Zippie ZM-310 Group 3

Transcription

1 Zippie ZM310 Grup 3 K0848, K0856 EIPW22, January 2019 Accunt: Date: PO#: Buyer: Marked Fr: Ship T: Name: Address: City,State,Zip: Phne: a Optin # The HCPCS CODES prvided are based n cde verificatin thrugh PDAC r ur interpretatin f the cde definitins. The use f HCPCS CODES des nt ensure cverage r payment. Fr cverage infrmatin, verify with the apprpriate payer's cverage plicy. HCPCS Definitin Price a Optin # HCPCS Definitin Price 1. Zippie ZM310 GROUP 3 CATEGORY (Select One) Zippie ZM310 BC (Grup 3 K0848/K0011) Zippie ZM310 BC w/ ASAPII Seat $7, Zippie ZM310 SC (Grup 3 K0856/K0011) Zippie ZM310 SC fr SPOT Tilt $7, PC106 K0848 K0011 Base Package $7, PC107 K0856 K0011 Base Package $7, BC Seating Specificatins SC Seating Specificatins HCPC Cde K0848/ K0011 HCPC Cde K0856 / K0011 Typical Chair Weight W/ battery 235 lbs. W/O Battery 157 lbs. Typical Chair Weight W/ battery 260 lbs. W/O Battery 182 lbs. Transit WC19 w/ptinal crash tested belt Transit WC19 w/ptinal crash tested belt Seat Type ASAP II / Optinal Manual tilt and/r Manual Recline Seat Type ASAP II / Optinal Manual Recline Seat size range Width 10" 16" Depth 10" 19" Seat size range Width 10" 16" Depth 10" 19" STFH range 15.5" 21.6" STFH range 17.6" 21.8" Pwer Seating 9" Seat elevatr Pwer Seating 50º CG tilt / ptinal 12" seat elevatr Zippie ZM310 Base Specificatins Drive Wheel Psitin Midwheel Drive Drive Wheels 13" Drive Wheels w/ flat free insert (Black) User weight Cap 165 lbs. Tires/Casters 7" Frnt / 6" rear (Black) Base size Width 24" Length 34" Turn Radius 18" Charger 8A Dual Mde Charger (Cmpact) CTE Drive Cntrl VR2 90A (nnexpand) Rnet EL90 (Expandable) Battery Size Grup 22 Driving Range Up t 13.5 miles Shrud Clrs 12 standard clrs, 3 upgrade prints Drive Mtrs 4ple 6 mph Grund Clearance 3" Sunrise Medical 2842 Business Park Ave. Custmer Service: Fax: rders@sunmed.cm Web: 1/2019 MK REV K Page 1

2 2. BASE CHAIR OPTIONS 195EZ11 Candy Purple 195FA EZ12 Matte Black 195FA3 3 N/A with +3" r +4" STFH r Lift 195EZ13 Midnight Blue 195FA4 6 N/A with +3" r +4" STFH r Lift/Tilt Shrud Clr 195EZ01 195EZ02 195EZ03 Candy Blue 195EZ04 195EZ08 195EZ17 195EZ18 195EZ16 Drive wheel/tire package 195DW60 Candy Apple Red 195EZ05 Cpper Pearl White Grunge Skulls $ American Flag $ High Glss Black 195EZ09 Yellw 195EZ10 Pearl Pink 195EZ15 Silver Green Apple Cast Wheel Slid Dual Density Inserts Black Knbby Tires and Black Casters Pink Cam $ Transit Optin (Required) 195WN03 WC19 Transit Lap Belt 195WN02 PreSet Seat Frame Angle Seat Height WC19 Transit Package (rder belt separately belw) WC19 Transit Lap Belt (Measured in the frnt) Obtain Qute t verify est. STFH 195HT44 195HT45 195HT46 Lwest STFH +1" Seat t Flr Height +2" Seat t Flr Height 195HT47 +3" STFH 195HT48 +4" STFH $ Mtr Package 195PF lbs. 6mph 4Ple Std User weight 195WG17 195WG18 195WG19 195WG lbs. Ventilatr Optins < 75 lbs. Nt available w/ Transit lbs lbs. 195VT4 195VT9 E1029 E1029 Fixed Vent Tray (Pulmnetic LTV Mdels) Lift ff Vent Tray (Pulmnetic LTV Mdels) $ $ STFH Matrix Seating Type and Pwer Optin Cmbinatins 