Quickie IRIS SE o

Quickie IRIS SE
June 2015
SUBMIT
EIZ4-2
Mark For:
Submitting for:
Date:
PO#:
o Quote
o Order
Dealer Acct #:
Dealer:
ADDITIONAL SHIPPING INFORMATION
Dealer Contact:
Ship To:
Dealer Address:
Attention:
Dealer City:
Dealer Phone: (
Confirmation Email:
Confirm Via:
ST:
)
Address:
ZIP:
Fax: (
Address:
)
Ship To City:
o Fax
o Email
ST:
Ship To Phone: (
)
ZIP:
Fax: (
)
The HCPCS CODES provided are based on code verification through PDAC or our interpretation of the code definitions.
The use of HCPCS CODES does not ensure coverage or payment. For coverage information, verify the appropriate payer's coverage policy.
a
Option #
HCPCS
Definition
Price
a
Option #
HCPCS
Definition
Price
1. FRAME STYLE & SETUP
Base Model
o
o
o
o
o
o
o
183WM57
E1161 Quickie IRIS SE
Pre-Set Tilt Angle (55° range) (Default in Bold)
-5 to 50°
183TA5
E1161
NA w/ Heavy Duty and 12.5" STFH
183TA6
E1161 0 to 55°
+5 to 60°
183TA7
E1161
NA w/Heavy Duty Package
Pre-Set Tilt Angle (40° range) (Default in Bold)
-5 to 35°
183TA8
E1161
NA w/ Heavy Duty and 12.5" STFH
183TA1
E1161 0 to 40°
+5 to 45°
183TA10
E1161
NA w/Heavy Duty Package
o
183FS23
o
183HV1
o
183FS24
Frame Options
Standard Base and Seat Frame
Maximum Weight: 250 lbs.
Heavy Duty Package (Max: 350lbs)
NA w/ Vent, Battery Tray and Mono Back
Vent/Battery Tray Base NA w/
E1029 Attendant Wheel Lock, Mono Back and
$2,745.00
NC
NC
NC
NC
NC
183FT46
o
183TT8
o
183TT12
Contracture Seat Frame NA w/ 14"
or 15" frame depths. NA w/ drop seat
pan.
Tilt Release Options
Foot Release - No Cables
NA with Vent and Battery Tray. NA
with 21-22" depth and +5° set-ups.
o Left o Right (Facing from rear)
Backrest Dual trigger cable releases
STD
$395.00
$425.00
NC
NC
183TO45
WC-19 Transit Option
Frame Struts
Fixed (Standard)
STD
Width Adjusting System
o
183GY02
o
o
o
o
o
o
o
183W5
183W6
183W7
183W8
183W9
183W10
183W11
o
183W12
o
183W13
o
o
o
o
o
o
o
o
o
o
183C140
183C2
183C141
183C10
183C38
183C36
183C14
183C35
183C142
183C143
o
o
o
o
o
183C116
183C151
183C150
183C149
183C152
o
o
o
183C112
183C43
183C42
o
183C108
NC
Transit
o
183GY01
NC
14" and 15" frame width; min 17" STFH.
o
o
$250.00
$45.00
Avail. range 14"-21". Max growth 22"
NA with Mono Back
Frame Width
14"
15"
16"
17"
18"
19"
E2201 20"
21"
NA w/ removable stroller
E2201
handle extension
22"
NA w/ removable stroller
E2201
handle extension
Standard Frame Color
Aztec Gold
o
183C126
NC
Black
o
183C144
NC
Black Cherry NC
o
183C147
Black Opal
o
183C148
NC
Blue Opal
o
183C103
NC
Candy Blue
o
183C114
NC
Candy Purple NC
o
183C145
Candy Red
o
183C113
NC
Electric Blue NC
o
183C8
Evergreen
NC
Matte Frame Color
Matte Black
Matte Black Cherry
Matte Electric Blue
Matte Evergreen
Matte Purple
Custom Frame Color
Desert Camouflage
Mossy Oak Camouflage
Stars & Stripes
NC
NC
NC
NC
NC
NC
$500.00
$500.00
$500.00
Glow
Green Apple
Hot Pink
Mauve Pink
Rootbeer
NC
NC
NC
NC
NC
Sparkle Silver
NC
Sunrise Orange NC
Titanium
NC
Yellow
NC
NC
NC
NC
NC
NC
$295.00
$295.00
$295.00
Zebra (Choose above base color) Std
with White unless above base paint is
chosen NA w/ Black
ORDER INFORMATION: Customer Service: 800-333-4000 Fax: 800-300-7502 www.sunrisemedical.com
Specifications are subject to change without notice. Copyright © 2011 Sunrise Medical (US) LLC. Quickie IRIS, MK-100052 REV G
Page 1
$295.00
a
Option #
HCPCS
Definition
Price
a
Option #
HCPCS
Definition
Price
2. FRAME DEPTH SET UP (Fill out either A or B)
A. Setup By QUICKIE
B. Setup By DEPTH
A. User's Weight (Default in Bold)
251-350 lb options only available w/ HD Package
183BO01
0 - 250 lbs
o
183BO02
251 - 300 lbs
o
183BO03
301 - 350 lbs
o
NC
NC
NC
OR
A. User's Seated Height
See Figure 1.2, Dimension B. Distance from seat surface to top of the head.
183SJ01
Less than 37"
NC
o
183SJ02
37" or Greater
NC
o
A. Backrest Position
See FIGURE 1.1 and FIGURE 1.3, Dimension C. The location of the backrest
surface in relation to the front of the backpost. The measurement is taken from
the front surface of the backpost to the deepest area of the backrest in contact
with the user's body.
183BQ01
+3"
NC
o
183BQ05
+2"
NC
o
183BQ02
+1"
NC
o
183BQ03
Flush
NC
o
183BQ04
-1"
NC
o
183BQ06
-2"
NC
o
o
o
o
183FL91
183FL92
183FL93
B. Frame Depth Range
Short Seat Frame 14"-18"
Medium Seat Frame 16"-20"
Long Seat Frame 18"-22"
o
o
o
o
o
o
o
o
o
183FD5
183FD6
183FD7
183FD8
183FD9
183FD10
183FD11
183FD16
183FD17
B. Frame Depth
14" recommend short seat frame
15" recommend short seat frame
16" recommend short seat frame
17" recommend short seat frame
18" recommend medium seat frame
19" recommend medium seat frame
E2203 20" recommend long seat frame
E2203 21" recommend long seat frame
E2204 22" recommend long seat frame
NC
NC
NC
A. Figures for Setup by Quickie
Figure 1.1
Figure 1.2
A. Desired Seat Depth
See Figure 1.1 for pricing, Figure 1.2, Dimension A for measurement
183SD7
14"
o
183SD8
15"
o
183SD9
16"
o
183SD10
17"
o
183SD11
18"
o
183SD12
19"
o
183SD13
E2203 20"
o
183SD14
E2203 21"
o
183SD33
E2204 22"
o
Desired Seat Depth
A. Top of Cushion to Seat Rail
See FIGURE 1.4 Dimensions A & B. This measurement is taken from the top of
the cushion to the upper surface of the seat rail. If the cushion has a wedged
shape and/or has significant lateral pelvic contour, then determine the height of
the cushion at the point where the ischial tuberosities would contact (not
immerse) the cushion surface.
