comfort panel, filter. Item Order# Maxi CT14356 114" Length CT14357 20/Box CT14359 HCPCS: A4425 Opaque, two-sided cloth panels, no filter. Item Order# Coupling Size Maxi CT14525 s" -1f" 114" Length 20/Box HCPCS: A5063 Transparent, one-sided cloth panels, no filter. Item Order# Coupling Size Maxi CT14521 s" -1f" 114" Length 20/Box HCPCS: A5063 Opaque, two-sided cloth panels, filter. Item Order# XL CT14379 122" Length, 20/Box HCPCS: A4425 Transparent, one-sided comfort panel, no filter. Item Order# XL CT14527 122" Length, 20/Box HCPCS: A5063

•• •

Color Code

•• • •

Color Code

Color Code

•

Color Code

•

Color Code

•

Color Code

To reach our Ostomy Center of Excellence, please call: 1-800-308-9445

60

Reorder your supplies online at

www.mybyramhealthcare.com

Ostomy

COLOPLAST

1-877-902-9726

ASSURA® AC CLOSED END POUCHES Assura® AC Closed End Pouches with Filter

Assura® AC Closed End Pouches adhere to the Assura® AC Barrier without the locking mechanism of a standard flange for easy application.

M

•• • •• •• •

Item Midi 7" Length 30/box HCPCS: A4419

Order # CT14316 CT14317 CT14319

Style Opaque Opaque Opaque

Color Code

Item Maxi 82" Length 30/Box HCPCS: A4419

Order # CT14331 CT14332 CT14333* CT14334

Style Opaque Opaque Opaque Opaque

Color Code

Item Extra Large 102" Length 30/Box HCPCS: A4419

Order # CT14355

Style Opaque

Color Code

Item Maxi 82" Length 30/Box HCPCS: A4419

Order # CT14326 CT14327 CT14328* CT14329

Style Transparent Transparent Transparent Transparent

Color Code

•• ••

*Includes perforated rings providing the option for an exact fit around the stoma.

M

Items marked with “M” are Medicare Reimbursable.

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

61

COLOPLAST

Ostomy

ASSURA® DRAINABLE POUCHES Assura® Flat Drainable Pouch with EasiClose™ WIDE Outlet

Wide outlet pouch with EasiClose™ feature. Recommended for people with thicker output. Maxi pouch with slimline filter or without filter. Slick interior pouch film makes emptying easier and faster. Velcro closure on back. Choose Standard wear adhesive or Extra-Extended wear adhesive. Bag length: 112".

M

Standard wear adhesive, one-sided comfort panel, filter. Item Order # Cut-to-Fit Style 10/Box CT15860 s"-3" Transparent HCPCS: A4424 Standard wear adhesive, two-sided comfort panels, filter. Item Order # Cut-to-Fit Style 10/Box CT15870 s"-3" Opaque HCPCS: A4424 Standard wear adhesive, two-sided comfort panels, filter. Item Order # Pre-Cut Size Style 10/Box CT15874 1" Opaque HCPCS: A4424 CT15875 13⁄16" Opaque CT15876 1s" Opaque Standard wear adhesive, two-sided comfort panels, no filter. Item Order # Cut-to-Fit Style 10/Box CT15871 s"-3" Opaque HCPCS: A5061 Extra-Extended wear adhesive, one-sided comfort panel, no filter. Item Order # Cut-to-Fit Style 10/Box CT15869 s"-3" Transparent HCPCS: A4388 Extra-Extended wear adhesive, two-sided comfort panels, no filter. Item Order # Cut-to-Fit Style 10/Box CT15879 s"-3" Opaque HCPCS: A4388

Experience the Byram Difference

Byram offers reliable, accurate service nationwide to home care agencies, managed care organizations, healthcare professionals and the patient at home.

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Ostomy

COLOPLAST

1-877-902-9726

ASSURA® DRAINABLE POUCHES Assura® Flat Drainable Pouch with EasiClose™ Outlet

EasiClose™ Outlet. No clips or clamps required. Standard wear adhesive. Pouch with odor barrier film and charcoal filter. Cut-to-Fit or Pre-Cut. Two-sided comfort panels, filter. Item Order# Midi CT13840 10 4" Length 10/Box HCPCS: A4424 Two-sided comfort panel, filter. Item Order# Midi, 10 4" Length, 10/Box HCPCS: A4424 CT13844 HCPCS: A4424 CT13845 HCPCS: A4424 CT13846 One-sided comfort panel, filter. Item Order # Maxi CT13860 114" Length 10/Box HCPCS: A4424 Two-sided comfort panel, filter. Item Order # Maxi CT13870 114" Length, 10/Box HCPCS: A4424 Two-sided comfort panel, filter. Item Order # Maxi CT13874 114" CT13875 10/Box CT13876 HCPCS: A4424

Cut-to-Fit 3⁄8"-2 ½"

Style Opaque

Pre-Cut Size

Style

1" 1 3⁄16" 1 3⁄8"

Opaque Opaque Opaque

Cut-to-Fit 3⁄8"-3"

Style Transparent

Cut-to-Fit 3⁄8"-3"

Style Opaque

Pre-Cut Size 1" 1 3⁄16" 1 3⁄8"

Style Opaque Opaque Opaque

M

When you call to place an order, please have the following information ready: • Your insurance information • Your doctor’s information (name and phone number) • Items you wish to order

M

Items marked with “M” are Medicare Reimbursable.

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

63

Ostomy

COLOPLAST ASSURA® DRAINABLE POUCHES

Assura® Convex Light Drainable Pouch with EasiClose™ Outlet EasiClose™ feature. No clips or clamps required. Standard wear adhesive. Pouch with odor barrier film and charcoal filter. Cut-to-Fit or Pre-Cut. Two-sided comfort panels, filter. Item Order # Midi CT14404 104" Length CT14405 10/Box HCPCS: A4389

Cut-to-Fit 5⁄8"-15⁄16" 5⁄8"-111⁄16"

M

Style Opaque Opaque

One-sided comfort panel, belt loops, filter. Item Order# Cut-to-Fit Maxi CT14411 5⁄8"-15⁄16" 114" Length CT14412 5⁄8"-111⁄16" 10/Box HCPCS: A4389

Style Transparent Transparent

Two-sided comfort panels, belt loops, filter. Item Order # Cut-to-Fit Maxi CT14414 5⁄8"-15⁄16" 114" Length CT14415 5⁄8"-111⁄16" 10/Box HCPCS: A4389

Style Opaque Opaque

Two-sided comfort panels, belt loops, filter. Item Order # Pre-Cut Maxi CT14421 f" 114" Length CT14422 1" 10/Box CT14423 18" HCPCS: A4389 CT14424 14"

Style Opaque Opaque Opaque Opaque

Assura® Convex Light Drainable Pouch with EasiClose™ WIDE Outlet

Extra-Extended wear with WIDE outlet. No clips or clamps required. Pouch with belt tabs, odor barrier film, no filter.

M

Extra-Extended wear, one-sided comfort panel, no filter. Item Order# Cut-to-Fit Style Maxi CT14413 5⁄8"-15⁄16" Transparent 114" Length CT14416 5⁄8"-111⁄16" Transparent 10/Box HCPCS: A4390 Extra-Extended wear two-sided cloth comfort panels, no filter. Item Order# Cut-to-Fit Style Maxi CT14419 5⁄8"-111⁄16" Opaque 114" Length 10/Box HCPCS: A4390

64

Reorder your supplies online at

www.mybyramhealthcare.com

Ostomy

COLOPLAST

1-877-902-9726

ASSURA® DRAINABLE POUCHES Assura Convex Drainable Pouch with EasiClose™ Outlet and Belt Tabs

EasiClose™ feature. No clips or clamps required. Standard wear adhesive. Pouch with odor barrier film and charcoal filter. Cut-to-Fit or Pre-Cut. One-sided comfort panel, filter. Item Order# Maxi CT14103 11 ¼” Length 10/Box HCPCS: A4389 One-sided comfort panel, filter. Item Order# Maxi CT14163 11 ¼” Length CT14164 10/Box CT14165 HCPCS: A4389 CT14166 Two-sided comfort panels, filter. Item Order# Maxi CT14106 11 ¼” Length 10/Box HCPCS: A4389 Two-sided comfort panels, filter. Item Order# Maxi CT14173 11 ¼” Length CT14174 10/Box CT14175 HCPCS: A4389 CT14176 Two-sided comfort panels, filter. Item Order# Midi CT14196 10 ¼” Length 10/Box HCPCS: A4389

Cut-to-Fit 5⁄8” - 1 11⁄16”

Style Transparent

Pre-Cut 7⁄8” 1” 1 1⁄8” 1 ¼”

Style Transparent Transparent Transparent Transparent

Cut-to-Fit 5⁄8” - 1 11⁄16”

Style Opaque

Pre-Cut 7⁄8” 1” 1 1⁄8” 1 ¼”

Style Opaque Opaque Opaque Opaque

Cut-to-Fit 5⁄8” - 1 11⁄16”

Style Opaque

M

To reach our Ostomy Center of Excellence, please call: 1-800-308-9445

M

Items marked with “M” are Medicare Reimbursable.

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

65

Ostomy

COLOPLAST ASSURA® CLOSED POUCHES Assura® Flat Closed End Pouch

Spiral, standard wear adhesive with charcoal filter and odor-proof film. Two-sided comfort panels. Cut-to-Fit or Pre-Cut.

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Item Order # Maxi CT12170 11¼" Length, 30/Box HCPCS: A4416

Cut-to-Fit 13⁄16"-3"

Style Opaque

Item Maxi 82" Length 30/Box HCPCS: A4416

Order # CT12174 CT12175 CT12176 CT12177

Pre-Cut 1" 1 3⁄16" 1 3⁄8" 1 9⁄16"

Style Opaque Opaque Opaque Opaque

Item Midi 7" Length, 30/Box HCPCS: A4416

Order # CT12140

Cut-to-Fit 13⁄16"-2 ½"

Style Opaque

Item Order # Midi, 7" Length, 30/Box HCPCS: A4416 CT12144 HCPCS: A4416 CT12145 HCPCS: A4416 CT12146 HCPCS: A4416 CT12147 HCPCS: A4416 CT12149

Pre-Cut

Style

1" 1 3⁄16" 1 3⁄8" 1 9⁄16" 2"

Opaque Opaque Opaque Opaque Opaque

Item Midi 7" Length, 30/Box HCPCS: A4416

Order # CT12130

Cut-to-Fit 13⁄16"-2 ½"

Style Transparent

Item Midi 7" Length 30/Box HCPCS: A4416

Order # CT12134 CT12135 CT12136

Pre-Cut 1" 1 3⁄16" 1 3⁄8"

Style Transparent Transparent Transparent

Item Mini 5” Length, 30/Box HCPCS: A4416

Order # CT12110

Cut-to-Fit 13⁄16”-2 ½”

Style Opaque

M

Ostomy

COLOPLAST

1-877-902-9726

ASSURA® CLOSED POUCHES Assura® Convex Light Closed End Pouch

Spiral, standard wear adhesive. Shallow convexity for flush or slightly retracted stomas. Charcoal filter and odor-proof film. Two-sided comfort panels. Cut-to-Fit or Pre-Cut. Belt tabs. Item Mini 7” Length 10/Box HCPCS: A4417

Order # CT14434 CT14435

Cut-to-Fit 5⁄8” -15⁄16” 5⁄8”- 111⁄16”

Style Opaque Opaque

Item Mini 7” Length 10/Box HCPCS: A4417

Order # CT14431 CT14432

Cut-to-Fit 5⁄8”- 15⁄16” 5⁄8”-111⁄16”

Style Transparent Transparent

Item Mini 7” Length 10/Box HCPCS: A4417

Order # CT14451 CT14452 CT14453 CT14454

Pre-Cut f” 1” 18” 14”

Style Opaque Opaque Opaque Opaque

Item Maxi 8 2" Length 10/Box HCPCS: A4417

Order # CT14444 CT14445

Cut-to-Fit 5⁄8"-15⁄16" 5⁄8"- 111⁄16"

Style Opaque Opaque

Item Maxi 8 2" Length 10/Box HCPCS: A4417

Order # CT14441 CT14442

Cut-to-Fit 5⁄8"-15⁄16" 5⁄8"-111⁄16"

Style Transparent Transparent

M

Why Select a Closed-End Pouch? Closed-end pouches can enhance the quality of your life. Discard after use for easier self-care and improved cleanliness. There is no need for tail closures. They are covered by Medicare and most private insurance plans.

M

Items marked with “M” are Medicare Reimbursable.

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

67

“Not worrying about leakage makes life so much easier.” Henry, 65 Ileostomy since 2008

Henry is a Brava® user who has received compensation from Coloplast to provide this information

Leakage protection + skin protection with the ease of handling you desire Call 1-888-726-7872 or visit us online at www.coloplast.us

Coloplast Corp. Minneapolis, MN 55411 / 1-800-533-0464 www.coloplast.us The Coloplast logo is a registered trademark of Coloplast A/S. © 2017 Coloplast Corp. All rights reserved.

PM-00503 06.17

Ostomy

COLOPLAST

1-877-902-9726

ASSURA® ONE-PIECE UROSTOMY SYSTEM Assura® Multi-Chamber Urostomy Pouch

Pouch divided into chambers for a more discreet, quiet pouch. Standard wear adhesive features an erosion-resistant barrier and provides increased absorption. Includes 3 adaptors. Flat Item 10w” Length 10/Box HCPCS: A5071

Order # CT14222

Convex Light, with Belt Tabs Item Order # 10w" Length CT14717 10/Box HCPCS: A4392

Cut-to-Fit s” to 24”

Style Transparent

Cut-to-Fit s" to 2¼"

Style Transparent

M

Assura Flat Urostomy Pouch

Adhesive features an erosion-resistant barrier and provides increased absorption. Includes 3 adaptors. Maxi, Standard wear. Item Order# 10 ¾” Length CT5585 10/Box CT5580 HCPCS: A5071

Cut-to-Fit 3⁄8” - 2 ¼” 3⁄8” - 2 ¼”

Style Transparent Opaque

Midi, Standard wear. Item Order # 7” Length CT5575 10/Box CT5570 HCPCS: A5071

Cut-to-Fit 3⁄8” - 2 ¼” 3⁄8” - 2 ¼”

Style Transparent Opaque

Cut-to-Fit 3⁄8” - 2 ¼”

Style Transparent

Cut-to-Fit 3⁄8” - 2 ¼” 3⁄8” - 2 ¼”

Style Transparent Opaque

Maxi. Extended wear. Item Order # 9 ½” Length CT12474 10/Box HCPCS: A4391 Midi, Extended wear. Item Order # 9 ½” Length CT12472 10/Box CT12471 HCPCS: A4391

M

Items marked with “M” are Medicare Reimbursable.

M

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

69

Ostomy

COLOPLAST ASSURA® ONE-PIECE UROSTOMY SYSTEM Assura Convex Urostomy Pouch

Adhesive features an erosion-resistant barrier and provides increased absorption. Includes 3 adaptors. Standard wear, Cut-to-Fit Item Order# 10 ¾” Length CT12595 10/Box CT12596 HCPCS: A4392

Cut-to-Fit 5⁄8” - 1 5⁄16” 5⁄8” - 1 11⁄16”

Style Transparent Transparent

Standard wear, Pre-Cut Item Order # 10 ¾” Length CT12991 10/Box CT12992 HCPCS: A4392 CT12993 CT12994 CT12995 CT12996 CT12997

Pre-Cut Size 5⁄8” ¾” 7⁄8” 1” 1 1⁄8” 1 ¼” 1 3⁄8”

Style Transparent Transparent Transparent Transparent Transparent Transparent Transparent

Extra-Extended wear, Cut-to-Fit Item Order # 10 3/4” Length CT12432 10/Box CT12433

Cut-to-Fit 5⁄8” - 1 5⁄16” 5⁄8” - 1 11⁄16”

Style Transparent Transparent

M

ASSURA® POST-OP DRAINABLE POUCHES Assura® Drainable Post-Op Pouch without Window

Large, drainable pouch for post-op and draining wounds. Soft, moisture-absorbent backing. Odor-proof film. Includes plastic clamp and 5 twist-tie closures. Cut-to-fit. Choose sterile or non-sterile.

M

Non-sterile. Item 5/Box 12¼" Length HCPCS: A6154 Sterile. Item 5/Box 12¼” Length HCPCS: A6154

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Order # CT12805

Cut-to-Fit 2" to 2w"

Style Transparent

Order # CT12818

Cut-to-Fit 2” to 2w”

Style Transparent

Reorder your supplies online at

www.mybyramhealthcare.com

Ostomy

COLOPLAST

1-877-902-9726

ASSURA® POST-OP DRAINABLE POUCHES Assura® Drainable Post-Op Pouch with Window

Large, drainable pouch for post-op and draining wounds. Soft, moisture-absorbent backing. Odor-proof film. Detachable window. Includes plastic clamp and 5 twist-tie closures. Cut-to-Fit. Transparent. Choose sterile or non-sterile.

M

Non-sterile. Item 5/Box 13" Length HCPCS: A6154

Order # CT12800 CT12802

Cut-to-Fit 2"-2w" 2"-4"

Style Transparent Transparent

Sterile. Item 5/Box 13" Length HCPCS: A6154

Order # CT12808 CT12810

Cut-to-Fit 2"-2w" 2"-4"

Style Transparent Transparent

COLOKIDS™ ASSURA® TWO-PIECE PEDIATRIC SYSTEMS Assura® ColoKids™ Pediatric Skin Barrier

Pediatric, Flat, Cut-to-Fit. Flexible flange allows pouch to be secured with minimal pressure. Can be used with pediatric drainable pouch or any green color-coded adult pouch.

M

Item 5/Box HCPCS: A4414

Order # CT2182

Cut-to-Fit s"-13⁄8"

•

Color Code

Assura® ColoKids™ Pediatric Drainable Pouch

Soft backing for comfort, odor-proof film. Locking system reduces pressure to abdomen. Item 82" Length 20/Box HCPCS: A4426

Order # CT2156

Style Transparent

M

•

Color Code

Assura® ColoKids™ Pediatric Closed Pouch

Soft backing for comfort, odor-proof film. Locking system reduces pressure to abdomen. Filter for odor control. Item 5 ¾” Length 30/Box HCPCS: A4423

M

Items marked with “M” are Medicare Reimbursable.

Order # CT2161

Style Opaque

M

•

Color Code

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

71

Ostomy

COLOPLAST COLOKIDS™ ASSURA® TWO-PIECE PEDIATRIC SYSTEMS Assura® ColoKids™ Pediatric Urostomy Pouch

Soft backing for comfort, odor-proof film. Locking system reduces pressure to abdomen. Item 8 ½” Length 10/Box HCPCS: A4433

Order # CT1789

Style Transparent

M

•

Color Code

ASSURA® AC TWO-PIECE PEDIATRIC SYSTEMS Assura® Flat AC Pediatric Skin Barrier

Adhesive coupling system for kids! The adhesive coupling pouching system is based on adhesives that makes it easy to apply the pouch to the barrier and easy to remove. This system is hygienic and easy to clean. Standard wear barrier. No starter hole.

M

Item 10/Box HCPCS: A4414

Order # CT14307 CT14308

Size 0 - d" 0 - 1"

••

Color Code

Assura® AC EasiClose™ Pediatric Pouches with Filter

The Assura AC with Filter system is available with an integrated closure, providing maximum comfort for children with ostomies. The EasiClose outlet makes emptying easier for parents (no clips or clamps to worry about.)

M

Transparent. Item 52" Length 62" Length 10/Box HCPCS: A4425

Order # CT14681 CT14682

Opaque (teddy bear design). Item Order # 52" Length CT14691 62" Length CT14692 10/Box HCPCS: A4425

72

Style Transparent Transparent

••

Color Code

••

Style Color Code Opaque Opaque (teddy bear design)

Ostomy

COLOPLAST

1-877-902-9726

COLOKIDS® OSTOMY SYSTEM COLOKIDS™ ASSURA® ONE-PIECE PEDIATRIC SYSTEMS Assura® ColoKids™ Pediatric Drainable Pouch

Flat, spiral adhesive is secure and gentle on skin. Soft backing for comfort, odor-proof film. Clamp closure. Item 8 ½” Length 10/Box HCPCS: A5061

Order # CT2115

Cut-to-Fit 3⁄8”-13⁄8”

M

Style Transparent

Assura® ColoKids™ Flat Pediatric Drainable Pouch Standard wear, soft backing for comfort, odor-proof film. Filter. Item 5w" Length 30/Box HCPCS: A4416

Order # CT2125

Cut-to-Fit 3⁄8"-13⁄8"

M

Style Transparent

Assura® ColoKids™ Pediatric Urostomy Pouch

Flat, spiral adhesive is secure and gentle on skin. Soft backing for comfort, odor-proof film. Item 8 ½” Length 10/Box HCPCS: A5071

Order # CT8009

Cut-to-Fit 3⁄8”-13⁄8”

M

Style Transparent

COLOPLAST® IRRIGATION PRODUCTS COLOPLAST® IRRIGATION PRODUCTS Economy Irrigation Set

Economy Irrigation Set includes water bag/regulator thermometer and cone (CT1110). Use with either Assura® or Sensura® One- and Two-Piece Systems. Item Set

M

Items marked with “M” are Medicare Reimbursable.

M

Order # CT1500

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

73

Ostomy

COLOPLAST COLOPLAST® IRRIGATION PRODUCTS SenSura® Irrigation Faceplate

Use with blue Irrigation Sleeve (CT12836) and ostomy belt. Item 1/Box HCPCS: A4361

Order # CT12820

Coloplast® Stoma Cone

M

Soft and flexible stoma cone with tubing. Item 1/Box HCPCS: A4399

M

Order # CT1110

Coloplast® Irrigation Sleeves

Irrigation sleeves for use with SenSura® or Assura® barriers or faceplate simply match the sleeve color code to your barrier’s color code. Item 10/Box HCPCS: A4397

•• •

Order # CT12834 CT12835 CT12836

Color Code

SenSura® 1-Piece Irrigation Sleeve Adhesive-backed and transparent. Disposable. Item 10/Box HCPCS: A4397

M

M

Order # CT1003

Byram has one of the largest inventories of ostomy products in the country. We only carry brand name ostomy products from trusted manufacturers.

74

Reorder your supplies online at

www.mybyramhealthcare.com

COLOPLAST Have you seen our new and improved reorder website, myByram?

Reorder your medical supplies online! It’s easy with myByram. • Place reorders online • View your order history • Update your account information • Securely make a payment • Chat live with a customer service representative • Add ostomy accessories to your order If you don’t already have an account, you can enroll online today!

Check it out today! www.mybyramhealthcare.com Visit us online: www.byramhealthcare.com ■

Wound Care

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Diabetes

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Urology

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Ostomy

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Incontinence

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Enteral Nutrition

©2017 Byram Healthcare Centers, Inc. All rights reserved. Printed in the United States.

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Breast Pumps

Ostomy

CONVATEC

ESTEEM synergy® TWO-PIECE OSTOMY SYSTEM Esteem synergy® OSTOMY SYSTEM The Esteem synergy® system utilizes innovative Adhesive Coupling Technology™ to connect the pouch with the skin barrier. It eliminates use of a plastic ring that must be snapped or locked together. This revolutionary two-piece product not only provides the versatility of a two-piece system, skin friendliness and low profile comfort but it also provides the flexibility of a conventional one-piece system. The flat, flexible adhesive foam ring on the pouch, securely connects with a clear, flat, flexible plastic "Landing Zone" flange. For correct application, the barrier color code must match the pouch color code.

Esteem synergy® TWO-PIECE SYSTEM Esteem synergy® Drainable Pouch, Straight

Transparent straight pouch can be used on either left or right side. One-sided comfort panel. 10 tail closures. Item 12" Length 10/Box HCPCS: A5063

76

Order # SQ405406

Stoma Extra Large

•

Color Code

M

Ostomy

CONVATEC

1-877-902-9726

ESTEEM synergy® TWO-PIECE UROSTOMY POUCHES Esteem synergy® Urostomy Pouch with Accuseal® Tap with Valve Designed for easy manipulation and rapid emptying. The built-in anti-reflux valve resists the back flow of urine.

