Description - DE Medical Assistance Program

K0064 ZERO PRESSURE TUBE FLAT FREE O $0.00
K0065 SPOKE PROTECTORS 3 $44.24
K0066 SOLID TIRE ANY SIZE EACH O $0.00
K0067 PNEUMATIC TIRE ANY SIZE EACH O $0.00
K0068 PNEUMATIC TIRE TUBE EACH O $0.00
K0069 REAR WHL COMPLETE SOLID TIRE 3 $99.42
K0070 REAR WHL COMPL PNEUM TIRE 3 $182.26
K0071 FRONT CASTR COMPL PNEUM TIRE 3 $108.71
K0072 FRNT CSTR CMPL SEM-PNEUM TIR 3 $65.43
K0073 CASTER PIN LOCK EACH 3 $34.63
K0074 PNEUMATIC CASTER TIRE EACH O $0.00
K0075 SEMI-PNEUMATIC CASTER TIRE O $0.00
K0076 SOLID CASTER TIRE EACH O $0.00
K0077 FRONT CASTER ASSEM COMPLETE 3 $58.56
K0078 PNEUMATIC CASTER TIRE TUBE O $0.00
K0079 WHEEL LOCK EXTENSION PAIR O $0.00
K0080 ANTI-ROLLBACK DEVICE PAIR O $0.00
K0081 WHEEL LOCK ASSEMBLY COMPLETE O $0.00
K0082 22 NF NONSEALED LEADACID O $0.00
K0083 22NF SEALED LEADACID BATTERY O $0.00
K0084 GR24 NONSEALED LEADACID O $0.00
K0085 GR 24 SEALED LEAD ACID BATTERY O $0.00
K0086 U1NONSEALED LEADACID BATTERY O $0.00
K0087 U1 SEALED LEADACID BATTERY O $0.00
K0088 BATTERY CHARGER, SINGLE MODE O $0.00
K0089 BATTERY CHARGER, DUAL MODE O $0.00
K0090 REAR TIRE POWER WHEELCHAIR O $0.00
K0091 REAR TIRE TUBE POWER WHLCHR O $0.00
K0092 REAR ASSEM CMPLT POWR WHLCHR O $0.00
K0093 REAR ZERO PRESSURE TIRE TUBE O $0.00
K0094 WHEEL TIRE FOR POWER BASE O $0.00
K0095 WHEEL TIRE TUBE EACH BASE O $0.00
K0096 WHEEL ASSEM POWR BASE COMPLT O $0.00
K0097 WHEEL ZERO PRESURE TIRE TUBE O $0.00
K0098 DRIVE BELT POWER WHEELCHAIR 3 $27.07
K0099 PWR WHEELCHAIR FRONT CASTER O $0.00
K0100 AMPUTEE ADAPTER PAIR O $0.00
K0101 ONE-ARM DRIVE ATTACHMENT O $0.00
K0102 CRUTCH AND CANE HOLDER O $0.00
K0103 TRANSFER BOARD < 25" O $0.00
K0104 CYLINDER TANK CARRIER O $0.00
K0105 IV HANGER 3 $98.94
K0106 ARM TROUGH EACH O $0.00
K0107 WHEELCHAIR TRAY O $0.00
K0108 W/C COMPONENT-ACCESSORY NOS 5 $0.00
K0109 CUSTOMIZE WHLCHR BASE FRAME 9 $0.00
K0110 SUPPLIES FOR MAINTENANCE OF DRUG IN 9 $0.00
K0111 SUPPLIES FOR EXTERNAL DRUG INFUSION 9 $0.00
K0112 TRUNK VEST SUPPRT INNR FRAME O $0.00