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Brava Protective Sheet

Brand: Coloplast
Category: Accessories › Barrier extenders
System: Not found in our sources
Pouch type: Not found in our sources
Barrier type: Not found in our sources
Opening: Not found in our sources
Filter: Not found in our sources
Box quantity: 5, 10
Flange sizes: Not found in our sources
HCPCS code(s): A4362, A5121, A5122 (Coloplast product page (variant name))
Lowest cash price seen: From $21.14 / Box of 10 ($2.11 each)
Vitality Medical, Nov 4, 2026
Source: products.coloplast.us · checked Nov 4, 2026

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Sizes, codes and prices

Prices are cash prices one retailer listed on the date shown, per the retailer's unit. Retailer links are marked as sponsored for search engines and may become affiliate links later. We do not take referral fees from suppliers that bill Medicare. The retailer page says the manufacturer labels this item Rx only.

Code	Description / size	Box	HCPCS	Price seen
`32105`	Protective sheet - 10x10cm \| 4 x 4in	10 per box	A4362	$2.21 / Each Vitality Medical · Nov 4, 2026$21.14 / Box of 10 Vitality Medical · Nov 4, 2026
`32155`	Protective sheet - 15x15cm \| 6 x 6in	5 per box	A5121	$40.41 / Box of 5 Vitality Medical · Nov 4, 2026
`32205`	Protective sheet - 20x20cm \| 8 x 8in	5 per box	A5122	$64.96 / Box of 5 Vitality Medical · Nov 4, 2026

Medicare usual maximums for these codes

A4362: Skin barrier; solid, 4 x 4 or equivalent; each. Usual maximum in LCD L33828: 20 per month.
A5121: Skin barrier; solid, 6 x 6 or equivalent, each. Usual maximum in LCD L33828: 20 per month.
A5122: Skin barrier; solid, 8 x 8 or equivalent, each. Usual maximum in LCD L33828: 20 per month.

From our Medicare guide (LCD L33828). Informational only; coverage depends on your plan and documentation. Confirm with your supplier or plan.