Mark Fr: Submitting fr: Qute Order Dealer Cntact: Dealer Dealer Phne: ( ) Fax: ( ) JAY J3 Psterir (PA) Backrest E2613 (<22" Wide) Cnfirmatin Email: Ship T City: Cnfirm Via: Fax Email Ship T Phne: ( ) Fax:( ) 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 the apprpriate payer's cverage plicy. JAY J3 Psterir (PA) BACK - E2613 Ship T: Attentin: Lwer Thracic (LT) 9.5" Mid Thracic (MT) Upper Thracic (UT) BACKREST WID BACKCANE WIDS MAX. USER TRUNK WID 6.5" 8.0" Shulder Height () J3PASxx J3PASxx J3PASxx J3PALTSxx J3PALTSxxRH J3PALTSxxRHF J3PALTMxx J3PALTMxxRH J3PALTMxxRHF J3PALTTxx J3PALTTxxRH J3PALTTxxRHF J3PAMTSxx J3PAMTSxx J3PAMTSxx J3PAMTMxx J3PAMTMxx J3PAMTMxx J3PAMTTxx J3PAMTTxx J3PAMTTxx J3PAUTSxx J3PAUTSxx J3PAUTSxx J3PAUTMxx J3PAUTMxx J3PAUTMxx J3PAUTTxx J3PAUTTxx J3PAUTTxx J3PAMxx J3PAMxx J3PAMxx J3PATxx J3PATxx J3PATxx 12" 14" 16" 18" 20" 12"- 14" 14"- 16" 16"- 18" 18"- 20" 20"- 22" 11" 13" 15" 17" 19" 14 $535 16 $535 18 $535 14 $535 16 $535 18 $535 14 $535 16 $535 18 $535 12 $535 14 $535 16 $535 18 $535 12 $535 14 $535 16 $535 18 $535 12 $535 14 $535 16 $535 18 $535 12 $535 14 $535 16 $535 18 $535 20 $535 12 $535 14 $535 16 $535 18 $535 20 $535 12 $535 14 $535 16 $535 18 $535 20 $535 12 $535 14 $535 16 $535 18 $535 20 $535 12 $580 14 $580 16 $580 18 $580 20 $580 12 $580 14 $580 16 $580 18 $580 20 $580 12 $535 14 $535 16 $535 18 $535 20 $535 12 $580 14 $580 16 $580 18 $580 20 $580 12 $580 14 $580 16 $580 18 $580 20 $580 12 $535 14 $535 16 $535 18 $535 20 $535 12 $580 14 $580 16 $580 18 $580 20 $580 12 $580 14 $580 16 $580 18 $580 20 $580 12 $535 14 $535 16 $535 18 $535 20 $535 12 $580 14 $580 16 $580 18 $580 20 $580 12 $580 14 $580 16 $580 18 $580 20 $580 14 $535 16 $535 18 $535 20 $535 14 $580 16 $580 18 $580 20 $580 14 $580 16 $580 18 $580 20 $580 14 $535 16 $535 18 $535 20 $535 14 $580 16 $580 18 $580 20 $580 14 $580 16 $580 18 $580 20 $580 14 $535 16 $535 18 $535 20 $535 14 $580 16 $580 18 $580 20 $580 14 $580 16 $580 18 $580 20 $580 16 $535 18 $535 20 $535 16 $580 18 $580 20 $580 16 $580 18 $580 20 $580 18 $535 20 $535 18 $580 20 $580 18 $580 20 $580 Nte: Hardware chices are nt ffered n every size f J3 Backrest, nly ptins listed abve are available. RH RHF Custmer Service: 800-333-4000 Fax: 800-300-7502 Email: rders@sunmed.cm www.sunrisemedical.cm Specificatins are subject t change withut ntice. Cpyright 2017 Sunrise Medical (US) LLC. J3 Back, MK-100141 REV. C Page 1 f 8