M

Opaque with 1-sided comfort panel. Item Order # 10” Length SQ405448 10/Box SQ405449 HCPCS: A4432 SQ405450

Stoma Small Medium Large

Color Code

Transparent with 1-sided comfort panel. Item Order # 10” Length SQ405451 10/Box SQ405452 HCPCS: A4432 SQ405453

Stoma Small Medium Large

Color Code

Transparent with 1-sided comfort panel. Item Order # 9” Length SQ405446 10/Box SQ405447 HCPCS: A4432

Stoma Small Medium

Color Code

•• • •• • ••

ESTEEM synergy® + TWO-PIECE CLOSED END POUCHES ESTEEM synergy® + TWO-PIECE CLOSED END POUCHES

ConvaTec’s Esteem synergy® pouches with Adhesive Coupling Technology™ provide security, comfort and discretion. Filter, Transparent with 1-sided comfort panel. Item Order # Stoma 8” Length SQ416774 Small 30/Box SQ416778 Medium HCPCS: A4419 SQ416782 Large Filter, Opaque with 2-sided comfort panel. Item Order # 8” Length SQ416775 30/Box SQ416779 HCPCS: A4419 SQ416783

Stoma Small Medium Large

Filter, “Mini” Transparent with 1-sided comfort panel. Item Order # Stoma 6” Length SQ416776 Small 30/Box SQ416780 Medium HCPCS: A4419

M

Items marked with “M” are Medicare Reimbursable.

M

•• • •• • ••

Color Code

Color Code

Color Code

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

77

Ostomy

CONVATEC ESTEEM synergy® + TWO-PIECE CLOSED END POUCHES

ESTEEM synergy® + TWO-PIECE CLOSED END POUCHES (cont.)

ConvaTec’s Esteem synergy® pouches with Adhesive Coupling Technology™ provide security, comfort and discretion. Filter, “Mini” Opaque with 2-sided comfort panel. Item Order # Stoma 6” Length SQ416777 Small 30/Box SQ416781 Medium HCPCS: A441

M

••

Color Code

ESTEEM synergy® + TWO-PIECE DRAINABLE POUCHES ConvaTec’s Esteem synergy® pouches with Adhesive Coupling Technology™ provide security, comfort and discretion. Soft and quiet materials and streamlined rounded shape. Tail of opening securely hides away. Esteem synergy® + Drainable Pouch with InvisiClose® Tail Closure System Transparent with 1-sided comfort panel. Item Order # 12” Length SQ416797 10/Box SQ416900 HCPCS: A5063 SQ416903

•• • •• • •• •

Stoma Small Medium Large

Color Code

Filter, Transparent with 1-sided comfort panel. Item Order # Stoma 12” Length SQ416795 Small 10/Box SQ416798 Medium HCPCS: A4435 SQ416901 Large Filter, Opaque with 2-sided comfort panel. Item Order # 12” Length SQ416796 10/Box SQ416799 HCPCS: A4425 SQ416902

M

Color Code

Stoma Small Medium Large

Color Code

ESTEEM synergy® TWO-PIECE SYSTEM

Esteem synergy® Moldable Durahesive® Convex Skin Barrier Mold-to-fit with flexible tape collar. Match color code of barrier with that of Esteem synergy® pouch.

Item 10/Box HCPCS: A4407

78

Order # SQ409268 SQ409269 SQ409270

Reorder your supplies online at

Size Small Medium Large

M

•• •

Stoma Color Code 2" to f" f" to 14" 14" to 1w"

www.mybyramhealthcare.com

Ostomy

CONVATEC

1-877-902-9726

Esteem synergy® TWO-PIECE SYSTEM Esteem synergy® Moldable Stomahesive® Skin Barrier with Mold-to-Fit Opening Item 10/Box HCPCS: A4414 HCPCS: A4415 HCPCS: A4415

Order #

Size

Stoma

SQ411657 SQ411658 SQ411659

Small ½” to 7⁄8” Medium 7⁄8” to 1 ¼” Large 1 ¼” to 1 ¾”

M

Color Code

•• •

Esteem synergy® Stomahesive® Skin Barrier

Landing Zone flange. Choose flexible tape or no-tape collar. Match color code of barrier with that of Esteem synergy® pouch. Cut-to-Fit. Flexible tape collar. Item Order # 10/Box HCPCS: A4414 SQ405456 HCPCS: A4415 SQ405457 HCPCS: A4415 SQ405458

M

Items marked with “M” are Medicare Reimbursable.

Size

Stoma

Small Medium Large

up to 1s” up to 1f" up to 2s"

Cut-to-Fit. No tape collar. Item Order # 10/Box HCPCS: A4414 SQ405467 HCPCS: A4415 SQ405468 SQ403948 SQ405483

Size

Stoma

Small Medium Large Extra-Large

up to 1s" up to 1f" up to 2s" up to 32"

Pre-Cut. Flexible tape collar. Item Order # 10/Box SQ405473 HCPCS: A4414 SQ405474 SQ405475 SQ405476 SQ405477 SQ405478 SQ405479 HCPCS: A4415 SQ405480 SQ405481 SQ405482

Size Small Small Small Small Small Small Small Medium Medium Medium

Stoma d" w" f" 1" 18" 14" 1s" 12" 1d" 1w"

M

Color Code

•• •

Color Code

•• •

• •• •• •• •• ••

Color Code

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

79

CONVATEC

Ostomy

ESTEEM® + ONE-PIECE DRAINABLE POUCHES The one-piece system that’s gentle on the skin, while remaining secure and easy to use! Flexible and discreet, the Esteem® + one-piece system is the all-in-one solution that combines the skin barrier and pouch in a single unit, allowing for a simple, secure, and comfortable experience. Available with a modified Stomahesive® or Durahesive Plus® skin barrier that gently adheres to skin and protects it from breakdown. The Esteem® + one piece pouching system offers the latest technologies from ConvaTec including: • A state-of-the art filter with an anti-clogging film layer, keeping the pouch flat while virtually eliminating odor • InvisiClose® clipless tail closure with a strong hook and hook fastener • The Lock-It Pocket™ which securely hides away the tail to provide the comfort of a closed end pouch • Comfort panel pouch material that is soft and smooth against the skin, nearly rustle-free and resists water and dries quickly. ConvaTec’s latest pouches and advanced adhesives offer you the security, comfort, and discretion you deserve. Esteem® + Drainable Pouch with InvisiClose® Tail Closure Moldable Stomahesive® Skin Barrier. Filter, Transparent, 1-sided comfort panel. Item Order # Stoma size opening 12” Length SQ413515 13⁄16” – 1 3⁄16” 10/Box SQ413516 1 3⁄16” – 1 9⁄16” HCPCS: A4424 SQ413517 1 9⁄16” – 1 15⁄16” Moldable Stomahesive® Skin Barrier. Transparent, 1-sided comfort panel. Item Order # Stoma size opening 12” Length SQ413518 13⁄16” – 1 3⁄16” 10/Box SQ413519 1 3⁄16” – 1 9⁄16” HCPCS: A5061 SQ413520 1 9⁄16” – 1 15⁄16”

Experience the Byram Difference

Byram offers reliable, accurate service nationwide to home care agencies, managed care organizations, healthcare professionals and the patient at home.

80

M

Ostomy

CONVATEC

1-877-902-9726

ESTEEM® + ONE-PIECE DRAINABLE POUCHES Esteem® + Drainable Pouch with InvisiClose® Tail Closure

M

Moldable Stomahesive® Skin Barrier. Filter, Opaque, 1-sided comfort panel. Item Order # Stoma size opening 12” Length SQ413521 13⁄16” – 1 3⁄16” 10/Box SQ413522 1 3⁄16” – 1 9⁄16” HCPCS: A4424 SQ413523 1 9⁄16” – 1 15⁄16” Durahesive Plus® Skin Barrier, Tape Collar. Filter, Opaque, 2-sided comfort panel. Item Order # Cut-to-Fit 12” Length SQ416975 ¾” - 2 ½ “ 10/Box, HCPCS: A5056 Durahesive Plus® Skin Barrier, Tape Collar. Filter, Transparent, 1-sided comfort panel. Item Order # Cut-to-Fit 12” Length SQ416976 ¾” - 2 ½” 10/Box, HCPCS: A5056 Modified Stomahesive® Skin Barrier. Transparent, 1-sided comfort panel. Item Order # Cut-to-Fit 12” Length SQ416721 ¾” – 2 ¾” 10/Box, HCPCS: A5061

M

Items marked with “M” are Medicare Reimbursable.

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

81

Ostomy

CONVATEC ESTEEM® + ONE-PIECE DRAINABLE POUCHES

Esteem® + Drainable Pouch with InvisiClose® Tail Closure

The one-piece system that’s gentle on the skin, while remaining secure and easy to use. Flexible and discreet. Filter, Modified Stomahesive® Skin Barrier. Item Order # Cut-to-Fit 12” Length SQ416718 ¾” – 2 ¾” 10/Box HCPCS: A4424 SQ416719 ¾” – 2 ¾” Modified Stomahesive® Skin Barrier. Item Order # 14” Length SQ416908 10/Box HCPCS: A5061

Cut-to-Fit 4”

Filter, Modified Stomahesive® Skin Barrier. Item Order # Pre-Cut 12” Length SQ416724 1” 10/Box HCPCS: A4424 SQ416728 1 3⁄16” SQ416732

1 3⁄8”

SQ416736

1 9⁄16”

SQ416725

1”

SQ416729

1 3⁄16”

SQ416733

1 3⁄8”

SQ416737

1 9⁄16”

Style Transparent, 1-sided comfort panel Opaque, 2-sided comfort panel Style Transparent, 1-sided comfort panel

Style Transparent, 1-sided comfort panel Transparent, 1-sided comfort panel Transparent, 1-sided comfort panel Transparent, 1-sided comfort panel Opaque, 1-sided comfort panel Opaque, 1-sided comfort panel Opaque, 1-sided comfort panel Opaque, 1-sided comfort panel

Esteem® + Drainable Pouch with Durahesive® Convex Skin Barrier, InvisiClose® Tail Closure Filter, Transparent, 1-sided comfort panel. Item Order # 12” Length SQ416738 10/Box SQ416740 HCPCS: A5057 SQ416742 SQ416744 SQ416746 SQ416748 SQ416750

82

Reorder your supplies online at

M

M

Pre-Cut ¾” 7⁄8” 1” 1 1⁄8” 1 ¼” 1 3⁄8” 1 ½”

www.mybyramhealthcare.com

Ostomy

CONVATEC

1-877-902-9726

ESTEEM® + ONE-PIECE DRAINABLE POUCHES Esteem® + Drainable Pouch with Durahesive® Convex Skin Barrier, InvisiClose® Tail Closure (cont) Filter, Opaque, 1-sided comfort panel. Item Order # 12” Length SQ416739 10/Box SQ416741 HCPCS: A5057 SQ416743 SQ416745 SQ416747 SQ416749 SQ416751

M

Pre-Cut ¾” 7⁄8” 1” 1 1⁄8” 1 ¼” 1 3⁄8” 1 ½”

ESTEEM + ONE-PIECE CLOSED-END POUCHES Esteem® + One-Piece Closed-End Pouch with Modified Stomahesive® Skin Barrier and Filter Item 8” Length 30/Box HCPCS: A4416

Order # SQ416700

Cut-to-Fit ¾” – 2 ¾”

SQ416701

¾” – 2 ¾”

Item 8” Length 30/Box HCPCS: A4416

Order # SQ413509

Moldable 13⁄16” – 1 13⁄16”

SQ413510

1 13⁄16” – 1 9⁄16”

SQ413511

1 9⁄16” – 1 15⁄16”

Order # SQ416702

Cut-to-Fit ¾” – 2 ¾”

Item 6” Length 30/Box HCPCS: A4416

Opaque with 2-sided comfort panel. Item Order # 8” Length SQ416704 30/Box SQ416707 HCPCS: A4416 SQ416710 SQ416713 SQ416715

M

Items marked with “M” are Medicare Reimbursable.

M

Style Transparent, 1-sided comfort panel Opaque, 2-sided comfort panel Style Opaque, 2-sided comfort panel Opaque, 2-sided comfort panel Opaque, 2-sided comfort panel Style Opaque, 2-sided comfort panel

Pre-Cut 1” 13⁄16” 1 3⁄8” 1 9⁄16” 2”

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

83

CONVATEC

Ostomy

ESTEEM®+ FLEX CONVEX ONE-PIECE SYSTEM The latest addition to the range of ConvaTec one-piece ostomy solutions. Combines the comfort and freedom of flexibility with the firmness of convexity. It fits the contours of the body, moving with the wearer to provide confidence. Three Plateau Sizes: The Esteem® + Flex Convex system is available in 3 plateau sizes to accommodate a range of stomas.

Plateau Size

Convexity Depth

Convexity Width

V1

7mm (0.28")

50mm (1.97")

V2

7mm (0.28")

40mm (1.57")

V3

7mm (0.28")

30mm (1.18")

Esteem® + Flex Convex Closed-End Pouches

M

Cut-to-Fit, Opaque, 2-sided comfort panel; Pouch Size 5.71x8.07” Item Order # Plateau Size Cutting Range 30/Box SQ421612 V1 20-43mm (0.79 x 1.69”) HCPCS: A4417 SQ421613 V2 20-35mm (0.79 x 1.38”) SQ421614 V3 20-25mm (0.79 x .98”)

Esteem® + Flex Convex Drainable Pouches

M

Cut-to-Fit, Opaque, 2-sided comfort panel; Pouch Size 5.91 x 8.66” Item Order # Plateau Size Cutting Range 10/Box SQ421615 V1 20-43mm (0.79 x 1.69”) HCPCS: A4389 SQ421619 V2 20-35mm (0.79 x 1.38”) SQ421622 V3 20-25mm (0.789 x .98”) Pre-Cut, Opaque, 2-sided comfort panel; Pouch Size 5.91 x 8.66” Item Order # Plateau Size Stoma Size Opening 10/Box SQ421616 V1 25mm (0.98”) HCPCS: A4389 SQ421617 V1 30mm (1.18”) SQ421618 V1 35mm (1.38”) SQ421620 V2 25mm (0.98”) SQ421621 V2 30mm (1.18”)

84

IS YOUR PRODUCT FLEXIBLE ENOUGH?

ESTEEM

TM

Flex Convex

The Esteem™+ Flex Convex is a one-piece system that fits the contours of your body, moving with you and helping to give you confidence to live life the way you want.

Moves with you flexible convexity fits to body contours for comfort and easy positioning

Skin health and security hydrocolloid skin barrier is designed to stay firmly in place, helping to minimize leakage

Support, insights & products for those living with an ostomy. Learn more at 1-800-422-8811 or visit www.ConvaTec.com/ostomy

© 2017 ConvaTec Inc. All rights reserved. TM indicates trademark of ConvaTec Inc. AP-017680-US

Comfort and discretion with soft and quiet fabric, designed to allow for a secure and comfortable experience

Ostomy

CONVATEC ESTEEM®+ FLEX CONVEX ONE-PIECE SYSTEM Esteem® + Flex Convex Urostomy Pouches

M

Cut-to-Fit, Opaque, 2-sided comfort panel; Pouch Size 5.12 x 7.68” Item Order # Plateau Size Cutting Range 10/Box SQ421623 V1 10-43mm (0.39 x 1.69”) HCPCS: A4392 SQ421626 V2 10-35mm (0.39 x 1.38”) SQ421628 V3 10-25mm (0.39 x 0.98”) Pre-Cut, Opaque, 2-sided comfort panel; Pouch Size 5.12 x 7.68” Item Order # Plateau Size Stoma Size Opening 10/Box SQ421624 V1 15mm (0.59”) HCPCS: A4392 SQ421625 V1 20mm (0.79”) SQ421627 V2 15mm (0.59”) SQ421629 V3 15mm (0.59”)

Experience the Byram Difference

Byram offers reliable, accurate service nationwide to home care agencies, managed care organizations, healthcare professionals and the patient at home.

86

Reorder your supplies online at

www.mybyramhealthcare.com

Ostomy

CONVATEC

1-877-902-9726

SUR-FIT Natura® TWO-PIECE OSTOMY SYSTEM SUR-FIT Natura® Ostomy System features a low-profile locking closure system with security that patients can both feel and hear and many options that help patients to feel comfortable and confident. Options include: drainable or closed-end pouches with or without filters, Cut-to-Fit, Mold to fit or pre-cut skin barriers. Stomahesive® for effective adhesion on wet or dry skin, Durahesive® for extended wear and for those with liquid or semi-liquid output. For correct application, the barrier’s color code must match the pouch color code. SUR-FIT Natura® CLOSED END POUCHES SUR-FIT Natura® Closed-End Pouch

Closed Pouch with flange is made of quiet, odor-proof film with soft, two-sided comfort panels. Flange features pouch tab and belt loops.

M

•• •• •• •• •• •• •• ••

Item 8" Length Opaque 60/Box HCPCS: A5054

Order # SQ413169 SQ413170 SQ413171 SQ413172

Flange 12" 1w" 24" 2w"

Color Code

Item 8” Length Opaque 30/Box HCPCS: A5054

Order # SQ401521 SQ401522 SQ401523 SQ401524

Flange 1 ½” 1 ¾” 2 ¼” 2 ¾”

Color Code

Includes Filter Item 8" Length Opaque 60/Box HCPCS: A4419

Order # SQ413173 SQ413174 SQ413175 SQ413176

Flange 12" 1w" 24" 2w"

Color Code

Includes Filter Item 8” Length Opaque 30/Box HCPCS: A4419

Order # SQ401525 SQ401526 SQ401527 SQ401528

Flange 1 ½” 1 ¾” 2 ¼” 2 ¾”

Color Code

Our ostomy specialists are commited to your satisfaction. Please call us with any questions. 1-877-902-9726

M

Items marked with “M” are Medicare Reimbursable.

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

87

Ostomy

CONVATEC SUR-FIT Natura® CLOSED END POUCHES SUR-FIT Natura® Closed-End Mini Pouch Item 5" Length Opaque 20/Box HCPCS: A5054

Order # SQ401529 SQ401530 SQ401531 SQ401532

Flange 14" 12" 1w" 24"

SUR-FIT Natura® Disposable Flange Cap

•• ••

Color Code

Opaque, one-sided comfort panel and filter. Item 25/Box HCPCS: A5055

Order # SQ401909

Flange 1w"

M

M

•

Color Code

SUR-FIT Natura® DRAINABLE POUCHES SUR-FIT Natura® Drainable Pouch

Drainable pouch with flange is made of quiet, odor-proof film with soft, flocked comfort panels. Flange features pouch tab and belt loops. Includes 2 tail closures per box. Opaque with two-sided comfort panel. Item Order # 10" Length SQ404030 20/Box SQ404031 HCPCS: A5063 SQ404032 SQ404033 SQ404034 Item 10” Length 10/Box HCPCS: A5063

Order # SQ401505 SQ401506 SQ401507 SQ401508 SQ401509

•• •• • •• •• •

Flange 14" 12" 1w" 24" 2w"

Color Code

Flange 1 ¼” 1 ½” 1 ¾” 2 ¼” 2 ¾”

Color Code

Reordering supplies online is simple! Visit the improved www.mybyramhealthcare.com and sign up today!

88

M

Ostomy

CONVATEC

1-877-902-9726

SUR-FIT Natura® DRAINABLE POUCHES SUR-FIT Natura® Drainable Pouch

Drainable pouch with flange is made of quiet, odor-proof film with soft, flocked comfort panels. Flange features pouch tab and belt loops. Includes 2 tail closures per box. Opaque with two-sided comfort panel. Item Order # 12" Length SQ404025 20/Box SQ404026 HCPCS: A5063 SQ404027 SQ404028 SQ404029 Item 12” Length 10/Box HCPCS: A5063

Order # SQ401500 SQ401501 SQ401502 SQ401503 SQ401504

Opaque with one-sided comfort panel. Item Order # 12" Length SQ404014 20/Box SQ404015 HCPCS: A5063 SQ404016 SQ404017 SQ404018 Item 12” Length 10/Box HCPCS: A5063

Order # SQ401932 SQ401933 SQ401934 SQ401935 SQ401936

Color Code

Flange 1 ¼” 1 ½” 1 ¾” 2 ¼” 2 ¾”

Color Code

Flange 14" 12" 1w" 24" 2w"

Color Code

Flange 1 ¼” 1 ½” 1 ¾” 2 ¼” 2 ¾”

Color Code

Transparent with one-sided comfort panel. Item Order # Flange 14"Length SQ401515 4" 10/Box HCPCS: A5063

M

Items marked with “M” are Medicare Reimbursable.

•• •• • •• •• • •• •• • •• •• • •• •• • •

Flange 14" 12" 1w" 24" 2w"

Transparent with one-sided comfort panel. Item Order # Flange 12" Length SQ401510 14" 10/Box SQ401511 12" HCPCS: A5063 SQ401512 1w" SQ401513 24" SQ401514 2w"

M

Color Code

Color Code

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

89

Ostomy

CONVATEC

SUR-FIT Natura® TWO-PIECE OSTOMY SYSTEM SUR-FIT Natura® DRAINABLE POUCHES SUR-FIT Natura® Drainable Pouch

Drainable pouch with odor barrier and activated charcoal filter. Flange includes pouch tab and belt loops. 2 tail closures per box. Filter, opaque with two-sided comfort panel. Item Order # Flange 10" Length SQ411288 14" 20/Box SQ411289 12" HCPCS: A4425 SQ411290 1w" SQ411291 24" SQ411292 2w" Filter, opaque with two-sided comfort panel. Item Order # Flange 12" Length SQ411489 14" 20/Box SQ411490 12" HCPCS: A4425 SQ411491 1w" SQ411492 24" SQ411493 2w" Filter, transparent with one-sided comfort panel. Item Order # Flange 12" Length SQ411264 12" 10/Box SQ411265 1w" HCPCS: A4425 SQ411266 24" SQ411267 2w"

M

•• •• • •• •• • •• ••

Color Code

Color Code

Color Code

SUR-FIT Natura® Drainable Pouch with InvisiClose™ Tail Closure System Drainable pouch with clipless tail closure. Easy to open outlet with strips and tail design helps control flow and reduces splashing. Enhanced locking mechanism includes additional security flap. Filter, Transparent with 1-sided comfort panel. Item Order # Flange 12” Length SQ411360 1 ¾” 10/Box SQ411361 2 ¼” HCPCS: A4425 SQ411362 2 ¾” Filter, Opaque with 2-sided comfort panel. Item Order # Flange 12” Length SQ411309 1 ½” 20/Box SQ411310 1 ¾” HCPCS: A4425 SQ411311 2 ¼” SQ411312 2 ¾”

90

Reorder your supplies online at

M

•• • •• ••

Color Code

Color Code

www.mybyramhealthcare.com

Ostomy

CONVATEC

1-877-902-9726

SUR-FIT Natura® DRAINABLE POUCHES SUR-FIT Natura® Drainable Pouch with InvisiClose™ Tail Closure System Drainable pouch with clipless tail closure. Easy to open outlet with strips and tail design helps control flow and reduces splashing. Enhanced locking mechanism includes additional security flap. Opaque with one-sided comfort panel. Item Order # 12” Length SQ413334 20/Box SQ413335 HCPCS: A5063 SQ413336

Flange 1w” 24” 2w”

Transparent with one-sided comfort panel. Item Order # Flange 12" Length SQ413312 1w" 10/Box SQ413313 24" HCPCS: A5063 SQ413314 2w"

M

•• • •• •

Color Code

Color Code

SUR-FIT Natura® Drainable Pouch for High Output

Drainable Pouch for High Output holds an extra 100 cc. of fluid. Flange features pouch tab and belt loops. Includes 1 DuoLock® tail closure, a night drainage interconnector, and 5 replaceable charcoal filters per box.

M

Opaque with one-sided comfort panel. Item Order # 14" Length SQ401557 5/Box SQ401558 HCPCS: A4413 SQ401559

Flange 1w" 24" 2w"

Transparent with one-sided comfort panel. Item Order # Flange 14” Length SQ420695 1 ¾” 5/Box SQ420696 2 ¼” HCPCS: A4413 SQ420697 2 ¾”

•• • •• •

Color Code

Color Code

To reach our Ostomy Center of Excellence, please call: 1-800-308-9445

M

Items marked with “M” are Medicare Reimbursable.

