Description - DE Medical Assistance Program

K0015 DETACH NON-ADJUS HGHT ARMRST 3 $180.80
K0016 DETACH ADJUST ARMRST CMPLETE O $0.00
K0017 DETACH ADJUST ARMREST BASE 3 $50.85
K0018 DETACH ADJUST ARMRST UPPER 3 $28.41
K0019 ARM PAD EACH 3 $14.58
K0020 FIXED ADJUST ARMREST PAIR 3 $46.23
K0021 ANTI-TIPPING DEVICE EACH O $0.00
K0022 REINFORCED BACK UPHOLSTERY O $0.00
K0023 PLANR BACK INSRT FOAM W/STRP O $0.00
K0024 PLNR BACK INSRT FOAM W/HRDWR O $0.00
K0025 HOOK-ON HEADREST EXTENSION O $0.00
K0026 BACK UPHOLST LGTWT WHLCHR O $0.00
K0027 BACK UPHOLST OTHER WHLCHR O $0.00
K0028 MANUAL FULLY RECLINING BACK O $0.00
K0029 REINFORCED SEAT UPHOLSTERY O $0.00
K0030 SOLID PLNR SEAT SNGL DNSFOAM O $0.00
K0031 SAFETY BELT/PELVIC STRAP O $0.00
K0032 SEAT UPHOLS LGTWT WHLCHR O $0.00
K0033 SEAT UPHOLSTERY OTHER WHLCHR O $0.00
K0034 HEEL LOOP EACH O $0.00
K0035 HEEL LOOP WITH ANKLE STRAP O $0.00
K0036 TOE LOOP EACH O $0.00
K0037 HIGH MOUNT FLIP-UP FOOTREST 3 $47.93
K0038 LEG STRAP EACH 3 $24.14
K0039 LEG STRAP H STYLE EACH 3 $53.61
K0040 ADJUSTABLE ANGLE FOOTPLATE 3 $67.58
K0041 LARGE SIZE FOOTPLATE EACH 3 $52.65
K0042 STANDARD SIZE FOOTPLATE EACH 3 $36.25
K0043 FTRST LOWER EXTENSION TUBE 3 $19.44
K0044 FTRST UPPER HANGER BRACKET 3 $16.56
K0045 FOOTREST COMPLETE ASSEMBLY 3 $56.34
K0046 ELEVAT LEGRST LOW EXTENSION 3 $19.44
K0047 ELEVAT LEGRST UP HANGR BRACK 3 $76.10
K0048 ELEVATE LEGREST COMPLETE O $0.00
K0049 CALF PAD EACH O $0.00
K0050 RATCHET ASSEMBLY 3 $32.34
K0051 CAM RELESE ASSEM FTRST/LGRST 3 $52.35
K0052 SWINGAWAY DETACH FOOTREST 3 $91.98
K0053 ELEVATE FOOTREST ARTICULATE 3 $101.51
K0054 SEAT WDTH 10-12/15/17/20 WC O $0.00
K0055 SEAT DPTH 15/17/18 LTWT WC O $0.00
K0056 SEAT HT =21 LTWT WC 3 $94.63
K0057 SEAT WDTH 19/20 HVY DTY WC O $0.00
K0058 SEAT DPTH 17/18 POWER WC O $0.00
K0059 PLASTIC COATED HANDRIM EACH O $0.00
K0060 STEEL HANDRIM EACH O $0.00
K0061 ALUMINUM HANDRIM EACH O $0.00
K0062 HANDRIM 8-10 VERT/OBLIQ PROJ O $0.00
K0063 HNDRM 12-16 VERT/OBLIQ PROJ O $0.00