Mark Fr: Submitting fr: Qute Order Dealer Cntact: Dealer Dealer Phne: ( ) Fax: ( ) JAY J3 Psterir (PA) Backrest E2614 (>22" Wide) Ship T: Attentin: Cnfirmatin Email: Ship T City: Cnfirm Via: Fax Email Ship T Phne: ( ) Fax:( ) 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 the apprpriate payer's cverage plicy. JAY J3 Psterir BACK - E2614 Back Height Lwer Thracic (LT) 6.5" Mid Thracic (MT) Upper Thracic (UT) Shulder Height () BACKREST WID BACKCANE WIDS MAX. USER TRUNK WID 8.0" 9.5" J3PAMTSxx J3PAMTSxx J3PAMTTxx J3PAMTTxx J3PAUTMxx J3PAUTMxx J3PASxx J3PASxx 22" 24" 26" 22"-24" 24"-26" 26"-28" 21" 23" 25" 22 $795 24 $795 26 $795 22 $795 24 $795 26 $795 22 $795 24 $795 26 $795 22 $795 24 $795 26 $795 22 $795 24 $795 22 $795 24 $795 22 $795 22 $795 Nte: Back shells 22"-26" will measure 1" t 4" shrter as the material has been remved t accmmdate additinal tissue. (MT std -1", MT tall -2", UT med -3", std -4") Nte: Hardware chices are nt ffered n every size f J3 Backrest, nly ptins listed abve are available. Custmer Service: 800-333-4000 Fax: 800-300-7502 Email: rders@sunmed.cm www.sunrisemedical.cm Specificatins are subject t change withut ntice. Cpyright 2017 Sunrise Medical (US) LLC. J3 Back, MK-100141 REV. C Page 1 f 8
Mark Fr: Submitting fr: Qute Order Dealer Cntact: Dealer JAY J3 Psterir Lateral (PL) Backrest E2615 Ship T: Attentin: Dealer Phne: ( ) Fa( ) Cnfirmatin Email: Ship T City: Cnfirm Via: Fax Email Ship T Phne: ( ) Fax:( ) 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 the apprpriate payer's cverage plicy. JAY J3 Psterir Lateral BACK - E2615 Lwer Thracic (LT) X Y 6.5" 8" 9.5" Upper Thracic (UT) X Y Shulder Height () X Y BACKREST WID BACKCANE WIDS MAX. USER TRUNK WID 5.5" 7.5" 5.5" 8.5" J3PLSxx 5.5" 8.5" J3PLSxx J3PLSxx J3PLMxx 5.5" 9.5" J3PLMxx J3PLMxx J3PLTxx 5.5" 10.5" J3PLTxx J3PLTxx 12 $625 14 $625 16 $625 18 $625 20 $625 12 $670 14 $670 16 $670 18 $670 20 $670 12 $670 14 $670 16 $670 18 $670 20 $670 12 $625 14 $625 16 $625 18 $625 20 $625 12 $670 14 $670 16 $670 18 $670 20 $670 12 $670 14 $670 16 $670 18 $670 20 $670 12 $625 14 $625 16 $625 18 $625 20 $625 12 $670 14 $670 16 $670 18 $670 20 $670 12 $670 14 $670 16 $670 18 $670 20 $670 12 $625 14 $625 16 $625 18 $625 20 $625 12 $670 14 $670 16 $670 18 $670 20 $670 12 $670 14 $670 16 $670 18 $670 20 $670 14 $625 16 $625 18 $625 20 $625 14 $670 16 $670 18 $670 20 $670 14 $670 16 $670 18 $670 20 $670 14 $625 16 $625 18 $625 20 $625 14 $670 16 $670 18 $670 20 $670 14 $670 16 $670 18 $670 20 $670 14 $625 16 $625 18 $625 20 $625 14 $670 16 $670 18 $670 20 $670 14 $670 16 $670 18 $670 20 $670 16 $625 18 $625 20 $625 16 $670 18 $670 20 $670 16 $670 18 $670 20 $670 18 $625 20 $625 18 $670 20 $670 18 $670 20 $670 Nte: Hardware chices are nt ffered n every size f J3 Backrest, nly ptins listed abve are available. Mid Thracic (MT) X Y J3PLMTSxx 4.5" 5.5" J3PLMTSxx J3PLMTSxx J3PLMTMxx 4.5" 7.0" J3PLMTMxx J3PLMTMxx J3PLMTTxx 4.5" 8.5" J3PLMTTxx J3PLMTTxx J3PLUTSxx J3PLUTSxx J3PLUTSxx J3PLUTMxx J3PLUTMxx J3PLUTMxx J3PLUTTxx J3PLUTTxx 5.5" 9.5" J3PLUTTxx 12" 14" 16" 18" 20" 12"- 14" 14"- 16" 16"- 18" 18"- 20" 20"- 22" 9.5" 11.5" 15.5" 17.5" Custmer Service: 800-333-4000 Fax: 800-300-7502 Email: rders@sunmed.cm www.sunrisemedical.cm Specificatins are subject t change withut ntice. Cpyright 2017 Sunrise Medical (US) LLC. J3 Back, MK-100141 REV. C Page 1 f 8
