Quickie 2 September 2017 EIQ2X a Mark Fr: Submitting fr: Qute ST: Dealer Phne: ( ) Fax: ( ) ZIP: Cnfirmatin Email: Ship T City: ST: ZIP: 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. Specificatins are subject t change withut ntice. Optin # Date: Dealer Acct #: Dealer: Dealer Cntact: Dealer Address: Dealer City: HCPCS Definitin Price a 1. FRAME Optin # PO#: Ship T: Attentin: Address: Address: HCPCS Definitin Order ADDITIONAL SHIPPING INFORMATION Price Base mdel E1236 cding still applies fr EIQ2X with certain sizes 002WM32 K0005 Quickie 2 $2,050.00 002RS1 002RS2 Rear Frame Type (300 lbs. Weight Capacity) Rear Side Frame Straight Rear Side Frame Runded Transit Optin NA n Strller Handles (Remvable Push Handles) r Xtender 002TO46 Transit System WC19 $315.00 002RS3 Depth Adjustable Back (DAB) NA w/ swing-away, flip-back armrests. Backrest set 2" rear f seat tube w/ 1" adjustable frward. $195.00 002FS31 002FS30 Frame Style Standard Swing Away Hemi Swing Away 002HV1 Heavy Duty Package (350 lbs. weight capacity) Heavy Duty (18"-22" Wide nly) NA w/ Xtender. Includes Reinfrced Back Uphlstery & Stabilizer Bar. $500.00 Frame Width Frame Depth 002W3 12" Seat Depth can be rdered up t 3" smaller fr grwth.std & HD frame available with 13"-20" 002W4 13" frame Depth. Hemi available 16-18 & 20 frame depth. Please refer t matrix in page 8 f 002W5 14" Appendix fr frame Depth Vs seat Depth matrix. Grwth is achieved t the frnt f the depth. 002W6 002FD4 13" 002W7 16" 002FD5 14" 002W8 17" 002FD6 002W9 18" 002FD7 16" 002W10 19" 002FD8 17" 002W11 E2201 20" $500.00 002FD9 18" 002W12 E2201 21" (Only Avail. w/ Heavy Duty) $500.00 002FD10 19" Steel reinfrced 002W13 E2201 22" (Only Avail. w/ Heavy Duty) $500.00 002FD36 20" Steel reinfrced Seat Depth Seat Sling 12" seat depth nt available with Hemi frame 002SL1 Standard Seat Sling 002SD5 12" 002SL6 Omit Seat Sling -$15.00 002SD6 13" JAY Cushins (Optinal) 002SD7 14" T rder any JAY cushins n-chair, please see the JAY price list. 002SD8 Cushin name r part number must be filled ut with desired width and depth 002SD9 16" JAY Bundled Cushin 002SD10 17" 002JC20 Cushin Name r Part # Price List 002SD11 002SD72 002SD13 E2203 18" 19" 20" 2. SIZE / SEATING Width: Depth: $75.00 Cushin $550.00 002CU1 2" Cushin $120.00 Custmer Service: 800-333-4000 Fax: 800-300-7502 Email: rders@sunmed.cm www.sunrisemedical.cm Page 1
3. CASTERS / SEAT HEIGHT Frnt Seat Height Please see matrix n Page 9 fr additinal infrmatin. 13.5"-14" Hemi nly Caster Frk Please see matrix n Page 9 fr additinal infrmatin. Frg Legs nt 21.5"-22" nt available in Hemi Frame available with Integral caster husing 002SH40 13.5" 002SH18 18.0" 002CF46 Multi Psitin Frk-Shrt 002SH41 14.0" 002SH20 18.5" 002CF47 Multi Psitin Frk- Tall 002SH42 14.5" 002SH21 19.0" 002CF62 3" Frk 002SH12 15.0" 002SH23 19.5" 002CF12 5 1/4" Frk 002SH13 15.5" 002SH24 20.0" 002CF17 6 " Frk 002SH14 16.0" 002SH26 20.5" 002CF23 7" Frk 002SH15 16.5" 002SH27 21.0" 002CF29 8" x 2" Frk 002SH16 17.0" 002SH29 21.5" Multiple Psitin 002CF65 002SH17 17.5" 002SH36 22.0" Integral caster husing nly Caster Wheels 002CF69 Multiple Psitin Single Sided Frk Integral caster husing nly $150.00 All 8" casters NA w/ 90 hangers r 13"-14" frame depth. 