Zippie ZM-310 Group 3

Transcription

1 Zippie ZM310 Group 3 (K0848, K0856) EIPW22, February 2018 Account: Date: PO#: Buyer: Marked For: Ship To: Name: Address: City,State,Zip: Phone: 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 1. Zippie ZM310 GROUP 3 CATEGORY (Select One) Zippie ZM310 BC (Group 3 K0848/K0011) Zippie ZM310 BC w/asapii Seat $7, Zippie ZM310 SC (Group 3 K0856/K0011) Zippie ZM310 SC for SPOT Tilt $7, PC106 K0848 K0011 Base Package $7, PC107 K0856 K0011 Base Package $7, BC Seating Specifications SC Seating Specifications HCPC Code K0848/ K0011 HCPC Code K0856 / K0011 Typical Chair Weight W/battery 235lbs W/O Battery 157lbs Typical Chair Weight W/battery 260lbs W/O Battery 182lbs Transit WC19 w/optional crash tested belt. Transit WC19 w/optional crash tested belt. Seat Type ASAP II / Optional Manual tilt and/or Manual Recline Seat Type ASAP II / Optional 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" Power Seating 9" Seat elevator Power Seating 50º CG tilt / optional 12" seat elevator Zippie ZM310 Base Specifications Drive Wheel Position Midwheel Drive Drive Wheels 13" Drive Wheels w/ flat free insert (Black or Grey) User weight Cap 165 lb Tires/Casters 7" Front / 6" rear (Black or Grey) Base size Width 24" Length 34" Turn Radius 18" Charger 8A Dual Mode Charger (Compact) CTE Drive Control VR2 90A (nonexpand) Rnet EL90 (Expandable) Battery Size Group 22 Driving Range Up to 13.5 miles Shroud Colors 12 standard colors, 3 upgrade prints. Drive Motors 4pole 6 mph Ground Clearance 3" Sunrise Medical 2842 Business Park Ave. Fresno, CA USA (800) Canada (800) FAX: (800) Specifications are subject to change without notice. Copyright 2018 MK REV H Page 1

2 2. BASE CHAIR OPTIONS 195EZ11 Candy Purple 195FA EZ12 Matte Black 195FA3 3 NA with +3" or +4" STFH or lift 195EZ13 Midnight Blue 195FA4 6 NA with +3" or +4" STFH or Lift/Tilt Shroud Color 195EZ01 195EZ02 195EZ03 Candy Blue 195EZ04 195EZ05 195EZ08 195EZ17 195EZ18 195EZ16 Drive wheel/tire package 195DW60 195EZ09 Yellow 195EZ10 Pearl Pink 195EZ15 Candy Apple Red Pearl White High Gloss Black Silver Copper Grunge Skulls $ American Flag $ Green Apple Cast Wheel Solid Dual Density Inserts Black Knobby Tires and Black Casters Pink Camo $ Transit Option (Required) 195WN03 WC19 Transit Lap Belt 195WN02 PreSet Seat Frame Angle Seat Height 195HT44 195HT45 195HT46 (Measured in the front) Obtain Quote to verify est. STFH Lowest STFH 195HT47 +3" STFH 195HT48 +4" STFH WC19 Transit Package (order belt separately below. WC19 Transit Lap Belt +1" Seat to Floor Height +2" Seat to Floor Height $ NC NC NC NC NC Motor Package 195PF96 165lbs 6mph 4Pole Std User weight 195WG17 195WG18 195WG19 195WG lbs Ventilator Options < 75 Not available w/ Transit 76100lbs lbs 195VT4 195VT9 E1029 E1029 Fixed Vent Tray (Pulmonetic LTV Models) Lift off Vent Tray (Pulmonetic LTV Models) $ $ STFH Matrix Seating Type and Power Option Combinations 0 SeattoFloor Height at 0 tilt +1" +2" +3" +4" BC ASAP II No power seating.* *For seat widths 1216" add.5" BC ASAP II 9" Lift only BC ASAP II Manual Tilt SC ASAP II Tilt only SC ASAP II Tilt and 12" Lift combo BATTERIES and CHARGERS Batteries Battery Charger 195AG21 E2361 GP22 Flat Top Batteries Pair w/strap $ BJ19 8A Dual Mode Charger (Compact) CTE 195AG05 Omit batteries (Includes harness) Sunrise Medical 2842 Business Park Ave. Fresno, CA USA (800) Canada (800) FAX: (800) Specifications are subject to change without notice. Copyright 2018 MK REV H Page 2