Mark Fr: Submitting fr: Qute Order Dealer Cntact: Dealer Dealer Phne: ( ) Fa( ) JAY J3 Psterir Deep (PD) Backrest E2620 Ship T: Attentin: Cnfirmatin Email: Ship T City: Cnfirm Via: Fax Email Ship T Phne: ( ) Fax:( ) 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 the apprpriate payer's cverage plicy. JAY J3 Psterir Deep BACK - E2620 Lwer Thracic (LT) 6.5" 8" 9.5" Mid Thracic (MT) Upper Thracic (UT) Shulder Height () BACKREST WID 14" 16" 18" 20" BACKCANE WIDS 14"- 16" 16"- 18" 18"- 20" 20"- 22" MAX. USER TRUNK WID 11" 13" 15" 17" J3PDMTSxx J3PDMTSxx J3PDMTSxx J3PDMTTxx J3PDMTTxx J3PDMTTxx 14 $750 16 $750 18 $750 20 $750 14 $795 16 $795 18 $795 20 $795 14 $795 16 $795 18 $795 20 $795 14 $750 16 $750 18 $750 20 $750 14 $795 16 $795 18 $795 20 $795 14 $795 16 $795 18 $795 20 $795 J3PDUTMxx 14 $750 16 $750 18 $750 20 $750 J3PDUTMxx 14 $795 16 $795 18 $795 20 $795 J3PDUTMxx 14 $795 16 $795 18 $795 20 $795 J3PDSxx J3PDSxx J3PDSxx 14 $750 16 $750 18 $750 20 $750 14 $795 16 $795 18 $795 20 $795 14 $795 16 $795 18 $795 20 $795 Nte: Hardware chices are nt ffered n every size f J3 Backrest, nly ptins listed abve are available. Custmer Service: 800-333-4000 Fax: 800-300-7502 Email: rders@sunmed.cm www.sunrisemedical.cm Specificatins are subject t change withut ntice. Cpyright 2017 Sunrise Medical (US) LLC. J3 Back, MK-100141 REV. C Page 1 f 8
Mark Fr: Submitting fr: Qute Order Dealer Cntact: Dealer Dealer Phne: ( ) Fa( ) JAY J3 Psterir Deep Lateral (PDL) Backrest E2620 Ship T: Attentin: Cnfirmatin Email: Ship T City: Cnfirm Via: Fax Email Ship T Phne: ( ) Fax:( ) 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 the apprpriate payer's cverage plicy. JAY J3 Psterir Deep Lateral BACK - E2620 BACKREST WID 14" 16" 18" 20" BACKCANE WIDS 14"- 16" 16"- 18" 18"- 20" 20"- 22" MAX. USER TRUNK WID 11" 13" 15" 17" Lwer Thracic (LT) X Y 6.5" 8.0" 9.5" Mid Thracic (MT) X Y Upper Thracic (UT) X Y 9.3" Shulder Height () X Y 7.5" 8" 5.8" 6.8" J3PDLUTSxx J3PDLUTSxx J3PDLUTSxx J3PDLUTMxx 8.3" 6.5" J3PDLUTMxx J3PDLUTMxx 6" 8.8" 6.5" J3PDLUTTxx J3PDLUTTxx J3PDLUTTxx J3PDLSxx J3PDLSxx J3PDLSxx J3PDLMxx J3PDLMxx J3PDLMxx J3PDLTxx 9.5" 7.3" J3PDLTxx J3PDLTxx 14 $750 16 $750 18 $750 20 $750 14 $795 16 $795 18 $795 20 $795 14 $795 16 $795 18 $795 20 $795 14 $750 16 $750 18 $750 20 $750 14 $795 16 $795 18 $795 20 $795 14 $795 16 $795 18 $795 20 $795 14 $750 16 $750 18 $750 20 $750 14 $795 16 $795 18 $795 20 $795 14 $795 16 $795 18 $795 20 $795 14 $750 16 $750 18 $750 20 $750 14 $795 16 $795 18 $795 20 $795 14 $795 16 $795 18 $795 20 $795 16 $750 18 $750 20 $750 16 $795 18 $795 20 $795 16 $795 18 $795 20 $795 18 $750 20 $750 18 $795 20 $795 18 $795 20 $795 Nte: Hardware chices are nt ffered n every size f J3 Backrest, nly ptins listed abve are available. Custmer Service: 800-333-4000 Fax: 800-300-7502 Email: rders@sunmed.cm www.sunrisemedical.cm Specificatins are subject t change withut ntice. Cpyright 2017 Sunrise Medical (US) LLC. J3 Back, MK-100141 REV. C Page 1 f 8
Mark Fr: Submitting fr: Qute Order Dealer Cntact: Dealer Dealer Phne: ( ) Fa( ) JAY J3 Psterir Deep Cntur (PDC) Backrest E2620 Ship T: Attentin: Cnfirmatin Email: Ship T City: Cnfirm Via: Fax Email Ship T Phne: ( ) Fax:( ) 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 the apprpriate payer's cverage plicy. JAY J3 Psterir Deep Cntur BACK - E2620 Lwer Thracic (LT) X Y 6.5" 8.0" 9.5" Mid Thracic (MT) X Y Upper Thracic (UT) X Y Shulder Height () X Y BACKREST WID 14" 16" 18" 20" BACKCANE WIDS 14"- 16" 16"- 18" 18"- 20" 20"- 22" MAX. USER TRUNK WID 11" 13" 15" 17" 5".5" 5.2".5" 5.5".5" 6.5".5" 6.5".5" 6.5".5" J3PDCLTMxx J3PDCLTMxxRH J3PDCLTMxxRHF J3PDCLTTxx J3PDCLTTxxRH J3PDCLTTxxRHF J3PDCMTSxx J3PDCMTSxx J3PDCMTSxx J3PDCMTTxx J3PDCMTTxx J3PDCMTTxx J3PDCUTMxx J3PDCUTMxx J3PDCUTMxx J3PDCSxx J3PDCSxx J3PDCSxx 14 $750 16 $750 18 $750 14 $750 16 $750 18 $750 14 $750 16 $750 18 $750 14 $750 16 $750 18 $750 20 $750 14 $750 16 $750 18 $750 20 $750 14 $750 16 $750 18 $750 20 $750 14 $750 16 $750 18 $750 20 $750 14 $790 16 $790 18 $790 20 $790 14 $795 16 $795 18 $795 20 $795 14 $750 16 $750 18 $750 20 $750 14 $790 16 $790 18 $790 20 $790 14 $795 16 $795 18 $795 20 $795 14 $750 16 $750 18 $750 20 $750 14 $790 16 $790 18 $790 20 $790 14 $795 16 $795 18 $795 20 $795 16 $750 18 $750 20 $750 16 $790 18 $790 20 $790 16 $795 18 $795 20 $795 Nte: Hardware chices are nt ffered n every size f J3 Backrest, nly ptins listed abve are available. RH RHF Custmer Service: 800-333-4000 Fax: 800-300-7502 Email: rders@sunmed.cm www.sunrisemedical.cm Specificatins are subject t change withut ntice. Cpyright 2017 Sunrise Medical (US) LLC. J3 Back, MK-100141 REV. C Page 1 f 8
