116AG05 - Omit batteries Includes harness & straps for
-standard post batteries N/C
116PC3 K0877 Quickie P222 SE (Base Only)
$8,725.00
N/C
3. BATTERIES and CHARGERS
Battery Charger 116BJ19
116BJ3 8.5 (8.5 mph / 350 LB Capacity) (Max.
Wt. cap. For CG Tilt 250lbs)
Aztec Gold
116C141 Black Cherry
116C38
GP24 Std Post Pair w/strap Batteries (Gel Cells)
116AG03 E2363 $735.00
116PC1
Quickie P222 SE 116PC19
Quickie P222 SE SD
(solid seat/single power seat option) K0877
K0877 Quickie P222 SE BD (Solid Seat - No Power)
$8,725.00
Price Option # HCPCS Definition Price Option # HCPCS Definition
Date: Name:
1. QUICKIE P222 SE GROUP 4 CATEGORY
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.
Phone:
QUICKIE P222 SE BD/SD
Solid Seat (No Power or Single Power Seating Options)
EIPW2 - Effective July 2014PO#: 116ST2 Ship To: Account: Marked For: Address: Buyer: City,State,Zip: 116PF8 P222 SE Power CG Tilt
Max. Wt. capacity for CG Tilt 250lbs. Not available with base only purchase.
$5,045.00
See electronic section for control options
Power CG Tilt (53° Tilt)
E1002
$8,125.00
Tilt Weight Capacity
116LB3 N/C
N/C 116LB4
Up to 175 lb Weight Capacity
Performance Package 176 to 250 lb Weight Capacity
$1,030.00 LED Light Package (Rnet only)
116LI04 LED Light Package (NA Base only)
-$40.00
- 8A Dual Mode (Compact) CTE N/C
Omit Charger
116C114 Sparkle Silver
2. FRAME COLOR OPTIONS
Standard Colors 116C103 Rootbeer NC
116C140 NC
116C2 Black (Not avail as base w/Zebra) NC 116C145 Sunrise Orange NC
NC
Yellow NC
NC 116C113 Titanium Color Paint
Blue Opal NC Standard Matte Colors
NC
116C10 Black Opal NC 116C8
116C116 Matte Black NC
116C36 Candy Blue NC
116C151 Matte Black Cherry NC
116C14 Candy Purple NC
116C152 Matte Purple NC
116C35 Candy Red NC
Matte Electric Blue NC
116C142 Electric Blue NC 116C143 Evergreen NC 116C150 Glow NC 116C149 Matte Evergreen Custom Colors NC
116C144 Green Apple NC 116C43 Mossy Oak Camouflage $305.00
116C126
116C42 Stars and Stripes $305.00
116C147 Hot Sparkle Pink NC
116C108 Zebra (Choose base color above:
White Std, n/a black) $305.00
116C148 Mauve Pink NC
To order any JAY cushions on-chair, please see the JAY price list.
Cushion name or part number must be filled out w/ desired width & depth
N/C N/C N/C 23" N/C N/C 20" 116BT3
5. SEAT CUSHIONS
116SL2 116HT12 116HT14116JB01 - Jay J3 (select OMIT Back Uph above)
6. BACKS
N/C 17" 24" 116B37 See J3 OF 22" 18" 19" 21" Jay 3 Option20" ( add 1.75" for CG Tilt) 116HT10
116B44 116B43 116BP1
8 Bend Back Post - Not avail. w/ Jay Solid backrest
Straight Back Post
116BP41 $105.00 116B42 N/C
N/C 116B41
N/C Omit Back Upholstery
Jay Solid Backrest (select back height; Decrease seat depth by 1")
116SD73 20" N/C 116BU27 N/C N/C 116CU1 Medium 17.5" N/C 116B4
Back Height (Upholstery) 116JC20 N/C N/C 116SD11 18" N/C 116SD12 116SD10 -$15.00 19" Seat Height N/C Seat Depth N/C 116S6
JAY Cushions (Optional)
N/C 116SL5
116SL6 15" (not avail. w/ 19" & 20" seat depths) N/C
116S5 14" (not avail. w/ 19" & 20" seat depths) N/C
18" 116S11 116S9 116S10 17" N/C 116S8 N/C 116S28 116S27 N/C N/C 116SD8 15" N/C 20" N/C
24" (not avail. w/CG Power Tilt; Base width is 26.5" w/ 12"x4" tires) 22" (not avail. w/CG Power Tilt; Base width is 26.5" w/ 12"x4" tires) 19" Back Upholstery N/C N/C 116SD7
Standard Cushion
116SD9 16" 17" 116S7 K0669Back Post Type
116BU14 -$15.00