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

91

Ostomy SUR-FIT Natura® UROSTOMY POUCHES SUR-FIT Natura® Urostomy Pouch with Bendable Tap Transparent. One-sided comfort panel. Bendable tap. Item Order # Flange 9" Length SQ401538 14" 10/Box SQ401539 12" HCPCS: A5073 SQ401540 1w" SQ401541 24" 10" Length 10/Box HCPCS: A5073

SQ401533 SQ401534 SQ401535 SQ401536 SQ401537

14" 12" 1w" 24" 2w"

M

•• •• •• •• •

Color Code

SUR-FIT Natura® Urostomy Pouch with Accuseal® Tap with Valve

M

Transparent. One-sided comfort panel. Accuseal® tap with valve. Item Order # Flange Color Code 10" Length SQ401542 14" 10/Box SQ401543 12" HCPCS: A4432 SQ401544 1w" SQ401545 24" SQ401546 2w"

•• •• •

SUR-FIT Natura® Urostomy Pouch with Accuseal® Tap with Valve Opaque. One-sided comfort panel. Accuseal® tap with valve. Item Order # Flange Color Code 9" Length SQ401547 14" 10/Box SQ401548 12" HCPCS: A4432 SQ401549 1w" SQ401550 24" 10" Length 10/Box HCPCS: A4432

92

SQ401551 SQ401552 SQ401553 SQ401554 SQ401555

14" 12" 1w" 24" 2w"

•• •• •• •• •

M

Ostomy

CONVATEC

1-877-902-9726

NATURA® + POUCHES These pouches were developed to be noticeably more comfortable and discreet. Compatible with SURFIT Natura® Skin Barriers. Natura® + Drainable Pouch with InvisiClose® Tail Closure System Transparent with 1-sided comfort panel. Item Order # 12” Length SQ416418 10/Box SQ416421 HCPCS: A5063 SQ416424 14” Length SQ416472

Flange 1 ¾” 2 ¼” 2 ¾” 4”

Filter, Transparent with 1-sided comfort panel. Item Order # Flange 12” Length SQ416414 1 ½” 10/Box SQ416416 1 ¾” HCPCS: A4425 SQ416419 2 ¼” SQ416422 2 ¾” Filter, Opaque with 2-sided comfort panel. Item Order # Flange 12” Length SQ416415 1 ½” 10/Box SQ416417 1 ¾” HCPCS: A4425 SQ416420 2 ¼” SQ416423 2 ¾”

NATURA® + POUCHES

M

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Color Code

Color Code

Color Code

M

Natura® + Closed End Pouch

M

Items marked with “M” are Medicare Reimbursable.

Opaque with 2-sided comfort panel. Item Order # 8” Length SQ416401 30/Box SQ416404 HCPCS: A5054 SQ416407 SQ416410 SQ416413

Flange 1 ¼” 1 ½” 1 ¾” 2 ¼” 2 ¾”

Color Code

Opaque with 2-sided comfort panel. Item Order # 6” “Mini Length SQ416402 30/Box SQ416405 HCPCS: A5054 SQ416408 SQ416411

Flange 1 ¼” 1 ½” 1 ¾” 2 ¼”

Color Code

•• •• • •• ••

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

93

Ostomy

CONVATEC NATURA® + POUCHES

M

Natura® + Closed End Pouch (Cont.) Filter, Opaque with 2-sided comfort panel. Item Order # Flange 8” Length SQ416400 1 ¼” 30/Box SQ416403 1 ½” HCPCS: A4419 SQ416406 1 ¾” SQ416409 2 ¼” SQ416412 2 ¾”

•• •• •

Color Code

Natura® + Urostomy Pouch with Soft-Tap Transparent with 1-sided comfort panel. Item Order # 10” Length SQ413435 10/Box SQ413436 HCPCS: A5073 SQ413437 SQ413438 SQ413439

Flange 1 ¼” 1 ½” 1 ¾” 2 ¼” 2 ¾”

Color Code

Transparent with 1-sided comfort panel. Item Order # 9” Length SQ421074 10/Box SQ421075 HCPCS: A5073 SQ421076

Flange 1 ¼” 1 ½” 1 ¾”

Color Code

•• •• • •• •

SUR-FIT Natura® SKIN BARRIERS SUR-FIT Natura® Disposable Convex Insert

Convex Insert for retracted stomas for use with SUR-FIT Natura® skin barriers only. Not for use with ConvaTec Moldable Technology™ skin barriers. Select an insert that is at least 1/4” larger than the maximum diameter of the stoma.

M

94

Item Fits 12" Natura® Flange 5/Box HCPCS: A5093

Order # SQ404006 SQ404007 SQ404008

Stoma w" f" 1"

Fits 1w" Natura® Flange 5/Box HCPCS: A5093

SQ404009 SQ404010 SQ404011

18" 14" 1s"

Fits 24" Natura® Flange 5/Box HCPCS: A5093

SQ404012 SQ404013

12" 1d"

Reorder your supplies online at

•• • •• • ••

Color Code

www.mybyramhealthcare.com

Ostomy

CONVATEC SUR-FIT Natura® SKIN BARRIERS SUR-FIT Natura Low Pressure Adaptor Item 10/Box HCPCS: A4421

Order # SQ401993 SQ401994 SQ401995 SQ401996

M

•• ••

Flange 1 ¾” 2 ¼” 2 ¾” 4”

Color Code

SUR-FIT Natura® Durahesive® Moldable Convex Skin Barrier with Flange

SUR-FIT Natura® Durahesive® Moldable Convex Barrier with a white flexible tape collar molds to fit the shape and size of the stoma. Provides deep convexity. Eliminates the need to trim the opening. Compatible with SUR-FIT Natura® pouches. Mold to fit.

M

Item 4.5" x 4.5" 10/Box HCPCS: A4407

Order # SQ404592 SQ404593 SQ404594

Stoma Flange 2-f” 1w" f-14” 1w" 14-1w” 24"

•• •

Color Code

SUR-FIT Natura® Durahesive® Skin Barrier with Convex-IT®

Durahesive® skin barrier with audible-click flange, white tape collar and pre-cut opening. Convexity provides extra skin protection for flush or retracted stomas, or stomas located in skin folds.

95

Item 4.5" x 4.5" 1w" Flange 10/Box HCPCS: A4407

Order # SQ413177 SQ413178 SQ413179 SQ413180 SQ413181 SQ413182 SQ413183 SQ413184

Pre-cut 2" d" w" f" 1" 18" 14" 1s"

5" x 5" 24" Flange 10/Box HCPCS: A4407

SQ413185 SQ413186 SQ413187 SQ413188

12" 1d 1w" 2"

•• •• •• •• •• ••

Color Code

M

Ostomy

CONVATEC

SUR-FIT Natura® TWO-PIECE OSTOMY SYSTEM SUR-FIT Natura® SKIN BARRIERS SUR-FIT Natura® Durahesive® Skin Barrier with Flange Durahesive® skin barrier with low-profile, audible-click flange without tape collar. Cut-to-fit. Item 4" x 4" Tan 10/Box HCPCS: A4409

Order # SQ413153 SQ413154 SQ413155 SQ413156

Flange 14" 12" 1w" 24"

Stoma 2”-w” 7⁄8”-1” 11⁄8”-1¼” 13⁄8”-1¾”

5" x 5" Tan 10/Box HCPCS: A4410

SQ413157

2w"

17⁄8”-2¼”

6" x 6" Tan 5/Box HCPCS: A4410

SQ401905

4"

M

•• •• • •

Color Code

23⁄8”-3½”

SUR-FIT Natura® Durahesive® Skin Barrier with Flange Durahesive® skin barrier with low-profile, audible-click flange and tape collar. Cut-to-fit.

96

M

•• • •• •• • ••

Item 4" x 4" White 10/Box HCPCS: A4409

Order # SQ413159 SQ413160 SQ413161

Flange 14" 12" 1w"

Stoma Color Code ½”-¾” 7⁄8”-1” 11⁄8”-1¼”

5" x 5" White 10/Box HCPCS: A4409

SQ413162 SQ413163

24" 2w"

13⁄8”-1¾” 17⁄8”-2¼”

4" x 4" Tan 10/Box HCPCS: A4409

SQ413164 SQ413165 SQ413166

14" 12" 1w"

½”-¾” 7⁄8”-1” 11⁄8”-1¼”

5" x 5" Tan 10/Box HCPCS: A4409

SQ413167 SQ413168

24" 2w"

13⁄8”-1¾” 17⁄8”-2¼”

Ostomy

CONVATEC

1-877-902-9726

SUR-FIT Natura® SKIN BARRIERS Natura® Durahesive® Cut-to-Fit Accordion Flange Skin Barrier with Acrylic Collar and white acrylic tape collar Item 10/Box HCPCS: A4409

Order # SQ421454 SQ421458 SQ421462

Flange 1 ¾” 2 ¼” 2 ¾”

•• •

Stoma Color Code ½” – 13⁄16” ½” – 15⁄16”” ½” – 1 ¾”

Natura® Moldable Durahesive® Skin Barrier with Accordion Flange and Hydrocolloid flexible collar Item 10/Box HCPCS: A4409

Order # SQ421039 SQ421040 SQ421041

Flange 2 ¼” 2 ¼” 2 ¾”

M

M

•• •

Stoma Color Code ½” – 7⁄8” 7⁄8” – 1 ¼” 1 ¼” – 1 ¾”

SUR-FIT Natura® Moldable Durahesive® Skin Barrier with Hydrocolloid Flexible Collar

Extended wear barrier. Soft, pliable adhesive rolls to fit stoma size and shape. Mold-to-fit. No cutting necessary. Flexibility of the adhesive permits the skin barrier to adapt to changing stoma size. Will maintain a contoured fit during wear. Recommended for those with more liquid type output.

M

Item 10/Box HCPCS: A4409

Order # SQ411800 SQ411802 SQ411804 SQ411806

Flange 1 w" 1 w" 2 4" 2 w"

•• ••

Stoma Color Code 2"-f" f"-14" 14"-1w" 14”-1w” by 1w”-28”

SUR-FIT Natura® Moldable Durahesive® Skin Barrier with white acrylic tape collar Item 10/Box HCPCS: A4409

M

Items marked with “M” are Medicare Reimbursable.

Order # SQ413417 SQ413418 SQ413419 SQ413420

Flange 1 ¾” 1 ¾” 2 ¼” 2 ¾”

M

•• ••

Stoma Color Code ½” – 7⁄8” 7⁄8” – 1 ¼” 1 ¼” – 1 ¾” 1 ¼” – 1 ¾” By 1 ¾” – 2 1⁄8”

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

97

Ostomy

CONVATEC SUR-FIT Natura® SKIN BARRIERS

SUR-FIT Natura® Moldable Stomahesive® Skin Barrier with Hydrocolloid Flexible Collar

Stomahesive® skin barrier rolls to open and fit stoma size and shape. Mold-to-fit. No cutting necessary. ConvaTec Moldable Technology™ eliminates gaps that can compromise skin protection.

M

Item 10/Box HCPCS: A4414

Order # SQ411801 SQ411803 SQ411805 SQ411807

Flange 1w" 1w" 24" 2w"

•• ••

Stoma Color Code 2"-f" f"-14" 14"-1w" 14"-1w" by 1w"-28"

SUR-FIT Natura® Moldable Stomahesive Skin Barrier with white acrylic tape collar Item 10/Box HCPCS: A4414

Order # SQ413421 SQ413422 SQ413423 SQ413424

Flange 1 ¾” 1 ¾” 2 ¼” 2 ¾”

M

•• ••

Stoma Color Code ½” – 7⁄8” 7⁄8” – 1 ¼” 1 ¼” – 1 ¾” 1 ¼” – 1 ¾” By 1 ¾” – 2 1⁄8”

Natura® Stomahesive® Cut-to-Fit Accordion Flange Skin Barrier with white acrylic tape collar Item 10/Box HCPCS: A4414

Order # SQ421456 SQ421460 SQ421464

Flange 1 ¾” Sm 2 ¼” Md 2 ¾” Lg

•• •

Stoma Color Code ½” – 13⁄16” ½” –15⁄16” ½” – 1 ¾”

Natura® Moldable Stomahesive® Skin Barrier with Accordion Flange and Hydrocolloid flexible collar Item 10/Box HCPCS: A4414

98

Order # SQ421033 SQ421034 SQ421035

Reorder your supplies online at

Flange 2 ¼” 2 ¼” 2 ¾”

M

M

•• •

Stoma Color Code ½” – 7⁄8” 7⁄8” – 1 ¼” 1 ¼” – 1 ¾”

www.mybyramhealthcare.com

Ostomy

CONVATEC

1-877-902-9726

SUR-FIT Natura® SKIN BARRIERS SUR-FIT Natura® Stomahesive® Flexible Skin Barrier, Cut-to-Fit Stomahesive® skin barrier with low-profile, audible-click flange and acrylic tape collar. Cut-to-fit.

M

•• • •• •• • ••

Item 4" x 4" White 10/Box HCPCS: A4414

Order # SQ125257 SQ125258 SQ125259

Flange 14" 12" 1w"

Stoma Color Code ½”-¾” 7⁄8”-1” 11⁄8”-1¼”

5” x 5” White 10/Box HCPCS: A4414

SQ125260 SQ125261

24” 2w”

13⁄8”-1¾” 17⁄8”-2¼”

4" x 4" Tan 10/Box HCPCS: A4414

SQ125262 SQ125263 SQ125264

14" 12" 1w"

½”-¾” 7⁄8”-1” 11⁄8”-1¼”

5" x 5" Tan 10/Box HCPCS: A4414

SQ125265 SQ125266

24" 2w"

13⁄8”-1¾” 17⁄8”-2¼”

SUR-FIT Natura® Stomahesive® Flexible Skin Barrier, Pre-Cut Stomahesive® skin barrier with low-profile, audible-click flange, tape collar and pre-cut opening.

M

Items marked with “M” are Medicare Reimbursable.

Item 4" x 4" Tan 1w" Flange 10/Box HCPCS: A4414

Order # SQ125267 SQ125268 SQ125269 SQ125270 SQ125271 SQ125272 SQ125273 SQ125274

Pre-Cut 2" d" w" f" 1" 18" 14" 1s"

5" x 5" Tan 24" Flange 10/Box HCPCS: A4414

SQ125275 SQ125276 SQ125277

12" 1d" 1w"

•• •• •• •• •• •

M

Color Code

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

99

Ostomy

CONVATEC SUR-FIT Natura® OSTOMY SYSTEMS SUR-FIT Natura® SKIN BARRIERS

SUR-FIT Natura® Stomahesive®Skin Barrier with Flange Stomahesive® skin barrier with low-profile, audible-click flange without tape collar. Cut-to-fit. Item 4" x 4" Tan 10/Box HCPCS: A4414

Order # SQ401573 SQ401574 SQ401575 SQ401576

Flange 1¼" 1½" 1¾" 2¼"

5" x 5" Tan 10/Box HCPCS: A4415

SQ401577

2¾"

17⁄8”-2¼

6" x 6" Tan 5/Box HCPCS: A4415

SQ401906

4"

23⁄8”-3 ½”

•• •• • •

Stoma Color Code ½”-¾” 7⁄8”-1” 1 1⁄8”-1 ¼” 13⁄8”-1¾

To reach our Ostomy Center of Excellence, please call: 1-800-308-9445

100

M

Have you seen our new and improved reorder website, myByram?

Reorder your medical supplies online! It’s easy with myByram. • Place reorders online • View your order history • Update your account information • Securely make a payment • Chat live with a customer service representative • Add ostomy accessories to your order If you don’t already have an account, you can enroll online today!

Check it out today! www.mybyramhealthcare.com Visit us online: www.byramhealthcare.com ■

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©2017 Byram Healthcare Centers, Inc. All rights reserved. Printed in the United States.

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Breast Pumps

Ostomy

CONVATEC ACTIVELIFE® ONE-PIECE OSTOMY SYSTEM ActiveLife ® DRAINABLE POUCHES

ActiveLife® Drainable Pouch with Stomahesive® Skin Barrier

Quiet, odor-proof film with a durable, cloth-like backing. Includes 1 tail closure per box. Stomahesive® barrier with pre-cut opening and tape collar provides optimal skin protection and minimizes irritation.

M

Item 10" Length Opaque 20/Box HCPCS: A5061

Order # SQ125331 SQ125333 SQ125334 SQ125335 SQ125336 SQ125337

Pre-Cut w" 14" 12" 1w" 2" 22"

12" Length Opaque 20/Box HCPCS: A5061

SQ125338 SQ125339 SQ125340 SQ125341 SQ125342 SQ125343 SQ125344

w" 1" 14" 12" 1w" 2" 22"

12" Length Transparent 10/Box HCPCS: A5061

SQ22764 SQ22765 SQ22766 SQ22767 SQ22768 SQ22769 SQ22770

w" 1" 14" 12" 1w" 2" 22"

Item 12" Length Transparent 10/Box HCPCS: A5061

Order # SQ22771

Cut-to-Fit w" to 22"

Reordering supplies online is simple! Visit the improved www.mybyramhealthcare.com and sign up today!

102

Reorder your supplies online at

www.mybyramhealthcare.com

Ostomy

CONVATEC

1-877-902-9726

ActiveLife ® DRAINABLE POUCHES ActiveLife® Drainable Pouch with Convex Durahesive® Skin Barrier Drainable Pre-cut Pouch with convex Durahesive® barrier for retracted stomas. Quiet, odor-proof film with one-sided comfort panel. The microporous adhesive collar and adhesive around the skin barrier eliminate the need for taping. Includes convenient belt loops and 1 tail closure. Item 12" Length Transparent 10/Box HCPCS: A4390

Order # SQ125352 SQ125353 SQ125354 SQ125355 SQ125356 SQ125357 SQ125358 SQ125359

M

Pre-Cut w" f" 1" 18" 14" 1s" 12" 1w"

ActiveLife® Drainable Pouch with Durahesive® Plus™ Skin Barrier

Quiet, odor-proof film with a durable, cloth-like backing. Includes 1 tail closure. The microporous adhesive collar and adhesive around the skin barrier eliminates the need for taping. Cut-to-Fit.

M

Item 12" Length Transparent 10/Box HCPCS: A4388

Order # SQ400598

Cut-to-Fit w" to 22" Stoma Opening

12" Length Opaque 10/Box HCPCS: A4388

SQ400599

w" to 22" Stoma Opening

When you call to place an order, please have the following information ready: • Your insurance information • Your doctor’s information (name and phone number) • Items you wish to order

M

Items marked with “M” are Medicare Reimbursable.

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

103

Ostomy

CONVATEC ActiveLife ® CLOSED-END POUCHES ActiveLife® Closed-End Pouch with Filter

Quiet, odor-proof film with a durable, cloth-like backing. Includes 60 filter covers. Closed Pouch with special Stomahesive® skin barrier allows frequent removal (up to 5 times daily) with optimal skin protection. Cut-to-Fit or Pre-cut.

M

Item 8" Length Opaque 60/Box HCPCS: A4416

Order # SQ413141

Cut-to-Fit w" to 22"

Order # SQ413142 SQ413143 SQ413144 SQ413145 SQ413146

Pre-Cut 1" 14" 12" 1w" 2"

Item 8" Length Transparent 60/Box HCPCS: A4416

Order # SQ413147

Cut-to-Fit ¾"-22"

Order # SQ413148 SQ413149 SQ413150 SQ413151 SQ413152

Pre-Cut 1" 14" 12" 1w" 2"

ActiveLife® Closed-End Pouch with Filter

Quiet, odor-proof film with a durable, cloth-like backing. Closed Cut-to-Fit Pouch with Stomahesive® skin barrier that allows frequent removal (up to 5 times daily) with optimal skin protection. 30 filter covers.

M

Item Transparent 30/Box HCPCS: A4416

Order # SQ650422

Cut-to-Fit w" to 2"

Opaque 30/Box HCPCS: A4416

SQ650408

w" to 2"

ActiveLife® Stoma Cap with Skin Barrier

M

Quiet, odor-proof film with a durable, cloth-like backing. Item 30/Box HCPCS: A5055

104

Order # SQ175611

Cut-to-Fit w" - 2 "

Color Opaque

Ostomy

CONVATEC

1-877-902-9726

ActiveLife ® UROSTOMY POUCHES ActiveLife® Urostomy Pouch with Durahesive® Skin Barrier

Light-weight, flexible one-piece system. Pre-cut opening. Microporous adhesive. Transparent pouch has one-sided comfort panel and bendable tap.

M

Item 10" Length 10/Box HCPCS: A4393

Order # SQ125361 SQ125362 SQ125363 SQ125364 SQ125365 SQ125366 SQ125367 SQ125368 SQ125369

Stoma 2" d" w" f" 1" 18" 14" 1s" 12"

Color Transparent

ActiveLife® Urostomy Pouch with Durahesive® Skin Barrier and Accuseal® Tap with Valve

Light-weight, flexible one-piece system. Pre-cut opening. Microporous adhesive. Transparent pouch has one-sided comfort panel. Accuseal® Tap with valve.

M

Item 10" Length 10/Box HCPCS: A4428

Order # SQ650828 SQ650829 SQ650830 SQ650831 SQ650832 SQ650833

Stoma w" f" 1" 18" 14" 12"

Color Transparent

Want a better night sleep?

Urostomy care can be so much easier when you use a night drainage bag. These larger capacity bags lessen the chance of accidental leakage and ensure a better night sleep.

M

Items marked with “M” are Medicare Reimbursable.

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

105

Ostomy

CONVATEC IRRIGATION PRODUCTS VISI-FLOW® IRRIGATION PRODUCTS

M

Visi-Flow® Irrigator with Stoma Cone Item Order # 1/Box SQ401989 HCPCS: A4398/A4399

Visi-Flow® Irrigation Starter Set

Includes Visi-Flow® Irrigator with stoma cone, 2 SUR-FIT Natura® Stomahesive® skin barrirs with Flange, 2 Visi-Flow® Irrigation Sleeves, 2 SUR-FIT® Natura® Closed Pouches, stoma lubricant, ostomy belt, tail closure, brush and convenient carrying case.

M

Item 1/Box

Order # SQ401916 SQ401917

Flange 1w" 2w"

Visi-Flow® Irrigation Sleeves

M

Includes 1 tail closure. Item 5/Box HCPCS: A4397

Order # SQ401911 SQ401912 SQ401913 SQ401914

Flange 12" 1w" 24" 2w"

Visi-Flow® Irrigation Adapter Faceplate

Allows use of Irrigation Sleeve with one-piece pouch. Item Each HCPCS: A4361

Order # SQ401918 SQ401919

•• ••

Color Color Code Transparent

M

Flange 1w" 2w"

Visi-Flow® Irrigation Sleeve Tail Closure Item Each HCPCS: A4363

106

Order # SQ175650

Reorder your supplies online at

www.mybyramhealthcare.com

Ostomy

CONVATEC

1-877-902-9726

PEDIATRIC OSTOMY SYSTEMS Little Ones® ONE-PIECE PEDIATRIC POUCHES Little Ones® Urostomy Pouch with Skin Barrier

Custom Urostomy Pouch with Stomahesive® Cut-to-Fit barrier and 2 universal night drain adapters. Transparent with one-sided flocking. Quiet odor barrier film. Item 5" Length 15/Box HCPCS: A5071

Order # SQ20917

M

Cut-to-Fit 5⁄16” to 1"

Little Ones® Drainable One-Piece Pouch with Skin Barrier

Custom Drainable Pouch with Stomahesive® Cut-to-Fit skin barrier provides optimal skin protection and minimizes irritation. Transparent with one-sided flocking with 15 individual pediatric tail closures per box. Quiet odor barrier film.

M

Item 6" Length 15/Box HCPCS: A5061

Order # SQ20922

Cut-to-Fit 5⁄16”" to 2"

Little Ones® SKIN BARRIERS Little Ones® Flexible Skin Barrier

Stomahesive® Cut-to-Fit wafer with low-profile, audible click flange and tape collar. Item 3" x 3" White 5/Box HCPCS: A4414

Order # SQ401925

Flange 14"

4" x 4" White 5/Box HCPCS: A4414

SQ401926

1w"

M

• •

Color Code

Keep in touch with Byram Healthcare! Like us on Facebook www.facebook.com/byramhealthcare

M

Items marked with “M” are Medicare Reimbursable.

