j6 with tru-balance 3 positioning order form · infinfb3950/reva/01ma2018 page 1 of 14 j6 with...

of 11INFINFB3950/RevB/01AUG2018

J6 with TRU-Balance 3 Positioning Order Form

Quantum® Rehab401 York Ave., Duryea, PA 18642Phone: 866-800-2002 | Fax: 866-707-3422 | Email: [email protected]

Account Number: ___________ Date: ________________

Provider Name: __________________________________

Contact: ________________________________________

Phone: ___________________ Fax: _________________

Email: __________________________________________

PO Number: _____________________________________

Marked for: _____________________________________

Ship to Address: _________________________________

City: _____________________ State: ______ Zip: ______

Weight:________ Height:________

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

A. Shoulder Width: _______B. Chest Width: _________C. Hip Width: ___________

D. Max Sitting Height: ____E. Shoulder Height: ______F. Axilla Height: _________

G. Thigh Depth: _________H. Lower Leg Length: ____I. Elbow Height: ________

This form is interactive when viewed with Adobe Acrobat Reader and may not function correctly if opened with applications other than Acrobat. Com-plete the form by placing checks in the desired boxes and provide information in the interactive fields. Buttons shown at the bottom of the form may be utilized to print or submit the order form through a desktop email application. To email via a web-based application, please ‘Save As’ and attach the PDF to your email. This order form contains a large variety of options to fulfill various patient needs. Descriptions and section notes, such as optional or required, are included to help you complete your order. Please contact Quantum Sales at 866-800-2002 if assistance is needed. Send the completed order form by fax (866-707-3422) or email ([email protected]). Incomplete forms may delay the quote or order. Customer service will contact you if the order is incomplete or if there are compatibility issues. If special order requests are needed, be sure that the Patient Information section is completed or include a completed physical assessment form with this order form. HCPCS codes provided should not be considered as legal advice and do not guarantee reimbursement. DME providers are responsible for deter-mining the appropriate billing codes when submitting for insurance reimbursement. Payer coding, coverage, and bundling guidelines may apply. All prices are MSRP. Prices, specifications, part numbers, and availability are subject to change without notice. Prices and part numbers as shown are only available when configured as a complete power chair. Please contact technical service for accurate parts ordering. Options noted with "XRef" have multiple possible part numbers based on system configuration. Please see cross-reference spreadsheet for the XRef part numbers.

Thank you for choosing Quantum!

INTRODUCTION

PATIENT INFORMATION

1. BASE MODELREQUIRED. Select a group 2 power base. 300 lb. weight capacity. Includes 5 amp off board charger. Dimensions of base without legrests: 23.19”W x 34.74”L.

J6 2S-SS ................................................................... $5,971Part: J6 2S-SS. HCPCS: K0822Solid seat pan standard.

J6 2SP-SS .................................................................$6,250Part: J6 2SP-SS. HCPCS: K0835Single power option.

2. BASE COLORREQUIRED. Select one shroud color. Colors shown here may differ from actual product depending on monitor/printer calibration used.

Candy Apple RedPart: SHDASMB4630

Viper BluePart: SHDASMB4631

Onyx BlackPart: SHDASMB4632

Pearl PinkPart: SHDASMB4958

Sunburst OrangePart: SHDASMB4634

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Base Mounted Foot Platform ...................................... StandardPart: FRMASMB16077

Bell Shaped, Base Mounted Foot Platform .......................... $235Part: RIGASMB7120041

Omit Base Mounted Foot Platform ............................. No ChargePart: PTOINDV3674

10" Flat Free Black Tires ........................................... StandardPart: WHL140393 x2 qty

10" Pneumatic Black Tires ....................................... No ChargePart: WHL140390 x2 qty

Account Number: ___________ Date: ________________ Marked for: _____________________________________

Swing-away, Inline, Left Side Mount ..................$245NE/NE+ Part: ACC142526. HCPCS: E1028

Swing-away, Inline, Right Side Mount ................$245NE/NE+ Part: ACC142527. HCPCS: E1028

Swing-away, 1” Offset, Left Side Mount .............$245NE/NE+ Part: ACC142747. HCPCS: E1028

Swing-away, 1” Offset, Right Side Mount ............$245NE/NE+ Part: ACC142748. HCPCS: E1028

Seat Mounted, LED, Full Light Package ...............................................................................................................................$995Part: ELE131477

3. DRIVE WHEELSREQUIRED. Select a type of drive wheels.

5. FULL LIGHT PACKAGEOptional. Requires NE+ 8 Key Joystick.

4. BASE MOUNTED FOOT PLATFORMREQUIRED. May interfere with seat mounted legrests. Not available with center mount foot platforms.

