Invacare eForms For additional information, visit www.invacare.com/eForms Customer Service: 800-333-6900 Fax: 800-678-4682 www.invacare.com To order Literature: 800-828-6282 Invacare eForms offer new functionality! Invacare is pleased to offer you an upgraded solution to your ordering process. Our enhanced order forms allow you to fill out a form electronically, print and fax the form, save and email* it to Customer Service, or maintain the business practices that work for you today. 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For information on downloading Adobe Reader for free, or puchasing Adobe Acrobat Professional, please visit www.adobe.com. NOTE: All specifications and dimensions are approximate. For the most current pricing information, go to www.invacare.com/homecare. Page 1 of 5 Invacare® Compass™ SPT™ 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 Country Zip Code 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. FRAME TYPE SPT Seat-to-Floor Matrix 8" Casters Self Propelling Tilt ......................................... $2,825.00 E1161 SEAT WIDTH SETTING W14 W15 W16 W17 W18 W19 W20 W21 W22 14'' Seat Width ............................................... No Charge 15'' Seat Width ............................................... No Charge 16'' Seat Width ............................................... No Charge 17'' Seat Width ............................................... No Charge 18'' Seat Width ............................................... No Charge 19'' Seat Width ............................................... No Charge 20'' Seat Width ................................................... $300.00 21'' Seat Width ................................................... $300.00 22'' Seat Width ................................................... $300.00 15'' Seat Depth ............................................... No Charge 16'' Seat Depth ............................................... No Charge 17'' Seat Depth ............................................... No Charge 18'' Seat Depth ............................................... No Charge 19'' Seat Depth ............................................... No Charge 20'' Seat Depth ................................................... $300.00 21'' Seat Depth ................................................... $300.00 22'' Seat Depth ................................................... $300.00 Wheel Size Wheel Mounting Position 16 1/2" Top 20" Bottom 16 1/2" Top 24" Top 17 1/2" Middle 22" Bottom 18 1/2" Bottom 24" Bottom Seat-to-Floor Matrix 6" x 2" Casters E2201 E2201 Seat to Floor Height Caster Mounting Position Wheel Size Wheel Mounting Position 15 1/2" Top 22" Top 16 1/2" Middle 20" Bottom 16 1/2" Middle 24" Top 17 1/2" Bottom 22" Bottom E2203 ARM SELECTION E2203 E2204 SEAT PAN FLSEAT Flush Mounted Seat Pan ...................................... $75.00 Caster Mounting Position E2201 SEAT DEPTH SETTING SDS15 SDS16 SDS17 SDS18 SDS19 SDS20 SDS21 SDS22 Seat to Floor Height K0108 Seating systems must be purchased for use with this wheelchair. SEAT-TO-FLOOR HEIGHT ARM TYPE (PAIR) ADJDESK ADJFULL TAD TAF FXDESK Seat-To-Floor .................................................................................... No Charge Conv Adjust. Ht., Desk Lgth. Arms ..................... $195.00 Conv Adjust. Ht., Full Lgth. Arms ....................... $195.00 T - Arm Adj Height, Desk Length ..................... $225.00 T - Arm Adj Height, Full Length ....................... $225.00 Conv Fixed Ht., Desk Lgth. Arms ................. No Charge E0973 E0973 E0973 E0973 Only available with FWDFS. FXFULL Conv Fixed Ht., Full Lgth. Arms .................. No Charge (MUST WRITE IN SEAT TO FLOOR TO COMPLETE ORDER) Only available with FWDFS. T-ARM HEIGHT Seat-to-Floor Matrix 6" Casters Seat to Floor Height Caster Mounting Position Wheel Size Wheel Mounting Position 14 1/2" Top 20" Top 15 1/2" Middle 22" Top 16 1/2" Bottom 24" Top 16 1/2" Bottom 20" Bottom L8-12 H10-16 Clear Low Range 8'' - 12'' (T - Arm Height) ................... No Charge High Range 10'' - 16'' (T - Arm Height) ................ No Charge 13 1/2" seat-to-floor height available with 18" composite wheel and 5" caster. Use specials number SM-060929111549 NOTE: All specifications and dimensions are approximate. For the most current pricing information, go to www.invacare.com/homecare. Revised Oct 25, 2012 Form No. 03-069 Invacare® Compass™ SPT™ BACK SELECTION FRAME FINISH FRAME COLORS BACK HEIGHT ABH1720 Adjustable Height Back Canes (17'' - 20'') ............. No Charge Must choose the AASH or AASHIN when ordering the ABH1720. The 1483 Non-Adjustable Rigidizing Handle bar is not available with ABH1720. BH20 BH24 20'' Back Height ..................................................... No Charge 24'' Back Height ..................................................... No Charge BACK ANGLE ADJUSTMENT 90BA 100BA 110BA 120BA 90° Back Angle Setting .......................................... No Charge 100° Back Angle Setting ........................................ No Charge 110° Back Angle Setting ........................................ No Charge 120° Back Angle Setting ........................................ No Charge Clear BACK UPHOLSTERY BKUP With Back Upholstery ............................................ No Charge 24P 29P 60P 115P 105P 116P 117P 30P 61P 119P 120P 62P 127P Wet Black ............................................................... No Charge White Snow............................................................. No Charge Silver Metallic ........................................................ No Charge Black Prism ............................................................ No Charge Midnight Blue ........................................................ No Charge Sunkissed Orange ................................................... No Charge Tangerine Red ........................................................ No Charge Sunny Yellow ......................................................... No Charge Electric Red ............................................................ No Charge Bubblegum Pink ..................................................... No Charge Grape Madness ....................................................... No Charge Electric Blue ........................................................... No Charge Grasshopper Green ................................................. No Charge Touch Up Paint ............................................................. $20.00 Touch up paint is not available in all colors. CASTER AND WHEEL SELECTION Touch Up Color CASTER OPTIONS (PAIR) Discontinued frame colors are available through our specials department. C-070109030544 13 1/2" seat-to-floor height available with 18" composite wheel and 5" caster. Use Special # SM-060929111549. 61DC 81DC 1292 81DC 1259 1299 1492 6'' x 1" Urethane Casters ............................... No Charge 8'' x 1'' Urethane Casters ................................ No Charge 8'' x 1 1/4'' Pneumatic Casters .............................. $60.00 8'' x 1.5'' Urethane Casters .............................No Charge 6'' x 2'' Semi Pneumatic Casters ........................... $60.00 8'' x 1'' Solid Rubber Casters .......................... No Charge Flat Free Inserts for 8'' x 1 1/4'' Pneu Casters ...... $64.00 POSITIONING STRAPS POSITIONING STRAPS E2213 FRONT WHEEL CONFIGURATIONS FWDFS RWDFS E0978 E0978 E0960 E0960 E0960 ACCESSORIES BP02 1483 AASH Back Pack .................................................................... $50.00 Non Adjustable Rigidizing Handle Bar ...................... $85.00 Adj. Angle Stroller Handles (Outside Mount) .......... $235.00 AASH release buttons are mounted on the outside and AASIN release buttons are mounted on the inside. Clear PNEU Pneumatic Tires ................................................... $60.00 PNEUFF Flat Free Inserts .................................................... $65.00 URETH Urethane (Treaded) ........................................ No Charge AASHIN Adj. Angle Stroller Handles (Inside Mount) ............. $235.00 AASH release buttons are mounted on the outside and AASIN release buttons are mounted on the inside. E2213 Only available with with 24COM7 Wheel Option. ® KIK Black Tires ................................................. $60.00 AXLE TYPE (PAIR) A1577 PAXLE E0978 BACK ACCESSORIES 20COM 20'' Composite Wheels ........................................... No Charge 22COM 22'' Composite Wheels ........................................... No Charge 24COM7 24'' Composite 7 Spoke Wheels ............................. No Charge TIRE OPTIONS (PAIR) Clear Airline Style Buckle Seat Pos Strap (ea) ............. $50.00 Push Button Buckle Seat Pos Strap (ea) .............. $50.00 Hook and Loop Seat Pos Strap (ea) ..................... $40.00 Airline Style Chest Pos Strap (ea) ..................... $100.00 Push Button Chest Pos Strap (ea) ...................... $100.00 Hook and Loop Chest Pos Strap (ea) ................. $100.00 Front Wheel Configuration .................................... No Charge Rear Wheel Configuration ..................................... No Charge WHEEL OPTIONS (PAIR) KIKB 1311BK A1515 A1321 7311BK 9515 7321BK SEAT ACCESSORIES SP-01 Seat Pouch .................................................................... $35.00 MISCELLANEOUS ACCESSORIES Quick Release Axles .............................................. No Charge Permanent Axles ................................................... No Change HANDRIM OPTIONS (PAIR) AHDRM Aluminum Handrims .............................................. No Charge CHDRM Chrome Plated Handrims ....................................... No Charge A1512K Black Plastic Coated Handrims .................................... $72.00 AT1224-8 Plastic Coated with 8 Oblique Projections ................. $240.00 AT1225-8 Plastic Coat with 8 Vertical Projections ....................... $240.00 AT1225-12 Plastic Coat with 12 Vertical Projections ..................... $240.00 NFITSD Natural Fit® Handrims Standard Grip ......................... $295.00 Available only on 24COM7 NFITSP Natural Fit® Handrims Super Grip .............................. $340.00 L8702 Omit Handrims ...................................................... Less $15.00 A1576 3421 A1569 A1209 ATFA TLL Clear Clear Wheel Lock Extensions (6'') (pair) ...................... $39.00 3/4'' - 1'' Clamp Assembly .................................... $21.00 Crutch and Cane Holder ....................................... $46.00 Tire Pump ............................................................. $32.00 Foot Operated Tilt Assist ................................... $125.00 Tilt Trigger Lock Out Levers ........................ No Charge E0961 E2207 Not available with 14'' wide. WHEEL LOCKS Clear ATHUB Cane Mount Hublock (attendant) ................................. $50.00 USEHUB Seat Rail Mount Hublock ............................................. $50.00 USEHUB not available with FWDFS Front Wheel Drive Configuration. Available only on 24COM7 NOTE: All specifications and dimensions are approximate. For the most current pricing information, go to www.invacare.com/homecare. Revised Oct 25, 2012 Form No. 03-069 Invacare® Compass™ SPT™ FRONT RIGGING OPTIONS SEATING AND POSITIONING FRONT RIGGING (PAIR) Clear Swingaway Footrest 13 1/2'' - 19''.................. No Charge SWING1319 60° Swingaway Footrests .............................. No Charge Center Pivot Front Rigging only available with RWDFS 70NTAPER 70° Swingaway Footrests ...............................No Charge Not available with 15", 16" or 17" seat depths. 70MFX ITSG InTouch™ Stabilite™ Gentle Contour Cushion..... $320.00 E2601 Available in even sizes only. See form 07-027 for more information. ™ E2605 InTouch Flovair Gentle Contour Cushion ....... $390.00 E2607 ITSM InTouch Stabilite Max Contour Cushion ........... $320.00 E2607 E0990 SEATING BACK SELECTION E0990 For additional information (size availability, additional seating options and pricing) see form # 07-027 Rehab Seating and Positioning Products price list. K0053 K0053 Clear Flip - Up Composite Footplates .................... No Charge Aluminum Footplates ........................................... $59.00 Extra Large Aluminum Footplates ....................... $59.00 K0041 Adjustable Angle Flip - Up Footplates .............. $165.00 K0041 Doris / Plantar Angle Adjustment. HEEL AND TOE LOOP (PAIR) Clear A1600BK Heel Loops with Ankle Straps ............................ $51.00 HLOOP Heel Loops without Ankle Straps ....................... $51.00 1345 Toe Loops ............................................................ $39.00 FOOTREST AND LEGREST ACCESSORIES PBR PBT PPR PPT ITPR ITPCSR ITPCST Clear Personal Back 10™ Reg. Height ......................... $615.00 Personal Back 10 Tall Height ............................ $615.00 Personal Back 10 Plus Reg. Height ................... $695.00 Personal Back 10 Plus Tall Height .................... $695.00 InTouch Propel™ Back ....................................... $490.00 InTouch PCS Regular ........................................ $645.00 InTouch PCS Tall .............................................. $645.00 E2615 E2615 E2615 E2615 E2611 E2620 E2621 E2620 E2621 INTOUCH PCSTM ACCESSORIES PCSPS Pelvic Stabilizers, 3" (Pair).........................................$230.00 PCSTL Thoracic Lateral Supports, 4" (Pair)...........................$230.00 E0951 E0951 E0952 Clear Calf Strap (each) ................................................... $24.00 K0038 FRMPRBK ChairArmor Black Neoprene Frame Protectors ... $65.00 ChairArmor Silver Neoprene Frame Protectors ... $65.00 ChairArmor Red Neoprene Frame Protectors ...... $65.00 ChairArmor Blue Neoprene Frame Protectors ..... $65.00 Longer Pivot And Slide Tubes (pair) ............. No Charge ALPT is available on PHW93 and 70NTAPER on 16" - 22" chairs using composite or adjustable angle footplates. ALPT is not available on 70MFX or extra large footplates. Not available with 90SWING, 70MFX or 90LIFTMFX front riggings. 9342 Absolute Cushion ............................................... $104.00 ITFG FOOTPLATE TYPE (PAIR) FRMPRS FRMPRR FRMPRB ALPT EC Not available with 1651 flip-up composite footplates. 