183CJ01
2 1/2" or Greater
NC
o
183CJ02
Less than 2 1/2"
NC
o
183CJ03
Below Seat Rail
NC
o
Figure 1.4
Figure 1.3
NC
NC
NC
Figure 1.1
Figure 1.1
Figure 1.1
Figure 1.1
Figure 1.1
Figure 1.1
3. SEATING
o
183ST35
o
183ST36
o
183ST54
E2231
Seat Type
Standard Seat Pan
For growth ranges, see Figure 1.5
Drop Seat Pan
NA w/ transit, HD,
contracture footrest system
Omit Seat Pan
$200.00
$200.00
NC
JAY Cushions (Optional)
To order any JAY cushions on-chair, please see the JAY price list.
Cushion name or part number must be filled out with desired width and depth.
JAY Bundled Cushion
o
183JC20 Cushion Name/Part #:
Price List
Width:
Depth:
o
o
183QC01
183QC02
Custom Seating
Surefit
Configurfit
Figure 1.5
Frame Width Seat Pan Growth
14"
14" - 16"
15"
15" - 16"
16"
16" - 18"
17"
17" - 18"
18"
18" - 20"
19"
19" - 20"
20"
20" - 22"
21"
21" - 22"
22"
NA
ORDER INFORMATION: Customer Service: 800-333-4000 Fax: 800-300-7502 www.sunrisemedical.com
Specifications are subject to change without notice. Copyright © 2011 Sunrise Medical (US) LLC. Quickie IRIS, MK-100052 REV G
Page 2
NC
NC
NC
NC
NC
NC
$550.00
$550.00
$900.00
a
Option #
HCPCS
Definition
Price
a
Option #
HCPCS
Definition
Price
4. BACKREST
Dynamic Backrest
o
183BT101
Dynamic Backrest
NA w/ Reclining Backrest or
19"-22" seat depths
$1,195.00
o
183JB01
JAY J3 Back
JAY J3 Back
NA w/ O2 Holder
See OF
Backpost Style - (Choose ONE Option - A, B, C, or D)
o
o
o
183BP9
183BP10
183BP11
o
183BP13
A. Stroller Handle Backpost (Fixed)
Low (18")
Medium (21")
Tall (24")
Removable Extension NA w/ 21"22" frame width, height adj back with
adj stroller handles
OR
NC
NC
NC
A
$85.00
C. Reclining Backrest (0-40°)
Only available with 40 degree tilt range. NA w/ 22" Deep Frame.
183BT21
E1225 Reclining Backrest
o
o 183B5 Medium
o 183B9 Tall
OR
C
OR
B. Height Adjustable Back w/ Adj. Stroller Handles
Select desired Push Handle
183PH8
Standard Push Handle
o
Long Push Handle Recommended
o
183PH9
in combo w/ vent & battery tray
AND select desired Back Cane
183B200
Standard 15"-21"
o
183B201
Tall 18"-24"
o
D. Mono Back System
Must select JAY J3 or JAY Custom Back when ordering Mono Back System.
NC
NC
B
NC
NC
Select One
183MO1
o
Mono Backrest System
Mono Backrest System w/Dynamic
o
183MO2
Backrest
AND Select desired Push Handle
183PH8
Standard Push Handle
o
o
Reclining/Fixed Handle Ht. Diagram
$850.00
NC
NC
Height Adj. Handle Height Diagram
183PH9
Long Push Handle
Mono Height Adj. Handle Height Diagram
ORDER INFORMATION: Customer Service: 800-333-4000 Fax: 800-300-7502 www.sunrisemedical.com
Specifications are subject to change without notice. Copyright © 2011 Sunrise Medical (US) LLC. Quickie IRIS, MK-100052 REV G
Page 3
$395.00
$995.00
NC
NC
D
a
Option #
HCPCS
Definition
Price
a
Option #
HCPCS
Definition
Mono Backrest Options ONLY
NA on HD, Vent/Battery Tray Base(LTV only), Reclining Backrest, Desk Length Armpads and Canopy.
JAY J3 Back for Mono Backrest System
JAY J3 Back for Mono Backrest System Cont.
183JB04
JAY J3 Back Mono
See OF
o
Select desired Headrest Mount (optional)
183JB05
JAY J3 via JAY Your Way
See OF
183MH10
E1028 Axys Mount & Bracket
o
o
183MH15
E1028 Cobra Flip Back Mount and Bracket
JAY J3 Backrest Contour
o
183MH16
E1028 Onyx Mount and Bracket
J3 PA Back (2.2" of Contour Depth)
o
o
183JP01
E2613
$535.00
14"-20" Wide
183MH17
Omit
J3 PA Back (2.2" of Contour Depth)
o
o
183JP02
E2614
$795.00
22" Wide
Select desired Headrest Pad (optional)
183HE65
E0955 Plush Head Support Pad 8"
J3 PL Back (3.0" of Contour Depth)
o
o
183JP03
E2615
$620.00
14"-20" Wide
183HE66
E0955 Plush Head Support Pad 10"
o
183HE78
E0955 Plush Head Support Pad 14"
J3 PDL Back (6.0" of Contour Depth)
o
o
183JP04
E2620
$745.00
14"-20" Wide
183HE87
E0955 HeadsUp Lrg: 5.3" Lng Arms
o
183HE88
E0955 HeadsUp Med: 4.1" Sht Arms
J3 PDC Back (6.0" of Contour Depth)
o
o
183JP05
E2620
$745.00
14"-20" Wide
183HE89
E0955 HeadsUp Sml: 3.5" Sht Arms
o
183HE83
E0955 Adjust-A-Plush Standard
JAY J3 Backrest Height
o
183HE82
E0955 Adjust-A-Plush Narrow
UT Standard 16.5" shell height
o
o
183JR07
NC
Select desired Lateral (optional)
UT Medium 18" shell height
o LAT 4X4 S/A MOUNTS includes 1" OFFSET - PR
o
183JR08
NC
183ZV14
E0956 LATERAL 4X4 W/ 1" OFFSET - PAIR
183ZS07
E1028 LATERAL SWING AWAY MOUNT - PAIR
UT Tall 19.5" shell height
o
183JR09
NC
o LAT 4X5 S/A MOUNTS includes 1" OFFSET - PR
183ZV15
E0956 LATERAL 4X5 W/ 1" OFFSET - PAIR
o
183JR10
SH Standard 21" Shell Height
NC
183ZS07
E1028 LATERAL SWING AWAY MOUNT - PAIR
o LAT 4X6 S/A MOUNTS includes 1" OFFSET - PR
o
183JR11
SH Medium 22.5"
NC
183ZV16
E0956 LATERAL 4X6 W/ 1" OFFSET - PAIR
183ZS07
E1028 LATERAL SWING AWAY MOUNT - PAIR
o
183JR12
SH Tall 24"
NC
o LAT 6X4 S/A MOUNTS includes 1" OFFSET - PR
183ZV17
E0956 LATERAL 6X4 W/ 1" OFFSET - PAIR
JAY J3 Backrest Width
183ZS07
E1028 LATERAL SWING AWAY MOUNT - PAIR
Some interference with armrest may exist when ordering a Backrest
with greater than 4" wider than the base.