3 4. ELECTRONICS Drive Control Options NonExpandable Controllers 195ER02 RNet Expandable Drive Control Upgrade (90A) Nonexpandable VR290 controller 195ER01 (NA with High Speed Motor package) 195EX01 195EX02 E2377 E2313 VR2 (nonexpandable) 195J94 ***Rnet Non Expandable VR2 195J70 Std LED for Rnet Ctrls 195J120 Expandable Controllers $ Expandable Controller Rnet $ Harnessing for Expandable Controller CJSM1: Standard: w/stereo Jacks & Color Display $ Rnet OMNI and Output Options 195ON1 195ON2 OMNI Mount (For expandable controls, choose all that apply) 195DS04 Swing Away Left Side OMNI Mount $ DS03 E2351 Rnet OMNI Input Control Module and display with built in Infrared and armrest mount. Choose mount below. (required for Specialty Input Devices.) Rnet Output Module (ECM) (If used with must be mounted opposite side) Swing Away Right Side OMNI Mount $1, $1, $ J112 CJSM2: Advanced: 3.5" Color Display, Paddle Switches, Shortcut Keys, IR and Stereo Jack. $1, J95 Omit JS. For use with OMNI * Mount (Fixed, Swing Away, Retractable, Mid) 195JM10 195JM11 195JM15 195JM14 Fixed Mount Swing Away Mount Retractable mount w/45º stops Mid Line Mount $ $ $ Mount (Location) Height Adjustable. 195HM1 Right Side Mount 195HM2 Left Side Mount Handle (Optional) 195JH1 E2323 Ball Handle $ JH2 E2323 Foam Ball Handle $ JH4 E2323 THandle $ JH6 E2323 Goalpost $80.00 Switch inputs for RNet s or OMNI Drive or Mode / Profile Control 195SW22 Stereo to 2 Mono Splitter 195SW1 Buddy Button Switch 195SW4 Micro Light Switch 195SW24 Egg SwitchBlack $65.00 $80.00 $80.00 $ SW21 Dual toggle switch and bracket $ SW35 Switchit Mini 1 button on Mono plug $ SW36 Switchit Mini 2 button on 2 Mono plugs $ SW37 Switchit Mini 2 button on 1 Stereo plug $ SW38 Switchit Mini 4 button on DB9 connector $ Attendant Control 1950A A02 E2331 E2331 Attendant Control for VR2 Attendant Control for Rnet $1, $1, Single Switch Mount Bracket 195EM01 Single Switch Mount Bracket $ Attendant Mounting location Electronic Programmers 195DN1 Mounting location: Right Back Cane 195PR2 VR2 Hand Held Programmer 195DN2 Mounting Location: Left Back Cane 195PR5 Rnet PC Programmer with Dongle $ $ Sunrise Medical 2842 Business Park Ave. Fresno, CA USA (800) Canada (800) FAX: (800) Specifications are subject to change without notice. Copyright 2018 MK REV H Page 3

4 Head Control Proportional Packages Switchit Dual Pro Proportional Head Control with Whitmyer and Facial Pads (Adult) 5. Specialty Driver Control Options Requires expandable Rnet controls and OMNI unless otherwise noted. Not available with Upholstered backs. 5a. Proportional Control Packages Chin Control Proportional Packages $5, Switchit VersaGuide Chin Control Compact and Egg Switch Package $2, ID72 195IJ09 Hand Control Proportional Packages 195IJ07 S/A Gatlin Mount $ Switchit VersaGuide Compact Midline and prox flex switches with Gatlin Package 195IM08 195ID62 195IJ08 S/A SpaceDisc mount $ ASL Proportional Micro Extremity (ASL130) Midline with Gatlin Package 195IJ07 S/A Gatlin Mount $ ID61 ASL Compact $1, IJ07 E2328 $3, E2312 MicroPilot