002CF53 E1015 Frg Legs Suspensin (0-100 lbs) $425.00 See matrix n page 9. 002CF54 E1015 Frg Legs Suspensin (101-190 lbs) $425.00 002CW1 3" Micr 002CF55 E1015 Frg Legs Suspensin (191-265 lbs) $425.00 002CW3 4" Lw Prfile Plyurethane NA w/ HD package 002CW31 4" Micr Lighted $70.00 Caster Optins 002CW72 002CW44 4" x 1" Aluminum Plyurethane 4" x 1.25" Semi Pneumatic $100.00 $55.00 002OC1 K0073 Caster Pin Lcks (N/A w/8"x2") NA w/ Xtender, Frg Legs r Transit $195.00 002CW64 4" x 1.5" Aluminum Sft Rll $175.00 002CW5 002CW51 5" Lw Prfile Plyurethane 5" Micr Lighted Standard 002CW6 5" Sft Rll (Grey) NA w/ Frg Legs 002CW65 5" x 1" Aluminum Plyurethane $110.00 002CW7 5" x 1.5" Semi-Pneumatic 002CW66 5" x 1.5" Aluminum Sft Rll 002CW34 6" Plyurethane 002CW33 E2214 E2215 6" Pneumatic $75.00 002CW35 002CW68 6" x 1.5" Semi Pneumatic 6" x 1.5" Aluminum Sft Rll $195.00 Multi Psitin Frg Leg 002CW16 002CW32 002CW21 E2214 E2215 7" Plyurethane 8" Plyurethane 8" Pneumatic $75.00 integral Caster Husing Multi Psitin Single side 002CW39 8" x 1.5" Semi Pneumatic 002CW36 E2214 E2215 8" x 2" Pneumatic $145.00 002CW37 E2214 K0108 8" x 2" Pneumatic w/airless Insert $225.00 Caster Husing Integral bearing frks nly available with Integral caster husing 002CP2 Standard 002CP14 Integral Caster Husing NA with caster Pin lcks $75.00 Custmer Service: 800-333-4000 Fax: 800-300-7502 Email: rders@sunmed.cm www.sunrisemedical.cm Page 2
4. REAR WHEELS / SEAT HEIGHT 002RH11 13.0" 002RH26 17.5" 002RH12 13.5" 002RH20 18.0" 002RH13 14.0" 002RH27 18.5" 002RH14 14.5" 002RH21 19.0" 002RH15 15.0" 002RH37 19.5" 002RH16 15.5" 002RH22 20.0" 002RH17 16.0" 002RH38 20.5" 002RH18 16.5" 002RH23 21.0" 002RH19 17.0" 002RH39 21.5" 002RH40 22.0" E0958 One Arm Drive Adj. Axle Plate $850.00 002OA1 Small Handrim (NA w/ 20" wheels) 002OA2 Standard Handrim RH psitin Select Wheel Size: 20" 22" Please select ne f the fllwing handrim ptins 002XH5 Plastic Cated 002XT4 E0986 Axle Quick Release Steel LH psitin Xtender Pwer Assist RSH f 14.5"-20" fr 22" rear wheels and RSH 15.5"-21" fr 24" wheels. Frnt seat height must be greater than rear. NA HD Package r Transit Optin.Dual Drive mde available with B4ME. Max weight capacity f 265 lbs 002AL102 002AL6 002AX1 002AX11 002AL16 002XT6 002XT7 002XT5 002XH6 E0959 E0986 E0986 E0986 Rear Seat Height Axle Plate Standard Adjustable (All in-ne) Amputee Adjustable NA w/ Padded Armrest Quad Quick Release Muntain Wheel nly One Arm Drive Xtender Pwer Assist 22" Xtender Pwer Assist JWX-2 NICKEL Stainless Steel 24" 22" Xtender Pwer Assist JWX-2 LITHIUM 24" Xtender Pwer Assist JWX-2 NICKEL 24" Xtender Pwer Assist JWX-2 LITHIUM $175.00 NA w/ Xtender, 12", 21" & 22" wide, HD package, amputee axle plates, and small tray table. NA w/ cmbinatin f Padded SA arms and Anti tips. Only available w/ 20", 22", 24" mag wheels. Only available in 6 spke Mags $7,895.00 $8,695.00 $7,895.00 $8,695.00 002RW103 002RW104 002RW28 002RW95 002RW97 002RW32 002RW49 002RW111 002RT3 002RT39 002RT27 002RT21 002RT38 002RT12 E2218 Rear Wheel Type Nt applicable w/ Xtender Pwer Assist Optin. Ultra Lightweight Wheels nly available w/ Alum Andized Handrim. Handrims cannt be mitted n Lite Spke Wheels.