o LAT 6X5 S/A MOUNTS includes 1" OFFSET - PR
183JQ06
12" Backrest Width
NC
183ZV18
E0956 LATERAL 6X5 W/ 1" OFFSET - PAIR
o
183JQ01
14" Backrest Width
NC
183ZV07
E1028 LATERAL SWING AWAY MOUNT - PAIR
o
183JQ02
16" Backrest Width
NC
o
o LAT 6X6 S/A MOUNTS includes 1" OFFSET - PR
183JQ03
18" Backrest Width
NC
183ZV19
E0956 LATERAL 6X6 W/ 1" OFFSET - PAIR
o
183JQ04
20" Backrest Width
NC
183ZS07
E1028 LATERAL SWING AWAY MOUNT - PAIR
o
183JQ05
22" Backrest Width
NC
o
JAY J3 Backrest Color
183GZ01
Black
NC
o
183GZ02
Matching Frame- Standard Colors
NC
o
183GZ03
Matching Frame- Custom Color
$50.00
o
ORDER INFORMATION: Customer Service: 800-333-4000 Fax: 800-300-7502 www.sunrisemedical.com
Specifications are subject to change without notice. Copyright © 2011 Sunrise Medical (US) LLC. Quickie IRIS, MK-100052 REV G
Page 4
Price
$230.00
$280.00
$200.00
NC
$230.00
$230.00
$230.00
$310.00
$310.00
$310.00
$260.00
$260.00
$805.00
$260.00
$545.00
$805.00
$260.00
$545.00
$805.00
$260.00
$545.00
$805.00
$260.00
$545.00
$805.00
$260.00
$545.00
$805.00
$260.00
$545.00
a
Option #
HCPCS
Definition
Price
a
Option #
HCPCS
Definition
Price
5. ARMREST
Armrest
Heavy Duty Option only available w/ Dual Post Armrest
183AA63
E0973 Dual Post Height Adjustable
o
183AA43
Dual Post Flip Back
o
183AA62
Dual Post
o
183AA48
E0973 Dual Post Flip Back Height Adj
o
183AA11
E0973 Single Post Height Adjustable - Std
o
183AA29
E0973 Single Post Height Adjustable - Low
o
Length Adjustable Locking Flip-Up
o
183AA7
E0973
NA w/ Contour Armpad
o
o
183AA1
183AA154
E0973 Adjustable Locking Flip-Up
Height Adj. Cantilever Armrest
E0973 Available with Mono Back only. NA w/ 20",
22" and 24" rear wheels.
o
183AA14
Omit Armrest
o
o
Armrest Receiver (Single Post Height Adjustable Only)
183AR17
Low
183AR18
Std
o
o
o
o
183AM23
183AM21
183AM24
183AM22
o
183AM9
o
183AM10
Armpad
Desk Length Classic
Desk Length Contour
Full Length Classic
Full Length Contour
Foam Short
Option for Length
Adj Locking Flip Up
Foam Long
Option for Length
Adj Locking Flip Up
Armrest Matrix for Single Post
Classic Pad
$270.00
$95.00
NC
$295.00
$285.00
$285.00
$265.00
Armrest Size
STD
LOW
Transfer Tube
Length D
8"
5 1/4"
Receiver
STD
10 3/4" to 15 3/4"
LOW
8 3/4" to 13 3/4"
STD
9" to 13"
LOW
7 1/4" to 11 1/4"
NC
H Range
STD
10" to 15"
LOW
8 1/4" to 12 1/2"
STD
8 1/2" to 12 1/2"
LOW
6 3/4" to 10 3/4"
NC
NC
NC
NC
NC
NC
NC
NC
JAY Arm Troughs
NA with Length Adj. Locking Flip Up and Adj Locking Flip Up armrests
and Single Post Height Adj Armrests. Full Lentgh Classic Armpads will
automatically be selected when chosing only one side Arm Trough.
o
o
o
o
o
o
o
o
o
183JL01
183JL04
183JL05
183JL02
183JL06
183JL07
183JL03
183JL08
183JL09
o
o
✔
o
o
183JN01
183JN03
183JN02
183JN04
E2209 Arm Trough - 14" long - Left
E2209 Arm Trough - 14" long - Right
E2209 Arm Trough - 14" long - Pair
E2209 Arm Trough - 18" long - Left
E2209 Arm Trough - 18" long - Right
E2209 Arm Trough - 18" long - Pair
E2209 Arm Trough - 22" long - Left
E2209 Arm Trough - 22" long - Right
E2209 Arm Trough - 22" long - Pair
JAY Arm Trough - Hardware
Fixed (EA)
Fixed (Pair)
E1028 Swing Away - Rotational (EA)
E1028 Swing Away - Rotational (Pair)
Pad Length L
Desk
Full
10 1/4"
14"
Contour Pad
Receiver
$255.00
$250.00
H Range
$205.00
$205.00
$410.00
$205.00
$205.00
$410.00
$205.00
$205.00
$410.00
NC
NC
$250.00
$500.00
ORDER INFORMATION: Customer Service: 800-333-4000 Fax: 800-300-7502 www.sunrisemedical.com
Specifications are subject to change without notice. Copyright © 2011 Sunrise Medical (US) LLC. Quickie IRIS, MK-100052 REV G
Page 5
Pad Length L
Desk
Full
10 1/2"
14 1/4"
a
Option #
HCPCS
Definition
Price
a
Option #
HCPCS
Definition
Price
6. HANGER AND FOOTPLATE OPTIONS
Footrest (Choose ONE Option - A, B, or C)
o
o
o
o
183H140
183H142
183H158
183H146
o
183H132
o
183H147
o
183H161
A. Hanger Mounted Footrest
70° Swing In/Swing Out -Front Mount
80° Swing In/Swing Out -Front Mount
90° Swing In/Swing Out -Front Mount
70° Heavy Duty Front Mount Lift Off
80° Heavy Duty Front Mount Lift Off
NA w/ 4" casters
90° Heavy Duty Front Mount Lift Off
NA w/ 4" casters
Elevating Hanger - Front Mount
E0990 NA 90 ° footboard, some interference with
OR
NC
NC
NC
$95.00
C. Contracture Footrest System
Multi-Adjustable Padded Hangers & Angle Adjustable Aluminum Footrests
Contracture Footrest System NA w/
o
183H26
$325.00
drop seat pan. NA w/ 15" frame depth
$95.00
$95.00
$295.00
casters if not tilted, 17" wide chairs & up.