Proportional $2, IM06 Bib mount Large $ IJ08 S/A SpaceDisc mount $ Switchit MicroGuide with SpaceDisc Package ASL Mushroom (ALS135) Midline with Gatlin Package Switchit Dual Pro Head Control w/facial pad (Adult) SA Boom Mount with Egg Switch Control $ IM07 Switchit Dual Pro Proportional Head Control with Spot Pads Package 195ID70 E2328 Switchit Dual Pro Head Control w/spot pads Switchit VersaGuide Compact Midline with Gatlin Package 195IJ07 Switchit VersaGuide Compact Proportional S/A Gatlin Mount Switchit MicroPilot with SpaceDisc Package Switchit VersaGuide Compact Proportional Dual Flex Proximity Switches (requires no force) 195ID63 E2312 MicroGuide Proportional $2, ID59 E2312 Micro Extremity ASL Compact w Integrated buttons (ASL134) Midline with Gatlin Package $5, $5, $ $3, $3, $3, $2, $1, Switchit VersaGuide Chin Control Compact and Proximity Flex Switches Package 195IM08 195IM08 SA Boom Mount with egg switch $ IJ04 SA Boom Mount with egg switch $ SwitchIt MicroPilot Bib Chin Control with Egg Switch Package Large 8" 195IM06 S/A Mount off backrest Switchit VersaGuide Compact Proportional Switchit VersaGuide Compact Proportional SA Boom Mount with egg switch $ SwitchIt MicroGuide Bib Chin Control with Egg Switch Package Large 8" $2, $2, $2, $3, $2, $3, IM06 Bib mount Large $ SA Boom Mount with egg switch $ ASL Proportional Micro Extremity Chin / Lip with Egg Switch Control Package $ IJ04 SA Boom Mount with egg switch $ IM06 195IM05 Bib mount Small $ SwitchIt VersaGuide Bib Chin Control Compact with Proximity Flex Switches Package Large 8" 195IM08 Switchit VersaGuide Compact Proportional Dual Flex Proximity Switches (requires no force) Switchit VersaGuide Compact Proportional Dual Flex Proximity Switches (requires no force) Switchit VersaGuide Compact Proportional SwitchIt MicroPilot Bib Chin Control with Egg Switch Package Std 6" E2312 S/A Mount off backrest $ Dual Flex Proximity Switches (requires no force) SwitchIt VersaGuide Bib Chin Control Compact with Egg Switch Package Std 6" 195IM05 Bib mount Small 195ID60 Mushroom $2, IJ04 195IJ07 S/A Gatlin Mount $ ASL Micro Mini w Hand Pad (ASL136) Midline with Gatlin Package 195ID68 E2312 Micro Mini $5, IJ09 SA Boom Mount with Egg Switch Control $ $1, $2, $ S/A Gatlin Mount $ $3, $2, IJ07 S/A Gatlin Mount $ IJ04 SA Boom Mount with egg switch $ SwitchIt VersaGuide Bib Chin Control Compact with Proximity Flex switches Package Std 6" SwitchIt VersaGuide Bib Chin Control Compact with Egg Switch Package Large 8" MicroPilot Proportional $ $ $ $3, ID62 E2312 MicroPilot Proportional $2, ID63 195IJ04 Bib mount Large $ IJ04 SA Boom Mount with egg switch $ E2312 MicroGuide Proportional $ $2, $3, IM05 Bib mount Small $ $2, $3, ID59 E2312 Micro Extremity $3, IM07 S/A Mount off backrest $ IJ04 SA Boom Mount with egg switch $ Sunrise Medical 2842 Business Park Ave. Fresno, CA USA (800) Canada (800) FAX: (800) Specifications are subject to change without notice. Copyright 2018 MK REV H Page 4 195IM07 195ID62 195IM05 195IJ04 $2, Bib mount Large $ Bib mount Small $ SwitchIt MicroGuide Bib Chin Control with Egg Switch Package Std 6" 195ID63 E2312 Switchit VersaGuide Compact Proportional MicroGuide Proportional $2,790.00