* Omit Rear wheel will default chair cnfiguratin set up t a 24" wheel 002RW102 002RW90 002RW91 002RW92 002RW93 002RW94 002RW77 002RW78 002RW96 002RW98 002RW99 002RW40 002RW50 002RW25 002RT1 002RT2 E2213 E2218 20" Mag Wheel 5 Spke 22" Mag Wheel 5 Spke 24" Mag Wheel 5 Spke 22" Lite Spke Wheel 24" Lite Spke Wheel 25" Lite Spke Wheel 26" Lite Spke Wheel 22" Ultra Lightweight Spke Wheel 24" Ultra Lightweight Spke Wheel 22" Spinergy SPOX Black 24" Spinergy SPOX Black 25" Spinergy SPOX Black 26" Spinergy SPOX Black 24" Spinergy LX Black 26" Spinergy LX Black 24" Muntain Omit Rear Wheel (Use w/22" Xtender) Rear Wheel Tire Pneumatic Pneumatic Airless Insert Muntain Tire Only available n 24" Muntain Rear Wheel $795.00 $795.00 $795.00 $995.00 $995.00 25" Spinergy LX Black $995.00 Omit Rear Wheel (Use w/24" Xtender) Full Ply High-Pressure Clincher Black Knbby V-TRAK Schwalbe Marathn Plus Evlutin SHOX Perfrmance Ply 20" Lite Spke Wheel $200.00 22" Spinergy LX Black Omit Rear Wheel and Axle * $200.00 $80.00 $250.00 $250.00 $795.00 $995.00 $250.00 -$55.00 $80.00 $95.00 $95.00 $95.00 $95.00 002XA10 002XA11 002XA8 002XA9 002XA2 002XA4 E2213 E2213 Xtender - Other Optins Spare NiMH Pwer Pack - NICKEL Spare Li-in Pwer Pack - LITHIUM Xtender Wheel Optins SPARE 22" Lite Spke Pneu Alum SPARE 22" Lite Spke Pneu Plastic SPARE 24" Lite Spke Pneu Alum SPARE 24" Lite Spke Pneu Plastic $1,395.00 $1,795.00 Custmer Service: 800-333-4000 Fax: 800-300-7502 Email: rders@sunmed.cm www.sunrisemedical.cm Page 3
4. REAR WHEELS / SEAT HEIGHT (CONT) Rear tire, side frame, and axle plate selectins dictate seat height availability. *Nt all cmbinatins are pssible within acceptable seat height ranges Rear Tire 20" Pneumatic, Ply 22" Pneumatic, Ply 22" HP Clincher Blk 22" Schwalbe 24" Pneumatic, Ply 24" Knbby Rear Seat Height Availability Matrices Min RSH Max RSH 14.0" 24" HP Clincher Blk 14.5" 24" Schwalbe 24" SHOX Ply 24" Muntain 15.0" 19.5" 20.5" 20.5" 25" HP Clincher Blk 15.0" 21.0" 25" Schwalbe 25" SHOX Ply 26" Pneumatic 26" HP Clincher Blk 26" Schwalbe 13" 13.5" 13.5" 14.5" 14.5" 15.0" 14.5" 16.0" 15.5" 15.5" 19.0" 20.0" 19.5" 21.0" 21.0" 20.5" 21.0" 21.0" 20.5" 22.0" 21.5" 21.5" Rear Side Frame Min RSH 13 13 Max RSH Curved 13" 21.0" Straight DAB Std Adj 22.0" 22.0" Handrim Natural Fits available in 22", 24", and 25". Handrim selectin NA w/ Xtender. Ultra lightweight wheels nly available w/ alum andized handrim. Plastic cated limited t certain rims and sizes. Natural Fit w/ 5 spke MAG nly available in 24" 002HR1 002HR4 002HR22 002HR25 002HR23 002HR30 002HR31 002HR32 002HR26 002HR27 002HR28 002HR24 002HR7 002HR8 Aluminum Andized Plastic Cated - NA n every rim $95.00 Natural Fit - Standard Grip Natural Fit - N Thumb Grip Natural Fit - Super Grip Natural Fit LT- Standard Grip Natural Fit LT- Super Grip Natural Fit LT - N Thumb Grip The Surge - Oval w/griptin Strip The Surge LT - Oval