90° Swingaway Footrests .............................. No Charge Swingaway Elevating Legrest 16" - 19 3/4'' ...... $303.00 Elevating Legrests .............................................. $255.00 Smartleg® Articulating Legrest 17 1/4'' - 21 1/2'' $320.00 Center Pivot Articulating Legrests .................... $320.00 70° Lift off Non - Taper Footrests ......................... $95.00 90LIFTMFX 90° Lift off MFX Footrests .................................. $95.00 A1337 Clear 70° Swingaway Footrests MFX ..................... No Charge 90SWING PH904A AT5044 PHAL4A ATL4 70LIFTNT 1651 A1562 A1564 AT5543 SEATING CUSHION SELECTION For additional information (size availability, additional seating options and pricing) see form # 07-027 Rehab Seating and Positioning Products price list. PHW93 "H" Strap (each) ................................................... $56.00 HEADREST HR01S HR02S HR03S HR04S CP175 CP275 CP180 CP280 Clear Small Headrest ................................................... $284.00 Large Headrest ................................................... $284.00 Two Step Headrest ............................................. $284.00 Curved Headrest ................................................. $284.00 Stealth Headrest 14 Multi Axis Hardware ......... $225.00 Stealth Headrest 10 Multi Axis Hardware ......... $225.00 Stealth Headrest 14 TWB Hardware .................. $225.00 Stealth Headrest 10 TWB Hardware .................. $225.00 HEADREST HARDWARE K0039 Clear CP175HW Removable and Adjustable Hardware ............... $225.00 CP275HW Removable and Adjustable Hardware ............... $225.00 CP180HM Removable and Adjustable Hardware ............... $225.00 For additional seating needs please refer to the following: Invacare Matrx Seating Series Price List Form 11-036. To order any of the following products with your chair, please contact Invacare Customer Service. CUSHIONS Model Number Product Name MA-VI Matrx Vi PS-V Matrx PS FT Matrx Flotech BACKS Model Number Product Name MPB-V Matrx PB MPBD Matrx PB Deep PBE Matrx Elite EDB Matrx Elite Deep NOTE: All specifications and dimensions are approximate. For the most current pricing information, go to www.invacare.com/homecare. Revised Oct 25, 2012 Form No. 03-069 Invacare® Compass™ SPT™ Specials For your customization requests, please contact Customer Service for details and prices. Base Chair Includes • Self Propelling Tilt Frame • Front or Rear Wheel Configuration • Frame Width (W14 - W19) • Seat Depth Setting (SDS15 - SDS19) • Fixed Height Arms (FXDESK or FXFULL) • Back Height (BH20 or BH24) • Back Angle Adjustment (90BA - 120BA) • BKUP - Back Upholstery • Frame Finish • Seat to Floor Height Selection • Caster Options (61DC, 81DC or 1299) • Wheel Options • Tire Options (URETH) • Axle Type (A1577 or PAXLE) • Offset Axle Brackets • Handrim Options (AHDRM or CHDRM) • Front Rigging (PHW93, SWING1319, 70NTAPER, 70MFX OR 90SWING) Swingaway Footrests • ALPT Longer Pivot and Slide Tube • TLL Tilt Trigger Lock Out Levers • Anti - Tippers • Wheel Locks 1. Center pivot front rigging - swing-in (Available on FWDFS and RWDFS) SM-031219102723 2. One Arm Drive Option SM-030917114331 Specifications Tilt 14'' - 22'' 15'' - 22'' 22 1/2'' - 30 1/2'' (Seat width plus 9 1/2'') 33'' - 39'' (without anti-tippers and front rigging) • Overall Chair Height Range 35 1/2'' - 39 1/2'' • Back Angle Adjustment 90° to 120° in 10° increments • Tubing Outside Diameter 1'' • Tilt Range 0° - 45° • Weight of Chair 35 lbs.*61 lbs.** • Warranty Lifetime on frames and crossbraces • All units shipped standard with anti tippers and wheellocks. • Frame Style • Seat Width • Seat Depth • Overall Chair Width • Overall Chair Length *18'' x 18'', AT902, no rear wheels, no footrests, no seat pan, no back upholstery, spreader bar, no anti - tippers, no wheel locks, no arms. **18'' x 18'', AT902, 22COM/Urethane, PHW93/AT5543, seat pan, back upholstery, spreader bar, anti - tippers, wheel locks, no arms. Weight Limitation 250 lbs. Invacare recommends all Invacare wheelchairs be fitted to the consumer under the guidance of a healthcare professional, knowledgeable of the particular limitations of the product. For additional seating needs please refer to the following: Invacare Matrx Seating and Positioning Products Price List Form #11-036. Please contact Invacare Customer Service to ship Invacare Matrx Seating options with your chair order. Comments Print Form Email Form 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 Revised Oct 25, 2012 www.invacare.com ©2010 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. KIK is a registered trademark of KIK Technology, Inc. Specifications and prices are subject to change without notification. Page 5 of 5 Form No. 03-069
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