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D
D
Base Package
VR-2 90A Drive Control (non-expand)
300 lb 6 mph 4-pole Motor Package
ASAP II Seat Frame
13" Drive Wheels (flat free insert N/C)
Fig 1.1 Pulse™ 6 BC
Pulse™ 6 BC SEAT ONLY w/o elect.
For use to add/replace seating when
additional electronics are not required.
195NB83
195PC74
K0848
K0011
K0848
Pulse™ 6 BC SEAT ONLY w/ elec.
For use to add/replace seating when
additional electronics are required.
-
195EQ11
-
8A Dual Mode Charger (Compact) CTE
Pulse™ 6 BC BASE ONLY
For use with Aftermarket Seat frame.
1. QUICKIE Pulse™ 6 GROUP 3 CATEGORY (Select One
)
QUICKIE Pulse™ 6 BC (Group 3 K0848/K0011)
$5,765.00
Quickie Pulse™ 6 BC w/ASAPII Seat (Fig 1.1)
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 with the appropriate payer's coverage policy.
Option # HCPCS Definition Price Option # HCPCS Definition Price
Buyer:
City,State,Zip:
Marked For:
Phone:
Ship To:
Date:
Name:
Account:
PO#:
Address:
Quickie Pulse™ 6 Group 3
(K0848, K0849, K0856
)
EIPW22, November 2012
$5,765.00
195EQ08
$750.00
$750.00
ORDERING INFORMATION PHONE: (800) 236-4215, FAX: (602) 279-0952, WEBSITE: www.southwestmedical.com
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Shrnutí obsahu

Strany 1 - Quickie Pulse™ 6 Group 3

DDBase PackageVR-2 90A Drive Control (non-expand)300 lb 6 mph 4-pole Motor PackageASAP II Seat Frame 13" Drive Wheels (flat free insert N/C)Fig

Strany 2 - STFH Matrix

  0°3° NA with +3" or +4" STFH or lift6° NA with +3" or +4" STFH or Lift/Tilt +3" STFH NA with Capt Seat

Strany 3 - 4. ELECTRONICS

Quickie Sip n' Puff System195ID34195II01195IJ01195IH1ASL Head Array Package (Adult)195II02195IJ01ASL Head Array Package (Ped)195II03195IJ0

Strany 4 - Seat Depth

Adjustable 12x12 to 16X19 ( A )Adjustable 16x12 to 20x20 ( B )Adjustable 18x16 to 22x22 ( C )A = ASAP II Seat Frame Adjustable from 12x12 to 16X19

Strany 5

- Switch Mount Right- Switch Mount Left 195BP40    E0955 Plush Head Support Pad 8" E0955 Plush Head Support Pad

Strany 6 - Arm Pad Options for ASAPII

   Arm Pad Options for ASAPII $230.00Single Post Height Adjustable - Std.195EG05$230.00195EG07 E0973$230.00Low

Strany 7 - 14. ACCESSORIE

  ABCDEFHXXX XXX X XXXXXXXXXX     Centermount Pwr ELR w/ Articulation (F,H)$2,200.0013. HANGERS AND FOOTRES

Strany 8 - (must be same as Base Width)

 14 16 17 18 19 20  3  5  1  1.5  2 14.5 16 17 18 19 20  3.5  5  1  1.5  2 15 16 17 18 19 20  4  5  1  1.5  2 15.

Strany 9 - Not Available Not Available

ART SPO CUSTOM CURVED BACKRESTPosterior Positioning Backrest (E2617)EIPW22 - Effective November 20122. Back Relief 17.51617181920 4 3 4 5 6

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