A
A. Hanger Mounted Footrest Extension Tubes
NA w/ 12.5" seat height
2" NA w/ 90 swing away, 90 lift off
o
183E23
hangers
o
183E24
4" NA w/ 90 swing away, 90 lift off
$55.00
$55.00
A. Hanger Mounted Footrest Footplates
Heel loop or leg strap not included, See Footplate Options Section
Kids Angle Adj
o
183F4
K0040
o
o
183F8
183A7
K0040 Adult Angle Adj - Front Mount
Omit Footplate
Available w/ 14" to 16" frame width only
$185.00
$185.00
NC
183FP02
Outside Mount
o
183FP01
Center Mount
o
Select Extension Height Below for Short
183E25
Short
o
183EP1
o
10.5" Extension Height
183EP2
o
11.0" Extension Height
183EP3
o
11.5" Extension Height
183EP4
o
12.0" Extension Height
183EP5
o
12.5" Extension Height
183EP6
o
13.0" Extension Height
Select Extension Height Below for Regular
183E26
Regular
o
183EP5
o
12.5" Extension Height
183EP6
o
13.0" Extension Height
183EP7
o
13.5" Extension Height
183EP8
o
14.0" Extension Height
183EP9
o
14.5" Extension Height
183EP10 15.0" Extension Height
o
NC
NC
NC
NC
NC
NC
NC
NC
C
NC
NC
NC
NC
NC
NC
Additional Hanger and Footplate Options
B. Extension Tube Mounted Footrests
Footrests mount to extension tubes
183H145
60° Swing In/Swing Out
o
183H139
70° Swing In/Swing Out
o
80° Swing In/Swing Out
o
183H141
NA w/ 8" casters
o
183H160
Elevating Hanger - Ext Mount
E0990 NA w/ Platform Flip Up and Alum Angle
Hanger Mounts
1" Offset NA with -5-50 ° and -5-35° preset tilt angle and
possible interference with 80 ° & 90 ° hangers
183MZ02
Standard Hanger Mount
o
183MZ01
1" Offset Hanger Mount
o
NC
NC
NC
$295.00
o
o
183HL1
183HL5
$350.00
o
183IG2
NC
o
o
o
183H32
183HL4
183HL6
Adj Front Mount footplates.
o
183H159
Articulating Hanger
K0053 NA w/ Platform Flip Up and Alum Angle
Adj Front Mount footplates.
o
183E1
o
183E2
o
183E5
o
183E16
B. Extension Tube Mounted Footrests
Short
Medium
NA with 12.5" seat height
Long
NA with 12.5" seat height
High Mount Only available with
K0037
adult or kids angle adj. footplates
NC
NC
$55.00
B. Extension Tube Mounted Footrest Footplates
Heel loop or leg strap not included, See Footplate Options Section
o
183F1
Composite
o
183F5
Aluminum Only available w/ELR
o
183F3
K0040 Adult Angle Adjustable - Ext Mount
o
183F48
K0040
o
183F7
STD
NC
$185.00
Platform Flip-Up
NA w/ med ext tubes.
$190.00
Omit Footplate and Ext. Tube
-$15.00
B
Footrest Options
E0951 Heel Loop
K0038 Leg Strap
Impact Guard Neoprene
Only available w/ 60° or 70° ext.
mount hanger
Omit Hanger
Omit Heel Loop
Omit Single Leg Strap
STD
NC
$30.00
$35.00
$85.00
-$15.00
NC
NC
JAY FOOT BOXES
Only available with Swing Away, Lift-off Hangers , Adult Angle Adj Footplates and ELR
/ ALR.Single Foot Box pairs NA with 14"-15" frame widths. Full Foot Boxes NA with
Heel Loop or Leg Strap, Tall Height Full Footbox w/ 14"-15" frame width and ELR /
ALR.
o
o
o
o
o
o
o
o
o
o
183JX01
183JX02
183JX03
183JX04
183JX05
183JX06
OR
183JX07
183JX08
183JX09
183JX10
Single Foot Box
Standard Height - Left
Tall Height - Left
Standard Height - Right
Tall Height - Right
Standard Height - Pair
Tall Height - Pair
Full Foot Box
Full Foot box Std Height
Full Foot box Tall Height
Full Foot box w/ Divider Std Ht
Full Foot box w/ Divider Tall Ht
ORDER INFORMATION: Customer Service: 800-333-4000 Fax: 800-300-7502 www.sunrisemedical.com
Specifications are subject to change without notice. Copyright © 2011 Sunrise Medical (US) LLC. Quickie IRIS, MK-100052 REV G
Page 6
$225.00
$225.00
$225.00
$225.00
$450.00
$450.00
$350.00
$350.00
$400.00
$400.00
a
Option #
HCPCS
Definition
Price
a
Option #
HCPCS
Definition
Price
7. SEAT HEIGHT SETUP
Front Seat Height
Rear Wheel Size
4"
o 12.5" o
o
o
o
o
o
o
o
o
o
o
o
o
o
12" Mag
12" Low Poly
16" Mag
20" Mag
22" Mag
24" Mag & Spoke
o
183CW73
o
o
o
o
o
o
183CW53
183CW7
183CW45
183CW35
183CW46
183CW39
o
183CW36
o
183CW37
5"
o
o
o
o
o
o
o
o
o
o
13.5"
16.5"
17.0"
17.5"
16.0"
16.5"
17.0"
17.5"
CASTER SIZE
6"
8x1"
o 16.5"
o 17.0" o 17.0"
o 17.5" o 17.5"
o 18.0"
o 16.0"
o 16.5" o 16.5"
o 17.0" o 17.0"
o 17.5"
8x1.5"
o 16.5"
o 17.0"
o 17.5"
o 18.0"
o 16.0"
o 16.5"
o 17.0"
8x2"
o 17.0"
o 18.0"
o 16.5"
o 17.0"
13.5"
14.0"
183RW13
o
183RW14
o
183RW3
o
183RW8
o
o
183RW1
183RW51
183RT3
o
183RT4
o
183RT1
o
183RT2
Rear Wheel Tire
Full Polyurethane
Low Polyurethane
Only available w/ 12" Mag Wheel
E2211
Pneumatic
E2212
E2213
Pneumatic Airless Insert
E2211
Handrim
12" and 16" wheels not available with hand rims.
