IVC Tracer SX5 Recliner Wheelchair

IVC Tracer SX5 Recliner Wheelchair
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NOTE: All specifications and dimensions are approximate.
For the most current pricing information, go to www.invacare.com/homecare.
Page 1 of 4
Invacare® IVC™ Tracer® SX5 Recliner Wheelchair
Price List and Order Form
Customer Service: 800-333-6900
www.invacare.com
Fax: 800-678-4682
To order literature: 800-828-6282
TRANSACTION TYPE:
Order
Date
Quote
Account #
P.O. #
Company Name
Phone #
Address
State 0
City
Contact Name
Zip Code
Country
Comments
Special Note
HCPCS codes are not intended to be, nor should be considered billing or legal advice. Providers are responsible for determining the appropriate billing codes when
submitting claims to the Medicare Program and should consult an attorney or other advisor to discuss specific situations in further detail.
PRE-CONFIGURED STOCK WHEELCHAIRS
FRAMES
STOCK CHAIRS
Quantity Model ID
CHAIR TYPE
Price
Description
TRSX5RC Tracer SX5 Recliner Builder Wheelchair ........................ $695.00
TRSX5RC6 TRSX5RC/WD66/28/R/U67 (9153637779) ........ $1,135.00
FRAME WIDTH AND DEPTH
TRSX5RC8 TRSX5RC/WD86/28/R/U67 (9153637778) ........ $1,135.00
STOCK FRONT RIGGINGS
Quantity Model ID
T93HA
T93HC
T94HA
T94HC
AHL4A
T94HE
T93HE
Description
Price
Hemi Sw. Footrests
Aluminum Footplates (9153637801) ...... $93.00
Hemi Sw. Footrests
Composite Footplates (9153637786) ...... $93.00
Hemi Sw. Elev Legrests
Aluminum Footplates (9153637804) .... $180.00
Hemi Sw. Elev Legrests
Composite Footplates (9153637788) .... $180.00
Hemi Smart Leg Art.
Legrest Aluminum (9153619911) ......... $320.00
Hemi Legrest Composite
w/Black Non Rem Calfpad (9153637919) $110.00
Hemi Footrest without Loop
Composite Footplate (9153637918) ........ $65.00
WD46
14" Wide x 16" Deep .......................................... $90.00
A9900
WD48
14" Wide x 18" Deep ........................................ $118.00
A9900
WD66
16" Wide x 16" Deep .....................................No Charge
WD68
16" Wide x 18" Deep ........................................ $118.00
WD86
18" Wide x 16" Deep .....................................No Charge
WD88
18" Wide x 18" Deep ........................................ $118.00
A9900
20" Wide x 16" Deep .................................... No Charge
E2201
WD06
A9900
20" and 22" widths have 300 lbs. weight limit requiring 1228
casters (upcharge necessary, see "Casters" section), and 24"
rear wheels (no upcharge).
WD08
20" Wide x 18" Deep ........................................ $254.00
20" and 22" widths have 300 lbs. weight limit requiring 1228
casters (upcharge necessary, see "Casters" section), and 24"
rear wheels (no upcharge).
WD26
22" Wide x 16" Deep ........................................ $142.00
20" and 22" widths have 300 lbs. weight limit requiring 1228
casters (upcharge necessary, see "Casters" section), and 24"
rear wheels (no upcharge).
WD28
22" Wide x 18" Deep ........................................ $254.00
E2201
20" and 22" widths have 300 lbs. weight limit requiring 1228
casters (upcharge necessary, see "Casters" section), and 24"
rear wheels (no upcharge).
ARMS
ARM TYPE
All arm types below are removable, conventional and nonflip-back.
18
19
28
29
Full Length Fixed Height Conv. 10" ............ No Charge
Full Length Adj. Height Conv. 10" - 14" ......... $130.00
Desk Length Fixed Height Conv. 10" .......... No Charge
Desk Length Adj. Height Conv. 10" - 14" ........ $130.00
A9900
E0973
A9900
E0973
FRAME TYPE
R
Recliner Frame ................................................... $410.00 E1226
90 degree to 180 degree of recline. 24" back height with 10"
headrest extension.
NOTE: All specifications and dimensions are approximate.
For the most current pricing information, go to www.invacare.com/homecare.
Revised December 8, 2014
Page 2 of 4
Form No. 02-077
Invacare® IVC™ Tracer® SX5 Recliner Wheelchair
COLOR OPTIONS
ACCESSORIES
UPHOLSTERY COLORS
U240
U550
U67
U86
BACK ACCESSORIES
L8601
Black Nylon Upholstery ......................................... No Charge
Midnight Blue Vinyl Upholstery ............................... Standard
Black Vinyl ............................................................ No Charge
Ruby Red Vinyl ...................................................... No Charge
STC
Omit Back Upholstery .............................. Less $10.00
Stencil Back Upholstery .................................... $29.00
A9270
3/4 Block Letters.
SEAT ACCESSORIES
CASTERS
L8651
CASTER OPTIONS
AT903
1228
1252
4252
8" x 1.25" Composite Urethane ....................... Standard
8" x 1.75" Semi Pneumatic Casters Lt Grey ....... $56.00
8" x 1.25" Pneumatic Casters ............................. $87.00
8" x 1.25" Pneumatic Casters w/FF Inserts ...... $179.00
Omit Seat Upholstery ................................ Less $10.00
MISCELLANEOUS ACCESSORIES
1322SXR IV Rod and Bracket, Telescopic, Recliner ................ $110.00
1514
Overhead Anti Theft Device ....................................... $46.00
MUPH
Matching Upholstery ............................................ No Charge
A9900
Applys to arm pads and calf pads.