5 3 Switch Proximity Head Arrays Choose headrest mount below Sip N Puff Package Choose headrest and HR mount below ASL Proximity Head Array Package (Adult) ASL Proximity Head Array Package (Ped) SwitchIt Head Array Package 3 Switch Curved (Long) SwitchIt Head Array Package 3 switch curved (Stubby) Quickie Sip n' Puff System 195II02 E2330 ASL Proximity Head Array (Adult) $4, ID34 E IJ09 SA Boom Mount with Egg Switch Control 195II03 195IJ09 195II13 195II04 Switchit Proximity Head Array Long 195IJ09 SA Boom Mount with Egg Switch Control $ Multiple Switches. 195SW33 195SW34 E II14 E2330 Switchit Proximity Head Array Stubby 195IJ09 Switchit 5 Naked proximity switches on DB9 connector. (requires OMNI) ASL (502) 5Switch adaptor box on DB9 connector. (for use with 5 mono switches, not included) $4, $4, $4, $ Switch Proximity Head Array (No Egg Switch Needed) Choose "Headrest Mount for Special Controls" 195SW31 195SW32 195SW23 E2330 E2330 ASL Proximity Head Array (Ped) SA Boom Mount with Egg Switch Control SA Boom Mount with Egg Switch Control SwitchIt Head Array 5 switch flat Switchit 3 Naked proximity switches on DB9 connector. (requires OMNI) Switchit 4 Naked proximity switches on DB9 connector. (requires OMNI) 4way toggle switch button DB9 Connector. Includes bracket 5. Specialty Driver Control Options (cont.) 5b. Switch Control Requires Headrest and/or Headrest Mount $4, $ $4, IJ10 $4, $ $4, $4, $2, $3, $3, $3, $ MH12 Axys Mount & Bracket for Specialty Controls 195MH13 195HE79 E0955 Plush Pad 8" for Specialty controls 195HE80 195HE81 E0955 Plush Pad 14" for Specialty controls Extra Swing Away Head Boom Egg Switch and Mount 195IJ05 Extra SA Boom Mount with egg switch #1 $ IJ06 195IB03 E1029 Single Switches Sip N' Puff Kit 195IH1 E2326 Sip n' Puff Tubing and SA Hardware Headrest Mount for Specialty Controls Headrest Pad for Specialty controls Extra SA Boom Mount with egg switch #2 $ IB01 Ribbon Switch $ IB02 E0955 SA Boom Mount with egg switch 195MH14 Linx Mount & Bracket for Specialty Controls Plush Pad 10" for Specialty controls Disc Switch $ IB04 Wobble Switch $ IB05 Micro Light Switch $ IB06 Egg SwitchBlack $ IB07 $2, $1, $ $ Cobra Mount & Bracket for Specialty Controls $ Buddy Button Switch $80.00 Switchit Mini 1 button on Mono plug $ Sunrise Medical 2842 Business Park Ave. Fresno, CA USA (800) Canada (800) FAX: (800) Specifications are subject to change without notice. Copyright 2018 MK REV H Page 5

6 6. SEAT TYPE 195ST56 A.S.A.P II (Adjustable Seating and Positioning) Choose Seat Frame Size Platform. ASAP II Frame size (each frame is width and depth adjustable within given range. ) 195FU16 Adjustable 10x10 to 13x16 ( Z ) 195FU17 Adjustable 12x12 to 16X19 ( A ) 7. SEAT SIZE Z = ASAP II Seat Frame Adjustable from 10x10 to 13x16 Seat Size Matrix. Seat type is chosen in section 5. A = ASAP II Seat Frame Adjustable from 12x12 to 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" 195R46 11" Seat width 195RF41 11" 195R21 12" Seat width 195RF20 12" 195R22 13" Seat width 195RF21 13" 195R23 14" Seat width 195RF22 14" 195R24 15" Seat width 195RF23 15" 195R5 16" Seat width 195RF5 16" 195RF6 17" 195RF7 18" 195RF8 19" 8. SEAT CUSHIONS JAY/Zip Cushions (Optional) To order any JAY/Zip cushions onchair, please see the JAY/Zip price list. Cushion name or part number must be filled out w/ desired width & depth JAY/Zip Bundled Cushion 195JC20 Cushion Name or Part # Price List Width: Depth: Sunrise Medical 2842 Business Park Ave. Fresno, CA USA (800) Canada (800) FAX: (800) Specifications are subject to change without notice. Copyright 2018 MK REV H Page 6