183HR1
Aluminum Anodized
o
183HR4
Plastic Coated
o
183HR7
Omit Handrim
o
NC
NC
NC
$80.00
NC
$95.00
NC
14.5" o 14.5"
15.0" o 15.0"
18.0" o 18.0" o 18.0" o 18.0" o 18.0"
18.5" o 18.5" o 18.5" o 18.5"
16.0"
16.5"
17.0"
17.5"
17.0"
17.5"
18.0"
18.5"
18.0"
18.5"
o 19.0" o 19.0" o
o
o 16.0"
o
o 16.5" o 16.5" o
o 17.0" o 17.0" o
o 17.5"
o 17.0" o 17.0"
o 17.5" o 17.5" o
o 18.0" o 18.0" o
o
o 18.0"
o
o 18.5" o 18.5" o
o 19.0" o 19.0" o
o 19.5"
Casters
4" x 1.25" Semi Pneumatic
NA w/ Heavy Duty Option
5" x 1" Polyurethane
5" x 1.5" Semi Pneumatic
6" x 1" Polyurethane
6" x 1.5" Semi Pneumatic
8" x 1" Polyurethane
8"x 1.5" Semi Pneumatic
E2214
8"x 2" Pneumatic
E2215
E2214
8"x 2" Pneumatic w/Insert
K0108
12" Mag Wheel
NA w/ hand rims
and full poly tires. With attendant
wheel lock NA w/ +5 - 60° tilt angle.
16" Mag Wheel
NA w/ hand rims.
Only avail w/pneumatic or pneumatic
w/ airless inserts tires.
20" Mag Wheel
NA w/ projection handrims.
22" Mag Wheel
NA w/ projection handrims.
24" Mag Wheel
24" Spoke Wheel
Projections
Not available on plastic coated. Only available with 24" rims.
183HR8
8 Oblique
o
$325.00
19.0" o 19.0"
19.5"
16.0"
16.5" o 16.5"
17.0" o 17.0"
o
183AX1
o
183AX17
o
183AL33
Axle
Quick Release Axles
NA w/ one arm drive
Threaded Axles
NA w/ 24" spoke wheels
NC
NC
o 17.0"
17.5"
18.0" o 18.0"
18.5"
18.0" o 18.0"
o
o
18.5"
19.0" o 19.0"
o
NC
NC
$85.00
NC
$85.00
NC
$85.00
$145.00
$225.00
Rear Wheel
o
o
Axle Plate
Standard Axle Plate
One Arm Drive Axle Plate NA w/ 12"
183AL17
E0958
& 16" mag, 24" spoke wheels.
183OA2
One Arm Drive Standard Handrim
183HM1 Right Hand Mount
o
183HM2 Left Hand Mount
o
One Arm Drive Small Handrim
183OA1
NA w/ 20" mag wheels
183HM1 Right Hand Mount
o
183HM2 Left Hand Mount
o
Hub Lock
Only available w/ 12" or 16" wheels. NA w/ one arm drive.
183LK01
12" Hub Lock
o
183LK02
16" Hub Lock
o
o
183WL8
o
183WL41
o
183WL10
o
183EH7
Wheel Lock
Push to Lock
Attendant Wheel Lock (Foot Lock)
E2206 NA w/ ext handles. NA w/ one arm
drive
Omit Wheel Lock
NC
$850.00
NC
NC
NC
NC
NC
NC
$100.00
$100.00
NC
$80.00
NC
Extension Handle
NC
E0961 6" Pair
NC
NC
NC
NC
$200.00
ORDER INFORMATION: Customer Service: 800-333-4000 Fax: 800-300-7502 www.sunrisemedical.com
Specifications are subject to change without notice. Copyright © 2011 Sunrise Medical (US) LLC. Quickie IRIS, MK-100052 REV G
Page 7
$65.00
a
Option #
HCPCS
Definition
Price
a
Option #
HCPCS
Definition
Price
8. KEY OPTIONS AND ACCESSORIES
Anti Tips
Included with vent tray option. Not ordered as separate line item.
183AT1
E0971 Anti Tips (Pair)
o
o
o
o
183A1
183A8
183A54
o
183A82
o
183A601
Miscellaneous Accessories
Black Utility Backpack
Black Seat Pouch
Extra Leg Strap Black
Caddy Only available w/ extention
tube mounted footrests
O2 Holder NA w/ Height Adj Stroller
E2208 Handles. NA w/ Reclining Backrest, Mono
$140.00
$55.00
$45.00
$30.00
$45.00
$150.00
JAY Anterior Thoracic Support
Style
Classic Dynamic
Classic Structure
Contour Dynamic
Contour Structure
Center Opening with Buckle
Size
Small
Medium
Large
X-Large
o
o
o
o
o
183JY01
183JY02
183JY03
183JY04
183JY05
$187.00
$187.00
$187.00
$187.00
$187.00
o
o
o
o
183JZ01
183JZ02
183JZ03
183JZ04
o
o
183JA01
183JA02
JAY Padded Trunk Strap
Padded Trunk Strap - Small
Padded Trunk Strap - Medium
$187.00
$187.00
o
183JA03
Padded Trunk Strap - Large
$187.00
o
183JA04
Padded Trunk Strap - XL
$187.00
NC
NC
NC
NC
Back or Transit Option.
o
183A701
K0105
IV Pole
NA w/ Mono Back or transit option
$275.00
Vent Tray - Back Cane Mount
Utility hook has weight a limit of 15 lbs.
o
183LF12
Dovetail Vertical Frame Mounted
E1029 Hardware for LTV Ventilators
includes 1 utility hook
$495.00
$495.00
Additional Options Through Built for Me
To inquire about any unique customization for Quickie products, contact: Phone:
(800) 333-4000, Fax: (800) 333 9011
o
183LF13
Dovetail Vertical Frame Mounted
E1029 Hardware for Trilogy Ventilators
includes 1 utility hook
o
183A158
E0978 2" Dual Pull Squeeze Pad w/Clamp
$85.00
o
183A141
E0978 1.5" Auto Buckle Universal w/Clamp
$70.00

Commonly Requested Options Include:
23" & 24" Seat Widths
o
183A117
E0978 2" Aircraft Buckle w/Clamps
$110.00

Angle Adjustable Handle for Reclining Backrest
o
183A118
E0978 2" Aircraft Buckle Pad w/Clamp
$120.00

Frog Legs
o
183A120
K0108 Positioning Belt Clamps Only
$50.00

Longer Wheel Lock Extensions

Reverse Configuration

Dual Mount Wheel Locks - Attendant Foot Lock

Dynamic Back on Frame Depth up to 20"
Positioning Belt
Side Guard
Only available w/ length adj locking flip-up, adj locking flip-up and armrest styles.
NA w/ Mono Back.
o
183SG3
K0108 Plastic Regular
$125.00
o
183SG4
K0108 Plastic Kids
$125.00
Spoke Guards
Not available with 12" and 16" mag wheels or projection handrims.
183A24
K0065 Clear
o
o
183A23
K0065 Black NA w/ projection handrims
$115.00
$115.00
Wheelchair Tray Table
Only available if armrests are included. NA with JAY Arm Troughs.