0 SeattFlr Height at 0 tilt +1" +2" +3" +4" BC ASAP II N pwer seating* *Fr seat widths 12"16" add.5" BC ASAP II 9" Lift nly BC ASAP II Manual Tilt SC ASAP II Tilt nly SC ASAP II Tilt and 12" Lift cmb BATTERIES and CHARGERS Batteries Battery Charger 195AG21 E2361 GP22 Flat Tp Batteries Pair w/ strap $ BJ19 8A Dual Mde Charger (Cmpact) CTE 195AG05 Omit batteries (Includes harness) Sunrise Medical 2842 Business Park Ave. Custmer Service: Fax: rders@sunmed.cm Web: 1/2019 MK REV K Page 2

3 4. ELECTRONICS Drive Cntrl Optins NnExpandable Cntrllers 195ER02 RNet Expandable Drive Cntrl Upgrade (90A) Nnexpandable VR290 cntrller 195ER01 (N/A with High Speed Mtr package) 195EX01 195EX02 E2377 E2313 VR2 Jystick (nnexpandable) 195J94 Expandable Cntrllers Nn Expandable VR2 Jystick $ Expandable Cntrller Rnet $ Harnessing fr Expandable Cntrller $ Rnet OMNI and Output Optins 195ON1 195ON2 OMNI Munt (Fr expandable cntrls, chse all that apply) Rnet OMNI Input Cntrl Mdule and display with built in Infrared and armrest munt. Chse munt belw (required fr Specialty Input Devices) Rnet Output Mdule (ECM) (If used with Jystick must be munted ppsite side) $1, $1, DS04 Swing Away Left Side OMNI Munt $ ***Rnet Jystick 195J70 Std LED Jystick fr Rnet Ctrls 195J108 CJSM1: Jystick Standard: w/ Stere Jacks & Clr Display 195DS03 Swing Away Right Side OMNI Munt $ J114 CJSM2: Jystick Advanced: 3.5" Clr Display, Paddle Switches, Shrtcut Keys, IR, BT, and Stere Jack $1, J95 Omit JS. (Fr use with OMNI) *Jystick Munt (Fixed, Swing Away, Retractable, Mid) 195JM10 195JM11 195JM15 195JM14 Fixed Munt Swing Away Munt Retractable Jystick munt w/ 45º stps Mid Line Munt $ $ $ Switch inputs fr RNet Jysticks r OMNI Jystick Munt (Lcatin) Drive r Mde / Prfile Cntrl Height Adjustable. 195SW22 Stere t 2 Mn Splitter $ HM1 Right Side Munt 195SW1 Buddy Buttn Switch $ HM2 Left Side Munt 195SW4 195SW24 Micr Light Switch Egg SwitchBlack $80.00 $ Jystick Handle (Optinal) 195SW21 Dual tggle switch and bracket $ JH1 E2323 Ball Handle $ SW35 SwitchIt Mini 1 buttn n Mn plug $ JH2 E2323 Fam Ball Handle $ SW36 SwitchIt Mini 2 buttn n 2 Mn plugs $ JH4 E2323 THandle $ SW37 SwitchIt Mini 2 buttn n 1 Stere plug $ JH6 E2323 Galpst $ SW38 SwitchIt Mini 4 buttn n DB9 cnnectr $ Attendant Cntrl 1950A A02 E2331 E2331 Attendant Cntrl fr VR2 Attendant Cntrl fr Rnet $1, $1, Single Switch Munt Bracket 195EM01 Single Switch Munt Bracket $ Attendant Munting lcatin Electrnic Prgrammers 195DN1 Munting lcatin: Right Back Cane 195PR2 VR2 Hand Held Prgrammer $ DN2 Munting Lcatin: Left Back Cane 195PR5 Rnet PC Prgrammer with Dngle $ Sunrise Medical 2842 Business Park Ave. Custmer Service: Fax: rders@sunmed.cm Web: 1/2019 MK REV K Page 3