7 9. SEATING SYSTEMS NonPowered Seating 195PJ8 Manual Tilt 45 CG Tilt Must be ordered with Stroller handle NA with height adjustable back cane $ Powered Seat Elevator (AKA: Power Lift) 195PA8 195PA15 E2300 E2300 Power Seat Elevate (9") Power Seat Elevate for use with tilt (12") (Must be ordered with SPOT tilt) $2, $2, Power Seating Options (SC Models) 195PJ2 E1002 SPOT 50 CG Tilt $4, Power Seating Control Powered Seating Switch Control Method (For use with power seating actuators. Switch activation is standalone and does not require expandable or thrudrive electronics. 195EO10 Single Actuator Switch Control (Lift or Tilt) Switch Control 1 actuator with Dual Toggle Powered Seating Thrudrive Control Method. ThruDrive 1 or 2 Actuator 195EO26 E2310 Thru Drive 1 or 2 Actuator(s) For operating Tilt and/or Lift thru. Includes Ctrl+5 when ordered with Expandable Controls (Rnet) $1, EO11 195EO19 195EO20 195EO21 195EO12 195EO23 195EO22 Switch Control 1 actuator with Buddy Button Switch Control 1 actuator with Switchit Mini 1 button Switch Control 23 actuator with 4way toggle Switch Control 23 actuator with Switchit Mini 2 button $ $ Powered Seating Thrudrive Control Options Only available with Expandable Controls (Rnet) Assignable Buttons Switch Control 1 actuator with "Assignable Button" feature allows for customization of joystick buttons and/or Ctrl+5 Switchit Mini 2 button Switches allowing access to various wheelchair and seating functions. When enabled, chair will be preprogrammed with seating functions assigned to buttons on the joystick. Assignments can be changed via PC Dongle. 23 Actuator Switch Control (Lift and Tilt) 195PM01 Enable Assignable buttons Switch Control 23 actuator with Dual Toggle $ Ctrl+5 Switchbox Options Ctrl+5 allows direct control to 5 power seating functions (10 total switches). Switches can also be used with assignable buttons for greater flexibility. Box includes 3Amp USB port for charging portable devices 195QG01 Ctrl+5 Switchbox mounted behind joystick 195QG02 Ctrl+5 Switchbox mounted opposite joystick Switch Control 23 actuator with 195QG03 Ctrl+5 Switchbox mounted on back cane $ Switchit Mini 4 button 195QG05 Omit Ctrl+5 $ Switch Mount (for use with switch control powered seating) Ctrl+5 Switch Type 195EY01 Switch Mount Right 195EY03 Push buttons 195EY02 Switch Mount Left 195EY04 Toggle switches $ Sunrise Medical 2842 Business Park Ave. Fresno, CA USA (800) Canada (800) FAX: (800) Specifications are subject to change without notice. Copyright 2018 MK REV H Page 7

8 10. BACKREST AND BACK OPTIONS FOR ASAP II SEAT Backrest Frame Type 195BT8 195BT98 E1225 Angle Adjustable Manual Recline 40 (not width adjust.) $ Manual Recline Adjustment Method Option Back Cane Height 23". Fits all seat types. NA with Cantilever Arms 195MN01 Tool 195MN02 Knob (NA with dual post arms.) Back Type (Solid) 195BU86 195BU87 195BU14 E2613 S.P.O.T. Curved back with rail for mounting laterals Jay SPO Posterior (Curved back with TFoam inserts and mounting rails) Omit Backrest $ $ B118 12" 195BP40 Straight Back Post 195B132 14" Angle Adjustable Backrest Options 195OD8 195OD9 Cane Angle 195BP41 Cane Adjustable height 195B1 195B243 (NA with Manual recline) NonFolding Backrest Folding Backrest 8 o Bend Back Post (Avail. only on Zip or J3 Back) NA with Manual recline Fixed Low (15.5") 195B5 Fixed Med (17.5") 195B9 Fixed Tall (19.5") Adjustable Low 14" 18" 195B244 Adjustable High 20" 26" $ $ $ $ Back Height Required for SPOT Curved and SPO Backs. 