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

107

Ostomy

CONVATEC

Little Ones® TWO-PIECE PEDIATRIC POUCHES Little Ones® Drainable Pouch

Drainable Pouch with flange is made of quiet, odor-proof film. Flange features pouch tab and belt loops. Transparent with one-sided, flocked comfort panel. Includes 10 pediatric tail closures per box. Item 6" Length 10/Box HCPCS: A5063

Order # SQ401927 SQ401928

Flange 14" 1w"

M

••

Color Code

Little Ones® Closed-End Pouch

Closed Pouch with flange is made of quiet, odor-proof film with two-sided, soft, flocked comfort panels. Flange features pouch tab and belt loops. Item 8" Length Opaque 20/Box HCPCS: A5054

Order # SQ401930 SQ401931

Flange 14" 1w"

M

••

Color Code

Little Ones® Urostomy Pouch

Urostomy Pouch features nonreturn valve and secure tap. Made of quiet, odor-proof film with soft, one-sided flocking. Flange features pouch tab and belt loops. Includes 2 drainage adapters per box.

M

Item 6" Length Transparent 10/Box HCPCS: A5073

Order # SQ401929

Flange 14"

•

Color Code

Trap a Little Air! When emptying a pouch, before you replace the clip, pull the pouch walls apart to trap a small amount of air. It will help drainage to drop down into the pouch.

108

Ostomy

HOLLISTER

1-877-902-9726

NEW IMAGE™ TWO-PIECE OSTOMY SYSTEM The New Image™ Two- Piece Ostomy System features a “floating flange” which permits the flange and skin barrier to move independently of each other. This mechanism enables an exceptionally secure attachment between the skin barrier and the pouch without causing pressure on the abdomen. An audible click confirms that the connection has been completed. Choose the skin barrier according to the wearing time appropriate for you: FlexWear™ for standard wearing time, FlexTend™ for extended wearing time or CeraPlus™ also for extended wearing times. The CeraPlus skin barrier is designed to maintain adhesive properties, and features a proprietary formulation designed to help protect the skin’s own moisture barrier. Be sure to match the color code of the New Image™ skin barrier with the color code of the New Image™ pouch. NEW IMAGE™ SKIN BARRIERS New Image™ Flextend™ Skin Barrier with Floating Flange Extended wear flat skin barrier. Tapered with cloth backing. Audible click confirms connection. Choose tape or tapeless. Beige. Cut-to-Fit. Flat. Tape. Item Order # 5/Box HCPCS: A4409 HO14602 HCPCS: A4409 HO14603 HCPCS: A4409 HO14604 HCPCS: A4410 HO14606 Cut-to-Fit. Flat.Tapeless. Item Order # 5/Box HCPCS: A4409 HO15602 HCPCS: A4409 HO15603 HCPCS: A4410 HO15604 Pre-Cut. Flat. Tape. Item Order # 5/Box HO14701 HCPCS: A4409 HO14702 HO14703 HO14704 HO14705 HO14706 HO14707 HO14708 HO14709

M

Items marked with “M” are Medicare Reimbursable.

Flange

Cut-to-Fit

1w" 24" 2w" 4"

up to 14" up to 1w" up to 24" up to 32"

Flange

Cut-to-Fit

1w" 24" 2w"

up to 14" up to 1w" up to 24"

Flange 1w" 1w" 1w" 1w" 1w" 1w" 24" 24" 24"

Pre-Cut d" w" f" 1" 18" 14" 1s" 12" 1w"

Byram is a Medicare participating provider.

M

Color Code

•• ••

Color Code

•• • •• •• •• •• •

Color Code

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

109

Ostomy

HOLLISTER NEW IMAGE™ SKIN BARRIERS

New Image™ Flextend™ Skin Barrier with Floating Flange (Cont.) Extended wear flat skin barrier. Tapered with cloth backing. Audible click confirms connection. Tapeless. Beige. Pre-Cut. Flat. Tapeless. Item Order # 5/Box HO16101 HCPCS: A4409 HO16102 HO16103 HO16104 HO16105 HO16106 HO16107 HO16108

Flange 1w" 1w" 1w" 1w" 1w" 1w" 24" 24"

Pre-Cut d" w" f" 1" 18" 14" 1s" 12"

M

•• •• •• ••

Color Code

New Image™ FlexWear™ Skin Barrier with Floating Flange

Standard wear flat skin barrier. Tapered with cloth backing. Choose Cut-to-Fit or Pre-Cut. Choose tape or tapeless attachment. Beige. Cut-to-Fit. Flat. Tape. Item Order # 5/Box HCPCS: A4414 HO14202 HCPCS: A4414 HO14203 HCPCS: A4414 HO14204 HCPCS: A4415 HO14206 Cut-to-Fit. Flat. Tapeless. Item Order # 5/Box HCPCS: A4414 HO15202 HCPCS: A4414 HO15203 HCPCS: A4415 HO15204 Pre-Cut. Flat. Tape. Item Order # 5/Box HO14301 HCPCS: A4414 HO14302 HO14303 HO14304 HO14305 HO14306 HO14307 HO14308 HO14309

110

Reorder your supplies online at

Flange

Cut-to-Fit

1w" 24" 2w" 4"

up to 14" up to 1w" up to 24" up to 32"

Flange

Cut-to-Fit

1w" 24" 2w"

up to 14" up to 1w" up to 24"

Flange 1w" 1w" 1w" 1w" 1w" 1w" 24" 24" 24"

Pre-Cut d" w" f" 1" 18" 14" 1s" 12" 1w"

M

Color Code

•• ••

Color Code

•• • •• •• •• •• •

Color Code

www.mybyramhealthcare.com

Ostomy

HOLLISTER

1-877-902-9726

NEW IMAGE™ SKIN BARRIERS New Image™ FlexWear™ Skin Barrier with Floating Flange (Cont.) Standard wear flat skin barrier. Tapered with cloth backing. Choose Cut-to-Fit or Pre-Cut. Tapeless attachment. Beige. Pre-Cut. Flat. Tapeless. Item Order # 5/Box HO16402 HCPCS: A4414 HO16403 HO16404 HO16405 HO16406 HO16407 HO16408

Flange 1w" 1w" 1w" 1w" 1w" 24" 24"

Pre-Cut w" f" 1" 18" 14" 1s" 12"

•• •• •• •

Color Code

New Image™ CeraPlus™ (extended wear) Skin Barrier with Floating Flange Cut-to-fit. Tape. Item Order # 5/Box HO11202 HCPCS: A4409 HO11203 HO11204 Item 5/Box HCPCS: A4409 HCPCS: A4409 HCPCS: A4410

Order #

Pre-Cut up to 1 ¼” up to 1 ¾” up to 2 ¼”

Color Code

Flange

Pre-Cut

Color Code

up to 1 ¼” up to 1 ¾” up to 2 ¼”

M

•• • •• •

Flange 1 ¾” 2 ¼” 2 ¾”

HO15102 1 ¾” HO15103 2 ¼” HO15104 2 ¾”

M

Hollister Flextend™ Barriers

It is recommended you do not use a skin preparation with Flextend™ Skin Barriers.

Reordering supplies online is simple! Visit the improved www.mybyramhealthcare.com and sign up today!

M

Items marked with “M” are Medicare Reimbursable.

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

111

Ostomy

HOLLISTER NEW IMAGE™ SKIN BARRIERS

New Image™ Flextend™ Convex Skin Barrier with Floating Flange

Convex extended wear skin barrier. Tapered with cloth backing. Audible click confirms connection. Choose Cut-to-Fit or Pre-Cut. Choose tape or tapeless. Beige. Cut-to-Fit. Convex. With tape. Item Order # Flange 5/Box HO14802 1w" HCPCS: A4407 HO14803 24" HO14804 2w"

Cut-to-Fit up to 1" up to 12" up to 2"

Color Code

Cut-to-Fit. Convex. Tapeless. Item Order # 5/Box HO15802 HCPCS: A4407 HO15803 HO15804

Flange 1w" 24" 2w"

Cut-to-Fit up to 1" up to 12" up to 2"

Color Code

Pre-Cut. Convex. Tapeless. Item Order # 5/Box HO15903 HCPCS: A4407 HO15904 HO15905 HO15906

Flange 1w" 1w" 24" 24"

Pre-Cut f" 1" 18" 14"

Color Code

Pre-Cut. Convex with tape. Item Order # 5/Box HO14901 HCPCS: A4407 HO14902 HO14903 HO14904 HO14905 HO14906 HO14907 HO14908 HO14909 HO14910 HO14911

Flange 1w” 1w” 1w” 1w” 24” 24” 24” 24” 2w” 2w” 2w”

Pre-Cut d” w” f” 1” 18” 14” 13⁄8” 12” 1d” 1w” 2”

•• • •• • •• •• •• •• •• •• •• •

Color Code

Our Latino Program is designed to provide our Spanish speaking customers with a comfortable communication environment and access to customized support for ostomy management Call: 1-866-302-4295

112

M

Infused with the science of skin health

Adapt CeraRing barrier rings Sealed with the confidence of ceramide Infused with ceramide—a natural component of the skin—Adapt CeraRing is designed to support the healthy peristomal skin your patients deserve. Ceramides help protect the skin’s natural moisture barrier and help prevent water loss that may lead to damage and dryness. Available in flat, round convex and oval convex.

Adapt barrier ring technology enables the flat barrier ring to be stretched and shaped to help enhance fit and minimize the risk of leakage around the stoma. The convex barrier ring provides uniform pressure around the stoma to help prevent leakage and form a customized fit for each patient. Experience the confidence of ceramide—try Adapt CeraRings today.

The Hollister logo, Adapt, and Adapt CeraRing are trademarks of Hollister Incorporated. © 2017 Hollister Incorporated.

Ostomy

HOLLISTER NEW IMAGE™ SKIN BARRIERS

New Image™ Flextend™ Convex Skin Barrier with Floating Flange (Cont.)

Convex extended wear skin barrier. Tapered with cloth backing. Audible click confirms connection. Choose Cut-to-Fit or Pre-Cut. Tape. Beige. Pre-cut. Convex. Tape. Item Order # 5/Box HO13901 HCPCS: A4407 HO13902 HO13903 HO13904 HO13905 HO13906 HO13907 HO13908 HO13909 HO13910 HO13911

Flange 1 ¾” 1 ¾” 1 ¾” 1 ¾” 2 ¼” 2 ¼” 2 ¼” 2 ¼” 2 ¾” 2 ¾” 2 ¾”

Pre-Cut 5⁄8” ¾” 7⁄8” 1” 1 1⁄8” 1 ¼” 1 3⁄8” 1 ½” 1 5⁄8” 1 ¾” 2”

New Image™ FlexWear™ Convex Skin Barrier with Floating Flange

•• •• •• •• •• •

Color Code

Convex standard wear skin barrier. Tapered cloth backing. Audible click confirms connection. Choose Cut-to-Fit or Pre-Cut. Choose tape or tapeless. Beige.

114

Cut-to-Fit. Convex. Tape. Item Order # 5/Box HO14402 HCPCS: A4373 HO14403 HO14404

Flange 1w" 24" 2w"

Cut-to-Fit Color Code up to 1" up to 12" up to 2"

Cut-to-fit. Convex. Tapeless. Item Order # 5/Box HO13402 HCPCS: A4373 HO13403 HO13404

Flange 1 ¾” 2 ¼” 2 ¾”

Cut-to-Fit Color Code up to 1” up to 1 ½” up to 2”

Cut-to-Fit. Convex. Tapeless. Item Order # 5/Box HO15402 HCPCS: A4373 HO15403 HO15404

Flange 1w" 24" 2w"

Cut-to-Fit Color Code up to 1" up to 12" up to 2"

Reorder your supplies online at

M

M

•• • •• • •• •

www.mybyramhealthcare.com

Ostomy

HOLLISTER

1-877-902-9726

NEW IMAGE™ SKIN BARRIERS New Image™ FlexWear™ Convex Skin Barrier with Floating Flange (cont.)

M

Pre-Cut. Convex. Tape. Item Order # 5/Box HO14503 HCPCS: A4373 HO14504 HO14505 HO14506 Pre-cut. Convex. Tape. Item Order # 5/Box HO13503 HCPCS: A4373 HO13504 HO13505 HO13506

Flange 1w” 1w” 24” 24”

Pre-Cut f” 1” 18” 14”

Color Code

Flange 1 ¾” 1 ¾” 2 ¼” 2 ¼”

Pre-Cut 7⁄8” 1” 1 1⁄8” 1 ¼”

Color Code

Pre-Cut. Convex. Tapeless. Item Order # 5/Box HO15503 HCPCS: HO15504 A4373 HO15505 HO15506

Flange 1w" 1w" 24" 24"

Pre-Cut f" 1" 18" 14"

Color Code

•• •• •• •• •• ••

New Image™ CeraPlus™ (extended wear) Convex Skin Barrier with Floating Flange Cut-to-fit. Convex. Tape. Item Order # 5/Box HO11503 HCPCS: A4407 HO11504 HO11505 HO11506

Flange 1 ¾” 1 ¾” 2 ¼” 2 ¼”

Pre-Cut 7⁄8” 1” 1 1⁄8” 1 ¼”

•• ••

Color Code

New Image™ CeraPlus™ (extended wear) Convex Skin Barrier with Floating Flange Cut-to-fit. Convex. Tape. Item Order # 5/Box HO11402 HCPCS: A4407 HO11403 HO11404 Cut-to-fit without tape. Item Order # 5/Box HCPCS: A4407 HO15302 HCPCS: A4407 HO15303 HCPCS: A4408 HO15304

M

Items marked with “M” are Medicare Reimbursable.

M

M

•• •

Flange 1 ¾” 2 ¼” 2 ¾”

Pre-Cut Color Code up to 1” up to 1 ½” up to 2”

Flange

Pre-Cut

1 ¾” 2 ¼” 2 ¾”

up to 1” up to 1 ½” up to 2”

Byram is a Medicare participating provider.

Color Code

•• •

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

115

Ostomy

HOLLISTER NEW IMAGE™ DRAINABLE POUCHES New Image™ Drainable Pouch

Drainable pouch with odor barrier. Choose one or two-sided comfort panel. Match pouch with color code of selected New Image™ skin barrier. Belt tabs. One-sided comfort panel. Transparent. Item Order # 12" Length HO18102 10/Box HO18103 HCPCS: A5063 HO18104

Flange 1w" 24" 2w"

Color Code

Two-sided comfort panel. Beige. Item Order # 12" Length HO18122 10/Box HO18123 HCPCS: A5063 HO18124

Flange 1w" 24" 2w"

Color Code

Two-sided comfort panel. Beige. Item Order # 9" Length HO18202 10/Box HO18203 HCPCS: A5063 HO18204

Flange 1w" 24" 2w"

Color Code

New Image™ Drainable Pouch with Clamp Closure

M

•• • •• • •• •

Drainable pouch without integrated filter. Odor-barrier film. Pouch clamp closure. ComfortWear™ panel. For correct fit match color code of barrier with color code of pouch. Belt tabs.

M

Ultra-Clear, one sided ComfortWear™ panel. 12" Length. Item Order # Flange Color Code 10/Box HO18172 1w" HCPCS: A5063 HO18173 24" HO18174 2w" HO18176 4"

•• ••

New Image™ Drainable Pouch with Integrated Filter

Pouch has upgraded AF300 filter and odor barrier. Match color code of pouch to color code of New Image™ Skin Barrier. Choose one or two-sided comfort panels. Beige or Transparent. Belt tabs. Beige. Two-sided comfort panels. Item Order # 12" Pouch HO18142 10/Box HO18143 HCPCS: A4425 HO18144

116

Flange 1w" 24" 2w"

•• •

Color Code

M

Ostomy

HOLLISTER

1-877-902-9726

NEW IMAGE™ DRAINABLE POUCHES New Image™ Drainable Pouch with Integrated Filter (Cont.)

Pouch has upgraded AF300 filter and odor barrier. Match color code of pouch to color code of New Image™ Skin Barrier. Choose one or two-sided comfort panels. Beige or Transparent. Belt tabs. Transparent. One-sided comfort panel. Item Order # 12" Pouch HO18162 10/Box HO18163 HCPCS: A4425 HO18164

Flange 1w" 24" 2w"

M

•• •

Color Code

NEW IMAGE™ LOCK ’N ROLL™ DRAINABLE POUCHES New Image™ Lock ‘n Roll™ Drainable Pouch with Integrated Filter

Drainable pouch with odor barrier and upgraded filter. Extra security of "Lock ‘n Roll"™ closure system. Choose one or two-sided comfort panel. Match pouch with color code of selected New Image™ skin barrier. Belt tabs. Two-sided comfort panel. Beige. Item Order # 12" Length HO18182 10/Box HO18183 HCPCS: A4425 HO18184

Flange 1w" 24" 2w"

Color Code

One-sided comfort panel. Transparent. Item Order # 12" Length HO18192 10/Box HO18193 HCPCS: A4425 HO18194

Flange 1w" 24" 2w"

Color Code

M

•• • •• •

Hollister New Image™ Fit Tip

It's easy to get a proper fit with Hollister New Image™ ostomy products! Just match the colors on boxes of barriers, pouches and irrigator sleeves to be assured that your system components will all fit together correctly.

M

Items marked with “M” are Medicare Reimbursable.

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

117

Ostomy

HOLLISTER NEW IMAGE™ LOCK ’N ROLL™ DRAINABLE POUCHES New Image™ Lock ‘n Roll™ Drainable Pouch without Filter

Drainable pouch with odor barrier. No Filter. Extra security of "Lock ‘n Roll" closure system. Choose one or two-sided comfort panel. Match pouch with color code of selected New Image™ skin barrier. Belt tabs.

M

One-sided comfort panel. Ultra-Clear. Item Order # 12" Length HO18002 10/Box HO18003 HCPCS: A5063 HO18004 HO18006

Flange 1w" 24" 2w" 4"

Color Code

One-sided comfort panel. Transparent. Item Order # 12" Length HO18132 10/Box HO18133 HCPCS: A5063 HO18134

Flange 1w" 24" 2w"

Color Code

Two-sided comfort panel. Beige. Item Order # 12" Length HO18112 10/Box HO18113 HCPCS: A5063 HO18114

Flange 1w" 24" 2w"

Color Code

New Image™ Lock ‘n Roll™ Drainable Mini-Pouch with Integrated Filter

•• •• •• • •• •

Drainable Mini pouch with odor barrier and integrated filter. Extra security of "Lock ‘n Roll"™ closure system. Choose one or two-sided comfort panel. Match pouch with color code of selected New Image™ skin barrier. Belt tabs.

M

118

Two-sided comfort panel. Beige. Item Order # 7" Length HO18282 20/Box HO18283 HCPCS: A4425 HO18284

Flange 1w" 24" 2w"

Color Code

One-sided comfort panel. Transparent. Item Order # 7" Length HO18292 20/Box HO18293 HCPCS: A4425 HO18294

Flange 1w" 24" 2w"

Color Code

Reorder your supplies online at

•• • •• •

www.mybyramhealthcare.com

Ostomy

HOLLISTER

1-877-902-9726

NEW IMAGE™ TWO-PIECE OSTOMY SYSTEM NEW IMAGE™ CLOSED POUCHES New Image™ Closed Pouch with Integrated AF300 Filter

QuietWear pouch material, odor-barrier rustle-free film, with belt tabs. With ComfortWear panels. Match color code of pouch with color code of New Image™ skin barrier. Two-sided comfort panel. Beige. Item Order # 9" Length HO18322 60/Box HO18323 HCPCS: A4419 HO18324

Flange 1w" 24" 2w"

M

•• •

Color Code

New Image™ Closed Pouch with AF300 Filter

Closed pouch with odor barrier and upgraded filter. Choose one or two-sided comfort panels. Match color code of pouch with color code of New Image™ skin barrier. Belt tabs.

M

Items marked with “M” are Medicare Reimbursable.

One-sided comfort panel. Transparent. Item Order # 7" Length HO18382 60/Box HO18383 HCPCS: A4419 HO18384

Flange 1w" 24" 2w"

Color Code

Two-sided comfort panels. Beige. Item Order # 7" Length HO18392 60/Box HO18393 HCPCS: A4419 HO18394

Flange 1w" 24" 2w"

Color Code

One-sided comfort panel. Transparent. Item Order # 9" Length HO18362 30/Box HO18363 HCPCS: A4419 HO18364

Flange 1w" 24" 2w"

Color Code

Two-sided comfort panel. Beige. Item Order # 9" Length HO18372 30/Box HO18373 HCPCS: A4419 HO18374

Flange 1w" 24" 2w"

Color Code

M

•• • •• • •• • •• •

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

119

Ostomy

HOLLISTER NEW IMAGE™ CLOSED POUCHES New Image™ Closed Pouch without Filter

Closed pouch with odor barrier, no filter. Choose one or two-sided comfort panels. Match color code of pouch to color code of selected New Image™ skin barrier. Belt tabs. Two-sided comfort panel. Beige. Item Order # 7" Length HO18352 30/Box HO18353 HCPCS: A5054 HO18354

Flange 1w" 24" 2w"

Color Code

Two-sided comfort panel. Beige. Item Order # 7" Length HO18752 60/Box HO18753 HCPCS: A5054 HO18754

Flange 1w" 24" 2w"

Color Code

Two-sided comfort panel. Beige. Item Order # 9" Length HO18332 30/Box HO18333 HCPCS: A5054 HO18334

Flange 1w" 24" 2w"

Color Code

Two-sided comfort panel. Beige. Item Order # 9" Length HO18732 60/Box HO18733 HCPCS: A5054 HO18734

Flange 1w" 24" 2w"

Color Code

NEW IMAGE™ UROSTOMY POUCHES

M

•• • •• • •• • •• •

New Image™ Urostomy Pouch

Urostomy pouch with odor barrier and drain tube adapter. One or two sided comfort panel. Match color code with selected New Image™ skin barrier. Belt tabs. Includes 2 adapters.

120

Transparent. One-sided comfort panel. Item Order # 9” Length HO18902 10/Box HO18903 HCPCS: A4432 HO18904

Flange 1 ¾” 2 ¼” 2 ¾”

Color Code

Beige. Two-sided comfort panel. Item Order # 9” Length HO18912 10/Box HO18913 HCPCS: A4432 HO18914

Flange 1 ¾” 2 ¼” 2 ¾”

Color Code

•• • •• •

M

Ostomy

HOLLISTER

1-877-902-9726

NEW IMAGE™ UROSTOMY POUCHES New Image™ Urostomy Pouch (Cont.)

Urostomy pouch with odor barrier and drain tube adapter. One or two sided comfort panel. Match color code with selected New Image™ skin barrier. Belt tabs. Includes 2 adapters. Ultra-clear. One-sided comfort panel. Item Order # 9” Length HO18922 10/Box HO18923 HCPCS: A4432 HO18924

Flange 1 ¾” 2 ¼” 2 ¾”

Color Code

Transparent. One-sided comfort panel. Item Order # 9" Length HO18402 9" Length HO18403 10/Box HO18404 HCPCS: A4432

Flange 1w" 24" 2w"

Color Code

Beige. Two-sided comfort panel. Item Order # 9" Length HO18412 10/Box HO18413 HCPCS: A4432 HO18414

Flange 1w" 24" 2w"

Color Code

M

•• • •• • •• •

Helpful Tips • Always have extra pouches handy. • Keep extra pouches and wafers assembled. • Keep all supplies together or in one central location. • Don't leave pouches and wafers in the car during hot or freezing weather.

Our ostomy specialists are commited to your satisfaction. Please call us with any questions. 1-877-902-9726

M

Items marked with “M” are Medicare Reimbursable.

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

121

Ostomy

HOLLISTER OSTOMY IRRIGATION PRODUCTS HOLLISTER IRRIGATION PRODUCTS Cone Irrigator Kit

Includes 1 Irrigator Bag, 1 Stoma Cone with Connector, and 1 Cleaning Brush.