Non-Folding Angle Adj. Backrest
Parapak Upholstery (select back height) 16" (not avail. w/19" & 20" seat depths and dual post arms )
Backrest Type
14"
116BT74 Folding Angle Adj. Backrest $115.00
116B36 116B13
N/C
Seat Sling Parapak (n/a w/CG Power Tilt)
N/C N/C 19" ( add 1.75" for CG Tilt)
18" (not avail. w/long ext. tubes; add 1.75" for CG Tilt)
Seat Base Type Seat Width
Low 15.5"
Jay Solid Backrest Back Height 116B8 Tall 19.5"
4. SEATING
116B39 116B38 116BU26 N/C 2" Cushion. $120.00 Width: Depth:JAY Bundled Cushion
N/C Seat Pan Aluminum
N/C Price List Cushion Name or Part #
Omit Seat Sling
16"
116B40
N/C N/C
Composite Footplate Heel Loop Headrest (9" x 4.5")
Lateral Pads Curved
Lateral Pads Straight
E0956 Lateral Pad Curved Pair E1028
$460.00
E1028 Removable Mount
Headrest (8" x 4.5")
Multi-Positional w/Heel Loop Not Avail. w/ fixed hangers
Kids Angle Adj. Footplate Full Length Standard (14")
$170.00 N/C N/C
Adult Angle Adjust. w/ heel loop Not Avail. w/ fixed hangers
N/C Desk Length Waterfall (10") (n/a. w/ sgl. post
Armrest w/Jay Solid Backrest)
Full Length Waterfall (14") (n/a. w/ sgl. post Armrest w/Jay Solid Backrest)
-$25.00 116AA52 N/C 116AA51 116HL10 -116F283 116AM1 116H2
Kids Angle Adjust. w/ heel loop Only avail. w/ 90° hangers
K0040 Heel Loops $170.00 E0951 $175.00 N/C $35.00 E0951 Multi-Positional Footplate Footrest Accessories 116LS3 K0038 K0040 116F47
Extra Leg Strap, Black 116F287 K0042 Aluminum (Only avail. with ELRs)
$35.00
116F58 116LS13
K0040
Solid One Piece not avail. w/Power CG Tilt Two-piece Locking w/Heel Loop
E0951 116HL10
9. FOOTRESTS
N/C N/C Leg Straps $205.00 $35.00 Heel Loop $270.00 Dual Post Hgt Adj - Long (16-20 in)116KE2
7. POSTURAL SUPPORTS
Headrest (Incl. on Specified Specialty Controls)116AM7
Hanger (Pair)
Composite w/ Heel Loops Not Avail. w/ fixed hangers 116AA8
116AA14 Desk Length Standard (10")
Single Post Height Adjustable
116AM8 Armrest (Pair)
8. ARMRESTS
N/C Dual Post Hgt Adj - Short (14-16 in)
Omit Armrests and mounts N/C
Footrest (Pair) 116HE66 E0955 Curved Headrest 9" x 4.5") $230.00
N/C
116KD4
Armpads (Pair)
116AM2
Omit Lateral Support Pad Size 116KD1 Lateral Support 3" x 6" (pr) N/C N/C N/C Lateral Support 4" x 6" (pr) Lateral Support 4" x 5" (pr) 116H12 $220.00 $50.00 116F282 K0040 Adult Angle Adj. Footplate
E0951 116HL1 $30.00 $285.00 116F1 -E0973 116H37 E0973
70° Swing Away Hanger (Not. Avail w/ solid 1-piece footplate.)
116KD2
N/C N/C
E1028 Removable Mount $230.00
E0973 $285.00
116AA132
Dual Post Flip Back Short (14-16in)
Single Post Height Adj. Armrests are N/C on Power CG Tilt
Dual Post Flip Back Long (16-20in) N/C N/C 116AA131
$450.00
$235.00 JAY Solid Backrest Only
$235.00 Swing Away Mount Pair
$470.00
JAY Solid Backrest Only
116HE65
$460.00
116LM1 $230.00
116MH1
Curved Headrest 8" x 4.5") $230.00 116KE1
$50.00 $220.00 $50.00 $225.00 $170.00 E0990 Short (13" - 15") $280.00 Extension Tube 116H16
Two-piece Locking Footplate
Omit Foot Plate w/Heel Loop 116F6
116HL10 Heel Loop 116E2 Medium (15" - 18") Not available with N/C
multi-position footplate. Omit Hangers 116E5 116H13
Not available with 90° hangers.
116H32 116MH1
N/C
80° Fixed Tapered (only avail. w/ solid 1-piece footplate.; n/a. w/ CG Power Tilt) 90° Swing Away (Only available with kids angle adjustable footplates)
116E1
Elevating Hanger (Req. aluminum footplate or angle adj.)