4 5. Specialty Driver Cntrl Optins Requires expandable Rnet cntrls and OMNI unless therwise nted. N/A with Uphlstered backs. 5a. Prprtinal Cntrl Packages Head Cntrl Prprtinal Packages Chin Cntrl Prprtinal Jystick Packages SwitchIt Dual Pr Prprtinal Head Cntrl with Whitmyer and Facial Pads (Adult) $5, SwitchIt VersaGuide Chin Cntrl Cmpact Jystick and Egg Switch Package $2, ID72 E2328 SwitchIt Dual Pr Head Cntrl w/ facial pad (Adult) $5, SwitchIt VersaGuide Cmpact Prprtinal Jystick 195IJ09 S/A Bm Munt with Egg Switch Cntrl $ IM07 S/A Munt ff backrest $ SwitchIt Dual Pr Prprtinal Head Cntrl with Spt Pads Package 195ID70 E2328 SwitchIt Dual Pr Head Cntrl w/ Spt pads $5, $5, IJ09 S/A Bm Munt with Egg Switch Cntrl $ IJ04 S/A Bm Munt with egg switch $ SwitchIt VersaGuide Chin Cntrl Cmpact Jystick and Prximity Flex Switches Package SwitchIt VersaGuide Cmpact Prprtinal Jystick $2, Hand Cntrl Prprtinal Jystick Packages 195IM08 Dual Flex Prximity Switches (requires n frce) $ SwitchIt VersaGuide Cmpact Jystick Midline with Gatlin Package SwitchIt VersaGuide Cmpact Prprtinal Jystick $1, IJ07 S/A Gatlin Munt $ IM07 SwitchIt VersaGuide Bib Chin Cntrl Cmpact Jystick with Prximity Flex switches Package Std 6" S/A Munt ff backrest SwitchIt VersaGuide Cmpact Prprtinal Jystick $ $2, SwitchIt VersaGuide Cmpact Jystick Midline and prx flex switches with Gatlin Package $2, IM08 Dual Flex Prximity Switches (requires n frce) $ IM08 195IJ07 SwitchIt VersaGuide Cmpact Prprtinal Jystick Dual Flex Prximity Switches (requires n frce) S/A Gatlin Munt $ $ IM05 Bib munt Small $ SwitchIt VersaGuide Bib Chin Cntrl Cmpact Jystick with Prximity Flex Switches Package Large 8" SwitchIt VersaGuide Cmpact Prprtinal Jystick $2, SwitchIt MicrPilt Jystick with SpaceDisc Package $3, IM08 Dual Flex Prximity Switches (requires n frce) $ ID62 E2312 MicrPilt Prprtinal Jystick $2, IM06 Bib munt Large $ IJ08 S/A SpaceDisc munt $ SwitchIt MicrGuide Jystick with SpaceDisc Package 195ID63 $3, E2312 MicrGuide Prprtinal Jystick $2, SwitchIt VersaGuide Bib Chin Cntrl Cmpact Jystick with Egg Switch Package Std 6" SwitchIt VersaGuide Cmpact Prprtinal Jystick $2, IJ08 S/A SpaceDisc munt $ IM05 Bib munt Small $ IJ04 SA Bm Munt with egg switch $ SwitchIt VersaGuide Bib Chin Cntrl Cmpact Jystick with Egg Switch Package Large 8" $2, SwitchIt VersaGuide Cmpact Prprtinal Jystick 195IM06 195IJ04 Bib munt Large $ SA Bm Munt with egg switch $ SwitchIt MicrPilt Bib Chin Cntrl with Egg Switch Package Std 6" $3, ID62 E2312 MicrPilt Prprtinal Jystick $2, IM05 Bib munt Small $ IJ04 S/A Bm Munt with egg switch $ SwitchIt MicrPilt Bib Chin Cntrl with Egg Switch Package Large 8" $3, ID62 E2312 MicrPilt Prprtinal Jystick $2, IM06 Bib munt Large $ IJ04 S/A Bm Munt with egg switch $ SwitchIt MicrGuide Bib Chin Cntrl with Egg Switch Package Std 6" $3, ID63 E2312 MicrGuide Prprtinal Jystick $2, IM05 Bib munt Small $ IJ04 S/A Bm Munt with egg switch $ SwitchIt MicrGuide Bib Chin Cntrl with Egg Switch Package Large 8" $3, ID63 E2312 MicrGuide Prprtinal Jystick $2, IM06 Bib munt Large $ IJ04 S/A Bm Munt with egg switch $ Sunrise Medical 2842 Business Park Ave. Custmer Service: Fax: rders@sunmed.cm Web: 1/2019 MK REV K Page 4