M

Item Order # Each HO7721 HCPCS: A4398 + A4399

M

Replacement Stoma Cone with Connector Item 10/Box HCPCS:A4399

Order # HO7723

Stoma Irrigator Drain

M

With attached closure and belt tabs. Clear. Item 20/Box HCPCS: A4397

Order # HO7728 HO7724

Size 2" 3"

PEDIATRIC OSTOMY SYSTEMS ONE-PIECE PEDIATRIC SYSTEMS Pouchkins™ Premie One-Piece System with SoftFlex™ Barrier, No Filter Pouch has soft wire closure. Can be used as closed end or drainable. No filter. Odor barrier film. Standard wear flat barrier without tape border. No starter hole. No comfort panels. Item Order # 4.5" Length HO3777 15/Box HCPCS: A5052 + A4362

122

Reorder your supplies online at

Cut-to-Fit up to d"

M

Color UC

www.mybyramhealthcare.com

Ostomy

HOLLISTER

1-877-902-9726

ONE-PIECE PEDIATRIC SYSTEMS Pouchkins™ Newborn One-Piece System with SoftFlex™ Barrier. No Filter.

Pouch has soft wire closure. Can be used with or without the drain valve. No filter. Odor barrier film. Standard wear flat barrier without tape border. No starter hole. No comfort panels.

M

Item Order # 6.5" Length HO3778 15/Box HCPCS: A5052 + A4362

Cut-to-Fit up to 1s x f"

Color UC

Pouchkins™ Urostomy Pouch with SoftFlex™ Skin Barrier

Urostomy pouch with odor barrier film. Standard wear flat skin barrier without starter hole. No tape border. One sided comfort panel. Item 8 w" Length 10/Box HCPCS:A5071

Order # HO3797

Cut-to-Fit up to 12"

M

Color T

Pouchkins™ Drainable Pouch with SoftFlex™ Barrier. No Filter

Drainable pouch with odor barrier film. Standard wear, flat skin barrier without starter hole. Lock ‘n Roll® closure. One-sided comfort panel. Item 6.5" Length 10/Box HCPCS:A5061

Order # HO3796

Cut-to-Fit up to 12"

M

Color T

Pouchkins™ Drainable Pouch with SoftFlex™ Skin Barrier with Integrated Filter

Drainable pouch with integrated filter and odor barrier film. Standard wear, flat skin barrier without starter hole. Lock ‘n Roll® closure. One-sided comfort panel. Item 7" Length 10/Box HCPCS:A4425

M

Items marked with “M” are Medicare Reimbursable.

Order # HO3795

Cut-to-Fit up to 2"

M

Color T

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

123

Ostomy

HOLLISTER TWO-PIECE PEDIATRIC SYSTEM Pouchkins™ SoftFlex™ Skin Barrier

Standard wear, flat barrier. No starter hole. No tape. Item 5/Box HCPCS: A4414

Order # HO3761

Flange 1w"

•

M

Color /Match

Pouchkins™ Drainable Pouch, No Filter, Lock ‘n Roll® Closure Pouch with odor barrier but no filter. Belt tabs. One-sided comfort panel. Item 6.5" Length 10/Box HCPCS:A5063

Order # HO3799

Flange 1w"

M

•

Color /Match

Pouchkins™ Drainable Pouch with Integrated Filter and Lock’n Roll® Closure Pouch with integrated filter and odor barrier. Belt Tabs. One-sided comfort panel: Transparent Two-sided comfort panel: Beige Item 7" Length 20/Box HCPCS:A4425

Order # HO18292 HO18282

Flange 1w" 1w"

M

••

Color /Match T B

Pouchkins™ Closed Mini Pouch with Integrated Filter Closed pouch with filter and odor barier. Belt tabs. One-sided comfort panel: Transparent. Two-sided comfort panel: Beige. Item 7" Length 60/Box HCPCS:A4419

Order # HO18382 HO18392

Flange 1w" 1w"

Pouchkins™ Urostomy Pouch

••

Color /Match T B

Urostomy pouch with odor barrier and flexible tap. Belt tabs. One-sided comfort panel: Transparent Two-sided comfort panel: Beige Item 62"Length 10/Box HCPCS:A4432

124

Order # HO18402 HO18412

Flange 1w" 1w"

M

••

Color /Match T B

M

Ostomy

HOLLISTER

1-877-902-9726

PREMIER™ ONE-PIECE OSTOMY SYSTEM PREMIER™ CLOSED POUCHES Premier Closed Mini Pouch with SoftFlex Skin Barrier

Closed mini pouch with integrated filter and odor barrier. Beige has two-sided comfort panels. Transparent has one-sided comfort panel. Tapeless, standard wear skin barrier. Item 7" Length 30/Box HCPCS:A4416 Item 7" Length 30/Box HCPCS:A4416 Item 9" Length 30/Box HCPCS:A4416 Oval. Item 9” 30/Box HCPCS: A4416 Item 9” Length 30/Box HCPCS:A4416

M

Items marked with “M” are Medicare Reimbursable.

Order # HO82100 HO82500

Cut-to-Fit up to 28" up to 28"

Color Beige Transparent

Order # HO82125 HO82130 HO82135 Order # HO82300 HO82400

Pre-Cut 1" 1 /16" 1s" Cut-to-Fit up to 28" up to 28"

Color Beige Beige Beige Color Beige Transparent

Order # HO82402 HO82302

Cut-to-Fit Up to 3 x 2.5” Up to 3 x 2.5”

Color Transparent Beige

Order # HO82325 HO82330 HO82335

Pre-Cut 1” 1 /16” 1s”

Color Beige Beige Beige

3

3

M

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

125

Ostomy

HOLLISTER PREMIER™ DRAINABLE POUCHES

Premier™ Drainable Pouch with CeraPlus™ Flat Skin Barrier Tape border, Lock ‘n Roll Microseal closure, Odor-Barrier Rustle Free Film. One-sided ComfortWear Panel Item Order # 12” HO8931 10/Box HCPCS: A4388

Cut-to-Fit Up to 2 ½”

M

Color Ultra-Clear

Two-sided ComfortWear Panels and Integrated AF300 Filter. Item Order # Type Stoma Fit Color 12” HO8901 Cut-to-Fit Up to 2 ½” Beige w/Viewing Option 10/Box HO8925 Pre-cut 1” Beige w/Viewing Option HCPCS: A5056 HO8930 Pre-cut 1 3/16” Beige w/Viewing Option HO8935 Pre-cut 1 3/8” Beige w/Viewing Option HO8940 Pre-cut 1 9/16” Beige w/Viewing Option

Premier™ Drainable Pouch with CeraPlus™ Soft Convex Skin Barrier Tape border, Integrated AF300 Filter, Lock ‘n Roll Microseal closure, OdorBarrier Rustle Free Film, Belt Tabs and Two-sided ComfortWear Panels. Item 12” 5/Box HCPCS: A5057

126

Order # HO8954 HO8958 HO89511 HO8960 HO8961 HO8962 HO8963

Reorder your supplies online at

Type Cut-to-Fit Cut-to-Fit Cut-to-Fit Pre-cut Pre-cut Pre-cut Pre-cut

Stoma Fit Up to 1” Up to 1 ½” Up to 2 1/8” ¾” 7/8” 1” 1 1/8”

M

Color Beige w/Viewing Option Beige w/Viewing Option Beige w/Viewing Option Beige w/Viewing Option Beige w/Viewing Option Beige w/Viewing Option Beige w/Viewing Option

www.mybyramhealthcare.com

Ostomy

HOLLISTER

1-877-902-9726

PREMIER™ DRAINABLE POUCHES Premier™ Drainable Pouch with CeraPlus™ Convex Skin Barrier Tape border, Lock ‘n Roll Microseal closure, Odor-Barrier Rustle Free Film and Belt Tabs. One-sided ComfortWear Panel Item Order # 12” HO8984 5/Box HO8988 HCPCS: A4390 HO89811

Cut-to-Fit Up to 1” Up to 1 ½” Up to 2”

M

Color Ultra-Clear Ultra-Clear Utra-Clear

Two-sided ComfortWear Panels and Integrated AF300 Filter. Item Order # Type Stoma Fit Color 12” HO8914 Cut-to-Fit Up to 1” Beige w/Viewing Option 5/Box HO8918 Cut-to-Fit Up to 1 ½” Beige w/Viewing Option HCPCS: A5057 HO89111 Cut-to-Fit Up to 2” Beige w/Viewing Option HO8990 Pre-cut ¾” Beige w/Viewing Option HO8991 Pre-cut 7/8” Beige w/Viewing Option HO8992 Pre-cut 1” Beige w/Viewing Option HO8993 Pre-cut 1 1/8” Beige w/Viewing Option

Premier™ Drainable Pouch with Flextend™ Flat Skin Barrier

Tape border, Lock ‘n Roll Microseal closure, Without Integrated Filter, with ComfortWear Panels. 12” Item 10/Box HCPCS: A4388

Order # HO8531 HO8551 HO8532 HO8552 HO8538 HO8558 HO8533 HO8553 HO8539 HO8559

Stoma Fit 2 ½” 2 ½” 1” 1” 1 ¼” 1 ¼” 1 ½” 1 ½” 1 ¾” 1 ¾”

M

Color Ultra-Clear –Body Side Only Beige Transparent-Body Side Only Beige Transparent-Body Side Only Beige Transparent-Body Side Only Beige Transparent-Body Side Only Beige

Our Latino Program is designed to provide our Spanish speaking customers with a comfortable communication environment and access to customized support for ostomy management Call: 1-866-302-4295

M

Items marked with “M” are Medicare Reimbursable.

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

127

Ostomy

HOLLISTER PREMIER™ DRAINABLE POUCHES

Premier™ Drainable Mini-Pouch with SoftFlex™ Flat Skin Barrier

Flat, standard wear, tapeless skin barrier. Choose Cut-to-Fit or Pre-Cut. Drainable pouch with odor barrier. Choose one or two-sided comfort panels. Cut-to-Fit. One-sided comfort panel. Item Order # Stoma Fit 7" Length HO88800 up to 28" 20/Box HCPCS:A4424 Cut-to-Fit. Two-sided comfort panel. Item Order # Stoma Fit 7" Length HO88700 up to 28" 20/Box HCPCS:A4424 Oval. Cut-to-fit. One-sided comfort panel. Item Order # Stoma Fit 12” HO88402 Up to 3 x 2.5” 10/Box HCPCS: A4424

128

Reorder your supplies online at

M

Color Transparent

Color Beige

Color Transparent

www.mybyramhealthcare.com

Ostomy

HOLLISTER

1-877-902-9726

PREMIER™ DRAINABLE POUCHES Premier™ Drainable Mini-Pouch with SoftFlex™ Flat Skin Barrier (Cont.)

Flat, standard wear, tapeless skin barrier. Choose Cut-to-Fit or Pre-Cut. Drainable pouch with odor barrier. Choose one or two-sided comfort panels. Oval. Cut-to-fit. Two-sided comfort panel. Item Order # Stoma Fit 12” HO88302 Up to 3 x 2.5” 10/Box HCPCS: A4424

Color Beige

Pre-Cut. Two-sided comfort panel. Item Order # 7" Length HO88725 20/Box HO88730 HCPCS:A4424 HO88735 HO88740

Color Beige Beige Beige Beige

Pre-Cut Size 1" 1 /16" 1s" 1 /16" 3

9

Premier™ Drainable Pouch with Flextend™ Convex Skin Barrier Tape. Filter. Belt Tabs. Cut-to-fit. One-sided comfort panel. Item 12” 5/Box HCPCS: A5057

Order # HO8584 HO8588 HO85811 HO8274 HO8278 HO82711

Stoma Fit Up to 1” Up to 1 ½” Up to 2” Up to 1” Up to 1 ½” Up to 2”

M

M

Color Transparent Transparent Transparent Transparent Transparent Transparent

Premier™ Drainable Pouch with Clamp Closure, SoftFlex™ Flat Skin Barrier Flat, standard wear, tapeless skin barrier. Cut-to-Fit. Drainable pouch with clamp closure. No filter. One-sided comfort panel. Cut-to-Fit. One-sided comfort panel. Item Order # Cut-to-Fit 12" Length HO88501 up to 22" 10/Box HCPCS:A5061

M

Items marked with “M” are Medicare Reimbursable.

M

Color Ultra-Clear

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

129

Ostomy

HOLLISTER PREMIER™ DRAINABLE POUCHES

Premier™ Soft Convex Drainable Pouch with Flextend™

M

Tape. Belt tabs. Beige with viewing option, and ultra clear. Item MAXI 12” 5/Box HCPCS: A5057

Order # HO8674 HO8678 HO86711 HO8661 HO8662 HO8663 HO8664 HO8665 HO8666 HO8574 HO8578 H085711

Type Cut-to-fit Cut-to-fit Cut-to-fit Pre-cut Pre-cut Pre-cut Pre-cut Pre-cut Pre-cut Cut-to-fit Cut-to-fit Cut-to-fit

Stoma Fit 5⁄8” to 1“ 5⁄8” to 1 ½” 5⁄8” to 2 1⁄8” 7⁄8” 1” 1 1⁄8” 1 ¼” 1 ½” 1 ¾” 5⁄8” to 1” 5⁄8” to 1 ½” 5⁄8” to 2 1⁄8”

Color Beige Beige Beige Beige Beige Beige Beige Beige Beige Ultra clear Ultra clear Ultra clear

Premier™ Drainable Pouch with Flextend™ Convex Skin Barrier

Convex, extended wear skin barrier with cloth tape. Choose Cut-to-Fit or Pre-Cut. Drainable pouch with odor barrier. One-sided comfort panel. Belt tabs. Cut-to-Fit. Item 12" Length. 5/Box HCPCS:A4390

Order # HO8624 HO8628 HO86211

Cut-to-Fit up to 1" up to 12" up to 2"

Color Transparent Transparent Transparent

Cut-to-fit. Item 12” 5/Box HCPCS: A4390

Order # HO82624 HO82628 HO826211

Cut-to-Fit Up to 1” Up to 1 ½” Up to 2”

Color Transparent Transparent Transparent

Order # HO8610 HO8611 HO8612 HO8613 HO8614 HO8615 HO8616 HO8617 HO8618 HO8619

Pre-Cut Size w” f” 1” 18” 14” 1s” 12” 1d” 1w” 2”

Color Transparent Transparent Transparent Transparent Transparent Transparent Transparent Transparent Transparent Transparent

Pre-Cut. Item 12” Length 5/Box HCPCS:A4390

130

M

Ostomy

HOLLISTER

1-877-902-9726

PREMIER™ DRAINABLE POUCHES Premier™ Drainable Pouch with Flextend™ Convex Skin Barrier (Cont.)

Convex, extended wear skin barrier with cloth tape. Choose Cut-to-Fit or Pre-Cut. Drainable pouch with odor barrier. One-sided comfort panel. Belt tabs. Pre-cut. Belt tabs. Item 12” 5/Box HCPCS: A4390

Order # HO82610 HO82611 HO82612 HO82613 HO82614 HO82615 HO82616 HO82617 HO82619

Pre-Cut Size ¾” 7⁄8” 1” 1 1⁄8” 1 ¼” 1 3⁄8” 1 ½” 1 5⁄8” 2”

M

Color Transparent Transparent Transparent Transparent Transparent Transparent Transparent Transparent Transparent

Premier™ Drainable Pouch with Flextend™ Flat Skin Barrier

Flat, extended wear skin barrier with cloth tape. Choose Cut-to-Fit or Pre-Cut. Drainable pouch with odor barrier. Choose one or two-sided comfort panels. Includes 1 clamp. Cut-to-Fit. One-sided comfort panel. Item Order # 9" Length HO8641 10/Box HCPCS:A4388 Cut-to-Fit. One-sided comfort panel. Item Order # 12" Length HO8651 10/Box HO8631 HCPCS:A4388 Pre-Cut. One-sided comfort panel. Item Order # 12" Length HO8637 10/Box HO8632 HCPCS:A4388 HO8638 HO8633 HO8639 HO8634 HO8635

M

Items marked with “M” are Medicare Reimbursable.

Cut-to-Fit up to 22"

Color Beige

Cut-to-Fit up to 2" up to 22"

Color Ultra-clear Transparent

Pre-Cut Size w" 1" 14" 12" 1w" 2" 22"

Color Transparent Transparent Transparent Transparent Transparent Transparent Transparent

M

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

131

Ostomy

HOLLISTER PREMIER™ DRAINABLE POUCHES

Premier™ Drainable Pouch with Flextend™ Flat Skin Barrier (Cont.) Flat, extended wear skin barrier with cloth tape. Choose Cut-to-Fit or Pre-Cut. Drainable pouch with odor barrier. Choose one or two-sided comfort panels. Includes 1 clamp. Pre-Cut. Two-sided comfort panel. Item Order # 9” Length HO8647 10/Box HO8642 HCPCS:A4388 HO8648 HO8643 HO8649

Pre-Cut Size w” 1” 14” 12” 1w”

M

Color Beige Beige Beige Beige Beige

Premier™ Drainable Pouch with FlexWear™ Skin Barrier

Flat, with tape border, with Integrated AF300 Filter, Lock ‘n Roll™ closure, OdorBarrier Rustle Free Film with ComfortWear™ panels. Cut-to-Fit. One-sided comfort panel. FlexWear™ (standard wear).

M

12” Length Item HCPCS:A4424 10/Box

Order # HO8081

Cut-to-Fit Up to 22"

Color Transparent

Pre-Cut. One-sided comfort panel. FlexWear™ (standard wear). 12” Length Item Order # Pre-Cut Size Color 10/Box HO8025 1" Transparent HO8030 1 /16" Transparent HO8035 1s" Transparent HO8040 1 /16" Transparent 3

9

Cut-to-Fit. Two-sided comfort panel. FlexWear™ (standard wear). 12” Length Item Order # Cut-to-Fit Color 10/Box HO8181 Up to 22" Beige HO8381 Up to 2-1/2” Beige w/Viewing Option Pre-Cut. Two-sided comfort panel. FlexWear™ (standard wear). 12” Length Item Order # Pre-Cut Color 10/Box HO8125 1" Beige HO8130 1 /16" Beige HO8135 1s" Beige HO8140 1 /16" Beige 3

9

132

Reorder your supplies online at

www.mybyramhealthcare.com

Ostomy

HOLLISTER

1-877-902-9726

PREMIER™ DRAINABLE POUCHES Premier™ Drainable Pouch with FlexWear™ Skin Barrier (Cont.)

Flat, with tape border, with Integrated AF300 Filter, Lock ‘n Roll™ closure, OdorBarrier Rustle Free Film with ComfortWear™ panels. Cut-to-Fit. One-sided comfort panel. FlexWear™ (standard wear).

M

Cut-to-Fit. One-sided comfort panel. FlexWear™ (standard wear). 12” Length Item Order # Cut-to-Fit Color 10/Box HO8031 Up to 22" Ultra Clear HCPCS: A5061 HO8131 Up to 22" Ultra Clear HCPCS:A5061

Premier™ Lock ‘n Roll™ Drainable Pouch with Flextend™ Convex Skin Barrier (Cut-to-Fit) Convex, extended wear skin barrier with cloth tape. Cut-to-Fit barrier. Drainable pouch with odor barrier. Choose one or two-sided comfort panels. Belt tabs. Cut-to-Fit. One-sided comfort panel. Item Order # 12" Length HO8524 5/Box HO8528 HCPCS:A4390 HO85211

Cut-to-Fit up to 1" up to 12" up to 2"

M

Color Transparent Transparent Transparent

Reordering supplies online is simple! Visit the improved www.mybyramhealthcare.com and sign up today!

M

Items marked with “M” are Medicare Reimbursable.

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

133

Ostomy

HOLLISTER PREMIER™ DRAINABLE POUCHES

Premier™ Lock ‘n Roll™ Drainable Pouch with Flextend™ Convex Skin Barrier (Cut-to-Fit) Convex, extended wear skin barrier with cloth tape. Cut-to-Fit barrier. Drainable pouch with odor barrier. Choose one or two-sided comfort panels. Belt tabs.

134

Cut-to-Fit. Two-sided comfort panel. Item Order # 12" Length HO8504 5/Box HO8508 HCPCS:A4390 HO85011

Cut-to-Fit up to 1" up to 12" up to 2"

Color Beige Beige Beige

Cut-to-fit. One-sided comfort panel. Item Order # 12” HO8244 5/Box HO8248 HCPCS: A4390 HO82411

Stoma Fit Up to 1” Up to 1 ½” Up to 2”

Color Transparent Transparent Transparent

M

Ostomy

HOLLISTER

1-877-902-9726

PREMIER™ DRAINABLE POUCHES Premier™ Lock ‘n Roll™ Drainable Pouch with Flextend™ Convex Skin Barrier (Pre-Cut) Convex, extended wear skin barrier with cloth tape. Pre-cut barrier. Drainable with odor barrier. Choose one or two-sided comfort panels. Belt tabs. Pre-Cut. One-sided comfort panel. Item Order # 12" Length HO8510 5/Box HO8511 HCPCS:A4390 HO8512 HO8513 HO8514 HO8515 HO85116 HO85118 HO85119

Pre-Cut Size w" f" 1" 18" 14" 1s" 12" 1w" 2"

Color Transparent Transparent Transparent Transparent Transparent Transparent Transparent Transparent Transparent

Pre-Cut. Two-sided comfort panel. Item Order # 12" Length HO8590 5/Box HO8591 HCPCS:A4390 HO8592 HO8593 HO8594 HO8595 HO8596 HO8597 HO8599

Pre-Cut Size w" f" 1" 18" 14" 1s" 12" 1d" 2"

Color Beige Beige Beige Beige Beige Beige Beige Beige Beige

M

Experience the Byram Difference

Byram offers reliable, accurate service nationwide to home care agencies, managed care organizations, healthcare professionals and the patient at home. To reach our Ostomy Center of Excellence, please call: 1-800-308-9445

M

Items marked with “M” are Medicare Reimbursable.

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

135

Ostomy

HOLLISTER PREMIER™ DRAINABLE POUCHES

Premier™ Lock ‘n Roll™ Drainable Pouch with Flextend™ Convex Skin Barrier (Pre-Cut) (Cont.) Convex, extended wear skin barrier with cloth tape. Pre-cut barrier. Drainable with odor barrier. Choose one or two-sided comfort panels. Belt tabs.

136

Pre-cut. One-sided comfort panel. Belt tabs. Item Order # Pre-Cut Size 12” HO8280 ¾” 5/Box HO8281 7⁄8” HCPCS: A4390 HO8282 1” HO8283 1 1⁄8” HO8284 1 ¼” HO8285 1 3⁄8” HO8286 1 ½” HO8288 1 ¾”

Color Transparent Transparent Transparent Transparent Transparent Transparent Transparent Transparent

Pre-cut. Two-sided comfort panel. Belt tabs. Item Order # Pre-Cut Size 12” HO8290 ¾” 5/Box HO8291 7⁄8” HCPCS: A4390 HO8292 1” HO8294 1 ¼” HO8295 1 3⁄8”

Color Beige Beige Beige Beige Beige

Reorder your supplies online at

M

www.mybyramhealthcare.com

Ostomy

HOLLISTER

1-877-902-9726

PREMIER™ DRAINABLE POUCHES Premier™ Lock ‘n Roll™ Drainable Pouch with SoftFlex™ Skin Barrier Flat, standard wear tapeless skin barrier. Choose Cut-to-Fit or Pre-Cut. Drainable pouch with odor barrier and upgraded filter. Beige has two-sided comfort panels. Transparent has one-sided comfort panel. Transparent and ultra-clear have one-sided comfort panels. Cut-to-Fit. Item 12" Length 10/Box HCPCS:A4424

Order # HO88300

Cut-to-Fit up to 28"

Color Beige

Cut-to-Fit

Color

up to 2" up to 22"

Transparent Ultra-Clear

Order # HO88325 HO88330 HO88335 HO88340

Pre-Cut Size 1" 1 /16" 1s" 1 /16"

Color Beige Beige Beige Beige

Order # HO88425 HO88430 HO88435 HO88440

Pre-Cut Size 1" 1 /16" 1s" 1 /16"

Color Transparent Transparent Transparent Transparent

Cut-to-Fit. Item Order # 12" Length, 10/Box HCPCS:A4424 HO88400 HCPCS:A5061 HO88401 Pre-Cut. Item 12" Length 10/Box HCPCS:A4424 Pre-Cut. Item 12" Length 10/Box HCPCS:A4424

3

9

3

9

M

When you call to place an order, please have the following information ready: • Your insurance information • Your doctor’s information (name and phone number) • Items you wish to order

M

Items marked with “M” are Medicare Reimbursable.