183A30
E0950 Small (13"-14")
o
$250.00
o
183A31
E0950 Medium (15"-17")
$250.00
o
183A32
E0950 Large (18"-20")
$250.00
o
183A33
E0950 X-Large (21"-22")
$250.00
Canopy (SunShade)
Need 2" back post clearance to mount canopy hardware. May require next
height based on seating. Some interferance may occur with some height
configurations. NA with Mono Back.
o
1838A06
K0108 Canopy (Sunshade) 10 "- 14" wide
$275.00
o
1838A07
K0108 Canopy (Sunshade) 15" - 20" wide
$275.00
ORDER INFORMATION: Customer Service: 800-333-4000 Fax: 800-300-7502 www.sunrisemedical.com
Specifications are subject to change without notice. Copyright © 2011 Sunrise Medical (US) LLC. Quickie IRIS, MK-100052 REV G
Page 8
a
Option #
HCPCS
Definition
Price
a
Option #
HCPCS
Definition
9. APPENDIX
Lower Leg Length Matrix
Front seat height must be at least 2" taller than lower leg length on all swing in/out hangers. Front seat height must be at least 2" taller than maximum lower
leg length on all front mount hangers.
ORDER INFORMATION: Customer Service: 800-333-4000 Fax: 800-300-7502 www.sunrisemedical.com
Specifications are subject to change without notice. Copyright © 2011 Sunrise Medical (US) LLC. Quickie IRIS, MK-100052 REV G
Page 9
Price
a
Option #
HCPCS
Definition
JAY
Price
®
a
Option #
HCPCS
Definition
Price
Signature Series Backrest and Accessories
Note: Not all sizes and configurations shown below, for full offering visit www.sunrisemedical.com
When ordering mark the part number desired and it will be added to the order as a separate line item .
JAY BACKREST
JAY J3 Back PA (2.2" Contour Depth)
JAY J3 Back PL (3" Contour Depth)
MT Shells- 4 Point Standard Hardware
MT Shells- 4 Point Standard Hardware
o
J3PAMTT12FS
E2613
12" Wide J3 Back w/ 15" Shell Height
$580.00
o
J3PLMTT12FS
E2613
12" Wide J3 Back w/ 15" Shell Height
$670.00
o
J3PAMTT14FS
E2613
14" Wide J3 Back w/ 15" Shell Height
$580.00
o
J3PLMTT14FS
E2613
14" Wide J3 Back w/ 15" Shell Height
$670.00
o
J3PAMTT16FS
E2613
16" Wide J3 Back w/ 15" Shell Height
$580.00
o
J3PLMTT16FS
E2613
16" Wide J3 Back w/ 15" Shell Height
$670.00
o
J3PAMTT18FS
E2613
18" Wide J3 Back w/ 15" Shell Height
$580.00
o
J3PLMTT18FS
E2613
18" Wide J3 Back w/ 15" Shell Height
$670.00
o
J3PAMTT20FS
E2613
20" Wide J3 Back w/ 15" Shell Height
$580.00
o
J3PLMTT20FS
E2613
20" Wide J3 Back w/ 15" Shell Height
$670.00
UT Shells- 4 Point Standard Hardware
UT Shells- 4 Point Standard Hardware
o
J3PAUTS12FS
E2613
12" Wide J3 Back w/ 16.5" Shell Height
$580.00
o
J3PLUTS12FS
E2613
12" Wide J3 Back w/ 16.5" Shell Height
$670.00
o
J3PAUTS14FS
E2613
14" Wide J3 Back w/ 16.5" Shell Height
$580.00
o
J3PLUTS14FS
E2613
14" Wide J3 Back w/ 16.5" Shell Height
$670.00
o
J3PAUTS16FS
E2613
16" Wide J3 Back w/ 16.5" Shell Height
$580.00
o
J3PLUTS16FS
E2613
16" Wide J3 Back w/ 16.5" Shell Height
$670.00
o
J3PAUTS18FS
E2613
18" Wide J3 Back w/ 16.5" Shell Height
$580.00
o
J3PLUTS18FS
E2613
18" Wide J3 Back w/ 16.5" Shell Height
$670.00
o
J3PAUTS20FS
E2613
20" Wide J3 Back w/ 16.5" Shell Height
$580.00
o
J3PLUTS20FS
E2613
20" Wide J3 Back w/ 16.5" Shell Height
$670.00
o J3PAUTM14FS
E2613
14" Wide J3 Back w/ 18" Shell Height
$580.00
o
J3PLUTM14FS
E2613
14" Wide J3 Back w/ 18" Shell Height
$670.00
o J3PAUTM16FS
E2613
16" Wide J3 Back w/ 18" Shell Height
$580.00
o
J3PLUTM16FS
E2613
16" Wide J3 Back w/ 18" Shell Height
$670.00
o J3PAUTM18FS
E2613
18" Wide J3 Back w/ 18" Shell Height
$580.00
o
J3PLUTM18FS
E2613
18" Wide J3 Back w/ 18" Shell Height
$670.00
o J3PAUTM20FS
E2613
20" Wide J3 Back w/ 18" Shell Height
$580.00
o
J3PLUTM20FS
E2613
20" Wide J3 Back w/ 18" Shell Height
$670.00
o J3PAUTM22FS
E2614
22" Wide J3 Back w/ 18" Shell Height
$795.00
o
J3PLUTT14FS
E2613
14" Wide J3 Back w/ 19.5" Shell Height
$670.00
o
J3PAUTT14FS
E2613
14" Wide J3 Back w/ 19.5" Shell Height
$580.00
o
J3PLUTT16FS
E2613
16" Wide J3 Back w/ 19.5" Shell Height
$670.00
o
J3PAUTT16FS
E2613
16" Wide J3 Back w/ 19.5" Shell Height
$580.00
o
J3PLUTT18FS
E2613
18" Wide J3 Back w/ 19.5" Shell Height
$670.00
o
J3PAUTT18FS
E2613
18" Wide J3 Back w/ 19.5" Shell Height
$580.00
o
J3PLUTT20FS
E2613