5 5. Specialty Driver Cntrl Optins (cnt.) 5b. Switch Cntrl Requires Headrest and/r Headrest Munt 3 Switch Prximity Head Arrays Chse headrest munt belw SipNPuff Package Chse headrest and HR munt belw SwitchIt Head Array Package 3 Switch Curved (Lng) $4, Quickie Sip n' Puff System $2, II13 E2330 SwitchIt Prximity Head Array Lng $4, ID34 E2325 SipNPuff Kit $1, IJ09 S/A Bm Munt with Egg Switch Cntrl $ IH1 E2326 SipNPuff Tubing and SA Hardware $ SwitchIt Head Array Package 3 switch curved (Stubby) $4, IJ10 S/A Bm Munt with egg switch $ II14 E2330 SwitchIt Prximity Head Array Stubby $4, IJ09 S/A Bm Munt with Egg Switch Cntrl $ Headrest Munt fr Specialty Cntrls 195MH12 Axys Munt & Bracket fr Specialty Cntrls 195MH13 Cbra Munt & Bracket fr Specialty Cntrls $ MH14 Linx Munt & Bracket fr Specialty Cntrls 5 Switch Prximity Head Array (N Egg Switch Needed) Chse "Headrest Munt fr Special Cntrls" 195II04 E2330 Multiple Switches 195SW31 195SW32 195SW33 195SW23 SwitchIt Head Array 5 switch flat SwitchIt 3 Naked prximity switches n DB9 cnnectr (requires OMNI) SwitchIt 4 Naked prximity switches n DB9 cnnectr (requires OMNI) SwitchIt 5 Naked prximity switches n DB9 cnnectr (requires OMNI) 4way tggle switch buttn DB9 Cnnectr. Includes bracket $4, $2, $3, $3, $ Headrest Pad fr Specialty cntrls 195HE79 195HE80 195HE81 E0955 E0955 E0955 Plush Pad 8" fr Specialty cntrls Plush Pad 10" fr Specialty cntrls Plush Pad 14" fr Specialty cntrls Extra Swing Away Head Bm Egg Switch and Munt 195IJ05 Extra SA Bm Munt with egg switch #1 $ IJ06 Extra SA Bm Munt with egg switch #2 $ Single Switches 195IB01 Ribbn Switch $ IB02 Buddy Buttn Switch $ IB03 Disc Switch $ IB04 Wbble Switch $ IB05 Micr Light Switch $ IB06 Egg SwitchBlack $ IB07 SwitchIt Mini 1 buttn n Mn plug $ Sunrise Medical 2842 Business Park Ave. Custmer Service: Fax: rders@sunmed.cm Web: 1/2019 MK REV K Page 5

6 6. SEAT TYPE 195ST56 A.S.A.P II (Adjustable Seating and Psitining) Chse Seat Frame Size Platfrm ASAP II Frame size (each frame is width and depth adjustable within given range) 195FU16 Adjustable 10x10 t 13x16 ( Z ) 195FU17 Adjustable 12x12 t 16X19 ( A ) 7. SEAT SIZE Z = ASAP II Seat Frame Adjustable frm 10x10 t 13x16 Seat Size Matrix. Seat type is chsen in sectin 6 A = ASAP II Seat Frame Adjustable frm 12x12 t 16X19 Seat Depth ASAPII Seat Width Z Z Z Z 11 Z Z Z Z 12 Z Z Z,A Z,A A A A 13 Z Z Z,A Z,A A A A 14 Z Z Z,A Z,A A A A 15 Z Z Z,A Z,A A A A 16 Z Z Z,A Z,A A A A 17 A A A A A 18 A A A A A 19 A A A A A Seat Width Seat Depth 195R45 10" Seat width 195RF40 10" Seat depth 195R46 11" Seat width 195RF41 11" Seat depth 195R21 12" Seat width 195RF20 12" Seat depth 195R22 13" Seat width 195RF21 13" Seat depth 195R23 14" Seat width 195RF22 14" Seat depth 195R24 15" Seat width 195RF23 15" Seat depth 195R5 16" Seat width 195RF5 16" Seat depth 195RF6 17" Seat depth 195RF7 18" Seat depth 195RF8 19" Seat depth 8. SEAT CUSHIONS JAY / Zip Cushins (Optinal) T rder any JAY / Zip cushins nchair, please see the JAY/Zip price list. Cushin name r part number must be filled ut w/ desired width & depth JAY / Zip Bundled Cushin 195JC20 Cushin Name r Part # Price List Width: Depth: Sunrise Medical 2842 Business Park Ave. Custmer Service: Fax: rders@sunmed.cm Web: 1/2019 MK REV K Page 6