JAY J3 BACK ACCESSORIES All JAY J3 Back accessries are ptinal. All accessries will be factry munted as much as pssible t insure prper shipping (If selected belw). IPPING INSTRUCTIONS N/A Ship Back n Chair (Chair t be rdered separately) N/C N/A Ship accessries munted n back N/C a Optin # HCPCS Definitin Price a Optin # HCPCS Definitin Price HEADRESTS Use this sectin fr selecting headrest. Head supprts are nt available n LT Back Shells r 22"-26" MT Back Shells STEP 1 - Select yur HEADREST POST Please select ne bx frm the belw Headrest Munt & Bracket chices. J3HEDX E1028 Axys Munt & Bracket $220.00 J3HEDO E1028 ONYX Munt & Bracket $200.00 J3HEDL E1028 LINX Munt & Bracket $280.00 J3HEDC E1028 Cbra Munt & Bracket $280.00 J3HEDL2 E1028 LINX 2 Munt & Bracket $310.00 J3HEDF E1028 Cbra Flip Back Munt and Bracket $350.00 AXYS LINX LINX 2 ONYX COBRA COBRA Flipback STEP 2 - Select yur HEADREST PAD Please select ne bx frm the belw Headrest Pad chices. 14 E0955 J3PL14-14" Plush Pad $174.00 AAPS E0955 J3AAPS - Adjust-A-Plush Standard (Lg) $260.00 10 E0955 J3PL10-10" Plush Pad $161.00 AAPM E0955 J3AAPS - Adjust-A-Plush Medium $260.00 8 E0955 J3PL8-8" Plush Pad $161.00 AAPN E0955 J3AAPN - Adjust-A-Plush Narrw (Sm) $260.00 HUPL E0955 J3HUPL - HeadsUp Lrg: 5.3" Lng Arms $310.00 CL E0955 J3CRDLLG - Lrg Cntur Cradle Pad $155.00 HUPM E0955 J3HUPM - HeadsUp Med: 4.1" Sht Arms $310.00 CM E0955 J3CRDLMD - Med Cntur Cradle Pad $143.00 HUPS E0955 J3HUPS - HeadsUp Sml: 3.5" Sht Arms $310.00 PL PM E0955 E0955 J3CPLULG - Large C-Plush Pad J3CPLUMD - Medium C-Plush Pad $155.00 $155.00 PLU STEP 1 - Headrest Pst Example = J3HEDX Heads Up + STEP 2 - Headrest Pad # Example = 14 Adjust-A-Plush = Cntur Cradle Cmpleted JAY J3 Headrest # Example = J3HEDX14 C-Plush UNIVERSAL MOUNTING PLATE J3UHM Universal Headrest Munting Plate Only $52.00 D ADD "CU" LATERAL SUPPORTS Use this sectin fr selecting laterals and hardware. Lateral supprts are nt available n Lwer Thracic Back Shells r 22"-26" MT Back Shells JAY CradleU LATERAL JAY's CradleU Lateral allws yu t ptimize the cntur and prvides lateral supprt behind the backrest cver E0956 JAY CradleU Lateral $250.00 T rder add "CU" t the end f yur J3 back part number The CradleU ships installed n the backrest Only available with 16", 18" & 20" back widths Nt available with LT, PD, & PDL Back Shells Custmer Service: 800-333-4000 Fax: 800-300-7502 Email: rders@sunmed.cm www.sunrisemedical.cm Specificatins are subject t change withut ntice. Cpyright 2017 Sunrise Medical (US) LLC. J3 Back, MK-100141 REV. C Accs Page 7 f 9
J3LAT4X4FX J3LAT4X5FX J3LAT4x6FX LATERAL SUPPORTS Cntinued Use this sectin fr selecting laterals and hardware. Lateral supprts are nt available n Lwer Thracic Back Shells r 22"-26" MT Back Shells LATERAL ORACIC SUPPORT (Fixed) Includes fixed munting hardware. Lateral pads use 3DX cvers with 1/2" Sunmate fam in the cre E0956 LATERAL 4" Depth X 4" Height FIXED J3LAT6X4FX E0956 LATERAL 6" Depth X 4" Height FIXED E0956 LATERAL 4" Depth X 5" Height FIXED J3LAT6X5FX E0956 