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

137

Ostomy

HOLLISTER PREMIER™ DRAINABLE POUCHES

Premier™ Urostomy Pouch with Flat Flextend ™ Skin Barrier Recommended replacement for HO8440/8450/8460. Upgraded Design w/ Multi-Chamber, Softer, Streamlined Tap. Anti-Reflux Valve, Tape Border, ComfortWear Panels. Includes 2 Adapters. 9” Item 10/Box HCPCS: A4428 Item 10/Box HCPCS: A4428

M

Order # HO84590 HO84690

Cut-to-Fit Up to 2 ½” Up to 2 ½”

Color Ultra-Clear-Body Side Only Transparent-Body Side Only

Order # HO84497 HO84692 HO84498 HO84693 HO84499 HO84694 HO84494

Pre-Cut ¾” 1” 1 ¼” 1 ½” 1 ¾” 2” 2”

Color Beige Transparent-Body Side Only Beige Transparent-Body Side Only Beige Transparent-Body Side Only Beige

Premier™ Urostomy Pouch with Convex Flextend ™ Skin Barrier

Recommended replacement for HO847x/843x series. Upgraded Design w/MultiChamber, Softer, Streamlined Tap. Anti-Reflux Valve, Tape Border, Belt Tabs, ComfortWear Panels. Includes 1 Adapter.

M

9” Item 5/Box HCPCS: A4430

Item 5/Box HCPCS: A4430

138

Order # HO84794 HO84798 HO847911 HO8439111

Cut-to-Fit Up to 1” Up to 1 ½” Up to 2” Up to 2”

Color Ultra-Clear-Body Side Only Ultra-Clear-Body Side Only Ultra-Clear-Body Side Only Beige

Order # HO84890 HO84991 HO84892 HO84992 HO84893 HO84993 HO84894 HO84994 HO84895 HO84896 HO84897 HO84997 HO84998 HO84999

Pre-Cut ½” 5⁄8” ¾” ¾” 7⁄8” 7⁄8” 1” 1” 1 1⁄8” 1 ¼” 1 3⁄8” 1 3⁄8” 1 ½” 1 ¾”

Color Ultra-Clear-Body Side Only Beige Ultra-Clear-Body Side Only Beige Ultra-Clear-Body Side Only Beige Ultra-Clear-Body Side Only Beige Ultra-Clear-Body Side Only Ultra-Clear-Body Side Only Ultra-Clear-Body Side Only Beige Beige Beige

Ostomy

HOLLISTER

1-877-902-9726

PREMIER™ UROSTOMY POUCHES Premier™ Urostomy Pouch with Convex Flextend™ Skin Barrier

Urostomy pouch with odor barrier. Beige has two-sided comfort panels. Transparent has one-sided comfort panel. Convex extended wear skin barrier with cloth tape. Choose Cut-to-Fit or Pre-Cut. Belt tabs. Includes 2 adapters.

M

Item 9" Length 5/Box HCPCS:A4430

Order # HO8434 HO8438 HO84311

Cut-to-Fit up to 1" up to 12" up to 2"

Color Beige Beige Beige

Item 9" Length 5/Box HCPCS:A4430

Order # HO8474 HO8478 HO84711

Cut-to-Fit up to 1" up to 12" up to 2"

Color Transparent Transparent Transparent

Item 9" Length 5/Box HCPCS:A4430

Order # HO8491 HO8492 HO8493 HO8494 HO8495 HO8496 HO8497 HO8498 HO8499

Pre-Cut d” w” f" 1" 18" 14" 1s" 12" 1w"

Color Beige Beige Beige Beige Beige Beige Beige Beige Beige

Item 9" Length 5/Box HCPCS:A4430

Order # HO8480 HO8481 HO8482 HO8483 HO8484 HO8485 HO8486 HO8487 HO8488 HO8489

Pre-Cut 2" d" w" f" 1" 18" 14" 1s" 12" 1w"

Color Transparent Transparent Transparent Transparent Transparent Transparent Transparent Transparent Transparent Transparent

We value your opinion and would like to hear from you. Please email your comments or suggestions to: [email protected]

M

Items marked with “M” are Medicare Reimbursable.

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

139

Ostomy

HOLLISTER PREMIER™ UROSTOMY POUCHES Premier™ Urostomy Pouch with Flat Flextend™ Skin Barrier

Urostomy pouch with odor barrier. Beige has two-sided comfort panels. Transparent has one-sided comfort panel. Extended wear, flat skin barrier with cloth tape. Choose Cut-to-Fit or Pre-Cut. Includes 2 adapters.

M

Item 9" Length 10/Box HCPCS:A4428

Order # HO8440 HO8450 HO8460

Cut-to-Fit up to 22" up to 22" up to 22"

Color Beige Ultra-Clear Transparent

Item 9" Length 10/Box HCPCS:A4428

Order # HO8447 HO8442 HO8448 HO8443 HO8449

Pre-Cut w" 1" 14" 12" 1w"

Color Beige Beige Beige Beige Beige

Item 9" Length 10/Box HCPCS:A4428

Order # HO8467 HO8462 HO8468 HO8463 HO8469 HO8464

Pre-Cut w" 1" 14" 12" 1w" 2"

Color Transparent Transparent Transparent Transparent Transparent Transparent

MISCELLANEOUS CLOSED POUCHES Closed Mini Pouch with Tape and Filter

Closed pouch with integrated filter. Barrier with microporous tape. Item 7" Length 30/Box HCPCS:A4418

Order # HO3142 HO3148 HO3143 HO3149 HO3144

Pre-Cut 1" 14" 12" 1w" 2"

Color Transparent Transparent Transparent Transparent Transparent

Hollister Stoma Cap with Filter

Stoma cap with odor-barrier film. Microporous, cloth tape and integrated, deodorizing filter. Item 44" 30/Box HCPCS:A5055

140

Order # HO3184 HO3186

Reorder your supplies online at

Opening 2" 3"

M

M

Color White White

www.mybyramhealthcare.com

Ostomy

NU-HOPE

1-877-902-9726

DRAINABLE POUCHES Nu-Flex™ OVAL DRAINABLE POUCHES Nu-Flex™ Oval Adult Post-Op Drainable Pouch • • • • • •

Odor-proof, strong & lightweight Easy application Several sizes in both Trim-to-Fit or Pre-Cut stoma openings Oval pre-coated water-proof adhesive foam pad* Available in Flat, Convex, & Deep Convex Box of 10 w/Closure Clamp

Use alone or with Barrier* recommended for Ileostomates

Adult - Trim-to-Fit, 24 oz., 11” Pouch Item Order# Size HCPCS: NH7534 A w" x 12" A4388 Flat NH7544 B 18" x 2" A4390 Convex NH7554 C 13⁄16" x 24" NH7564 D 12" x 2w" NH7574 E 1w" x 34" Adult - Trim-to-Fit, 40 oz., 11” Pouch NH7584 F 2 ¼” – 3 ¾” Adult - Pre-Cut, 24 oz., 11” Pouch Item Order# Size HCPCS: NH7535 A w" x 12" A4388 Flat NH7545 B 18" x 2" A4390 Convex NH7555 C 13⁄16" x 24" NH7565 D 12" x 2w" NH7575 E 1w" x 34" Adult - Pre-Cut, 40 oz., 11” Pouch NH7585 F 2 ¼” – 3 ¾”

M

Color Clear Clear Clear Clear Clear Clear Color Clear Clear Clear Clear Clear Clear

Options to Drainables To add Hydrocolloid Disc add: “40” prior to

catalog # (ie 407208). For regular convexity add “C” after catalog # (ie 7208C). For deep convexity add “DC” after catalog # (ie 7208DC). Roll-up Closure add “R” after catalog # (ie 7204R or 7204R-C)

M

Items marked with “M” are Medicare Reimbursable.

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

141

NU-HOPE

Ostomy

Nu-Flex™ ROUND DRAINABLE POUCHES Nu-Flex™ Round Drainable Pouch • • • • •

Odor-proof drainable pouch with belt tabs*, and comfort panel (one side) 3 1/2" pre-coated water-proof adhesive foam pad* Trim-to-Fit or Pre-Cut stoma opening Available in Flat, Convex, & Deep Convex Box of 10 w/Closure Clamp

Use alone or with Barrier* recommended for Ileostomates

Adult - Trim-to-Fit, 24 oz., 11” Pouch Item Order# Size HCPCS: NH7801 2" to f" A4388 Flat NH7802 1" to 1s" A4390 Convex NH7803 12" to 1w"

Color Clear Clear Clear

Adult - Pre-Cut, 24 oz., 11” Pouch Item Order# HCPCS: NH7804 A4388 Flat NH7805 A4390 Convex NH7806 NH7807 NH7808 NH7809 NH7810 NH7811 NH7812 NH7813 NH7814 NH7816 Trim-to-Fit NH7824 Flat Only

Color Clear Clear Clear Clear Clear Clear Clear Clear Clear Clear Clear Clear Clear

Size 2" d" w" f" 1" 18" 14" 1s" 12" 1d" 1w" 2" up to 28"

M

POST-OP ROUND DRAINABLE POUCHES Adult & Brief Post-Op Clear Drainable Pouch • • • • •

Odor-Proof Drainable pouch with belt tabs, and comfort panel (one side) 3 1/2" pre-coated water-proof adhesive foam pad* Trim to Fit or Pre-Cut stoma opening Available in Flat, Convex, & Deep Convex Box of 10 w/Closure Clamp

Use alone or with Barrier* recommended for Ileostomates

Adult - Trim-to-Fit, 24 oz. Item Order# HCPCS: NH7201 A4388 Flat NH7202 A4390 Convex NH7203

142

Size 2" to f" 1" to 1s" 12" to 1w"

Color Clear Clear Clear

M

Ostomy

NU-HOPE

1-877-902-9726

POST-OP ROUND DRAINABLE POUCHES Adult & Brief Post-Op Clear Drainable Pouch (Cont.) • • • • •

Odor-Proof Drainable pouch with belt tabs, and comfort panel (one side) 3 1/2" pre-coated water-proof adhesive foam pad* Trim to Fit or Pre-Cut stoma opening Available in Flat, Convex, & Deep Convex Box of 10 w/Closure Clamp

Use alone or with Barrier* recommended for Ileostomates

Adult - Pre-Cut, 24 oz., 11” Pouch Item Order# HCPCS: NH7204 A4388 Flat NH7205 A4390 Convex NH7206 NH7207 NH7208 NH7209 NH7210 NH7211 NH7212 NH7213* NH7214* NH7216*

Size 2" d" w" f" 1" 18" 14" 1s" 12" 1d" 1w" 2"

Color Clear Clear Clear Clear Clear Clear Clear Clear Clear Clear Clear Clear

M

Nu-Self Opaque Drainable Pouch Adult Adult - Trim-to-Fit, 24 oz., 11” Pouch Item Order# Size HCPCS: NH7401 2" to f" A4388 Flat NH7402 1" to 1s" A4390 Convex NH7403 12" to 1w" Adult - Pre-Cut, 24 oz., 11” Pouch Item Order# HCPCS: NH7404 A4388 Flat NH7405 A4390 Convex NH7406 NH7407 NH7408 NH7409 NH7410 NH7411 NH7412 NH7413* NH7414* NH7416* *With 4" adhesive foam pad.

M

Items marked with “M” are Medicare Reimbursable.

Size 2" d" w" f" 1" 18" 14" 1s" 12" 1d" 1w" 2"

M

Color Opaque Opaque Opaque Color Opaque Opaque Opaque Opaque Opaque Opaque Opaque Opaque Opaque Opaque Opaque Opaque

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

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Ostomy

NU-HOPE DRAINABLE & URINARY POUCHES POST-OP OVAL DRAINABLE POUCHES Oval Adult Post-Op Drainable Pouch • • • • • •

Odor-proof, strong & lightweight Easy application Several sizes in both Trim-to-Fit or Pre-Cut stoma openings Oval pre-coated water-proof adhesive foam pad* Available in Flat, Convex, & Deep Convex Box of 10 w/Closure Clamp

M

Use alone or with Barrier* recommended for Ileostomates

Adult - Trim-to-Fit , 11” Pouch Item Order# 24 oz. NH7234 A HCPCS NH7244 B A4388 Flat NH7254 C A4390 Convex NH7264 D NH7274 E NH7284 F

Size w" x 12" 18" x 2" 13⁄16" x 24" 12" x 2w" 1w" x 34" 24" x 3w"

Color Clear Clear Clear Clear Clear Clear

Adult - Pre-Cut, 11” Pouch Item Order# 24 oz. NH7235 HCPCS NH7245 A4388 Flat NH7255 A4390 Convex NH7265 NH7275 NH7285

Size w" x 12" 18" x 2" 13⁄16" x 24" 12" x 2w" 1w" x 34" 24" x 3w"

Color Clear Clear Clear Clear Clear Clear

A B C D E F

M

Nu-Self Opaque Drainable Pouch Adult Adult - Trim-to-Fit, 11” Pouch Item Order# 24 oz. NH7434 A HCPCS NH7444 B A4388 Flat NH7464 D A4390 Convex NH7474 E Adult - Pre-Cut, 11” Pouch Item Order# 24 oz. NH7435 A HCPCS NH7445 B A4388 Flat NH7455 C A4390 Convex

144

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Size w" x 12" 18" x 2" 12" x 2w" 1w" x 34"

Color Opaque Opaque Opaque Opaque

Size w" x 12" 18" x 2" 13⁄16" x 24"

Color Opaque Opaque Opaque

www.mybyramhealthcare.com

Ostomy

NU-HOPE

1-877-902-9726

POST-OP ROUND URINARY POUCHES Round Adult Post-Op Urinary Pouch • • • • • •

Durable vinyl is strong & lightweight Easy application - peel and stick 3½" pre-coated water-proof adhesive foam pad* Trim-to-Fit or Pre-Cut stoma opening Available with or without Flutter Valve, in flat, convex & deep convex Box includes 10 pouches w/10 caps and 1 night adapter

*Economical! - Can be re-applied using Nu-Hope Adhesive.

Adult - Trim-to-Fit, 11” Pouch Item Order# 24 oz. NH8291 HCPCS NH8292 A4391 Flat NH8293 A4393 Convex Adult - Pre-Cut, 11” Pouch Item Order# 24 oz. NH8254 HCPCS NH8255 A4391 Flat NH8256 A4393 Convex NH8257 NH8258 NH8259 NH8260 NH8261 NH8262 NH8263* NH8264* NH8266*

Size 2" to f" 1" to 1s" 12" to 1w"

Color Clear Clear Clear

Size 2" d" w" f" 1" 18" 14" 1s" 12" 1d" 1w" 2"

Color Clear Clear Clear Clear Clear Clear Clear Clear Clear Clear Clear Clear

M

Options to Urinaries Flutter Valve (Anti-Reflux) add: “FV” after catalog # (ie 8257FV). For regular convexity add “C” after catalog # (ie 8257C). For deep convexity add “DC” after catalog # (ie 8257DC).

M

Items marked with “M” are Medicare Reimbursable.

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

145

NU-HOPE

Ostomy

POST-OP OVAL URINARY POUCHES Oval Adult Post-Op Urinary Pouch • • • • • •

Durable vinyl is strong & lightweight Easy application - peel and stick Oval pre-coated water-proof adhesive foam pad* Several sizes in both Trim-to-Fit or Pre-Cut stoma openings Available with or without Flutter Valve, in flat, convex & deep convex Box includes 10 pouches w/10 caps and 1 night adapter

*Economical! - Can be re-applied using Nu-Hope Adhesive.

Adult - Trim-to-Fit Item Order# 24 oz. NH8634 HCPCS NH8644 A4391 Flat NH8654 A4393 Convex NH8664 NH8674 Adult - Pre-Cut Item 24 oz. HCPCS A4391 Flat A4393 Convex

Order# NH8635 NH8645 NH8655 NH8665 NH8675

A B C D E

Size w" x 12" 18" x 2" 1 3⁄16" x 24" 12" x 2w" 1w" x 34"

Color Clear Clear Clear Clear Clear

A B C D E

Size w" x 12" 18" x 2" 13⁄16" x 24" 12" x 2w" 1w" x 34"

Color Clear Clear Clear Clear Clear

Options to Urinaries

Flutter Valve (Anti-Reflux) add: “FV” after catalog # (ie 8257FV). For regular convexity add “C” after catalog # (ie 8257C). For deep convexity add “DC” after catalog # (ie 8257DC).

146

M

Ostomy

NU-HOPE

1-877-902-9726

Nu-Flex™ OVAL URINARY POUCHES Nu-Flex™ Oval Adult Post-Op Urinary Pouch • • • • • •

Durable vinyl is strong & lightweight Easy application - peel and stick Oval pre-coated water-proof adhesive foam pad* Several sizes in both Trim-to-Fit or Pre-Cut stoma openings Available with or without Flutter Valve, in flat, convex & deep convex Box includes 10 pouches w/10 caps and 1 night adapter

*Economical! - Can be re-applied using Nu-Hope Adhesive.

Adult - Trim-to-Fit Item Order# 24 oz. NH8834 HCPCS NH8844 A4391 Flat NH8854 A4390 Convex NH8864 NH8874

A B C D E

Size w" x 12" 18" x 2" 13⁄16" x 24" 12" x 2w" 1w" x 34"

Color Clear Clear Clear Clear Clear

Adult - Pre-Cut Item Order# 24 oz. NH8835 HCPCS NH8845 A4391 Flat NH8855 A4390 Convex NH8865 NH8875

A B C D E

Size w" x 12" 18" x 2" 13⁄16" x 24" 12" x 2w" 1w" x 34"

Color Clear Clear Clear Clear Clear

Large Oval - Trim-to-Fit - FLAT only Item Order# Size HCPCS NH7974 12" x 2w" A4391 Flat NH7975 1w" x 34"

Color Clear Clear

M

Nu-Flex™ ROUND URINARY POUCHES Nu-Flex™ Round Adult Post-Op Urinary Pouch • • • • • •

Durable vinyl is strong & lightweight Easy application - peel and stick 32" pre-coated water-proof adhesive foam pad* Trim-to-Fit or Pre-Cut stoma opening Available with or without Flutter Valve, in flat, convex & deep convex Box includes 10 pouches w/10 caps and 1 night adapter

*Economical! - Can be re-applied using Nu-Hope Adhesive.

Adult - Trim-to-Fit Item Order# 24 oz. NH7991 HCPCS NH7992 A4391 Flat NH7993 A4393 Convex

M

Items marked with “M” are Medicare Reimbursable.

Size 2" to f" 1" to 1s" 12" to 1w"

M

Color Clear Clear Clear

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

147

NU-HOPE

Ostomy

Nu-Flex™ OVAL URINARY POUCHES Nu-Flex™ Round Adult Post-Op Urinary Pouch (cont.) Adult - Pre-Cut Item 24 oz. HCPCS A4391 Flat A4393 Convex

148

Order# NH7954 NH7955 NH7956 NH7957 NH7958 NH7959 NH7960 NH7961 NH7962 NH7963 NH7964 NH7966

M

Size 2" d" w" f" 1" 18" 14" 1s" 12" 1d" 1w" 2"

Color Clear Clear Clear Clear Clear Clear Clear Clear Clear Clear Clear Clear

Mid Size - Pre-Cut Item Order# 20 oz. NH7654 HCPCS NH7655 A4391 Flat NH7656 A4393 Convex NH7657 NH7658 NH7659 NH7660 NH7661 NH7662 NH7663 NH7664 NH7666 NH7668

Size 2" d" w" f" 1" 18" 14" 1s" 12" 1d" 1w" 2" 24" with 4” adhesive foam pad

Color Clear Clear Clear Clear Clear Clear Clear Clear Clear Clear Clear Clear Clear

Brief Size - Pre-Cut Item Order# 12 oz. NH7754 HCPCS NH7755 A4391 Flat NH7756 A4393 Convex NH7757 NH7758 NH7759 NH7760 NH7761 NH7762

Size 2" d" w" f" 1" 18" 14" 1s" 12"

Color Clear Clear Clear Clear Clear Clear Clear Clear Clear

Reorder your supplies online at

www.mybyramhealthcare.com

The Nu-Comfort Belt

Are you tired of a 1 inch wide belt that rides up or feels like a rope? If the answer is “yes” consider our softer, wider belt.

Twice the width width of of standard ostomy belts belts standard ostomy Easy Velcro adjustment Easy Velcro adjustment on left & right

on left & right

pport to entire 360° of support wafer of support to 360°

entire wafer

Extra support to the peristomal area

Extra support to the peristomal In addition,area supports

small peristomal hernias

In addition, supports Latex Free | Patent small peristomal hernias Pending

14 Openings Available

Latex Free | Patent Pending

2” width

MADE IN MADE IN U S A U S A

® ®

NU-HOPE

Ostomy

Nu-Hope™ SUPPORT BELTS HOW TO MEASURE FOR THE NU-HOPE OSTOMY SUPPORT BELTS Belt Opening Sizes / Add letter to # For large hernias and/or bulges that no longer reduce flat we Belt opening size is dependent on the recommend the Nu-Form belt. pouching system worn. For hernia prevention, pouch 2” E 34” C support and smaller reducible 28” L 32” T hernias, we recommend the Flat 24” F 3w” M Panel belt. In a lying position, 2s” (STD) 4” R measure the circumference of the 22” G 33⁄8” V body inline with the stoma. Select 2d” I 42” O the belt that matches the length 25⁄8” x 31⁄8” W MED Oval H 2w” A LRG Oval K determined by your measurement. 2f” DC XL Oval J Belt width is determined based 2f” x 3s” Q NO HOLE NH on area that needs support. 3” B SPECIAL SP** Belt openings are sized to the 38” U style or flange size of the pouch **Can be customized, please include description. being worn. Add the corresponding letter to the end of the #. Example: 6594-A would be a Small, 3" belt with a 2¾" opening.

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Ostomy

NU-HOPE

1-877-902-9726

Nu-Hope™ SUPPORT BELTS Nu-Form™ SUPPORT BELTS The Nu-Form belt is a comfortable binder designed to allow the elastic to support bulges and other body shapes more naturally. The standard opening size is 2-3/8". Additional opening sizes are listed. Simply add the letter to the end of the catalog number. Openings are centered vertically on belts 3" thru 6" wide so the belt can be worn for either a left or right sided stoma. Openings are placed 1-1/2" from the bottom for belt widths 7", 8", and 9". All belts can be modified; hole size, hole placement, belt length, etc. To order, add "-SP" to the catalog number and include a detailed description of the customization required. To add a Prolapse Overbelt add "P" to the item#, ie 2667-P. Prolapse overbelts are designed to support prolapsing stomas.

M

2-3/8" center opening Item Regular Order # NH6300 NH6301 NH6302 NH6303 NH6304

Cool Comfort HCPCS:A4396 Order# Size Fits NH6400 Sm 28" - 32" NH6401 Med 32" - 36" NH6402 Lg 36" - 41" NH6403 X-Lg 41" - 47" NH6404 XX-Lg 47" - 52"

2-3/8" center opening Item Regular Order# NH6310 NH6311 NH6312 NH6313 NH6314

Cool Comfort HCPCS:A4396 Order# Size Fits NH6410 Sm 28" - 32" NH6411 Med 32" - 36" NH6412 Lg 36" - 41" NH6413 X-Lg 41" - 47" NH6414 XX-Lg 47" - 52"

2-3/8" center opening Item Regular Order # NH6320 NH6321 NH6322 NH6323 NH6324

5"

Cool Comfort HCPCS:A4396 Order# Size Fits NH6420 Sm 28" - 32" NH6421 Med 32" - 36" NH6422 Lg 36" - 41" NH6423 X-Lg 41" - 47" NH6424 XX-Lg 47" - 52"

2-3/8" center opening Item Regular Order# NH6330 NH6331 NH6332 NH6333 NH6334

Cool Comfort HCPCS:A4396 Order# Size Fits NH6430 Sm 28" - 32" NH6431 Med 32" - 36" NH6432 Lg 36" - 41" NH6433 X-Lg 41" - 47" NH6434 XX-Lg 47" - 52"

3" 4"

6" M

Items marked with “M” are Medicare Reimbursable.