7 9. SEATING SYSTEMS NnPwered Seating 195PJ8 Manual Tilt 45 CG Tilt Must be rdered with Strller handle N/A with height adjustable back cane $ Pwered Seat Elevatr (AKA: Pwer Lift) 195PA8 195PA15 E2300 E2300 Pwer Seat Elevate (9") Pwer Seat Elevate fr use with tilt (12") (Must be rdered with SPOT tilt) $2, $2, Pwer Seating Optins (SC Mdels) 195PJ2 E1002 SPOT 50 CG Tilt $4, Pwer Seating Cntrl Pwered Seating Switch Cntrl Methd Fr use with pwer seating actuatrs. Switch activatin is standalne and des nt require expandable r thrudrive electrnics 195EO10 Single Actuatr Switch Cntrl (Lift r Tilt) Switch Cntrl 1 actuatr with Dual Tggle Pwered Seating Thrudrive Cntrl Methd ThruDrive 1 r 2 Actuatr 195EO26 E2310 ThruDrive 1 r 2 Actuatr(s) Fr perating Tilt and/r Lift thru Jystick. Includes Ctrl+5 when rdered with Expandable Cntrls (Rnet) $1, EO11 195EO19 Switch Cntrl 1 actuatr with Buddy Buttn Switch Cntrl 1 actuatr with SwitchIt Mini 1 buttn Pwered Seating Thrudrive Cntrl Optins Only available with Expandable Cntrls (Rnet) Assignable Buttns 195EO20 Switch Cntrl 1 actuatr with SwitchIt Mini 2 buttn 23 Actuatr Switch Cntrl (Lift and Tilt) "Assignable Buttn" feature allws fr custmizatin f jystick buttns and/r Ctrl+5 Switches allwing access t varius wheelchair and seating functins. When enabled, chair will be preprgrammed with seating functins assigned t buttns n the jystick. Assignments can be changed via PC Dngle 195PM01 Enable Assignable buttns 195EO21 Switch Cntrl 23 actuatr with Dual Tggle $ Ctrl+5 Switchbx Optins 195EO12 Switch Cntrl 23 actuatr with 4way tggle $ Ctrl+5 allws direct cntrl t 5 pwer seating functins (10 ttal switches). Switches can als be used with assignable buttns fr greater flexibility. Bx includes 3Amp USB prt fr charging prtable devices 195EO23 195EO22 Switch Cntrl 23 actuatr with SwitchIt Mini 2 buttn $ QG01 Ctrl+5 Switchbx munted behind jystick 195QG02 Ctrl+5 Switchbx munted ppsite jystick Switch Cntrl 23 actuatr with 195QG03 Ctrl+5 Switchbx munted n back cane $ SwitchIt Mini 4 buttn 195QG05 Omit Ctrl+5 ($500.00) Switch Munt (fr use with switch cntrl pwered seating) Ctrl+5 Switch Type 195EY01 Switch Munt Right 195EY03 Push buttns 195EY02 Switch Munt Left 195EY04 Tggle switches $ Sunrise Medical 2842 Business Park Ave. Custmer Service: Fax: rders@sunmed.cm Web: 1/2019 MK REV K Page 7

8 10. BACKREST AND BACK OPTIONS FOR ASAP II SEAT Backrest Frame Type Back Type (Slid) 195BT8 195BT98 E1225 Angle Adjustable Manual Recline 40 (nt width adjust.) $ BU86 S.P.O.T. Curved back with rail fr munting laterals Manual Recline Adjustment Methd Optin 195BU87 E2613 JAY SPO Psterir (Curved back with T Fam inserts and munting rails) $ Back Cane Height 23". Fits all seat types. N/A with Cantilever Arms 195BU14 Omit Backrest ($15.00) 195MN01 Tl 195MN02 Knb (N/A with dual pst arms) 195B118 12" 195BP40 Straight Back Pst 195B132 14" Angle Adjustable Backrest Optins 195OD8 195OD9 Cane Angle 195BP41 Cane Adjustable height 195B1 195B5 195B9 195B243 (N/A with Manual recline) NnFlding Backrest Flding Backrest 8 Bend Back Pst (Avail. nly n Zip r J3 Back) N/A with Manual recline Fixed Lw (15.5") Fixed Med (17.5") Fixed Tall (19.5") Adjustable Lw 14" 18" 195B244 