20" Wide J3 Back w/ 19.5" Shell Height
$670.00
o
J3PAUTT20FS
E2613
20" Wide J3 Back w/ 19.5" Shell Height
$580.00
SH Shells- 4 Point Standard Hardware
SH Shells- 4 Point Standard Hardware
o
J3PLSHS14FS
E2613
14" Wide J3 Back w/ 21" Shell Height
$670.00
o J3PASHS14FS
E2613
14" Wide J3 Back w/ 21" Shell Height
$580.00
o
J3PLSHS16FS
E2613
16" Wide J3 Back w/ 21" Shell Height
$670.00
o J3PASHS16FS
E2613
16" Wide J3 Back w/ 21" Shell Height
$580.00
o
J3PLSHS18FS
E2613
18" Wide J3 Back w/ 21" Shell Height
$670.00
o J3PASHS18FS
E2613
18" Wide J3 Back w/ 21" Shell Height
$580.00
o
J3PLSHS20FS
E2613
20" Wide J3 Back w/ 21" Shell Height
$670.00
o J3PASHS20FS
E2613
20" Wide J3 Back w/ 21" Shell Height
$580.00
o J3PLSHM16FS
E2613
16" Wide J3 Back w/ 22.5" Shell Height
$670.00
o J3PASHS22FS
E2614
22" Wide J3 Back w/ 21" Shell Height
$795.00
o J3PLSHM18FS
E2613
18" Wide J3 Back w/ 22.5" Shell Height
$670.00
o J3PASHM16FS
E2613
16" Wide J3 Back w/ 22.5" Shell Height
$580.00
o J3PLSHM20FS
E2613
20" Wide J3 Back w/ 22.5" Shell Height
$670.00
o J3PASHM18FS
E2613
18" Wide J3 Back w/ 22.5" Shell Height
$580.00
o
J3PLSHT18FS
E2613
18" Wide J3 Back w/ 24" Shell Height
$670.00
o J3PASHM20FS
E2613
20" Wide J3 Back w/ 22.5" Shell Height
$580.00
o
J3PLSHT20FS
E2613
20" Wide J3 Back w/ 24" Shell Height
$670.00
o
J3PASHT18FS
E2613
18" Wide J3 Back w/ 24" Shell Height
$580.00
o
J3PASHT20FS
E2613
20" Wide J3 Back w/ 24" Shell Height
$580.00
JAY J3 Back PD (6" Contour Depth)
MT Shells- 4 Point Standard Hardware
UT Shells- 4 Point Standard Hardware Continued
o J3PDMTT14FS
E2620
14" Wide J3 Back w/ 15" Shell Height
$795.00
o J3PDUTM18FS
E2620
18" Wide J3 Back w/ 18" Shell Height
$750.00
o J3PDMTT16FS
E2620
16" Wide J3 Back w/ 15" Shell Height
$750.00
o J3PDUTM20FS
E2620
20" Wide J3 Back w/ 18" Shell Height
$750.00
o J3PDMTT18FS
E2620
18" Wide J3 Back w/ 15" Shell Height
$750.00
o J3PDMTT20FS
E2620
20" Wide J3 Back w/ 15" Shell Height
$750.00
UT Shells- 4 Point Standard Hardware
SH Shells- 4 Point Standard Hardware
o J3PDSHS14FS
E2620
14" Wide J3 Back w/ 21" Shell Height
$750.00
o J3PDSHS16FS
E2620
16" Wide J3 Back w/ 21" Shell Height
$750.00
o J3PDUTM14FS
E2620
14" Wide J3 Back w/ 18" Shell Height
$750.00
o J3PDSHS18FS
E2620
18" Wide J3 Back w/ 21" Shell Height
$750.00
o J3PDUTM16FS
E2620
16" Wide J3 Back w/ 18" Shell Height
$750.00
o J3PDSHS20FS
E2620
20" Wide J3 Back w/ 21" Shell Height
$750.00
JAY J3 Back Headrest
AXYS Mount and Pad
LINX Mount and Pad
o
J3HEDX8
E0955/E1028 AXYS Headrest with 8" Plush Pad
$381.00
o
J3HEDL8
E0955/E1028 LINX Headrest with 8" Plush Pad
$441.00
o
J3HEDX10
E0955/E1028 AXYS Headrest with 10" Plush Pad
$381.00
o
J3HEDL10
E0955/E1028 LINX Headrest with 10" Plush Pad
$441.00
o
J3HEDX14
E0955/E1028 AXYS Headrest with 14" Plush Pad
$394.00
o
J3HEDL14
E0955/E1028 LINX Headrest with 14" Plush Pad
$454.00
o
J3HEDXAAPN
E0955/E1028 AXYS with Adj-a-Plush Narrow Pad
$480.00
o
J3HEDLAAPN
E0955/E1028 LINX with Adj-a-Plush Narrow Pad
$540.00
o
J3HEDXAAPS
E0955/E1028 AXYS with Adj-a-Plush Std Pad
$480.00
o
J3HEDLAAPS
E0955/E1028 LINX with Adj-a-Plush Std Pad
$540.00
JAY J3 Back Laterals Swing Away Laterals With Pad - Pair
o
J3LAT4X4SA
E0956/E1028 SwingAway Lat with 4"x4" Pad (PR)
$778.00
o
J3LAT6X4SA
E0956/E1028 SwingAway Lat with 6"x4" Pad (PR)
$778.00
o
J3LAT4X5SA
E0956/E1028 SwingAway Lat with 4"x5" Pad (PR)
$778.00
o
J3LAT6X5SA
E0956/E1028 SwingAway Lat with 6"x5" Pad (PR)
$778.00
o
J3LAT4X6SA
E0956/E1028 SwingAway Lat with 4"x6" Pad (PR)
$778.00
o
J3LAT6X6SA
E0956/E1028 SwingAway Lat with 6"x6" Pad (PR)
$778.00
ORDER INFORMATION: Customer Service: 800-333-4000 Fax: 800-300-7502 www.sunrisemedical.com
Specifications are subject to change without notice. Copyright © 2011 Sunrise Medical (US) LLC. Quickie IRIS, MK-100052 REV G
Page 10
a
Option #
HCPCS
Definition
Price
JAY
®
a
Option #
HCPCS
Definition
Price
Signature Series Cushions
Note: Not all sizes and configurations shown below, for full offering visit www.sunrisemedical.com.
When ordering mark the part number desired and it will be added to the order as a separate line item .