LATERAL 6" Depth X 5" Height FIXED E0956 LATERAL 4" Depth X 6" Height FIXED J3LAT6X6FX E0956 LATERAL 6" Depth X 6" Height FIXED LATERAL ORACIC SUPPORT (Swing Away) Includes swing-away munting hardware. Lateral pads use 3DX cvers with 1/2" Sunmate fam in the cre J3LAT4X4SA LAT 4X4 W/ S/A MOUNTS - PR $778.00 J3LAT6X4SA LAT 6X4 W/ S/A MOUNTS - PR $778.00 J3LAT4X4 E0956 LATERAL 4" Depth X 4" Height - PAIR J3LAT6X4 E0956 LATERAL 6" Depth X 4" Height - PAIR J3LAT4X5SA LAT 4X5 W/ S/A MOUNTS - PR $778.00 J3LAT6X5SA LAT 6X5 W/ S/A MOUNTS - PR $778.00 J3LAT4X5 E0956 LATERAL 4" Depth X 5" Height - PAIR J3LAT6X5 E0956 LATERAL 6" Depth X 5" Height - PAIR J3LAT4X6SA LAT 4X6 W/ S/A MOUNTS - PR $778.00 J3LAT6X6SA LAT 6X6 W/ S/A MOUNTS - PR $778.00 J3LAT4X6 E0956 LATERAL 4" Depth X 6" Height - PAIR J3LAT6X6 E0956 LATERAL 6" Depth X 6" Height - PAIR J3LAT4X4SAO LAT 4X4 S/A MOUNTS W/ 1" OFET - PR $778.00 J3LAT6X4SAO LAT 6X4 S/A MOUNTS W/ 1" OFET - PR $778.00 J3LAT4X4O E0956 LATERAL 4" D X 4" H W/ 1" OFET - PAIR J3LAT6X4O E0956 LATERAL 6" D X 4" H W/ 1" OFET - PAIR J3LAT4X5SAO LAT 4X5 S/A MOUNTS W/ 1" OFET - PR $778.00 J3LAT6X5SAO LAT 6X5 S/A MOUNTS W/ 1" OFET - PR $778.00 J3LAT4X5O E0956 LATERAL 4" D X 5" H W/ 1" OFET - PAIR J3LAT6X5O E0956 LATERAL 6" D X 5" H W/ 1" OFET - PAIR J3LAT4X6SAO LAT 4X6 S/A MOUNTS W/ 1" OFET - PR $778.00 J3LAT6X6SAO LAT 6X6 S/A MOUNTS W/ 1" OFET - PR $778.00 J3LAT4X6O E0956 LATERAL 4" D X 6" H W/ 1" OFET - PAIR J3LAT6X6O E0956 LATERAL 6" D X 6" H W/ 1" OFET - PAIR SPINE ALIGN POSITIONING COMPONENTS J3 Back LT mdels cme standard with a Small Lumbar, MT,UT and mdels cme standard with a small and large lumbar. SPINE-ALIGN MINI FIT KIT 1 SPINE-ALIGN MINI FIT KIT 2 Includes: 3 wedges, 2 lateral shims, and 2 psterir/lateral pelvic psitining pads. Includes: 5 wedges, 2 lat shims, 2 pst/lat pelvic, 1 lg lumbar, 1 flat shim, and 1 curved J3SPNK112 SPINE-ALIGN MINI FIT KIT 1 (12") $101.00 J3SPNK212 SPINE-ALIGN MINI FIT KIT 2 (12") $139.00 J3SPNK114 SPINE-ALIGN MINI FIT KIT 1 (14") $101.00 J3SPNK214 SPINE-ALIGN MINI FIT KIT 2 (14") $139.00 J3SPNK116 SPINE-ALIGN MINI FIT KIT 1 (16") $101.00 J3SPNK216 SPINE-ALIGN MINI FIT KIT 2 (16") $139.00 J3SPNK118 SPINE-ALIGN MINI FIT KIT 1 (18") $101.00 J3SPNK218 SPINE-ALIGN MINI FIT KIT 2 (18") $139.00 J3SPNK120 SPINE-ALIGN MINI FIT KIT 1 (20") $101.00 J3SPNK220 SPINE-ALIGN MINI FIT KIT 2 (20") $139.00 J3SPNK122 SPINE-ALIGN MINI FIT KIT 1 (22"-26") $101.00 J3SPNK222 SPINE-ALIGN MINI FIT KIT 2 (22"-26") $139.00 LARGE LUMBAR PADS (Back Width) (W" x H" x D") J3SPNLL12 LG LUMBAR (12") (3.5" x 7" x 1.6") J3SPNLL14 LG LUMBAR (14") (3.5" x 7" x 1.6") J3SPNLL16 LG LUMBAR (16") (5.5" x 7" x 1.6") J3SPNLL18 LG LUMBAR (18") (7.5" x 