The order form has (MSRP) retail prices, but your price is at least 25% less than retail price. Multiply retail by.75 or call or email for a quote.
The order form has (MSRP) retail prices, but your price is at least 25% less than retail price. Multiply retail by.75 or call or email for a quote.
Client: P.O.#: X8 MSRP List 1325 Directional Lock (used to reverse in straight line) $1,375.00 * HEADREST MPS 1370 MPS Headrest $287.00 Rehab HD-MF Comfort Company Moldable Headrest Pad $250.00 E0955 HD-BH Removable Multi-Axis Headrest Hardware $250.00 E1028 LATERAL SUPPORTS MPS LT1-SA Comfort Company Single Swingaway Lateral Hardware Right Left $400.00/ea E0 56 LT1-L/RS4W4T Comfort Company Single Lateral Pad 5 W x 4 T, Stretch-Air Cover $53/ea E1028 Rehab LT1-SA Comfort Company Single Swingaway Lateral Hardware Right Left $263/ea E1028 LT1-RGD Comfort Company Single Rigid Lateral Hardware Right Left $79.00/ea E0956 LT1-L/RS4W4T Comfort Company Single Lateral Pad Rigid, 5 W x 4 T, Stretch-Air Cover Right Left circle xs,s,m,l $53.00/ea E0956 CHEST HARNESS 1401 Loop Style Positioning Chest Strap $105.00 E0960 SH103M Chest Strap BODYPOINT Monoflex, Rear-Pull M $110.00 E0960 BUTTERFLY STYLE: PBH Padded Butterfly Positioning Chest Strap $143.00 E0960 SH331L-B1 BODYPOINT Stayflex, Narrow Front-Pull L without zipper $168.00 E0960 Right Left CHOOSE JOYSTICK TYPE: DXREM420 Standard Joystick Module. No LCD Display and No Mono Jacks DX2 Color LCD Display w/mono Jack Ports for External Switches $380.00 E2323 E2323 CHOOSE JOYSTICK HANDLE TYPE: Cone-Shaped - Standard BodyPoint U Shaped w/flex Shaft 3 4 $143.00 E2323 BodyPoint Rubber Grip Handle 3 $134.00 E2323 BodyPoint Mushroom Head Rubber Grip Handle 2 2.5 $134.00 E2323 $134.00 E2323 CHOOSE JOYSTICK MOUNT: Left - Adjustable Depth Right- Adjustable Depth Swingaway Joystick Left Right $480.00 E2323 Midline Mount Left Armrest Right Armrest Call for Quote E1028 JOYSTICK ACCESSORIES: JSLK Joystick Lock- Electronically locks chair from driving $175.00 RVAL Reverse Alarm $175.00 ALTERNATIVE DRIVE SYSTEMS: Head Array Chin Control ASL Stealth Bibmount (Mini) Stealth Switch-It Swingaway Headrest Mount Call for Quote ENVIRONMENTAL CONTROLS: iportalacc Control Unit - Integrates Apple Devices (iphone, ipod, ipad) into Dynamic Control System through Blue Tooth Connection $950.00 iportacc + Mouse Move iportal with Computer Mouse Accessibility. Allows user to operate any computer through sip and puff, head array, or joystick through Blue Tooth connection $1,600.00 HIP GUIDES 1509 Hip Guides $300.00 KNEE ADDUCTORS I2010 Knee Adductors; Multi-Axis; Removable with 4.5x6 Pad $380.00
Client: P.O.#: X8 MSRP List 1608 1608XL ABSB EB205L-B1/HW312-KIT WC19 Push Button Style Seat Pos. Strap - 64 Push Button Style Seat Pos. Strap - 80 Airline Buckle Seat Pos. Strap BODYPOINT Evoflex Pelvic Stabilizer L And Mounting Bracket Kit $120.00 $145.00 Transit Hooks (WC 19 Compliant) with Lap Belt $1250.00 X8 Seating Systems below include: Either a MPS Seat/Seat Cushion, MPS Seat Back w/ Solid Seat Pan, or Rehab Seat (see pg. 1 for a description of each style), and height adjustable armrest. (No charge if ordered w/ Power Tilt or Recline) 1330 1872 1342 1337 2170 RDC X8 MPS Seating System or Rehab Seating and No Power Seating Options X8 50 Power TIS* X8 Rehab Seating System w/ 135 Integrated Shear Reduction (ISR) Power Recline* X8 MPS Seating System w/ 135 Power Recline* X8 12 Seat Elevator* - 300 lb. Capacity Reduced Drive Capability TIS