JAY CUSHIONS
JAY Fusion Cushion
JAY J2 Cushion
o
JFUSION1416
E2622
JAY Fusion 14" x 16"
$440.00
o
2108-MJ
E2622
JAY J2 14" x 16"
$435.00
o
JFUSION1616
E2622
JAY Fusion 16" x 16"
$440.00
o
2105-MJ
E2622
JAY J2 15.5" x 16"
$435.00
o
JFUSION1618
E2622
JAY Fusion 16" x 18"
$440.00
o
2106-MJ
E2622
JAY J2 15.5" x 18"
$435.00
o
JFUSION1620
E2622
JAY Fusion 16" x 20"
$440.00
o
2107-MJ
E2622
JAY J2 15.5" x 20"
$470.00
o
JFUSION1717
E2622
JAY Fusion 17" x 17"
$440.00
o
2117-MJ
E2622
JAY J2 17" x 17"
$435.00
o
JFUSION1816
E2622
JAY Fusion 18" x 16"
$440.00
o
2100-MJ
E2622
JAY J2 18" x 16"
$435.00
o
JFUSION1818
E2622
JAY Fusion 18" x 18"
$440.00
o
2101
E2622
JAY J2 18" x 18"
$435.00
o
JFUSION1820
E2622
JAY Fusion 18" x 20"
$440.00
o
2103-MJ
E2622
JAY J2 18" x 20"
$470.00
o
JFUSION2018
E2622
JAY Fusion 20" x 18"
$440.00
o
2118-MJ
E2622
JAY J2 20" x 18"
$470.00
o
JFUSION2020
E2622
JAY Fusion 20" x 20"
$440.00
o
2102-MJ
E2622
JAY J2 20" x 20"
$545.00
o
JFUSION2220
E2623
JAY Fusion 22" x 20"
$540.00
JAY Fusion Cushion w/ ROHO Single Valve Air Insert
JAY J2 Deep Contour Cushion
o
JFUSION1416AS
E2622
JAY Fusion 14" x 16"
$440.00
o
2446
E2622
JAY J2 Deep Contour 14" x 16"
$450.00
o
JFUSION1616AS
E2622
JAY Fusion 16" x 16"
$440.00
o
2466
E2622
JAY J2 Deep Contour 16" x 16"
$450.00
o
JFUSION1618AS
E2622
JAY Fusion 16" x 18"
$440.00
o
2468
E2622
JAY J2 Deep Contour 16" x 18"
$450.00
o
JFUSION1620AS
E2622
JAY Fusion 16" x 20"
$440.00
o
2460
E2622
JAY J2 Deep Contour 16" x 20"
$480.00
o
JFUSION1717AS
E2622
JAY Fusion 17" x 17"
$440.00
o
2477
E2622
JAY J2 Deep Contour 17" x 17"
$450.00
o
JFUSION1816AS
E2622
JAY Fusion 18" x 16"
$440.00
o
2486
E2622
JAY J2 Deep Contour 18" x 16"
$450.00
o
JFUSION1818AS
E2622
JAY Fusion 18" x 18"
$440.00
o
2488
E2622
JAY J2 Deep Contour 18" x 18"
$450.00
o
JFUSION1820AS
E2622
JAY Fusion 18" x 20"
$440.00
o
2480
E2622
JAY J2 Deep Contour 18" x 20"
$480.00
o
JFUSION2018AS
E2622
JAY Fusion 20" x 18"
$440.00
o
2408
E2622
JAY J2 Deep Contour 20" x 18"
$480.00
o
JFUSION2020AS
E2622
JAY Fusion 20" x 20"
$440.00
o
2400-MJ
E2622
JAY J2 Deep Contour 20" x 20"
$555.00
o
JFUSION2220AS
E2623
JAY Fusion 22" x 20"
$540.00
o
2428
E2623
JAY J2 Deep Contour 22" x 18"
$555.00
JAY Fusion Cushion w/ ROHO Dual Valve Air Insert
JAY X2 Cushion
o
JFUSION1416AD
E2622
JAY Fusion 14" x 16"
$440.00
o
JX21416
E2622
JAY X2 14" x 16"
$425.00
o
JFUSION1616AD
E2622
JAY Fusion 16" x 16"
$440.00
o
JX21616
E2622
JAY X2 16" x 16"
$425.00
o
JFUSION1618AD
E2622
JAY Fusion 16" x 18"
$440.00
o
JX21618
E2622
JAY X2 16" x 18"
$425.00
o
JFUSION1620AD
E2622
JAY Fusion 16" x 20"
$440.00
o
JX21620
E2622
JAY X2 16" x 20"
$425.00
o
JFUSION1717AD
E2622
JAY Fusion 17" x 17"
$440.00
o
JX21717
E2622
JAY X2 17" x 17"
$425.00
o
JFUSION1816AD
E2622
JAY Fusion 18" x 16"
$440.00
o
JX21816
E2622
JAY X2 18" x 16"
$425.00
o
JFUSION1818AD
E2622
JAY Fusion 18" x 18"
$440.00
o
JX21818
E2622
JAY X2 18" x 18"
$425.00
o
JFUSION1820AD
E2622
JAY Fusion 18" x 20"
$440.00
o
JX21820
E2622
JAY X2 18" x 20"
$425.00
o
JFUSION2018AD
E2622
JAY Fusion 20" x 18"
$440.00
o
JX22020
E2622
JAY X2 20" x 20"
$425.00
o
JFUSION2020AD
E2622
JAY Fusion 20" x 20"
$440.00
o
JFUSION2220AD
E2623
JAY Fusion 22" x 20"
$540.00
JAY Union Cushion
JAY Ion Cushion
o
JU1416
E2607
JAY UNION 14" x 16"
$445.00
o
JION1416
E2607
JAY ION 14" x 16"
$395.00
o
JU1616
E2607
JAY UNION 16" x 16"
$445.00
o
JION1616
E2607
JAY ION 16" x 16"
$395.00
o
JU1618
E2607
JAY UNION 16" x 18"
$445.00
o
JION1618
E2607
JAY ION 16" x 18"
$395.00
o
JU1620
E2607
JAY UNION 16" x 20"
$445.00
o
JION1620
E2607
JAY ION 16" x 20"
$395.00
o
JU1717
E2607
JAY UNION 17" x 17"
$445.00
o
JION1717
E2607
JAY ION 17" x 17"
$395.00
o
JU1816
E2607
JAY UNION 18" x 16"
$445.00
o
JION1816
E2607
JAY ION 18" x 16"
$395.00
o
JU1818
E2607
JAY UNION 18" x 18"
$445.00
o
JION1818
E2607
JAY ION 18" x 18"
$395.00
o
JU1820
E2607
JAY UNION 18" x 20"
$445.00
o
JION1820
E2607
JAY ION 18" x 20"
$395.00
o
JU2018
E2607
JAY UNION 20" x 18"
$445.00
o
JION2018
E2607
JAY ION 20" x 18"
$395.00
o
JU2020
E2607
JAY UNION 20" x 20"
$445.00
o
JION2020
E2607
JAY ION 20" x 20"
$395.00
o
JU2220
E2608
JAY UNION 22" x 20"
$545.00
o
JION2220
E2608
JAY ION 22" x 20"
$495.00
JAY Union Reduced Profile Cushion
o
JU1416RP
E2607
JAY Union RP 14" x 16"
$445.00
o
JU1816RP
E2607
JAY Union RP 18" x 16"
$445.00
o
JU1616RP
E2607
JAY Union RP 16" x 16"
$445.00
o
JU1818RP
E2607
JAY Union RP 18" x 18"
$445.00
o
JU1618RP
E2607
JAY Union RP 16" x 18"
$445.00
o
JU1820RP
E2607
JAY Union RP 18" x 20"
$445.00
o
JU1620RP
E2607
JAY Union RP 16" x 20"
$445.00
o
JU2018RP
E2607
JAY Union RP 20" x 18"
$445.00
o
JU1717RP
E2607
JAY Union RP 17" x 17"
$445.00
o
JU2020RP
E2607
JAY Union RP 20" x 20"
$445.00
ORDER INFORMATION: Customer Service: 800-333-4000 Fax: 800-300-7502 www.sunrisemedical.com
Specifications are subject to change without notice. Copyright © 2011 Sunrise Medical (US) LLC. Quickie IRIS, MK-100052 REV G
Page 11
Download PDF
Similar pages
Operating Instructions Push button Mechanism
Zippie® ZM-310™ Brochure
Documentation No.
QUICKIE S636 BC/SC/MPC - Quickie
summer