195B36 16" 195B38 18" 195B40 20" Jay 3 / ZIP Option 195JB01 195PH14 xxx Push Handle Options Jay J3/Zip (select OMIT above) (Limited combinations of widths) Measured from pan to top of solid back. Available on 10" 16" wide seats Available on 12" 16" wide seats Stroller Handle: Single height adjustable Bar Push Handle. w/2 utility hooks. Required with Manual Tilt (NA with adjustable height cane.) See J3 OF $55.00 Towel Bar Depth 195QT03 195QT04 Shallow Deep (Ext. 4" from back canes for deep backs) Sunrise Medical 2842 Business Park Ave. Fresno, CA USA (800) Canada (800) FAX: (800) Specifications are subject to change without notice. Copyright 2018 MK REV H Page 8

9 11. HEADREST OPTIONS Choose One Each. Headrest Mount Headrest Pad 195MH10 Axys Mount & Bracket 195HE65 E0955 Plush Head Support Pad 8" 195MH11 Cobra Mount and Bracket $ HE66 E0955 Plush Head Support Pad 10" 195MH1 Linx Mount and Bracket 195HE82 E0955 Adjustaplush pad Narrow 195HE83 E0955 Adjustaplush pad Standard 195HE84 E0955 Contour Cradle Small 195HE85 E0955 Contour Cradle Medium 195HE11 Omit headrest pad only. $ POSTURAL SUPPORTS LATERAL THORACIC SUPPORT (Swing Away) LAT 3x3 S/A FLUSH MOUNTS PR 195ZV20 195ZS07 195ZV14 195ZS07 195ZV15 195ZS07 195ZS07 Jay Rectangular Thigh Support Left 195JK01 E0960 LATERAL SWING AWAY MOUNT PAIR Removable Mount Right Small $ $ Thigh Support w/removable Mount Available with Cantilever Arms, NA with Manual Recline Back, Dual Post, Single Post or Cantilever w/ 2 pt Locking arms. 195TV3 195TX1 195TV4 195TX2 195JJ12 195JJ13 Available on all Solid Backs. LATERAL 3x3 Flush Mount PAIR LATERAL 4X4 W/ 1" OFFSET PAIR LAT 4X5 S/A MOUNTS W/ 1" OFFSET PR LATERAL 4X5 W/ 1" OFFSET PAIR LAT 4X6 S/A MOUNTS W/ 1" OFFSET PR 195ZV16 LATERAL 4X6 W/ 1" OFFSET PAIR Classic Dynamic Classic Structured Padded Chest Strap $ $ JK02 Medium NC $ XX05 Swing Away Short Right $ LM3 E0960 Contoured Dynamic E0960 Removable Mount Left Jay Rectangular Thigh Support Right E0960 E0960 Jay Anterior Trunk Support Size LATERAL SWING AWAY MOUNT PAIR 4" x 5" Thigh Support Left 4" x 5" Thigh Support Right Jay Anterior Trunk Support Style (Choose Size below) 195JJ14 195ZR03 $ E0884 LATERAL SWING AWAY MOUNT PAIR $ LAT 4X4 S/A MOUNTS W/ 1" OFFSET PR 195JJ15 LATERAL SWING AWAY MOUNT PAIR Contoured Structured $ $ $ $ $ $ $ $ NC Swing Away Knee Adductor Supports Not available with Dual Post Arm Rests or 2point Locking Cantilever Arms 195XX04 Knee Adductor Supports RIGHT (choose Pad and Arm) $ KB6 195KH12 Available only with Fixed and Power Center Mount Legrests. Knee Adductor Supports LEFT (choose Pad and Arm) 195KB5 195LM3 195KH13 195KH14 195LM3 Medial Thigh Support 195KH15 195LM3 Small Jay Style Wedge Medial Thigh Support (Height adjustable) Medium Jay Style Wedge Medial Thigh Support (Height adjustable) E0957 Pad Size Knee