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

151

NU-HOPE

Ostomy

Nu-Form™ SUPPORT BELTS

LEFT/2-3/8" center opening & 1-1/2" from bottom Item Regular Cool Comfort HCPCS:A4396 Order# Order# Size Fits NH6340 NH6440 Sm 28" - 32" NH6341 NH6441 Med 32" - 36" NH6342 NH6442 Lg 36" - 41" NH6343 NH6443 X-Lg 41" - 47" NH6344 NH6444 XX-Lg 47" - 52"

RIGHT/2-3/8" center opening & 1-1/2" from bottom Item Regular Cool Comfort HCPCS:A4396 Order# Order# Size Fits NH6345 NH6445 Sm 28" - 32" NH6346 NH6446 Med 32" - 36" NH6347 NH6447 Lg 36" - 41” NH6348 NH6448 X-Lg 41" - 47" NH6349 NH6449 XX-Lg 47" - 52"

7"

7"

LEFT/2-3/8” center opening & 1-1/2” from bottom Item Regular Cool Comfort HCPCS:A4396 Order# Order# Size Fits NH6350 NH6450 Sm 28” - 32” NH6351 NH6451 Med 32” - 36” NH6352 NH6452 Lg 36” - 41” NH6353 NH6453 X-Lg 41” - 47” NH6354 NH6454 XX-Lg 47” - 52”

RIGHT/2-3/8" center opening & 1-1/2" from bottom Item Regular Cool Comfort HCPCS:A4396 Order# Order# Size Fits NH6355 NH6455 Sm 28" - 32" NH6356 NH6456 Med 32" - 36" NH6357 NH6457 Lg 36" - 41" NH6358 NH6458 X-Lg 41" - 47" NH6359 NH6459 XX-Lg 47" - 52"

8"

8"

LEFT/2-3/8” center opening & 1-1/2” from bottom Item Regular Cool Comfort HCPCS:A4396 Order# Order# Size Fits NH6360 NH6460 Sm 28” - 32” NH6361 NH6461 Med 32” - 36” NH6362 NH6462 Lg 36” - 41” NH6363 NH6463 X-Lg 41” - 47” NH6364 NH6464 XX-Lg 47” - 52”

RIGHT/2-3/8” center opening & 1-1/2” from bottom Item Regular Cool Comfort HCPCS:A4396 Order# Order# Size Fits NH6365 NH6465 Sm 28” - 32” NH6366 NH6466 Med 32” - 36” NH6367 NH6467 Lg 36” - 41” NH6368 NH6468 X-Lg 41” - 47” NH6369 NH6469 XX-Lg 47” - 52”

9"

152

Reorder your supplies online at

9"

www.mybyramhealthcare.com

Ostomy

NU-HOPE

1-877-902-9726

Nu-Hope™ SUPPORT BELTS Nu-Hope™ Flat Panel Support Belt

All elastic ostomy belt for paristomal support and hernia prevention. Made of soft polyester blend elastic. Provides secure, comfortable, durable support. Features a no-stretch control, flat plastic support panel and 6" of Velcro® adjustment. Belt widths of 3" or 4" come with 2 s" centered openings. Belt widths of 6" come with a 2 s" opening located 1" from the bottom.

M

3" wide, 2 s" center opening. Item Order # HCPCS:A4396 NH6591 NH6592 NH6593 NH6594 NH6595 NH6596 NH6597 NH6598

Size 16” to 19” 20” to 23” 24” to 27” 28" to 32" 32" to 36" 36" to 41" 41" to 47" 47" to 52"

Petite/Youth S Petite/Youth M Petite/Youth L Small Medium Large XLarge XXLarge

4" wide, 2 s" center opening. Item Order # HCPCS:A4396 NH2660 NH2661 NH2662 NH2663 NH2664

Size 28" to 32" 32" to 36" 36" to 41" 41" to 47" 47" to 52"

Small Medium Large XLarge XXLarge

6" wide, 2 s" opening located 1" from bottom. Right-side stoma. Item Order # Size HCPCS:A4396 NH6610 28" to 32" Small NH6611 32" to 36" Medium NH6612 36" to 41" Large NH6613 41" to 47" XLarge NH6614 47" to 52" XXLarge 6" wide, 2 s" opening located 1" from bottom. Left-side stoma. Item Order # Size HCPCS:A4396 NH6600 28" to 32" Small NH6601 32" to 36" Medium NH6602 36" to 41" Large NH6603 41" to 47" XLarge NH6604 47" to 52" XXLarge 9” wide, 2 3⁄8” opening located 1” from bottom. Right-side stoma. Item Order # Size HCPCS: A4396 NH6640 28” to 32” Small NH6641 32” to 36” Medium NH6642 36” to 41” Large NH6643 41” to 47” XLarge NH6644 47” to 52” XXLarge

M

Items marked with “M” are Medicare Reimbursable.

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

153

NU-HOPE

Ostomy

Nu-Hope™ SUPPORT BELTS Nu-Hope™ Flat Panel Regular Elastic Support Belt (Cont.)

Ostomy belt for paristomal support and hernia prevention. Made of soft polyester blend elastic. Provides secure, comfortable, durable support. Features a no-stretch control, flat plastic support panel and 6" of Velcro® adjustment. Belt widths of 3" or 4" come with 2 s" centered openings. Belt widths of 6" come with a 2 s" opening located 1" from the bottom.

M

9” wide, 2 3⁄8” opening located 1” from bottom. Left-side stoma. Item Order # Size HCPCS: A4396 NH6630 28” to 32” Small NH6631 32” to 36” Medium NH6632 36” to 41” Large NH6633 41” to 47” XLarge NH6634 47” to 52” XXLarge

Nu-Hope™ Flat Panel Cool Comfort Support Belt

Perforated, breathable ostomy belt for paristomal support and hernia prevention. Made of soft polyester blend elastic. Offers security, comfortable support and durability. Features a no-stretch control, flat plastic support panel and 6" of Velcro® adjustment. Belt widths of 3" and 4" come with a 2 s" centered opening. 6" belts come with a 2 s" opening located 1" from the bottom.

M

154

3" wide, 2 s" center opening. Item Order # HCPCS:A4396 NH6694 NH6695 NH6696 NH6697 NH6698

Size 28" to 32" 32" to 36" 36" to 41" 41" to 47" 47" to 52"

Small Medium Large XLarge XXLarge

4" wide, 2 s" center opening. Item Order # HCPCS:A4396 NH2665 NH2666 NH2667 NH2668 NH2669

Size 28" to 32" 32" to 36" 36" to 41" 41" to 47" 47" to 52"

Small Medium Large XLarge XXLarge

6" wide, 2 s" opening located 1" from bottom. Right-side stoma Item Order # Size HCPCS:A4396 NH6710 28" to 32" NH6711 32" to 36" NH6712 36" to 41" NH6713 41" to 47" NH6714 47" to 52"

Smalll Medium Large XLarge XXLarge

Ostomy

NU-HOPE

1-877-902-9726

Nu-Hope™ SUPPORT BELTS Nu-Hope™ Flat Panel Cool Comfort Support Belt (Cont.)

Perforated, breathable elastic ostomy belt for paristomal support and hernia prevention. Made of soft polyester blend elastic. Offers security, comfortable support and durability. Features a no-stretch control, flat plastic support panel and 6" of Velcro® adjustment. Belt widths of 3" and 4" come with a 2 s" centered opening. 6" belts come with a 2 s" opening located 1" from the bottom.

M

6" wide, 2 s" opening located 1" from bottom. Left-side stoma Item Order # Size HCPCS:A4396 NH6700 28” to 32”" Small NH6701 32" to 36" Medium NH6702 36" to 41" Large NH6703 41" to 47" XLarge NH6704 47" to 52" XXLarge 9” wide, 2 3⁄8” opening located 1” from bottom. Right-side stoma. Item Order # Size HCPCS: A4396 NH6740 28” to 32” Small NH6741 32” to 36” Medium NH6742 36” to 41” Large NH6743 41” to 47” XLarge NH6744 47” to 52” XXLarge 9” wide, 2 3⁄8” opening located 1” from bottom. Left-side stoma. Item Order # Size HCPCS: A4396 NH6730 28” to 32” Small NH6731 32” to 36” Medium NH6732 36” to 41” Large NH6733 41” to 47” XLarge NH6734 47” to 52” XXLarge

M

Items marked with “M” are Medicare Reimbursable.

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

155

Ostomy

ACCESSORIES ACCESSORIES SKIN BARRIER ADHESIVES Nu-Hope™ Liquid Adhesive

Waterproof, brush-on adhesive. Integrated applicator brush in bottle cap. Offers exceptional adherence. Item Bottle HCPCS:A4364

Order # NH2400

M

Size 4 oz.

SKIN ADHESIVE REMOVER WIPES & LIQUIDS Coloplast Brava® Adhesive Remover Wipes

Sting-free, silicone-based adhesive remover wipes quickly dissolve and wipe away adhesive residue from the skin. Item 30/Box HCPCS: A4456

Order # CT120115

M

Size Wipes

ConvaTec AllKare® Adhesive Remover Wipe

For the gentle removal of all adhesives, including skin barriers, tapes, and hydrocolloid dressings. Item Wipes HCPCS: A4456

Order # SQ37436 SQ37443

M

Size 50/Box 100/Box

ConvaTec® Sensi-Care™ Sting-Free Adhesive Remover Wipe Non-alcohol, silicone based formula that offers fast, painless removal of adhesive residue. Item Wipes HCPCS: A4456

Order # SQ413500

M

Size 30/Box

To reach our Ostomy Center of Excellence, please call: 1-800-308-9445

156

Reorder your supplies online at

www.mybyramhealthcare.com

Ostomy

ACCESSORIES

1-877-902-9726

SKIN ADHESIVE REMOVER WIPES & LIQUIDS Hollister™ Adhesive Remover

M

Universal adhesive remover is gentle on skin. Item 50 Wipes/Box HCPCS:A4456

Order # HO7760

Safe n Simple™ Adhesive Remover

Effectively removes adhesive residue from tapes, wafers and appliances from the skin that can reduce wear time. Leaves no greasy residue on the skin surface. Item Wipes HCPCS: A4456

Order # SNS00650

M

Size 50/Box

Safe n Simple™ Peri-Stoma Cleanser & Adhesive Remover

Use these large soft wipes to emulsify and remove adhesives, dirt and oils from peri-stoma skin. Does not leave an oily residue. No-sting, alcohol-free skin cleanser and adhesive remover in a rinse free product. Gentle, convenient and scent-free. Convenient re-sealable pouch.

M

Item Order # 50 Large individual wipes/pk SNS00550 HCPCS:A4456

Smith & Nephew® Remove® Adhesive Remover

Universal adhesive remover for tapes, adhesives and hydrocolloid skin barriers. Environmentally-friendly formula contains aloe to soothe skin and has a pleasant fragrance. Item 50 Wipes/Box Bottle HCPCS:A4456

M

Items marked with “M” are Medicare Reimbursable.

Order # UN403100 UN403300

M

Size 8 oz.

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

157

Ostomy

ACCESSORIES SKIN ADHESIVE REMOVER WIPES & LIQUIDS

Smith & Nephew® Uni-Solve® Adhesive Remover Environmentally-friendly formula with soothing aloe and a pleasant fragrance for tape or dressing removal. Item Bottle 50 Wipes/Box HCPCS:A4455

Order # UN59402500 UN402300

M

Size 8 oz.

APPLIANCE CLEANSERS Hollister™ M-9™ Cleanser/Decrystalizer

Cleans and aids in deodorizing urinary collection systems. Non-caustic formula is pH balanced and non-acidic. Includes free wash bottle. Item Bottle HCPCS:A5131

Order # HO7736

M

Size 16 oz.

SKIN BARRIER SHEETS Coloplast Brava® Protective Sheet

Hydrocolloid skin barrier that protects the skin from stoma output. Offers effective protection for peristomal skin. Provides a ready surface for good adhesion. Adheres to moist skin.

158

Item 10/Box HCPCS: A4362 5/Box HCPCS: A5121

Order # CT32105

Size 4x4”

CT32155

6x6”

5/Box HCPCS: A5122

CT32205

8x8”

M

Ostomy

ACCESSORIES

1-877-902-9726

SKIN BARRIER SHEETS ConvaTec® Stomahesive® Skin Barrier Sheets Non-sterile.

Item 5/Box HCPCS:A4362 3/Box HCPCS:A5122

Order # SQ21712

Size 4" x 4"

SQ21715

8" x 8"

M

Eakin Cohesive® Skin Barrier

Moldable and moisture-absorbing. It is designed to help protect the skin from contact with body fluids. It is used whenever the skin is damaged, excoriated or vulnerable. Item 5/Box 5/Box HCPCS: A4385

Order # SQ839004 SQ839003

M

Size 4” x 4” 4” x 8”

HolliHesive™ Skin Barrier Sheets

Synthetic skin barrier provides good adhesion for wear times of more than one day. Peelable tape on both sides. No starter hole. Non-sterile. Item 5/Box HCPCS:A4362

Order # HO7700

M

Size 4" x 4"

Hollister™ Flextend™ Skin Barrier Sheets

Extended wear skin barrier with ElastaFlex Skin Barrier backing. Superior resistance to erosion. Cut-to-Fit. No starter hole. Recommended for both post-op and home use.

M

Item 5/Box HCPCS: A4385 3/Box HCPCS: A5122

M

Items marked with “M” are Medicare Reimbursable.

Order #

Size

HO8800

4" x 4"

HO8801

8" x 8"

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

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ACCESSORIES SKIN BARRIER SHEETS Hollister™ Premium Skin Barrier Sheets

Synthetic skin barrier provides aggressive adhesion for longer wear times. No starter hole. Non-sterile. Item 5/Box HCPCS:A4362

Order # HO7800

Size 4"x 4"

Safe n Simple™ Skin Barrier Sheet

A thin hydrocolloid sheet that protects the skin from stoma output. Highly absorbent. Cut to fit - no starter hole. Non-sterile. Item 5/box HCPCS: A4362

M

Order # SNS21605

M

Size 4”x4”

BELTS & RETAINER RINGS Byram Adjustable Ostomy Belt with Hooks

Light, airy mesh belt with stainless steel hooks. Will fit belt loops of most manufacturers. Easy to attach, adjustable. 1" wide. Item Ea Ea HCPCS:A4367

Order # BS2510 BS2510XL

M

Size 24" - 40" up to 50"

Coloplast Brava® Belt for SenSura® Mio

Neutral gray color was designed to blend in under clothing; adjustable plastic tab is encased in fabric to prevent it from digging into your skin. Designed specifically for use with SenSura® Mio Click barriers.

M

Item 15/box HCPCS: A4367

Order # CT4237 CT4247

Size 40“ length 61” length

Coloplast Brava® Ostomy Belt

Comfortable, adjustable belt offers extra security for people with a flush or retracted stoma by supporting a convex barrier and allowing the stoma to protrude. Neutral color won’t show under clothing. Item 15/box HCPCS: A4367

160

Reorder your supplies online at

Order # CT04215 CT04220

M

Size 43 1⁄3“ length 49” length

www.mybyramhealthcare.com

Ostomy

ACCESSORIES

1-877-902-9726

BELTS & RETAINER RINGS ConvaTec® Ostomy Appliance Belt

Adjustable up to 42”. Belt fits all ConvaTec® pouches with belt loops. Item Ea HCPCS:A4367

Order # SQ175507

Size 1"W x 42"L

Hollister™ Adult Ostomy Belt

M

Adjustable.

Item Medium Large Ea HCPCS:A4367

Order # HO7300 HO7299

Size 26" to 43" 29" to 49"

Hollister™ Pouchkins™ Pediatric Belt Item Adjustable Ea HCPCS:A4367

M

Items marked with “M” are Medicare Reimbursable.

Order # HO3774

M

M Size Up to 17"

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

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ACCESSORIES POWDERS ConvaTec® Stomahesive® Protective Powder

Convenient, highly effective formula helps form a protective barrier against discharge on open or weeping areas of peristomal skin. Natural, non-sensitizing powder soothes skin and helps prevent skin irritation.

M

Item Squeeze Bottle HCPCS:A4371

Order # SQ25510

Size 1 oz.

Coloplast Brava® Ostomy Powder

Non-sterile protective powder for moisture absorption. Item Bottle HCPCS: A4371

Order # CT19075

M

Size 1 oz.

Hollister™ ADAPT™ Stoma Powder

Premium synthetic powder offers soothing skin protection and helps prevent skin irritation by drying the skin surface and making it adherent. Item Puff Bottle HCPCS:A4371

Order # HO7906

M

Size 1 oz.

Hollister™ Karaya 5 Powder

Offers soothing skin protection and helps prevent skin irritation. Combines with moisture from eroded or weeping skin to form a paste. To use on normal skin, moisten the skin with water and apply powder to form a paste. Item Puff Bottle HCPCS:A4371

Order # HO7905

Size 2.5 oz.

Experience the Byram Difference

Byram offers reliable, accurate service nationwide to home care agencies, managed care organizations, healthcare professionals and the patient at home.

162

M

Ostomy

ACCESSORIES

1-877-902-9726

DEODORANTS Coloplast Brava® Lubricating Deodorant

A pouch lubricant and deodorizer in one. Powder-fresh liquid neutralizes odor and allows output to slide to the bottom of the pouch for easier emptying. Item Sachets Bottle HCPCS: A4394

Order # CT12060 CT12061

M

Size 20/.25 fl. oz. 8 oz.

Devrom® Chewable Tablets

DEVROM® is an FDA approved internal deodorant taken orally (chewed or swallowed) to eliminate odor from flatulence and stool. 200 mg. No prescription needed. Item Bottle HCPCS:A9270

Order # PN100M

Size 100 Tablets

Fortis Entrust Lubricating Odor Eliminator

Specially formulated to be gentle to the stoma and tissue. Eliminates odor, does not cover it up. No smell, no added scents. Lubricates pouch for easy draining. Item Bottle HCPCS: A4394

Order # FT6400 FT6401

M

Size/Type 8 oz. 1 oz.

Hollister™ ADAPT™ Lubricating Deodorizer

Odor neutralizer, not a perfume or masking agent. Eases pouch emptying. Helps prevent pouch static and sticking. Item Bottle HCPCS:A4394

Order # HO78500

Size 8 oz.

Packets HCPCS:A4394

HO78501

50/.27oz.

Hollister™ m9™ Odor Eliminator Drops

Just 4-12 drops safely destroys odors in pouches, bed pans, commodes etc. Item 6/Box 12/Box HCPCS:A4394

M

Items marked with “M” are Medicare Reimbursable.

Order # HO7717 HO7715

M

M

Size 8 oz. Drop Bottle 1 oz. Drop Bottle

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

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ACCESSORIES DEODORANTS Hollister™ m9™ Odor Eliminator Spray

Convenient pump spray safely destroys odors in bathrooms, bed pans, commodes, etc. Unscented. Item 12/Box 6/Box HCPCS:A9270

Order # HO7732 HO7733

Size 2 oz. Spray Bottle 8 oz. Spray Bottle

Safe n Simple™ Ostomy Appliance Deodorant

Efficient odor control with no perfumes or artificial scents added for discreet protection. Convenient tilt tip dispenser bottle and slick consistency helps to empty pouch content. Item Bottle HCPCS:A4394

Order # SNS40208

M

Size 8 oz.

Safe n Simple™ Assure C Odor Eliminator & Lubricant

Is a clear formulation that eliminates the fear or concern of staining associated with the blue color deodorant formulations. Delivers outstanding odor control with no perfumes or artificial scents added and contains a lubricant to help empty pouch contents. Convenient tilt tip dispenser bottle.

M

Item Bottle Bottle Packet HCPCS: A4394

164

Reorder your supplies online at

Order # SNS41408 SNS41404 SNS41425

Size 8 oz. 4 oz. ¼ oz. ea

www.mybyramhealthcare.com

Ostomy

ACCESSORIES

1-877-902-9726

SKIN BARRIER FILM WIPES & SPRAYS 3M™ Cavilon™ No-Sting Barrier Film

An alcohol-free, quick-drying, non-cytotoxic liquid film that forms a breathable, transparent protective coating on the skin. Protects intact or damaged skin from urine, feces, and other bodily fluids and adheres for up to 72 hours.

M

Item 50 Wipes/Box HCPCS:A5120

Order # 3M3342

Coloplast® Prep™ Protective Barrier Film

Clear film forms a breathable barrier, protecting against skin irritants such as adhesives, urine and feces. No need to remove between applications. Item 12/Box 12 pks/Case HCPCS:A5120

Order # CT0925 SW2041

M

Size 2 oz. Dabber 54 Wipes/Box

ConvaTec® AllKare® Protective Barrier Film Wipes

Provides a barrier film layer on skin used under tapes, skin barriers, adhesive, and hydrocolloid dressings to help protect against irritation, excoriation and adhesive build-up.

M

Item 50/Box 100/Box HCPCS:A5120

Order # SQ37439 SQ37444

Coloplast Brava® Skin Barrier Wipes

Large, silicone-based wipes leave a thin protective layer on the skin without affecting adhesion of the ostomy barrier to the skin. Alcohol-free and sting-free. Item 30/Box HCPCS: A5120

Order # CT120215

M

Size Wipes

To reach our Ostomy Center of Excellence, please call: 1-800-308-9445

M

Items marked with “M” are Medicare Reimbursable.

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

165

ACCESSORIES

Ostomy

SKIN BARRIER FILM WIPES & SPRAYS ConvaTec® Sensi-Care™ Sting-Free Skin Barrier Wipe

Non-alcohol, silicone based formula for skin protection. Provides a barrier film layer on the skin that protects it from the damaging effects of adhesives, body waste and enzyme attack. Item Wipes HCPCS: A5120, A6250

Order # SQ413501

M

Size 30/box

Hollister No Sting Skin Protective Wipes

Aqueous-based formulation provides effective skin protection, without the potential for irritation and pain associated with astringent wipes that contain alcohol. Item 50 Wipes/Box HCPCS:A5120

M

Order # HO7917

Safe n Simple™ Skin Barrier Alcohol Free Spray Film

Apply this no-sting spray to create a transparent film barrier on peri-stomal skin. Protects against friction and body fluids. Increases adhesion of tapes and wafers. Gentle, convenient and scent-free. Perfect item to assist with crusting technique. Item Bottle HCPCS:A4369

166

Order # SNS80792

Size 2 oz.

M

Ostomy

ACCESSORIES

1-877-902-9726

SKIN BARRIER FILM WIPES & SPRAYS Safe n Simple™ No-Sting Skin Barrier Film

An Alcohol free – Sting Free wipe. The wipe has no offensive odor. The 1 gram of liquid in each safe n simple wipe is used to place a synthetic & transparent film on the skin. This film is intended to provide a protective barrier between skin and adhesives and/or liquids. This film is intended to reduce skin damage in the areas the film is applied when removing adhesives from the skin. These wet wipes are cost effective and ideal for crusting around a stoma.

M

Item 25 large individual wipe/pk 100 wipes/box

Order # SNS00807 SNS80744

HCPCS:A5120 HCPCS:A5120

Safe n Simple™ Skin Barrier Film with Alcohol

Fast drying skin barrier help protect skin by forming a breathable transparent coating over the skin. Apply to intact skin before applying tape, ostomy pouch or products with adhesives. Item 50 individual wipes per box

Order # SNS81850

M

HCPCS:A5120

Smith & Nephew® Skin Prep™ Protective Barrier Film

Water-resistant, protective coating protects skin from irritants such as adhesives, urine and feces. Helps to increase the adhesive of tapes and wafers and reduces skin trauma that can occur with their subsequent removal.

M

Item Pump Bottle 50 Wipes/Box HCPCS:A6250

Order # UN420200 UN420400

Size 4.5 oz.

POUCH ACCESSORIES Hollister™ Stoma Lubricant

Provides lubrication to the stoma during an irrigation procedure. Item 10/Box HCPCS:A4402

M

Items marked with “M” are Medicare Reimbursable.

