Quickie P-11 Manual do Utilizador descarregar pdf (Página 3)

D D

The

HCPCS CODES

provided are based on code verification through PDAC or our interpretation of the code definitions.

The use of

HCPCS CODES

does not ensure coverage or payment. For coverage information, verify the appropriate payer's coverage policy.

Price

Definition

HCPCS

Option #

HCPCS

Price

Definition







105B88

105B95

N/C

(Not avail. on Pwr Recline or Tilt

& Recline)

15" - 16"

17" - 18"

19" - 20"

N/C

105B97

105JC02

See JAY OF

E2607

See JAY OF



105JC01

E2601

E2602



105JC11

E2607

E2609

Jay UNION

Jay Basic See JAY OF



105JC10

E2607

E2608

Jay ION See JAY OF



105JC08 Jay ZIP



105JC09

E2603

E2604

Jay GO

E2607 Jay Easy See JAY OF



105JC03

E2605

E2606

Jay Soft Combi P

105JC07

E2622

E2623

Jay J3 See JAY OF

E2622

E2623

Jay J2 Deep Contour See JAY OF



See JAY OF

105JC04

E2622

E2623

Jay J2 See JAY OF

Jay 3 Option

105JB01 -

Jay J3

(select OMIT Backrest above)

See J3 OF

21" - 22"

N/C

Back Height

105B100

105KE19 E0956 Lateral Pad Asymmetric

$190.00

Jay Solid Backrest (select back height)

N/C

21"-29" Only available on Reclining and Tilt and Recline Systems.When selecting 21"-29

with the Smart Seat only there will be a 7" gap btwn the seat pan & the bottom of the

backrest pad when the shear adj. is fully extended. This provides room for the shear

compensation to operate.

105B113 27" - 28"

N/C

105B99

23" - 24"

N/C

Only available on Reclining and Tilt and Recline Systems

25" - 26"

105PN1

105B112

105B114

Power Recline Back Preset Home Angle

N/C

Seat Pan Aluminum

95° 105QK2

105AM17

29"

N/C

Reclining Arm Pad (16")

105PN2

N/C

90° 105QK1

($45.00)

100° 105QK3

E0973

Reclining Height Adjustable ( Only

available on Reclining and Tilt and Recline

Systems. )

6. SEAT CUSHIONS

105CU1 2" Cushion. $95.00



Full Length Standard (14") (not avail. on

Reclining Height Adjustable Armrest)

N/C

105OB02

N/C

105AM8



105AA60

7. ARMREST

N/C

Otto Bock Lg forearm pads (13")

105AM19 K0106

To be used with Otto Bock Forearm Pads. Only available on Reclining and Tilt and

Recline Systems.

N/C

$240.00

Large Flat Hand Pads (5-1/2"x 9")

Medium Flat Hand Pads (4-1/2"x 7")

E2209

$105.00

N/C

Desk Length Standard (10") (not avail. on

Reclining Height Adjustable Armrest)



105AM2

N/C

105AM1

105AM7

N/C

Full Length Waterfall (14") (not avail. on

Reclining Height Adjustable Armrest)

105AA61

105JC05

105BU14

105AA8

105AA60

Single Post Height Adjustable

Std Height (9" - 12")



Lateral Pad Asymmetric Swing Away

Omit Jay Solid Backrest (This option

should be selected only when using a Jay

3 or other aftermarket backrests in

combination with tilt seating.)

(15.00)

$340.00

Omit Armrests

Desk Length Waterfall (10") (not avail. on

Reclining Height Adjustable Armrest)

Tall Height (11" - 14")

105AM18

Otto Bock Hand Pads (Pair)

Armpads - Reclining (Pair)

105OB01

Omit Seat Pan (not avail. w/Recline Seat)

$240.00

E2209

$105.00

$190.00

E0956

$340.00

$345.00

Jay Precision Back Tall w/ Laterals

E0956

E1028

Jay Precision Back Tall omit Laterals

Lateral Pad Symmetric

Lateral Pad Symmetric Swing Away (Not

avail. w/ push handles and backrest or

Back pad.)

105BU42

E0956

E1028

105KE20

$250.00

E0973

Dual Post Flip Back

See JAY OF



$260.00

K0106

Otto Bock Med forearm pads (11")

N/C

Dual Post Flip Back Height Adj.

Back Type

105BU27 Parapak Upholstery (select back height)

N/C



105BU35 E0956

105KE21

105BU26 K0669

105KE22

105AA14

Armrest (Pair)

105AA30

105AA40 E0973

$345.00

Seat Type

5. BACK

Armpads - Non Reclining (Pair)



ORDERING INFORMATION PHONE: (800) 236-4215, FAX: (602) 279-0952, WEBSITE: www.southwestmedical.com

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