7" x 1.6") J3SPNLL20 LG LUMBAR (20") (9.5" x 7" x 1.6") J3SPNLL22 LG LUMBAR (22"-26") (9.5" x 7" x 1.6") WEDGES (Back Width) (W" x H" x D") J3SPNWE12 WEDGES (12") (3.5" x 6.5" x 1.6") J3SPNWE14 WEDGES (14") (3.5" x 6.5" x 1.6") J3SPNWE16 WEDGES (16") (5.5" x 6.5" x 1.6") J3SPNWE18 WEDGES (18") (7.5" x 6.5" x 1.6") J3SPNWE20 WEDGES (20") (9.5" x 6.5" x 1.6") J3SPNWE22 WEDGES (22"-26") (9.5" x 6.5" x 1.6") SMALL LUMBAR PADS (Back Width) (W" x H" x D") J3SPNSL12 SML LUMBAR (12") (1.8" x 3.2" x 0.8") J3SPNSL14 SML LUMBAR (14") (3.5" x 4.3" x 1") J3SPNSL16 SML LUMBAR (16") (5.5" x 4.3" x 1") J3SPNSL18 SML LUMBAR (18") (7.5" x 4.3" x 1") J3SPNSL20 SML LUMBAR (20") (9.5" x 4.3" x 1") J3SPNSL22 SML LUMBAR (22"-26") (9.5" x 4.3" x 1") OER INDIVIDUAL SPINE-ALIGN COMPONENTS J3SPR Curved Shim J3SPNBS Small Bean Bag J3SPNFL J3SPNBL Flat Shim Large Bean Bag J3SPNLS Lateral Shim J3SPNLP Psterir/Lateral Pelvic $25.00 $27.00 $25.00 $29.00 $47.00 $47.00 W H D Sm Lumbar Lg Lumbar Wedge Curved Slim Flat Lateral Slim Sm Bean Bag Lg Bean Bag Pst/Lat Pelvic 1.8" - 9.5" 3.5" - 9.5" 3.5" - 9.5" 10" 10" 2.4" 6" 10" 5.3" 3.2" - 4.3" 7" 6.5" 4" 4" 4.3" 4.5" 3.2" 3.6" 0.8" - 1" 1.6" 1.6" 0.5" 0.3" 0.5" 0.75" 0.75" 0.75" Custmer Service: 800-333-4000 Fax: 800-300-7502 Email: rders@sunmed.cm www.sunrisemedical.cm Specificatins are subject t change withut ntice. Cpyright 2017 Sunrise Medical (US) LLC. J3 Back, MK-100141 REV. C Accs Page 8 f 9
CHEST STRAPS, HARNESSES, and BRACKETS Use this sectin fr selecting harnesses. Harnesses are nt available n Lwer Thracic Back Shells r 22"-26" MT Back Shells CHEST STRAPS & HARNESSES (Includes strap guides & munting hardware) J3HROS E0960 Center Opening w/ Buckle (Sml) J3HRNTDS E0960 Cntured-Dynamic Pull Dwn (Sml) J3HROM E0960 Center Opening w/ Buckle (Med) J3HRNTDM E0960 Cntured-Dynamic Pull Dwn (Med) J3HROL E0960 Center Opening w/ Buckle (Lrg) J3HRNTDL E0960 Cntured-Dynamic Pull Dwn (Lrg) J3HROX E0960 Center Opening w/ Buckle (X-Lrg) J3HRNTDX E0960 Cntured-Dynamic Pull Dwn (X-Lrg) J3HRDS E0960 Classic-Dynamic Pull Dwn (Sml) J3HRNTSS E0960 Cntured-Structured Pull Dwn (Sml) J3HRDM E0960 Classic-Dynamic Pull Dwn (Med) J3HRNTSM E0960 Cntured-Structured Pull Dwn (Med) J3HRDL E0960 Classic-Dynamic Pull Dwn (Lrg) J3HRNTSL E0960 Cntured-Structured Pull Dwn (Lrg) J3HRDX E0960 Classic-Dynamic Pull Dwn (X-Lrg) J3HRNTSX E0960 Cntured-Structured Pull Dwn (X-Lrg) J3HRSS E0960 Classic-Structured Pull Dwn (Sml) J3HRNPSS E0960 Padded Anterir Trunk Straps (Sml) J3HRSM E0960 Classic-Structured Pull Dwn (Med) J3HRNPSM E0960 Padded Anterir Trunk Straps (Med) J3HRSL E0960 Classic-Structured Pull Dwn (Lrg) J3HRNPSL E0960 Padded Anterir Trunk Straps (Lrg) J3HRSX E0960 