Adductor Pad SM 3" Left S/A Arm Pad Size Knee Adductor Pad SM 3" Right E0957 Small Wedge Pad (3" x 4") E0957 Push Button Flip Down Bracket Push Button Flip Down Bracket Small Jay Style OVAL Medial Thigh Support (Height adjustable) E0957 Swing Away Short Left S/A Arm Medium Wedge Pad (4.5" x 5") Small Wedge Pad (3" x 4") Push Button Flip Down Bracket Medium Jay Style Oval Medial Thigh Support (Height adjustable) Medium Wedge Pad (4.5" x 5") Push Button Flip Down Bracket $ $ $ $ $ $ $ $ $ JAY Pelvic Positioning Belts 195ZZ19 E ZZ20 E Point Pelvic Belt 1' Push Button Padded 2 Point Pelvic Belt 1' Side Release Padded 195ZZ21 E Point Pelvic Belt 1.5" Push Button Padded 195ZZ22 E Point Pelvic Belt 1.5" Side Release Padded 195ZZ23 E Pnt V Contour Pelvic Belt 1.5" Push Btn $95.00 $75.00 $95.00 $75.00 Sunrise Medical 2842 Business Park Ave. Fresno, CA USA (800) Canada (800) FAX: (800) Specifications are subject to change without notice. Copyright 2018 MK REV H Page 9

10 Armrest Mounting for K0848 Models with ASAP II Dual Post Armrests 195EG22 E0973 Lng Dual Post Flip Back HT Adj 10"15" Cantilever Armrests 195EG01 195EG03 E0973 Long Dual Post Flip Back 10" Height. Standard Cantilever Arm w/ 2 Point Locking 195EG04 E0973 Post. (11"12" Ht Range.) NA w/ seat depths below 16" 195EG05 195EG07 195EG08 E0973 E0973 E0973 Short Dual Post Flip Back 10" Height. Shrt Dual Post Flip Back HT Adj 10"15" STD Cantilever Arm 9"12" Ht Range (Adjustable length arm pad included (choose Pad setting below, except for Low Arm Option) NA with Manual Recline Back 195EG21 195EG02 195EG06 E0973 Single Post Armrests Standard Cantilever Arm w/ 2 Point Locking Post. (9"10" Ht Range.) NA w/ seat depths below 16" Low Cantilever Arm 7"10" Ht Range (Choose ASAPII pad type and size below) Single Post Height Adjustable Std. E0973 Single Post Height Adjustable Low 13. ARMREST AND ARMPAD OPTIONS Armrest Mounting for K0856 SC Models with Tilt. Cantilever Armrests (Adjustable length arm pad included (choose Pad setting below, except for Low Arm Option) NA with Manual Recline Back 195EG12 195EG13 195EG10 195EG11 Single Post Armrests 195EG14 195EG15 Dual Post Armrests 195EG09 195EG23 STD Cantilever Arm 9"12" Ht Range Low Cantilever Arm 7"10" Ht Range (Choose ASAPII pad type and size below) Standard Cantilever Arm w/ 2 Point Locking Post. (9"10" Ht Range.) NA w/ seat depths below 16" Standard Cantilever Arm w/ 2 Point Locking Post. (11"12" Ht Range.) NA w/ seat depths below 16" Single Post Height Adjustable Std. Single Post Height Adjustable Low Shrt Dual Post Flip Back HT Adj 10"15" Lng Dual Post Flip Back HT Adj 10"15" Arm Pad Options for ASAPII Pad Type / Size Options for Dual Post / Single Post / Low Cantilever Left Arm Pad () Right Arm Pad () 195AE01 Desk Length Waterfall (10") 195AB01 195AE02 Full Waterfall (14") NA w/low Cant 195AB02 195AE03 Desk Length Standard (10") 195AB03 195AE04 Full Standard (14") NA w/low Cant 195AB04 Pad Setting Options for 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. Fresno, CA USA (800) Canada (800) FAX: (800) Specifications are subject to change without notice. Copyright 2018 MK REV H Page 10