Adjustable High 20" 26" $ $ $ $ JAY J3 / ZIP Optin 195JB01 See J3 OF JAY J3 / Zip (select OMIT abve) Back Height Required fr SPOT Curved and SPO Backs (Limited cmbinatins f widths) Measured frm pan t tp f slid back 195B36 16" 195B38 18" 195B40 20" Available n 10" 16" wide seats Available n 12" 16" wide seats Push Handle Optins Strller Handle: Single height adjustable Bar 195PH14 Push Handle with 2 utility hks. Required with Manual Tilt (N/A with adjustable height cane) See J3 OF $55.00 Twel Bar Depth 195QT03 195QT04 Shallw Deep (Ext. 4" frm back canes fr deep backs) Sunrise Medical 2842 Business Park Ave. Custmer Service: Fax: rders@sunmed.cm Web: 1/2019 MK REV K Page 8

9 11. HEADREST OPTIONS Chse One Each Whitmyer Headrest Munt Whitmyer Headrest Pad 195MH10 Axys Munt & Bracket 195HE65 E0955 Plush Head Supprt Pad 8" 195MH11 Cbra Munt and Bracket $ HE66 E0955 Plush Head Supprt Pad 10" 195MH1 Linx Munt and Bracket 195HE82 E0955 Adjustaplush pad Narrw 195HE83 E HE84 E HE85 E HE11 Adjustaplush pad Standard Cntur Cradle Small Cntur Cradle Medium Omit headrest pad nly ($15.00) 12. POSTURAL SUPPORTS LATERAL THORACIC SUPPORT (Swing Away) LAT 3x3 S/A FLUSH MOUNTS PR 195ZV20 195ZS07 195ZS07 LATERAL SWING AWAY MOUNT PAIR $ XX04 Swing Away Shrt Left 195ZV15 195ZS07 195ZS07 JAY Rectangular Thigh Supprt Left 195JK01 Small LATERAL 3x3 Flush Munt PAIR LATERAL 4X4 W/ 1" OFFSET PAIR LATERAL SWING AWAY MOUNT PAIR $ Thigh Supprt w/ Remvable Munt Available with Cantilever Arms, N/A with Manual Recline Back, Dual Pst, Single Pst r Cantilever w/ 2 pt Lcking arms 195TV3 195TX1 195TV4 195JJ12 195JJ13 E0960 E0960 Available n all Slid Backs LATERAL 4X5 W/ 1" OFFSET PAIR Remvable Munt Right Classic Structured $ $ XX05 Swing Away Shrt Right $ E0960 Cntured Dynamic E0960 Remvable Munt Left JAY Rectangular Thigh Supprt Right 195TX2 E0960 JAY Anterir Trunk Supprt Size 195JK02 Medium LATERAL SWING AWAY MOUNT PAIR LAT 4X4 S/A MOUNTS W/ 1" OFFSET PR 195ZV14 E0884 LAT 4X5 S/A MOUNTS W/ 1" OFFSET PR LAT 4X6 S/A MOUNTS W/ 1" OFFSET PR 195ZV16 195JJ14 195JJ15 195ZR03 LATERAL 4X6 W/ 1" OFFSET PAIR LATERAL SWING AWAY MOUNT PAIR 5" x 6" Thigh Supprt Left 5" x 6" Thigh Supprt Right JAY Anterir Trunk Supprt Style (Chse Size belw) Classic Dynamic Cntured Structured Padded Chest Strap $ $ $ $ $ $ $ $ $ $ $ Swing Away Knee Adductr Supprts Nt available with Dual Pst Arm Rests r 2pint Lcking Cantilever Arms 195KH12 Knee Adductr Pad SM 3" Left Knee Adductr Supprts RIGHT (chse Pad and Arm) $ LM3 195LM3 Available nly with Fixed and Pwer Center Munt Legrests Knee Adductr Supprts LEFT (chse Pad and Arm) 195KB5 195KB6 Medial Thigh Supprt 195KH13 195KH14 195LM3 195KH15 195LM3 E0957 Small Wedge Pad (3" x 4") Medium JAY Style Wedge Medial Thigh Supprt (Height adjustable) E0957 E0957 Pad Size Push Buttn Flip Dwn Bracket Small JAY Style OVAL Medial Thigh Supprt (Height adjustable) E0957 Pad Size S/A Arm Knee Adductr Pad SM 3" Right S/A Arm Small JAY Style Wedge Medial Thigh Supprt (Height adjustable) Push Buttn Flip Dwn Bracket Small Wedge Pad (3" x 4") Push Buttn Flip Dwn Bracket Medium JAY