$35.00
E0956 Lateral Pad Straight Pair
116F60
$225.00 E1028 Swing Away Mount Pair $225.00 116LM1
116KD3
Long (18" - 20") Not available with
70° or 80° hangers. N/C
-$15.00 E0955
70° Fixed Straight (only avail. w/ solid 1-piece footplate.; n/a. w/ CG Power Tilt)
R-Net Non-Expandable Drive Control (120A)
Quickie Sip n' Puff System 116ID34
116II01 116IJ01
116IH1
ASL Head Array Package (Adult) 116II02
116IJ01
ASL Head Array Package (Ped)
116II03 116IJ01
Switch-It Head Array Package (Adult)
116II04
116IJ01
Switch-It Head Array Package (Pediatric) 116II05
116IJ01
Quickie Proportional Chin Control Package
116ID45 116IJ03
Mounting Location: Left Back Cane
R-net PC Programmer with Dongle
116PR5
N/C Attendant Mounting location
E1028 Headrest Removable Mount
N/C ASL Proportonal S/A Joystick Mount
1160A02
Electronic Programmers
Buddy Button Switch $80.00
Disc Switch
Drive or Mode / Profile Control
Wobble Switch $515.00
116SW1
116SW24
Micro Light Switch Egg Switch-Black
E1028
Ribbon Switch
Dual toggle switch only
$415.00 $80.00 $65.00 116SW2 116SW9 $165.00 $245.00
Stereo to 2 Mono Splitter
116SW4
$1,030.00
$175.00 $100.00
116SW23
DTT Rnet cables included. 116PR6
4-way toggle switch w/5th button DB9 Connector.
$175.00 116DS04
116DS03
116SW21
116DN1 Mounting location: Right Back Cane E1028 Swing Away Left Side OMNI Mount $245.00
E1028 Swing Away Right Side OMNI Mount Attendant Control
$100.00 Switch inputs for Joysticks or OMNI
E2312 Proportional Joystick $4,120.00 $230.00
E2331 Attendant Control for R-net $1,025.00 OMNI Mount
116DN2 (If used with Joystick must be mounted opposite side)
116SW6 116SW22
116ON1
-Rnet OMNI Input Control Module and display with built in Infrared and armrest mount. Choose mount below. (required for Specialty Input Devices.)
$1,005.00 R-net OMNI and Output Options
(For expandable controls, choose all that apply)
E2323 T-Handle $80.00
116JH1 E2323
116JH6 E2323 Goalpost $80.00
116JH4
116HM2 - Left Side Mount N/C
$230.00
116JH2 E2323 Foam Ball Handle $80.00 $4,350.00
E1028 Headrest Removable Mount
Ball Handle $80.00
$230.00
$4,140.00
Joystick Handle (Optional) E2330 Switch-it Proximity Head Array $3,910.00
Height Adjustable. $4,140.00
116HM1 - Right Side Mount N/C E2330 Switch-it Proximity Head Array $3,910.00
Headrest Removable Mount $230.00
$3,910.00 $230.00 Headrest Removable Mount
$4,140.00 ASL Proximity Head Array (Ped)
116JM10
-Joystick Mount (Location) E1028
E1028
E2330
$230.00 E1028
116JM11 E1028 Swing Away Mount $245.00
Joystick Mount (Fixed or Swing Away) E2330
Fixed Mount N/C
- Joystick W/Toggle, Spd Pot, Stereo Jacks & Color Display
116J95 - Omit JS for use with OMNI N/C
Sip N' Puff Kit $1,465.00
$410.00 116J108 Joystick w/Stereo Jacks & Color Display $210.00
116J88
R-net Joystick (for expandable electronics) Requires expandable controls and OMNI. All packages must be added to the specialty control on-chair package. Not available with Upholstered backs. 116J70 - Std LED Joystick for Expandable Ctrls N/C
R-Net Expandable Drive Control Upgrade (120A) $980.00 116EM02 NC
E2377 Expandable 120AController - R-net $540.00 116EM03 116EX03
ASL Proximity Head Array (Adult)
$4,140.00
$3,910.00 E2326 Sip n' Puff Tubing and Hardware $375.00
Headrest Removable Mount $230.00
E0955 Headrest
$2,300.00 E2325
E2313 Harnessing for 120A Expandable Controller $440.00 116ER04
$200.00 $200.00 Dual toggle switch mount bracket
116EX04
Specialty Driver Control Options Switch Mount Bracket 116EM01 Single Switch Mount Bracket
$200.00 4-way toggle switch mount bracket.
10. ELECTRONICS
Drive Control Options- Switch Mount Right
- Switch Mount Left
116EO15 E2310
Thru Drive 1 Actuator w/out assignable buttons. For use with R-net (For operating Tilt thru Joystick.)
$1,420.00
$1,420.00 116EO13 E2310
Thru Drive 1 Actuator with assignable buttons. (For operating Tilt thru Joystick and/or Joystick. Requires R-net.)
Thru-Drive 1 Actuator options.