w/griptin Strip Q-Grip Neprene Cated Spinergy Flex Rim Available n 24" & 25" Spinergy LX wheel Omit Handrim Optin may nt be available n all wheels 8 Oblique NA w/ Xtender. Only available with 24" r 26 " 6 spke Mag r Lite Spke rims. $375.00 $375.00 $410.00 $375.00 $410.00 $375.00 $375.00 $395.00 $315.00 $525.00 $325.00 Axle Plate Std Adj (All in ne) Amputee Min RSH Max RSH 13" 22.0" 14" 22.0" Camber 002CI1 0 00217CI 2 (default) 002CI3 4 Center f Gravity Preset Amputee Axle Plate will cme preset at 1.0 Center f Gravity (CG), range d adjustment is -3.0 t -1.75 and 1.0 t 3.5 CG. Tire Pneumatic Pneumatic w/airless Insert Full Ply Tire Wheel 5 Spke Mag Mag 20,22,24 20,22,24 20,22,24 20,22,24 20,22,24 20,22,24 Lite Spke 20,22,24,26 20,22,24,26 20,22,24 Ultra Lt wt Spinergy 24,26 24,26 002CC2 002CC3 002CC4 002CC5 002CC6 002CC7 1.0" (default) 1.5" 2.0" 2.5" 3.0" 3.5" High Pressure Clinch Blk 22,24,25,26 Knbby V-TRAK Schwalbe Marathn SHOX Perfrm. Ply 20,22,24 24,25,26 22,24 20"= 451 mm 22" = 501 mm 24" = 540 mm 25" = 559 26" = 590 24 24,25 22,24 22,24,26 24 24,25,26 24,25 002CC30 002CC31 002CC32 One Arm Drive CG 1AD Frward psitin 1AD Reward psitin 1AD Center psitin 5. WHEEL LOCKS Erg & cmpact NA w/ 13"-14" frame depth r amputee axle plate. Additinal N Gs may exist depending n wheel size and psitin 002WL46 002WL50 002WL75 002WL64 002WL24 002WL23 002WL10 Erg Scissr Cmpact Wheel Lck High Munt Push High Munt Pull Unilateral Wheel Lck Right Unilateral Wheel Lck Left Omit $110.00 $300.00 NA w/ erg scissr r cmpact wheel lcks 002EH7 E0961 Extensin Handle (Pair) $300.00 Only available w/ high munt push r pull t lck wheel lcks n pneumatic r pneumatic w/ airless tire ptins 002WL12 002GA1 E0974 Wheel Lck Optin D Nt Munt Extensin Handle Grade Aid Grade Aid $65.00 $150.00 Custmer Service: 800-333-4000 Fax: 800-300-7502 Email: rders@sunmed.cm www.sunrisemedical.cm Page 4
002LO01 9.0"(*) 002LO13 15.0" 002H145 60 Swing In/Out Hanger 002LO02 9.5"(*) 002LO14 15.5" 002H139 70 Swing In/Out Hanger 002LO03 10.0" 002LO15 16.0" 002H141 80 Swing In/Out Hanger 002LO04 10.5" 002LO16 16.5" 002H154 60 Swing In/Out Hanger Hemi 002LO05 11.0" 002LO17 17.0" 002H155 70 Swing In/Out Hanger Hemi 002LO06 11.5" 002LO18 17.5" 002H140 70 Swing In/Out Frnt Munt 002LO07 12.0" 002LO19 18.0" 002H142 80 Swing In/Out Frnt Munt 002LO08 12.5" 002LO20 18.5" 002H158 90 Swing In/Out Frnt Munt 002LO09 13.0" 002LO21 19.0" Articulating Hanger - Ext Munt 002LO10 13.5" 002LO22 19.5" 002H159 K0053 NA w/ Platfrm Flip Up and Alum Angle Adj $350.00 002LO11 14.0" 002LO23 20.0" Frnt Munt ftplates, 14"-22" width 002LO12 14.5" 002LO24 20.5"Std. Only* Heel lp r leg strap nt included, See Ftplate Optins Sectin 002H160 002F271 002F3 002F7 E0990 K0040 E0951 K0040 Hangers Frnt munt hangers nly available w/ aluminum angle adj ftplates. ALR/ELR Hangers NA w/ Push T Lck wheel lcks. 002H161 002H32 002F1 002F8 002F5 002F48 E0990 K0040 K0040 Elevating Hanger - Ext Munt NA w/ Platfrm Flip Up and Alum Angle Adj Frnt Munt ftplates, 14"-22" width Elevating Hanger - Frnt Munt Only available w/ frnt munt alum angle adj ftplates and 