Classic-Structured Pull Dwn (X-Lrg) J3HRNPSX E0960 Padded Anterir Trunk Straps (X-Lrg) A B C D E F G H A B C D E F G H A B C S 15" 4.5" 2" 9" 4" 4" 2" 8.5" S 15" 4.5" 2" 9" 1" 4" 2" 8.5" S 12.3" 9" 6.5" M 19" 5.5" 2" 11" 5" 5" 3" 9.5" M 18.5" 5.5" 2" 11" 1" 5" 2.5" 9.5" M 14.3" 11" 9.8" L 6.5" 2" 13" 6" 6" 3.5" 10.5" L 6.5" 2" 13" 1.5" 6" 3.5" 10.5" L 15.5" 11.5" 9.8" XL 25.5" 6.5" 2.5" 14" 7" 7" 4.5" 11.5" XL 25.5" 6.5" 2.5" 14" 1.5" 7" 4.5" 11.5" XL 17.5" 12.8" 10" GUIDE BRACKETS & HARDWARE ONLY J3GPSG Guide Brackets Only - Pair $41.00 J3HHP Hardware Pack Only 12" t 14" Wide 117100 MILITARY SERVICE PATCHES VAPH Purple Heart Service Patch 117096 117097 117098 117099 Classic Style 14" t 16" Wide 16" t 18" Wide 18" t 20" Wide Army Service Patch VACG Cast Guard Service Patch CUSTOM EMBROIDERY EMBROIDERY Embridery (32 Character Max) $22.00 Lcatin: Frnt Fnt: Blck Script $125.00 VAN Navy Service Patch Cntur Style VANITY FLAP All 22"-26" wide J3 Back shells ship standard with the vanity flap included SFPXT Extra Tall Spinal Fluid Pad (23" Height) $50.00 VISCO FOAM INSERT VF Visc Fam Insert $50.00 Nte: 2 Layers f 1" Yellw Visc fam is utilized as standard. Different clrs f visc fam can be utilized just list desired clr in ntes belw. Dn't see the ptin yu want? NO PROBLEM! Write yur request belw and we can evaluate it and prvide a qute. Ntes: 117101 117102 117103 VFWSR 20" t 22" Wide 22" t 24" Wide 24" t 26" Wide 26" t 28" Wide Center-Opening with Buckle INNER COVER T rder a ptinal inner cver enter a additinal line item by adding "IC" t the frnt f yur desired J3 back part number and remve yur hardware suffix. Add "IC" Inner Cver JAY YOUR WAY MODIFICATIONS Nte: T rder sizes ffered via JAY Yur Way add a "M" t the frnt f the part number and fllw the prmpts. Fr additinal mdificatins visit www.sunrisemedical.cm t view even mre! PAINTED BACK ELL COVER COLOR OPTIONS - Rear Center Flap SBC Painted Back Shell DCC Digital Camuflage Cver Clr: Match Quickie r Zippie Frame Clr SPINAL FLUID PAD Nte: Backshells can be painted any Quickie Or Zippie Frame clr at n charge please specify the desired clr in the NOTES bx belw. Fr a full listing f frame clrs available please visit www.sunrisemedical.cm SFPS SFPM SFPT Small Spinal Fluid Pad (16" Height) Medium Spinal Fluid Pad (18" Height) Tall Spinal Fluid Pad (20" Height) $50.00 $50.00 $50.00 VAM VAA VAAF Air Frce Service Patch Embridery Text: Marine Service Patch $20.00 Visc Fam Insert with Spinal Relief $50.00 Custmer Service: 800-333-4000 Fax: 800-300-7502 Email: rders@sunmed.cm www.sunrisemedical.cm Specificatins are subject t change withut ntice. Cpyright 2017 Sunrise Medical (US) LLC. J3 Back, MK-100141 REV. C Accs Page 9 f 9