Style Oval Medial Thigh Supprt (Height adjustable) Medium Wedge Pad (4.5" x 5") Medium Wedge Pad (4.5" x 5") Push Buttn Flip Dwn Bracket $ $ $ $ $ $ $ $ $ JAY Pelvic Psitining Belts 195ZZ19 2 Pint Pelvic Belt 1' Push Buttn Padded 195ZZ20 2 Pint Pelvic Belt 1' Side Release Padded 195ZZ21 2 Pint Pelvic Belt 1.5" Push Buttn Padded 195ZZ22 2 Pint Pelvic Belt 1.5" Side Release Padded 195ZZ23 4 Pnt V Cntur Pelvic Belt 1.5" Push Btn $95.00 $75.00 $95.00 $75.00 Sunrise Medical 2842 Business Park Ave. Custmer Service: Fax: rders@sunmed.cm Web: 1/2019 MK REV K Page 9

10 13. ARMREST AND ARMPAD OPTIONS Armrest Munting fr K0848 Mdels with ASAP II Dual Pst Armrests 195EG22 E0973 Lng Dual Pst Flip Back HT Adj 10"15" Cantilever Armrests 195EG01 195EG02 195EG03 195EG08 Lng Dual Pst Flip Back 10" Height Shrt Dual Pst Flip Back HT Adj 10"15" Standard Cantilever Arm w/ 2 Pint Lcking E0973 Pst, (9"10" Ht Range) N/A w/ seat depths belw 16" Standard Cantilever Arm w/ 2 Pint Lcking 195EG04 E0973 Pst, (11"12" Ht Range) N/A w/ seat depths belw 16" 195EG05 E0973 E0973 Shrt Dual Pst Flip Back 10" Height STD Cantilever Arm (9"12" Ht Range) Single Pst Height Adjustable Lw Adjustable length arm pad included (chse Pad setting belw, except fr Lw Arm Optin) N/A with Manual Recline Back 195EG21 195EG06 Single Pst Armrests 195EG07 E0973 E0973 E0973 Lw Cantilever Arm (7"10" Ht Range) Chse ASAPII pad type and size belw Single Pst Height Adjustable Std Armrest Munting fr K0856 SC Mdels with Tilt Cantilever Armrests Adjustable length arm pad included (chse Pad setting belw, except fr Lw Arm Optin) N/A with Manual Recline Back 195EG12 195EG13 195EG10 195EG11 Single Pst Armrests 195EG14 195EG15 Dual Pst Armrests 195EG09 195EG23 STD Cantilever Arm (9"12" Ht Range) Lw Cantilever Arm (7"10" Ht Range) Chse ASAPII pad type and size belw Standard Cantilever Arm w/ 2 Pint Lcking Pst, (9"10" Ht Range) N/A w/ seat depths belw 16" Standard Cantilever Arm w/ 2 Pint Lcking Pst, (11"12" Ht Range) N/A w/ seat depths belw 16" Single Pst Height Adjustable Std Single Pst Height Adjustable Lw Shrt Dual Pst Flip Back HT Adj 10"15" Lng Dual Pst Flip Back HT Adj 10"15" Arm Pad Optins fr ASAPII Pad Type / Size Optins fr Dual Pst / Single Pst / Lw Cantilever Left Arm Pad () Right Arm Pad () 195AE01 Desk Length Waterfall (10") 195AB01 195AE02 Full Waterfall (14") N/A w/ Lw Cant 195AB02 195AE03 Desk Length Standard (10") 195AB03 195AE04 Full Standard (14") N/A w/ Lw Cant 195AB04 Pad Setting Optins fr Standard Cantilever Arm Left Arm Pad () Right Arm Pad () 195AE11 Full Length Cantilever (14") 195AB11 195AE10 Desk Length Cantilever (10") 195AB10 Sunrise Medical 2842 Business Park Ave. Custmer Service: Fax: rders@sunmed.cm Web: 1/2019 MK REV K Page 10