14"-22" width Omit Hanger & Ftplate Ftplates Cmpsite (13"-22"w) Cmpsite Angle Adj (16"-22"w) Alum Angle Adj - Ext Mt (12"-22"w) Alum Angle Adj - Frnt Mt(12"-22"w) Alum Ftplate - Fixed (14"-22"w) Available w/ Ext Munt ELR r ALR Platfrm Flip Up Angle Adj (12"-22"w) NA w/ Hemi Hangers,ELR/ALR,Frnt Mnt Omit Ftplate & Ext Tube 6. HANGER & FOOTREST -$15.00 $150.00 $190.00 -$15.00 Recmmend 2" less than FSTFH. (*)dentes frame, 9" & 9.5" Hemi Only (Maximum weight capacity fr Z-Finity ftrests is 165 lbs) Sme interference may exist in certain cnfiguratins. NA with Heavy Duty 002H162 Z-finity Ftrest Munt STD 002DI22 Direct Hanger Mt/Fixed Frame - High 002DI23 002DI24 Z-finity Hanger Direct Hanger Mt/Fixed Frame - Lw Extensin Tube Munt Z-finity Ftrest Pivt Arm 002DI20 Shrt 2" 002DI21 Lng 3 1/4" Z-finity Ftplate Sme interference may exist in certain cnfiguratins. 002F320 K0040 Multi Angle Adjustable (Pair) (nt avail. w/8"-9" widths) 002F321 Lwer Leg Length Setting (Extensin Munt Only) Z-finity Hangers/Ftrest System K0040 Angle Adjustable Platfrm Ftbard $150.00 002HL1 002HL5 Ftplate Optins (Ext Tube & Frnt Munt) E0951 K0038 Heel Lp Leg Strap Ftrest Extensin Tubes Required w/ extensin tube munted hangers. See leg length matrix 002E61 Shrt Hemi 002E1 Shrt 002E2 Medium 002E5 Lng $30.00 $35.00 002F6 Omit Ftplate Z-finity ExtensinTube Length (When Chsing Ext. Tube Munt) 002E62 K0040 Hemi Shrt 002E1 K0040 Shrt 002E2 K0040 Medium 002E5 K0040 Lng 002E16 High Munt NA w/ ne-arm drive ptin r ELR/ALR r 90 frnt munt. Only available w/angle adj ftplates $55.00 002E23 2" - Frnt Munt Only NA w/ 6", 7" r 8" casters with 90 hangers, r ELR's $55.00 002E24 4" - Frnt Munt Only NA w/6", 7" r 8" casters w/ 90 hangers r ELR/ALR $55.00 Custmer Service: 800-333-4000 Fax: 800-300-7502 Email: rders@sunmed.cm www.sunrisemedical.cm Page 5
7. BACKREST / SEATING Must chse DAB Back type with B4ME ptins Std EXO uphlstery and Tensin adj binding is always black. Ballistic Nyln, 3DX & EXO Tensin Adj Uph NA with Heavy Duty. Max back height 20"fr EXO. 002BU1 Standard Uphlstery 002BU88 Standard Uphlstery EXO $50.00 Clr Binding: Silver Orange Red Blue Backrest Tensin Adjust Ballistic 002BU70 E2611 *Reference 186BU70 fr billing Std (19") Med (22") Tall (25") Clr Binding: Silver Orange Red Blue Std (18"-23") Tall (19"-26") 002BT128 B4ME - Reclining Backrest $1,095.00 Med (19") Tall (22") Standard Back type ptins: 002BP1 Push Handle Straight 002BP3 Push Handle 8 Med r Tall nly. NA w/ Angle Adjustable Backrest 002BP4 Angle Adj Back type ptins: 002BP5 Angle Adj. Straight Push Handles 002BP6 Angle Adj. Omit Push Handles, NA w/hd 002UX4 9" 002UX18 16" 002UX6 10" 002UX20 17" 002UX8 11" 002UX22 18" 002UX10 12" 002UX24 19" 002UX12 13" 002UX26 20" (*) 002UX14 14" 002UX28 21" (*) 002BT10 002BT20 002BT22 002BT6 002BT127 Omit push handles NA w/ stabilizer bar 002BP2 002PH17 002B1 002B5 002B9 002UX16 Angle Adjustable Back (5"-7" Pivt) Back Type - Build 4 Me Optins Flding Push Handle with Ht. Adj. Back NA w/angle Adj Back & Heavy D. Back Type Angle Adjustable Back (3-5" Pivt) Depth Adjustable (Required with DAB) Omit