11 14. HANGERS AND FOOTRESTS FOR ASAP II Hanger and Extension Tubes Options (see footplate compatibility in the brackets) Swingaway Hangers Centermount Legrests NonPowered Swing Away Legrests Center Mount Legrests Sold as Pairs 195H134 Fixed Center Mount Short w/ footplt 195H2 70 Swing Away (B,C) 195H135 Fixed Center Mount Long w/footplt 195H H H107 Swing Away Footplates 195F HL10 195F LS13 195F LS13 195F279 E0990 E0951 Adult Angle Adjustable Footplate C Kids Angle Adjust w/leg Strap for use with 70 hanger (Pair) K Swing InOut (B,C) Manual ELR S/A (B,C) (Avail. with Fixed Centermount, choose below) B Adult Angle Adjust w/heel Loop for use with 65 and 70 hanger (Pair) K0040 K0040 K0038 Heel Loop C Kids Angle Adjust w/leg Strap for use with 80 and 90 hanger(pair) K Swing Inout (B,C) Kids Angle Adjustable Footplate Leg Strap Kids Angle Adjustable Footplate Leg Strap Omit Footplate and extension tube $ $ $ $50.00 $ $ $35.00 $ $ $ H H H108 Centermount Footplates 195F F126 Angle adjustable Center Mount Short 3" 5.25" Choose Footplate (I or J) infinite and Independent leg length and angle adjustable Angle adjustable Center Mount Medium 3" 11.25" Choose Footplate (I or J) infinite and Independent leg length and angle adjustable Angle adjustable Center Mount Long 3" 13.25" Choose Footplate (I or J) infinite and Independent leg length and angle adjustable Small Angle Adjustable Footplates 5.75" x 6" J Angle adj Centermount Footplate pair Large K0040 Large Angle Adjustable Footplates 5.75" x 10" $ $ $ I Angle adj Centermount Footplate pair Small $ K0040 $ $ $ Omit Hangers. 195H144 Omit Hangers Hanger Extensions. (See range listed in matrix below) NOTE: Not all extension tube will be available; depending on the seat height, some extension tube options may not offer enough ground clearance. 195E16 195E1 195E2 195E5 195E23 Footrest Accessories 1952A02 K0037 E0952 High Mount Hanger Medium 2" Extension for swing in/out hanger $ E24 4" Extension for swing in/out hanger $ E A01 195LS A01 K0038 E0951 E0952 E0951 E0952 Short Long Omit Extension Toe Loop (Pair) Only avail on (opt B). Extra Leg Strap Shoe holders Small Pair w/ padded strap $55.00 $50.00 $35.00 $ Shoe holders Medium Pair w/ padded strap $ Hanger Type 70 Swing Away 80 Swing in/out 90 Swing in/out Manual ELR S/A Angle adj Cntmt Lower Leg Length Matrix (measured seat pan to the top of the footplate surface) High Mount Short 714" " " " 714" " " 5.59" Footplate mounts to front of hanger " 3"7" Medium " 3"13" Long 1518" 1721" 1721" Fixed Cntrmnt 12.5"15.5" 14.5"19.5" Footplate Matrix Hanger Type B C I 70 Swing Away X X 80 Swing in/out X X 90 Swing in/out X X Manual ELR S/A X X Ang Adj Cntmt X X Fixed Cntrmnt Sunrise Medical 2842 Business Park Ave. Fresno, CA USA (800) Canada (800) FAX: (800) Specifications are subject to change without notice. Copyright 2018 MK REV H 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/Charcoal Kids Accessories 1958A09 Ram Phone Mount on Round JS tube $ A10 Ram Tablet Mount on Round JS tube $ A11 Ram Cup holder $ A12 Switchit Remote Stop Switch $ $55.00 $50.00 Mounting Accessories (available with All Seats) Only one accessory can be mounted at a time. 195A603 E2207 Cane/Crutch Holder $ A604 E2208 O2 holder $ A605 Walker holder $ Sunrise Medical 2842 Business Park Ave. Fresno, CA USA (800) Canada (800) FAX: (800) Specifications are subject to change without notice. Copyright 2018 MK REV H Page 12