Order # HO7740

M

Size 4 oz. Bottle

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

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ACCESSORIES POUCH ACCESSORIES Nu-Hope™ Skin Barrier Hole Cutter

Circular steel blade mounted in a comfortable plastic handle for cutting holes in skin barriers and tapes. Item Ea Ea Ea Ea Ea Ea Ea Ea HCPCS:A9270

Order # NH2524 NH2525 NH2526 NH2527 NH2528 NH2529 NH2530 NH2531

Diameter 2" cut d" cut w" cut f" cut 1" cut 18" cut 14" cut 1s" cut

Osto-EZ-Vent™

Osto-EZ-Vent®, an air release vent that fits on any manufacturer’s ostomy pouch. Easy to install and use, releases air build-up quickly and easily, bonds permanently, last as long as wearer wears pouch, and is not affected by water. The OEV™ can also be used on Preemie, Infant, fistula pouches and wound drainage bags

M

Item 10/Pk HCPCS:A4366

Order # KEM01

SKIN BARRIER PASTES Coloplast Brava® Sting-Free Paste

New alcohol-free ostomy paste protects peristomal skin from stoma output without stinging the skin. Minimizes risk of maceration. Used to fill in uneven skin surfaces. Pectin-based.

M

Item Tube HCPCS: A4406

Order # CT12050

Size 2 oz.

Coloplast Ostomy Paste

Used to fill in uneven skin surfaces to create a flat pouching surface. Provides tight sealing around the stoma. Protects against stoma output. Minimizes risk of maceration. Non-pectin.

M

Item 12 units HCPCS:A4405

168

Order # CT2650

Reorder your supplies online at

Size 2 oz. Tube

www.mybyramhealthcare.com

Ostomy

ACCESSORIES

1-877-902-9726

SKIN BARRIER PASTES Coloplast Brava® Strip Paste

Pectin-based product that protects peristomal skin from stoma output. Used to fill uneven skin surfaces to create a flat pouching surface. Alcohol-free and sting free. Item 10 strips/box HCPCS: A4406

Order # CT26555

M

Size 2 oz. total (.2 oz per strip)

ConvaTec® Stomahesive® Paste

Convenient, highly effective filler, sealant and protective skin barrier for colostomy, ileostomy or urinary stomas. Protects exposed skin around fistula sites and can be used as a filler for skin folds, uneven skin surfaces and scars. Natural, non-sensitizing ingredients help prevent skin irritation.

M

Item Tube HCPCS:A4406

Order # SQ183910

Size 2 oz.

Eakin® Cohesive® Paste

Alcohol-free adhesive stoma paste used to fill all crevices, skin folds and scars in order to create an even pouching surface. Helps form a waterproof barrier around the stoma. Can be used in conjunction with all Eakin Cohesive® Seals. Item Tube HCPCS: A4405

Order # SQ839010

M

Size 2.1 oz

Fortis Entrust Skin Pastes with Pectin and Fortaguard

The Fortis Entrust Skin Pastes with Pectin and Fortaguard are formulated to handle high, liquid output as well as thick, heavy output. It is thick, yet pliable for ease in “caulking” around the stoma or filling in gaps, scars, folds and uneven skin surfaces. Can be used to hug the stoma and create a seal that expands to fill the empty space between the appliance and the stoma that can create leaks. Because stoma size changes even throughout the day, the paste helps maintain the seal for added security and user confidence. Specially created to be less sticky but tackier to create a good seal without unnecessary mess and residue on fingers and gloves.

M

Item Tube HCPCS: A4406

M

Items marked with “M” are Medicare Reimbursable.

Order # FT6300F FT6300 FT6301

Size/Type 2 oz with Fortaguard 2 oz 2 oz No Sting

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

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ACCESSORIES SKIN BARRIER PASTES Hollister™ ADAPT™ Paste

A paste tube you can empty down to the last drop! Soft, easy to squeeze tube. Easy to see red cap. Caulk and fill skin crevices to improve the fit of your barrier. Low alcohol paste minimizes stinging.

M

Item Tube HCPCS: A4406

Order # HO79300

Size 2 oz.

Hollister™ Karaya 5 Paste

M

Protects skin from irritating fluids. Item 12/Box HCPCS:A4405

Order # HO7910

Size 4.5 oz. Tube

We value your opinion and would like to hear from you. Please email your comments or suggestions to: [email protected]

Cleanse

SNS00525 Peri-stoma Cleanser & Adhesive Remover

OSTOMY CARE

ACCESSORIES for all types of ostomies

Protect

SNS80725 No-Sting Skin Barrier Film Wipe SNS80792 No-Sting Skin Barrier Spray

Secure

Do you use tape to secure your ostomy pouch?

SNS684U2 Skin Barrier-Conforming Seal SNS20630 Skin Barrier 1” Arcs SNS21130 Skin Barrier 2” Xtra Wide Arcs SNS21605 Skin Barrier 4”x4” Sheet SNS90502 Skin Barrier Paste

Try Simpurity DermaPro Waterproof Silicone Tape

Assure

Latex Free Repels moisture Gentle to remove No pain or damage to the skin Transparent appearance Order#: SNS57230 170 Rolls 1”x15’

SNS40208 Ostomy Pouch Deodorant SNS41408 Assure C Odor Eliminator

To request samples visit:

www.sns-medical.com or call: 844-767-6334

Ostomy

1-877-902-9726

SKIN BARRIER PASTES Safe n Simple™ Skin Barrier Paste

Skin Barrier Paste in an easy to squeeze tube. This pectin based skin barrier paste is used as a caulk or filler for the skin surface. Item Tube HCPCS:A4406

Order # SNS90502

M

Size 2 oz.

Trio Silken® Silicone Stoma Gel

Innovative use of silicone technology to produce a soft silicone stoma gel that fills surgical scars, skin folds, creases and uneven surfaces, removing in one piece when fully cured. Allows the skin to breathe and remains soft and flexible to ensure comfort.

M

Item Tube HCPCS: A4406

Order # TO1070

Size 60g

SKIN BARRIER RINGS, SEALS & STRIPS Coloplast Brava Protective Seal

Moldable Barrier ring designed to adhere securely and protect the skin around the stoma. Not made with natural rubber latex. Item 10/bx HCPCS: A4385

Order # CT112035 CT120307 CT12039 CT12045 CT12047 CT12049

M

Size ¾” (18mm) Thin 2.5mm 1 1⁄8” (27mm) Thin 2.5mm 1 3⁄8” (34mm) Thin 2.5mm ¾” (18mm) Thick 4.2mm 1 1⁄8” (27mm) Thick 4.2mm 1 3⁄8” (34mm) Thick 4.2mm

Coloplast Brava® Moldable Ring

Used to fill in uneven skin surfaces and protect the skin. Absorbs moisture without breaking down. Easy to handle, mold and apply. Alcohol-free and sting-free. Item 10/box HCPCS: A4385

M

Items marked with “M” are Medicare Reimbursable.

Order # CT120307 CT120427

M

Size 2 mm 4.2 mm

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

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ACCESSORIES SKIN BARRIER RINGS, SEALS & STRIPS Coloplast® Skin Barrier Rings

Soft, flexible, ring-shaped Standard Wear barrier provides skin protection for stomas, fistulas and draining wounds. Can be used for patients with sensitive skin. Non-Pectin based. Item Flat 30/Box HCPCS:A4404

Order # CT2310 CT2315 CT2320 CT2325 CT2330 CT2340 CT2350

M

Size s" d" w" 1" 18" 1r" 2"

Coloplast Brava® Elastic Barrier Strips – Curved

Skin-friendly strips are used to “picture frame” around an ostomy barrier, providing extra security and peace of mind that the edges won’t roll up. For round or oval barriers.

M

Item 20 strips/box HCPCS: A4362

Order # CT120700

Size 5 ½ “ long

Coloplast Brava® Elastic Barrier Strips – Y-Shape

M

Skin-friendly strips are used to “picture frame” around an ostomy barrier, providing extra security and peace of mind that the edges won’t roll up. Extra-wide strips esigned for users with varying body shapes, e.g. hernias or skin folds. Item 30 strips/box HCPCS: A5121

Order # CT120721

Size 5 ¾” long

Coloplast Brava® Elastic Barrier Strips – Straight

Skin-friendly strips are used to “picture frame” around an ostomy barrier, providing extra security and peace of mind that the edges won’t roll up. For square or rectangular barrier shapes. Item 20 strips/box HCPCS: A4362

Order # CT120740

ConvaTec® Stomahesive® Strips

Size 5 ¼ ” long

Moldable, Standard Wear, two-sided adhesive strips. Item 15/Box HCPCS:A4362

172

M

M

Order # SQ25542

Reorder your supplies online at

www.mybyramhealthcare.com

Ostomy

ACCESSORIES

1-877-902-9726

SKIN BARRIER RINGS, SEALS & STRIPS Eakin Cohesive® Seals

Moldable, Extended Wear, pectin based rings protect stomas and fistulas of all sizes. Rings absorb moisture and act as a physical and waterproof barrier. Requires no cutting. Compatible with most ostomy devices.

M

Item 10/Box 20/Box HCPCS:A4385

Order # SQ839001 SQ839002

Size 4" 2"

Eakin Cohesive® Slims™ Seals

Moldable to fit all shape and size stomas. This hydrocolloid barrier forms a gel that helps prevent skin damage by sealing the area between the skin and ostomy appliance. Low profile for added comfort and discretion. Easy to remove for multiple pouch changes.

M

Item 10/Box HCPCS:A4385

Order # SQ839005

Size 2"

Eakin Cohesive® StomaWrap™

Unique wrap shape makes it quick and easy to fit on the stoma. Ideal for large or oval shaped stomas. Item 10/box HCPCS: A4385

Order # SQ839006

M

Size 3 1⁄3”

Fortis Entrust Conforming Adhesive Seal Skin Barrier Rings

Fortaguard is a patented process that utilizes sequestered hydrogen peroxide, a well-known antibacterial agent. Formulated to handle high, liquid output as well as thick, heavy output. It gently hugs the stoma and creates a seal that expands when exposed to moisture to fill the empty space between the appliance and the stoma that can create leaks. Because stoma size changes even throughout the day, the rings help maintain the seal for added security and user confidence. Specially created to be less sticky but tackier to create a good seal without unnecessary mess and residue on fingers or gloves. Three sizes to meet changing needs of ostomate.

M

Item 20/Box 2” 10/Box 4” HCPCS: A4385

M

Items marked with “M” are Medicare Reimbursable.

Order # FT6101F FT6101 FT6100F FT6100 FT6000F FT6000

Size 2” 2” 2” 2” 4” 4”

Type Standard with Fortaguard Standard Thin with Fortaguard Thin with Fortaguard

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

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ACCESSORIES SKIN BARRIER RINGS, SEALS & STRIPS Fortis Entrust Crescent Barrier Extension Strips

Fortaguard is a patented process that utilizes sequestered hydrogen peroxide, a well-known antibacterial agent. Specially designed to have a strong adhesive but still be gentle to the skin. Three strips placed around the barrier in place of tape to “picture frame” the appliance will give the users additional security and possibly less leaks. Those with hernias may find it helps keep the appliance in place better for longer wear time. Heat from the skin activates the hydrocolloid for an even, secure fit.

M

Item 30/Box HCPCS: A4362

Order # FT6200F FT6200

Type with Fortaguard

Hollister™ ADAPT™ Convex Skin Barrier Rings

Easy to use Extended Wear Convex Rings! Cut, bend, stretch and stack together to improve the fit of your barrier. Use on oval, flush, or irregular shaped stoma openings.

M

Item 10/Box HCPCS:A4411

Order # HO79520 HO79530 HO79540

Opening /16" 1 /16" 1 /16" 13

3 9

Hollister Adapt CeraRing with Flextend Skin Barrier Ring

Infused with ceramide – a natural component of the skin – Adapt CeraRing is designed to support healthy peristomal skin. Easy to use extended wear rings. Cut, bend, stretch and stack together to improve the fit of your barrier. Item 10/Box HCPCS: A4385

Order# HO8805 HO8815

Outside Diameter 2” 2”

M

Thickness 4.5mm 2.3mm

Hollister™ ADAPT™ Skin Barrier Rings

Flexible, Extended Wear skin barrier provides gentle adhesive attachment to the skin. Cut, bend, stretch and stack together to improve the fit of your barrier. Item 10/Box HCPCS:A4385

174

Order # HO7805N HO7806N

Outside Diameter 2" 4"

M

Ostomy

ACCESSORIES

1-877-902-9726

SKIN BARRIER RINGS, SEALS & STRIPS Hollister Adapt CeraRing Oval Convex with Flextend Skin Barrier Ring

Infused with ceramide – a natural component of the skin – Adapt CeraRing is designed to support healthy peristomal skin. Easy to use extended wear Oval Convex Rings. Cut, bend, stretch and stack together to improve the fit of your barrier. Use on oval, flush, or irregular shaped stoma openings.

M

Item 10/Box HCPCS: A4411

Order # HO89601 HO89602 HO89603

Outside Diameter 7⁄8” x 1 ½” 1 3⁄16” x 1 7⁄8” 1 ½” x 2 3⁄16”

Hollister Adapt CeraRing Convex with Flextend Skin Barrier Ring Infused with ceramide – a natural component of the skin – Adapt CeraRing is designed to support healthy peristomal skin. Easy to use extended wear convex rings. Cut, bend, stretch and stack together to improve the fit of your barrier. Use on oval, flush, or irregular shaped stoma openings. Item 10/Box HCPCS: A4411

Order # HO89520 HO89530 HO89540

M

Outside Diameter 13⁄16” 1 3⁄16” 1 9⁄16”

Hollister® Adapt™ Oval Convex Skin Barrier Rings

Easy to use extended wear Oval Convex Rings. Cut, bend, stretch and stack together to improve the fit of your barrier. Use on oval, flush, or irregular shaped stoma openings. Item 10/Box HCPCS: A4411

Order # HO79601 HO79602 HO79603

M

Size 7⁄8” x 1 ½ “ 1 3⁄16” x 1 7⁄8” 1 ½” x 2 3⁄16”

Hollister Adapt Barrier Extenders

Easily frames the skin barrier, and the thin, flexible hydrocolloid formulation helps conform to uneven body folds and contours. This may help increase wear time, by reducing barrier edge lifting and increasing the adhesive coverage area. These may be beneficial for users who require an additional layer of security.

M

Item 30/Box HCPCS: A4362

M

Items marked with “M” are Medicare Reimbursable.

Order # HO79402

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

175

Ostomy

ACCESSORIES SKIN BARRIER RINGS, SEALS & STRIPS Hollister™ Adapt™ Barrier Strips

Easy to use Extended Wear barrier strips! Cut, bend, stretch and stack together to improve the fit of your barrier. Item 10/Box HCPCS:A4385

M

Order # HO79400

Safe n Simple™ Conforming Skin Barrier Rings

Creates a secure and comfortable “turtleneck” seal around the stoma to protect the skin from leakage and irritation. This highly absorbent ring is easy to mold and stays stable during hydration. Item 10 /Box HCPCS: A4385

Order # SNS684U2 SNS684U4

Size 2” 4”

Safe n Simple™ Skin Barrier Arc

Use as a skin-friendly alternative to tape. Picture frame around the border of the barrier, providing additional security and increasing pouch wear time. Item 30/Tray HCPCS: A4362

M

Order # SNS20630 SNS21130

M

Size 1” 2”

Trio Siltac® - Silicone ostomy seal

Innovative use of soft silicone technology to produce an ostomy seal that allows the skin to breathe, stretches to shape and lightly hugs the stoma. Maintains integrity & shape to provide a good seal and could extend wear time of ostomy appliances.

M

Item Order# 10/Box TO102010 HCPCS: A4385 TO102810 TO103510

Stoma Size 20-28mm 28-35mm 35-44mm

Inner Diameter 18.0mm 25.2mm 31.5mm

Outer Diameter 50mm 58mm 65mm

Experience the Byram Difference

Byram offers reliable, accurate service nationwide to home care agencies, managed care organizations, healthcare professionals and the patient at home.

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Reorder your supplies online at

www.mybyramhealthcare.com

Ostomy

ACCESSORIES

1-877-902-9726

SKIN BARRIER RINGS, SEALS & STRIPS Trio Silvex® - Silicone Convex seal

Innovative use of soft silicone technology to produce a convex seal that allows the skin to breathe, stretches to shape and lightly hugs the stoma. Giving mild convexity, perfect to fill skin folds, Silvex® maintains integrity & shape to provide a good seal and extend wear time of ostomy appliances. Item Order# Stoma Size Inner Diameter 10/Box TO1020CX 20-28mm 18mm HCPCS: A4411 TO1030CX 30-40mm 27mm

M

Outer Diameter 50mm 65mm

Trio Silex® - Silicone Flange Extender

Advanced, soft silicone gel flange extender that provides instant, high-tack adhesion to skin. Can improve security & increase wear time, allowing greater freedom of body movement. Allows skin to breathe, reducing risk of maceration and removes in one piece leaving no residue.

M

Item 20/Box HCPCS: A4362

Order # TO1060

TAIL CLOSURES & CLAMPS Coloplast® Drainable Pouch Clamp

Simple-closure clamp for extra security with drainable pouches is especially helpful for those with limited dexterity. Item 20 units HCPCS:A4363

Order # CT9500

ConvaTec® Tail Closures Item 10/Box 10/Box HCPCS:A4363

Order # SQ175635 SQ175652

M Type Straight DuoLock™, Curved

Hollister™ Drainable Pouch Clamp For use with all Hollister™ pouches. Beige. Item Beige 20/Box HCPCS:A4363

M

Items marked with “M” are Medicare Reimbursable.

M

M

Order # HO8770

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

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Ostomy

ACCESSORIES URINARY DRAINAGE CONTAINERS & ACCESSORIES Coloplast Urostomy Night Drainage Bag

Includes a fixed connector that fits directly to a SenSura® or Assura® Urostomy Pouch. The bag holds up to 2 liters and has a 120cm long flexible tube which can be cut with scissors. Anti-reflux valve. Transparent. Item 10/Box HCPCS:A4357

Order # CT21365

M

Size 2 liters

ConvaTec® Night Drainage Container Set

Set contains: 1 Night Drainage Container with tubing, 1 Night Drainage Container Cover and 1 Universal Adapter. Item Each HCPCS:A5102

Order # SQ27060

ConvaTec® Night Drainage Container Tubing Extra night drainage container tubing. Item Each HCPCS:A4331

Order # SQ27062

Use with HO84xx, HO14xx, HO390x and HO890x urostomy pouches. Order # HO7331

Clinical CareMail

Have a question? Email one of our clinicians at [email protected]

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M

Size 5 Ft.

Hollister™ Urostomy Drain Tube Adapter Item 10/Box HCPCS:A4421

M

M

ACCESSORIES COLOPLAST CONVATEC

Safe Travels!

Do you have concerns about traveling with a disability or medical condition? The Transportation Security Administration (TSA) announced the launch of TSA Cares. TSA Cares is a helpline to assist travelers with disabilities and medical conditions. Travelers may call TSA Cares toll free at 1-855-787-2227 prior to traveling with questions about screening policies, procedures and what to expect at the security checkpoint. Helpline operates: Monday - Friday, 8 AM – 11 PM EST Weekends and Holidays, 9 AM – 8 PM EST

Visit us online: www.byramhealthcare.com ■

Wound Care

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Enteral Nutrition

©2017 Byram Healthcare Centers, Inc. All rights reserved. Printed in the United States.

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Breast Pumps

Supply Order Form Phone: 1-877-902-9726

Fax: 1-866-811-4500

For CA orders: Phone: 1-800-213-0890 Patient Information

Physician Information

Customer Name:

Dr. Name:

Ship-To Address:

Dr. Address:

City, State, Zip:

City, State, Zip:

Tel # Daytime: (

)

Dr. Tel #: (

Tel # Evening: (

)

Dr. Fax #: (

Fax: 1-800-238-9252

) )

DOB:

q M q F If you are a prescriber, please complete the following: Is patient being seen by a home health nurse? q Yes q No Prescriber Name: Patient Insurance Information

Secure Fax #:

q Medicare q Medicaid q Private Insurance Insurance Policy #:

q Checking this box attests the prescriber signature below corresponds to the prescriber name and NPI detailed above.

Group #: Insurance Tel #: (

NPI:

)

Prescriber Signature:

Patient Secondary Insurance Information (if applicable)

Payment Method (if ordering non-covered items)

Insurance Policy #:

q Check or money order, payable to Byram Healthcare

Group #:

q MasterCard q VISA q AMEX q Discover

Insurance Tel #: (

)

Card #: Exp Date (mm/dd/yr):

Signature: I need to order (check all that apply): q Diabetes Supplies q Ostomy Supplies q Urology Supplies q Incontinence Supplies

Product Number

Product Description

*Medicare allows a 90 day order for many supplies.

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q Wound Care Supplies q Enteral Supplies

Quantity

Byram Healthcare Keep in Clinical touch Support Services

with Byram Healthcare!

We provide ongoing clinical and product support for all of our customers.

We're here for you!

Wound, Ostomy and Continence Clinical CareLine & Clinical CareMail 1-877-902-9726 ext. 43312

[email protected] The Clinical CareLine is designed to support the needs of our ostomy, wound and continence patients, new referrals and healthcare professionals. Our CareLine WOCN is a great resource for anyone with clinical questions or concerns that come up post discharge or between regular visits to the physician or hospital WOCN. Byram patients are able to call or email questions. Simply leave a message by phone or email, and we will respond to your question within 24 hours.

Latino Program 1-866-302-4295 Option 6 In an effort to improve access to services for the Latino population, Byram provides the option of communicating in Spanish through our dedicated Latino Customer Service Team and on our CareLine. Culturallyrelevant programs and literature are available for our Spanish speaking customers.

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Urology

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Ostomy

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Enteral Nutrition

Ostomy Notes: _____________________________________________ _____________________________________________ _____________________________________________ _____________________________________________ _____________________________________________ _____________________________________________ _____________________________________________ _____________________________________________ _____________________________________________ _____________________________________________ _____________________________________________ _____________________________________________ _____________________________________________ _____________________________________________ _____________________________________________ _____________________________________________ _____________________________________________ _____________________________________________ _____________________________________________ _____________________________________________ _____________________________________________

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Reorder your supplies online at

www.mybyramhealthcare.com

1-877-902-9726

Continuing Education Programs Byram Healthcare provides clinical education programs to support ongoing needs for healthcare professionals. Our educational courses consist of 1-hour of continuing education credit. Programs are geared towards nurses, WOCNs, CDEs, case managers, social workers*, and dietitians. Hi-R-Ed Online, an accredited provider of continuing education, developed these courses for Byram Healthcare. Ask your local sales representative about our monthly webinar.

*in most states

M

Items marked with “M” are Medicare Reimbursable.

Byram is a Medicare participating provider.

You are only responsible for any annual deductible, co-payment, or items not covered by Medicare, which Byram will bill to your Medicare Supplemental Insurance. Please see page 2 for additional information.

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COLOPLAST

Center of Excellence Benefits

Byram Healthcare provides focused care you can trust. Our ostomy center of excellence build on our existing high levels of customer care. Our centers of excellence offer extended hours of service and focused customer attention for all of your ostomy supply needs. We know you will enjoy this expanded service. • Dedicated customer service specialists highly trained in ostomy care patient support • Customer relationship management tools for advanced attention on improved health outcomes • Knowledgeable and friendly communication of insurance benefit coverage • Product expertise • Bilingual services Call today! 1-800-308-9445

FOUR EASY WAYS TO ORDER: 1.

CALL Byram Healthcare:

1-877-902-9726

Monday - Friday, 8:30 AM to 7:00 PM Local Time Saturday, 9:00 AM to 1:00 PM Local Time

2.

ONLINE – Reorder your supplies at:

www.mybyramhealthcare.com 24 hours a day, 7 days a week

3.

FAX us your order:

4.

MAIL your order form:

1-866-811-4500 Byram Healthcare Centers, Inc. Attention: Customer Service 3010 Woodcreek Drive - Suite A Downers Grove, IL 60515

Please be sure to indicate your method of payment, if applicable, and your daytime phone number.

Order by phone: 1-877-902-9726 Order by fax: 1-866-811-4500

Referral number: __________________ Visit us online: www.byramhealthcare.com ■

Wound Care

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Diabetes

■

Urology

■

Ostomy

■

Incontinence

■

Enteral Nutrition

©2017 Byram Healthcare Centers, Inc. All rights reserved. Printed in the United States.

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Breast Pumps