Push Handle Straight (NA w/hd) Omit Push Handle 8 (NA w/hd) Med r Tall nly Back Height (Std r Angle Adjustable) Medium (12"-) Tall (16"-19") Back Height Setting (Std r Angle Adjustable) (*)20" & 21" nly w/ Ang Adj Back B4ME - Dynamic Back $1,095.00 Fixed Back pst Back Pst Optins EXO uphlstery nt available with 21" back height Standard Height Adjustable Strller handles Lw (9"-12") Strller Handles (Remvable Push Handles) $25.00 $225.00 Only available w/ mit push handles. NA w/ DAB, amputee axle plate, push handles, r when angle adjustable back is selected, flip-back r flip-back height adjustable armrests, and JAY backs. 002SR2 Regular Strller Handles 002SR3 Tall Strller Handles $25.00 002BU71 Jay GO Backrest 002BU82 E2611 $400.00 NA n Heavy Duty 002BU14 002OD4 002AH2 002AH5 002BD4 002BD3 002BD2 002BD1 E2611 Backrest Tensin Adjust 3DX Vented *Reference 186BU71 fr billing Omit Back Uphlstery Standard Backrest Optin Reinfrced Uphlstery Only avail w/ Std Back Uphlstery. Std w/hd package Angle Adjustable Pivt 3" Angle Adjustable Pivt 5" Angle Adjustable Pivt 6" Angle Adjustable Pivt 7" 002BD5 Back Angle - 15 Back Angle - 12 Back Angle - 6 Back Angle - 0 Back Angle +3 $315.00 $15.00 $330.00 -$15.00 $50.00 Standard push handles nly. Sme interference w/ Padded SA arms. NA w/ flipback r flip-back height adjustable armrests (classic). 002AH1 002AH3 002AH4 Backrest Uphlstery (Standard r Angle Adjustable) 002BU89 E2611 Angle Adjustable Backrest Pivt Height Angle Adjustable Pivt 4" Preset Angle Adjustable Backrest (-15 t +3 ) (Optinal) Back Tube Height Pivt Regular set at 3" Pivt Regular set at 4" Pivt Regular set at 5" $15.00 Backrest Tensin Adj EXO *Reference XXXBU89 fr billing $330.00 13" 14" Pivt Tall set at 5" 14" 16" Pivt Tall set at 6" 16" 17" 16" 17" 18" 17" 18" 19" 17" 18" 19" 18" 19" 20" Pivt Tall set at 7" 16" 17" 18" 19" 20" 21" Adjustable Pivt Pint Measurement frm Seat Sling 19" 20" 21" If back height ptin is nt chsen, middle ptin will be present REFER TO CHART IN DETERMINING PUSH HANDLE LENGTH Angle Adjustable Backrest Chart Lw 12" 13" 14" 14" 16" 15 3 Medium 16" 17" Tall 17" 18" 19" 18" 19" 20" 19" 20" 21" N/A N/A Stabilizer Bar N/A with Flding Push Handle, r with Ht. Adj. Back r DAB Strller handles PSIS SEATING SURFACE CUSHIONTHICKNESS A B 002SZ1 Stabilizer Bar Standard with HeavyDuty Package and Recline $105.00 REGULAR 3 5 TALL 5 7 TO DETERMINETHEPROPER PIVOT-POINT HEIGHT, MEASURE BETWEEN THE PSIS AND THE TOP OF THE SEATING SURFACE (A), THEN ADD THE THIICKNESSOF THE CUSHION (B) IFONE ISUSED. IFADROP-SEATFALLS BELOWTHE SEATRAILS, SUBTRACTTHIS DISTAE FROM THE OVERALLVALUE. Custmer Service: 800-333-4000 Fax: 800-300-7502 Email: rders@sunmed.cm www.sunrisemedical.cm Page 6