1329BK
Toggle Wheel Lock Extension (8") ............................ $39.00
WHEELS
FRONT RIGGING OPTIONS
WHEEL OPTIONS
U1763BK
U1764BK
2244BK
4244BK
U2222C
U2244BK
20" Composite Urethane Tires ......................... $113.00
22" Composite Urethane Tires ......................... $113.00
24" Composite Pneumatic Tires ....................... $140.00
24" Composite Pneumatic with FF Inserts ....... $225.00
24" Composite Urethane Corded Tires ........... Standard
24" Composite Urethane Treaded Tires ........... $120.00
A9900
FRONT RIGGINGS
A9900
A9900
Hemi Footrests without heel loop, Composite Ftpl .. $65.00
Hemi Footrests Aluminum Footplates ................. $93.00
T93HC
Hemi Footrests ..................................................... $93.00
T94HE
Hemi Elevating Legrest Composite Ftpl Blk Plastic Calf Pad $110.00
A9900
T94HA
Hemi Elev. Lgrt Aluminum Ftpl ........................ $180.00
K0195
E0990
E2213
A9900
Not available with 14" wide.
Not available with 14" wide.
A9900
WHEEL LOCKS
9690B
9691B
T93HE
T93HA
Not available with 14" wide.
All calfpads are black.
Pull To Lock Wheel Locks (Std on Hemi) ............. No Charge
Push To Lock Wheel Locks (Std on Adult) ........... No Charge
T94HC
Hemi Elevating Legrests .................................... $180.00
K0195
E0990
Not available with 14" wide.
All calfpads are black.
HANDRIM OPTIONS
COM
AHL4A
Hemi Smartleg Articulating Lgrt Alum Ftpl ...... $320.00
K0053
Not available with 14" wide.
All calfpads are black.
Composite Handrims ................................................. Standard
Available with 24" rear wheels only.
AHL4C
AHDRM Aluminum Handrims ...............................................No Charge
Hemi Smartleg Art. Lgrt Comp Ftpl .................. $320.00
K0053
Not available with 14" wide.
All calfpads are black.
Not available with U2222C rear wheels.
AHS4A
Hemi Smartleg Art. Lgrt-14" W Chairs ............. $320.00
K0053
All calfpads are black.
POSITIONING STRAP OPTIONS
T93HS
T94HS
SEAT POSITIONING STRAPS
1515
Push Button Style Positioning Strap .................... $50.00
A9900
E0978
1321BK
Hook and Loop Seat Positioning Strap ............... $40.00
E0978
Hemi Footrests Aluminum Footplates 14" W ...... $90.00
Hemi Legrests Aluminum Footplates 14" W ..... $175.00
A9900
A9900
All calfpads are black.
FOOTPLATE TYPE
1350
Extra Large Footplates ....................................... $79.00
K0041
Not available on 14" width.
AT5543
Adjustable Angle Flip-Up Footplates ................ $67.00
FOOTREST/LEGREST ACCESSORIES
1820
1346
Non-Removable Device ..................................... $12.00
Heel Loops ......................................................... $39.00
A9900
K0951
Standard on swingaway footrests T93HA and T93HC.
NOTE: All specifications and dimensions are approximate.
For the most current pricing information, go to www.invacare.com/homecare.
Revised December 8, 2014
Page 3 of 4
Form No. 02-077
Invacare® IVC™ Tracer® SX5 Recliner Wheelchair
TRACER SX5 RECLINER CONVERSION KITS
Standard on SX5 Recliner
• Rear anti-tippers
• Patient only operated push-to-lock wheel lock
These selections do not include seat upholstery or clamp-on wheel locks required for
20" or 22" rear wheels.
Quantity Model ID
RCL14
Price
Description
14” Wide Conversion Kit ....................................... $420.00
Includes AT903 casters and Heavy-Duty forks.
RCL16
Weight Limitation 250 lbs., 300 lbs. 20" & 22" width
Invacare recommends all wheelchairs be fitted to the consumer under
the guidance of a healthcare professional, knowledgeable of the
particular limitations of the product.
16” Wide Conversion Kit ....................................... $420.00
Includes AT903 casters and Heavy-Duty forks.
RCL18
18” Wide Conversion Kit ....................................... $420.00
Includes AT903 casters and Heavy-Duty forks.
RCL20
20” Wide Conversion Kit ....................................... $390.00
RCL22
22” Wide Conversion Kit ....................................... $390.00
Seat-to-Floor 8" Casters
Seat-to-Floor
Height
Front Caster
Rear Wheel
Rear Wheel Size
Mounting Position
Mounting Position
17 1/2"
Top
20"
Recliner Axle
Mounting Bracket
18 1/3"
Middle
22"
Recliner Axle
Mounting Bracket
19 1/2"
Bottom
24"
Recliner Axle
Mounting Bracket
Comments
Print Form
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Clear Form
NOTE: All specifications and dimensions are approximate.
For the most current pricing information, go to www.invacare.com/homecare.
Invacare Corporation
USA
One Invacare Way
Elyria, OH USA
44035-4190
800-333-6900
www.invacare.com
©2013 Invacare Corporation
All rights reserved. Trademarks are identified by the symbols™ and ®. All trademarks are
owned by or licensed to Invacare Corporation unless otherwise noted. Specifications and
prices are subject to change without notification.
Page 4 of 4
Revised December 8, 2014
Form No. 02-077
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