11 14. HANGERS AND FOOTRESTS FOR ASAP II Hanger and Extensin Tubes Optins (see ftplate cmpatibility in the brackets) Swingaway Hangers Centermunt Legrests NnPwered Swing Away Legrests Center Munt Legrests Sld as Pairs 195H134 Fixed Center Munt Shrt w/ ftplate 195H2 70 Swing Away (B,C) 195H135 Fixed Center Munt Lng w/ ftplate 195H H H F282 E0990 Swing Away Ftplates 80 Swing InOut (Frnt Munt) (B,C) 90 Swing InOut (Frnt Munt) (B,C) Manual ELR S/A (B,C) (Avail. with Fixed Centermunt, chse belw) B Adult Angle Adjust w/heel Lp fr use with 65 and 70 hanger (Pair) K0040 Adult Angle Adjustable Ftplate $ $ H H H108 Angle adjustable Center Munt Shrt (3" 5.25") Chse Ftplate (I r J) infinite and Independent leg length and angle adjustable Angle adjustable Center Munt Medium (3" 11.25") Chse Ftplate (I r J) infinite and Independent leg length and angle adjustable Angle adjustable Center Munt Lng (3" 13.25") Chse Ftplate (I r J) infinite and Independent leg length and angle adjustable $ $ $ HL10 195F LS13 E0951 Heel Lp C Kids Angle Adjust w/leg Strap fr use with 70 hanger (Pair) K0040 K0038 Kids Angle Adjustable Ftplate Leg Strap $50.00 $ $35.00 Centermunt Ftplates 195F125 I Angle adj Centermunt Ftplate pair Small K0040 Small Angle Adjustable Ftplates 5.75" x 6" 195F LS13 C Kids Angle Adjust w/leg Strap fr use with 80 and 90 hanger(pair) K0040 K0038 Kids Angle Adjustable Ftplate Leg Strap $ $ F126 J Angle adj Centermunt Ftplate pair Large K0040 Large Angle Adjustable Ftplates 5.75" x 10" 195F279 Omit Ftplate and extensin tube Omit Hangers 195H144 Omit Hangers Hanger Extensins (See range listed in matrix belw) NOTE: Nt all extensin tube will be available; depending n the seat height, sme extensin tube ptins may nt ffer enugh grund clearance 195E16 195E1 195E2 High Munt Hanger 195E5 Lng 195E23 2" Extensin fr swing in/ut hanger $ E24 4" Extensin fr swing in/ut hanger $ E21 Ftrest Accessries 1955A01 195LS A A02 E0951 E0952 E0951 E0952 Shrt Medium Omit Extensin E0952 Te Lp (Pair) Only avail n (pt B) K0038 Extra Leg Strap She hlders Small Pair w/ padded strap $55.00 $50.00 $35.00 $ She hlders Medium Pair w/ padded strap $ Hanger Type 70 Swing Away 80 Swing in/ut 90 Swing in/ut Manual ELR S/A Angle adj Cntmt Lwer Leg Length Matrix (measured seat pan t the tp f the ftplate surface) High Munt Shrt 7" 14" 13.5" 16" 16" 18.5" 18" 20.5" 5.5" 9" Ftplate munts t frnt f hanger. 12.5" 17" Medium 14.5" 19" 3" 13" Lng 7" 14" 13.5" 16" 14.5" 19" 15" 18" 3" 7" 17" 21" 1721" Fixed Cntrmnt 12.5" 15.5" 14.5" 19.5" Ftplate Matrix Hanger Type B C I 70 Swing Away X X 80 Swing in/ut X X 90 Swing in/ut X X Manual ELR S/A X X Ang Adj Cntmt X X Fixed Cntrmnt Sunrise Medical 2842 Business Park Ave. Custmer Service: Fax: rders@sunmed.cm Web: 1/2019 MK REV K Page 11

12 15. ACCESSORIES Wheelchair Tray Table 1957A01 E0950 TRAY TABLE SM TUFFAK 12" 14" PWR 1957A02 E0950 TRAY TABLE MED TUFFAK 15" 17" PWR Backpack 195A1 Black Utility 195A2 Black/Charcal Kids Accessries 1958A09 Ram Phne Munt n Rund JS tube $ A10 Ram Tablet Munt n Rund JS tube $ A11 Ram Cup hlder $ A12 SwitchIt Remte Stp Switch $ $55.00 $50.00 Munting Accessries (available with All Seats) Only ne accessry can be munted at a time 195A603 E2207 Cane/Crutch Hlder $ A604 E2208 O2 hlder $ A605 Walker hlder $ Sunrise Medical (US) LLC 2842 Business Park Ave. Fresn, CA USA Sunrise Medical 2842 Business Park Ave. Custmer Service: Fax: rders@sunmed.cm Web: 1/2019 MK REV K Page 12