7. BACKREST / SEATING (cnt) DAB Back Height 002B66 002B67 Depth Adjustable 12" Depth Adjustable 14" 002B68 Depth Adjustable 16" 002B69 Depth Adjustable 18" 002B70 Depth Adjustable 20" DAB Back Pst Optins Diagram f DAB in Appendix n page 9. SA Strller Handle height range is 21.25"-28.5" 002BP33 DAB - Swing Away Strller Handles $100.00 002BP27 DAB - Pst Standard (19") 002BP28 DAB - Pst Medium (22") 002BP29 DAB - Pst Tall (25") Military Service Patches (Optinal) NA with standard Uphlstery 002VU2 Army Patch 002VU4 Air Frce Patch 002VU12 Cast Guard Patch 002VU1 Marines Patch 002VU3 Navy Patch 002VU5 Purple Heart Patch 002VU9 Purple Heart with Army Patch $145.00 002VU11 Purple Heart with Air Frce Patch $145.00 002VU13 Purple Heart with Cast Guard Patch $145.00 002VU8 Purple Heart with Marines Patch $145.00 002VU10 Purple Heart with Navy Patch $145.00 DAB Backrest ptins JAY Back (Optinal) 002BU28 Omit DAB Slid Back and Hardware 002JB01 J3 Back (See J3 Order Frm) Price List 002BU29 Omit DAB Slid Back Include Hardware $80.00 002BU23 Depth Adjustable Slid Back $195.00 8. ARMREST / SIDE GUARDS NA w/ DAB, Amputee axle. Sme limitatins may exist with integral push handles, sme RSTFHs and wheel sizes. **Nw available w/transit. 002AA18 002AA5 002AA65 Padded Swing-Away STD (9" t 13") $210.00 Setting 9" 10" 11" 12" 13" Padded Swing Away Flip Back NA w/ DAB, Xtender, 12" - 14" frame depth, amputee axle, Classic Style armpad in highest/lwest axle RSH n runded rear frame, r angle adjustable back. 002AA6 Flip Back Height Adj(Classic 8.5"-13.5") Flip Back (incl. Desk Length Pad) Flip Back Height Adj (LITE 8.5"-13.5") Flip Up (Fr use with Depth Adjustable Back) Requires an Armpad r Fam frm the Arm Pad sectin belw 002AA7 002AA1 Length Adjustable Lcking Flip-up Adj. Lcking Flip-up (Std. w/ fam) $265.00 $255.00 Erg armpad nly available with Single pst Height adj & Flip back armrest Erg nt available with Classic Flip Back armrest 002AM23 Desk Length - Classic (10") 002AM24 Full Length - Classic (14") 002AM9 Armpad Fam - Shrt (Flip Up armrests) 002AM10 Armpad Fam - Lng (Flip Up armrests) 002AM27 Erg Pad (9.5"-13.5") 002AA11 002AA29 002AA14 002SG29 K0108 Side Guard Plastic Lw (6.5" High) $285.00 Plastic side guards NA w/ height adj. arms. Side guard interference w/ Padded SA arms at sme heights may exist. 002SG33 K0108 Height Adjustable Single Pst Hgt. Adj. Std (8.5"-13.5") Single Pst Hgt. Adj. Lw (7"-11") Omit Armrest Omit Armrest Armpad fr Height Adjustable Plastic Standard (8.5" High) $285.00 9. KEY OPTIONS & ACCESSORIES Anti-Tip Additinal Cver & Pack Accessries 002AT1 E0971 Rear Anti-Tip ( w/ Xtender) $140.00 0028A02 Gel Cver Hanger/Frame $110.00 0028A01 Gel Cver Swing Away Arm $110.00 Backpack 002A1 Quickie Backpack Black $55.00 Psitining Belts 002A2 Quickie Kids Backpack Black $50.00 002A141 E0978 Belt 1.5" Aut Buckle w/clamps $70.00 002A117 E0978 Belt 2" Aircraft Buckle w/clamps $110.00 Seat Puch 002A118 E0978 Belt 2" Aircraft Buckle Pad w/clamp $120.00 0021A01 Seat Puch Black /Charcal $45.00 002A120 K0108 Psitining Belt Slide Clamps $50.00 Tray Tables Spke Guards 002A30 E0950 Small (13"-14"W) $250.00 Only available w/muntain, and Lite Spke wheels, 002A31 E0950 Medium (-17"W) $250.00 Nt available with 5 spke MAG wheels r Prjectin handrims 002A32 E0950 Large (18"-20"W) $250.00 0024A02 K0065 Quickie Clear Spke Guards $115.00 002A33 E0950 X-Large (21"-22"W) $250.00 0024A01 K0065 Quickie Black Spke Guards $115.00 Custmer Service: 800-333-4000 Fax: 800-300-7502 Email: rders@sunmed.cm www.sunrisemedical.cm Page 7