Seat Elevator (Option for driving while elevated and/or tilted) Must be ordered with upgraded electronics SFCK or MFCK depending on number of options selected $2,780.00 $4,995.00 $4,968.00 $3,495.00 $4,495.00 $700.00/ea. K0108 E1002 E1004 E1003 E2300 K0108 SFC Single Seat Function Control it - Function through oystick For operation of a single seat function through the wheelchair electronics via the drive controls and/or membrane switch. TOG2 Separate Toggle $1 365.00 E2310 $ 600.00 (add for separate toggle) MFC Multiple Seat Function Control it - Function through oystick M T be selected if ordering two or more seat functions. This device is used to operate two or $2 7 3.00 E2311 more seat functions through the wheelchair electronics via the drive controls and/or membrane switch. TOG4 Separate Toggle $ 600.00 (add for separate toggle) 12 x 12 12 x 14 14 x 12 14 x 14 14 x 16 16 x 16 16 x 18 18 x 16 18 x 18 18 x 20 20 x 18 20 x 20 22 x 18 22 x 20 24 x 18 24 x 20 1360 1520 151 1520 Standard MPS Seat Back 22 4 Extra Tall Seat Back All inyl Seat Back 4 Extra Tall Seat Back - All inyl $3 5.00 $1 5.00 $5 0.00 C -FN 46G M2-F B -M B -R B - Curve ushion - Molded foam w/ medial lateral thigh supports - si e: W x L Elements ushion - Single layer foam with uadra gel pack - si e: W x L M2 ushion - uadra gel with pelvic lateral medial thigh supports - si e: W x L ACTA - ac - with moldable center section and high resiliency wings circle height: 12 14 16 18 20 22 Radius ac - with high resiliency foam circle height: 12 14 16 18 20 22 isco Back - with high resiliency foam circle height: 12 14 16 18 20 22 $86.00 $86.00 $305.00 $640.00 $636.00 $578.00 E2601 E2601 E2607 E2613 E2611 E2611
Client: P.O.#: X8 MSRP List 13 6 Removable Clear Polycarb Table (May not work w/ some options) $525.00 E0 80 1605 Waterproof Wheelchair Cover $121.00 0108 1606 Waterproof oystick Cover $40.00 0108 1604 Deluxe Backpack $64.00 0108 1603 Armrest Bag $26.00 0108 2304 Full Lighting it- 2 headlights 2 Red Marker Lights w/turn Signals through oystick $ 5.00 0108 1141/1137/1363 Luggage Rack $270.00 0108 PT0035 Cane Holder (May not work w/some options) $302.50 PT0052 Cup Holder $100.00 PT0036 Lift Brackets- sed with 4-Point Boom Lift (NOT approved as transport tie downs) $368.00 A02H Articulating Oxygen Holder $800.00 PWB Power Buddy- Includes SB Charging Port and Reading Light $11. 5 1575C All Terrain Tire Complete w/ Rim Single Pair $175.00/ea. 1595 ack $150.00 LGS C Lift Gate Service (For facilites without dock) $105.00 *discounts do not apply BAT BCSTD BAT-G Group 24 Sealed LA/AGM, Installed (Two Required) Battery Charger Group 24 Sealed Gel Installed $275.00/ea. $325.00/ea. E2363 E2363 Special Notes: *Please note that the HCPCS codes indicated on this order form are our interpretation of the new codes and how we believe our products should be coded. The individual DMERC S will determine if our interpretation is appropriate and whether or not items will be accepted or denied. IIM cannot guarantee that use of the designated codes will ensure coverage or payment. Contact the insureer to confirm compliance with coding and coverage policy. *Innovation In Motion recommends all wheelchairs be fitted and programmed to the user under the guidance of the healthcare professional, knowledgeable of the particular limitations of the product. *All specifications and dimensions are approximate. *Specifications and prices are subject to change without notification. *Effective IIIQTR2014.