11. POWERED SEATING
Drive Wheel Type Switch Mount
$270.00
(for use with switch control powered seating)
N/C
Powered Seating Thru-drive Control Method.
N/C Wheel Lock Extension Handle
Extension Handle 6"
"Assignable Button" feature listed below (available on Rnet Systems) allows for direct "short-cut" access to various seating functions via joystick buttons. Functions accessed by depressing the button for more than 1 second. By selecting the thru-drive w/assignable button
the chair will be pre-programmed with seating functions assigned to buttons on the joystick. Assignments can be changed via PC Dongle.
$65.00
N/C
Suspension Fork Heavy. 251-350 lbs. (Only avail. w/ 8" front casters)
116EY01
Powered Seating Control Method (TILT)
N/C
Drive Wheel Tire 116DW5 12" x 3" Pneumatic w/Ins. 116EY02 116DW27
12. WHEELS
N/C N/C 116DT1 116WC1 N/C E1016 E1016Suspension Fork Options are only available with 8" casters.
Wheel Lock
116WL26 Push to Lock $90.00
Wheel-lock extensions handles are not available with 22" & 24" seats Do Not Mount
Front Caster Wheel
13. CASTERS
Suspension Fork Med. 150-250 lbs. (Only avail. w/ 8" front casters)
116CW29
Solid Caster Fork 116DT2
116CF35 9" Pneumatic (not avail. With Suspension
Fork)
$270.00 116DW6
The 12" x 3" wheel size reduces the overall width specifiation by approx. 2" and also alters the overall appearance of the chair.
N/C 116DW28 116EH1 N/C 12" x 3" Pneumatic Tire 12" x 4" Pneumatic w/Ins. E0961
116CW20 8" Airless with Insert N/C
V Groove Tire (n/a with 12"x3" tires)
N/C Caster Fork Knobby Tire 8" Pneumatic 116CF31 116CF36 9" Pneumatic w/Insert (not avail. With
Suspension Fork) $90.00 $90.00 116CW28 12" x 4" Pneumatic Tire
Switch Control 1 actuator w/dual toggle and mount. (For operating Tilt)
116EO10 N/C
(For use with power seating actuators. Switch activation is stand-alone and does not require expandable or thru-drive electronics.
N/C 116EO11 Switch Control 1 actuator w/buddy button &
mount. (For operating Tilt)
116CW17
N/C ✔
116A82105A1 115 lbs (without batteries) 31.5" (Without Footrests) Deduct 2" if using 12" x 3" Tire
Up to 8.5 mph 116HR1 Plastic Coated $200.00 116ET1 E0961 116WC1 Wheel Locks 116WC2 6" Extension Handles $55.00 Aluminum Anodized $95.00 Axle -$20.00 8 Oblique 116HR7 116HR4 Projections N/C $90.00 Omit handrim
14. MANUAL CONVERSION KIT
Hand Rim
24" Mag N/C
Quad Quick Release
Quick Release N/C
24" Spoke (not avail w/14" seat width) N/C
116HR8
-$55.00 116AX1
116AX11
Wheel Rim/Size
116RW7 Omit Manual Rear Wheel 116RW2
116RW1
116A1 116RT6
Black/Charcoal 116A2 Black/Charcoal Kids
Rear Wheel Tire
$85.00 116RT2 E2211 E2213 N/C N/C 116RT1 E2211 E2212 Do not mount
Push to Lock Wheel Lock $45.00
Pneumatic
Positioning Belt
116A142 E0978 1.5" Auto Buckle 2" Aircraft Buckle Padded
$75.00 116A12 $50.00 116A13 E0950 116A33 Seat Pouch 116A8 E0978 N/C N/C $100.00 E2211 E2212 $115.00 $125.00 E0978 Low Polyurethane
15. ACCESSORIES
Additional Specifications Weight:Using 12" x 4" Drive Tire: 24.5" using 14"-20" Seat Width 26.5" using 22" and 24" Seat Width
2" Aircraft Buckle
116A114
Miscellaneous
$25.00 Dual Post Armrest Pouch
Caddy $50.00
As far as 30 miles (With Group 24 batteries depending on conditions and user environment)
Range: Overall Width Overall Length: Top Speed: $260.00 $260.00 Large Tuffak (18"-20") Requires std.
armpads to mount tray
116A32
X-Large Tuffak (21"-22") Requires std. armpads to mount tray
E0950
Requires standard armpads to mount. Black Utility Backpack
116RT3 E2218
Backpack
High Pressure Clincher (not available with mag wheels)
116RT4
Full Polyurethane
$50.00 E0950 Medium Tuffak (15"-17") Requires std. $260.00 armpads to mount tray
116A31
Wheel Chair Tray Table 116CV2 Manual Wheelchair Conversion Kit
Pneumatic Airless Insert
$1,025.00