Miscellaneus O2 hlder N/A with Xtender in 12" - 13" frame width. Crutch hlder NA with EXO Tensin Adj uphlstery and Omit push handle 9. KEY OPTIONS & ACCESSORIES (cnt) 0028A03 Caddy (NA w/ frnt munt hangers) $45.00 002A2100 E2207 Crutch Hlder $195.00 002LS14 K0038 Extra Leg Strap Black $35.00 002IG2 Impact Guard Neprene 002A73 K0105 IV Hlder $275.00 002A145 E2208 O2 Hlder $310.00 0028A21 Tl Kit $45.00 002C140 Aztec Gld 002C116 002C2 Black (Nt avail as base w/zebra) 002C151 002C141 Black Cherry 002C150 002C10 Black Opal 002C149 002C38 Blue Opal 002C152 002C36 Candy Blue 002C14 Candy Purple 002C35 Candy Red 002C112 002C142 Electric Blue 002C43 002C143 Evergreen 002C42 002C126 Glw 002C144 Green Apple 002C108 002C147 Ht Sparkle Pink 002C148 Mauve Pink 002C103 002C114 002C145 002C113 002C8 Standard Frame Clrs Rtbeer Sparkle Silver Sunrise Orange Titanium Clr Paint Yellw 10. COLOR Matte Frame Clrs Matte Black Matte Black Cherry Matte Electric Blue Matte Evergreen Matte Purple Custm Frame Clr Desert Camuflage Mssy Oak Camuflage Stars & Stripes Zebra (Chse abve base clr) Std with White unless abve base paint is chsen NA w/ Black Additinal Optins Thrugh Built fr Me T inquire abut any unique custmizatin fr Quickie prducts, cntact: Phne: (800) 333-4000, Fax: (800) 333 9011 Cmmnly Requested Optins Include: Up t 24" wide Custm Andizing Dual Munt Wheel Lcks - Attendant Ft Lck Hub Wheel Lcks n Mag r Spke Wheels Clred handrims Frame Depth matrix 10. APPENDIX Depth Adjusable Back Frame SEAT DEPTH FRAME DEPTH SLING DEPTH.05 1.50 2.50 SEAT SLING TO PUSH HANDLE MEASUREMENT 3.50 BACKREST MOUNTING HARDWARE WILL AFFECT SEAT DEPTH Custmer Service: 800-333-4000 Fax: 800-300-7502 Email: rders@sunmed.cm www.sunrisemedical.cm Page 8
10. APPENDIX Lwer Leg Length Matrix 2" & 4" extensins fr frnt munt hangers shipped separate, nt munted. Frnt seat height must be at least 2" taller than lwer leg length n all swing in/ut hangers. Frnt seat height must be at least 2" taller than maximum lwer leg length n all frnt munt hangers. All values shwn apply t Standard frame style, subtract 1.5" t get Hemi equivalent.mre than 2" will require n field adjustment. Bckrest Height Matrix Custmer Service: 800-333-4000 Fax: 800-300-7502 Email: rders@sunmed.cm www.sunrisemedical.cm Page 9
10. APPENDIX Quickie 2 Seat T Flr Height Matrix - Standard Frame *Hemi ptins will result in a reductin f apprx 2 1/2" * Values Given are Estimates. Actual seat t flr height may vary based n seat depth and frnt seat t flr height selectin. Custmer Service: 800-333-4000 Fax: 800-300-7502 Email: rders@sunmed.cm www.sunrisemedical.cm Page 10
10. APPENDIX Quickie 2 Seat T Flr Height Matrix - Standard Frame *Hemi ptins will result in a reductin f apprx 2 1/2" * Values Given are Estimates. Actual seat t flr height may vary based n seat depth and frnt seat t flr height selectin. Sunrise Medical (US) LLC 2842 Business Park Ave. Fresn, CA 93727 USA Custmer Service: 800-333-4000 Fax: 800-300-7502 Email: rders@sunmed.cm www.sunrisemedical.cm Page 11