NE 4-Key Joystick ....................................StandardPart: CTLDC1554Available with Tilt Only through Toggle.

NE+ 6-Key Joystick (2 Actuators) ......................$200Part: CTLDC1560

NE+ 8-Key Joystick (2 Actuators & Lights) ..........$400Part: CTLDC1561

No Joystick, Setup for NE+ Joystick ...........No ChargePart: Configuration selection NE+ 6 Key Joystick

Omit Joystick Mounting Bracket

Swing Away JoystickInline Mount (Right)

Swing Away JoystickOffset Mount (Right)

Fixed, In-line, Bracket .............................................................................................................StandardNE/NE+ Part: FRMASMB12744.

Left Side MountPart: PTOINDV1225

Right Side MountPart: PTOINDV1226

Non-Expandable ControlsSelect a joystick below or omit selection if another controller type is desired. Non-expandable does not allow supplementary drive controllers.

7.1b. Swing-Away (Retractable) Joystick BracketAllows the joystick to retract to the side of the armrest while maintaining the same joystick orientation. "Inline bracket" is used with TRU-Balance 3 arms when the joystick is inline with armpad. "Inline bracket" will be offset 1" when used with tube style arms. Select "Offset Bracket" to have the joystick inline with armpad on tube style armrests.

7.1a. Fixed, In-line Joystick Bracket

Multi-Axis JoystickMount

Retract4

7.1c. Specialty Joystick MountsSelect a bracket and side to mount it. Not available with VSI Joystick.

Specialty Mount Side

Retract4 Mount ............................................$350NE/NE+ Part: MEC138876. HCPCS: E1028Full 180° of movement that translates into multi-position use, straight, right offset, left offset, or fold away. Joy-stick orientation varies as bracket is adjusted.

Multi-axis Mount ..........................................$100NE/NE+ Part: ACC142528. HCPCS: E1028Allows height adjustment of joystick.

Left Side MountPart: PTOINDV1225

Right Side MountPart: PTOINDV1226

6. ELECTRONICSREQUIRED. Other drive controls may be available by contacting customer service.

7. JOYSTICK MOUNTING BRACKETSREQUIRED. Select a mount to be used with a joystick selected in previous section.

8. JOYSTICK HANDLESOptional. The NE/NE Plus Joysticks are standard with a carrot handle (See A in image). The optional handle will be mounted to the joystick and the standard handle will be shipped with the unit.

Joystick Handles

Mushroom Handle (B) ..................................... $85Part: ACCASMB1860. HCPCS: E2323

Chin Cup (C) ................................................. $85Part: ACCASMB1861. HCPCS: E2323 (E2324 when chin control)

T-Bar (D) .................................................... $120Part: ACCASMB1858. HCPCS: E2323

Medium Ball Handle (E) ................................... $65Part: ACCASMB1859. HCPCS: E2323

Soft Ball Handle (F) ........................................ $65Part: ACCASMB1856. HCPCS: E2323

Extended I-Handle (G) .................................... $85Part: ACCASMB1857. HCPCS: E2323

Bodypoint 3” Goal Post Handle ......................... $99Part: PLSKNCP1057. HCPCS: E2323

Bodypoint 4” Goal Post Handle ......................... $99Part: PLSKNCP1058. HCPCS: E2323



Q-Logic EX/NE Programmer ............................................ $545Part: ELEASMB6976

TRU-Balance 3 Power Tilt Only ......................................$6,995Part: PTOINDV3443. HCPCS: E1002250 lb. maximum weight capacity. 50° Center of Gravity (CG) power tilt seating system.

TRU-Balance 3 Static Seat ............................................$2,295Part: PTOINDV3442Requires custom seating interface. 20° of limited recline adjustment (-5/ +15) via gas strut within back cover.

TRU-Balance 3 Power Recline Only ................................. $7,595Part: PTOINDV3444. HCPCS: E1004Requires custom seating interface. 175° of power recline.

Custom Seating Interface ................................................................................................................................................$250Part: SET1711139Custom seating interface will be automatically selected with TRU-Balance 3 Static Seat or Power Recline seating options.

Attendant Manual Recline ...............................................................................................................................................$500Part: PTOINDV3501. HCPCS: E1226Not available with NE joystick with Tilt through toggle. Available with Static Seat or Power Tilt. Will require extended lead time when selected with Articulating Foot Platform.

9. ELECTRONICS ACCESSORIESOptional.

10.1. TRU-Balance 3 Configuration

2. Manual Recline OptionOptional.

1. System SelectionREQUIRED.

10.2. Seat Dimension - WidthREQUIRED with seat selection. Part number is SETWDTH plus number following # below. 15” widths are only available with non-matching back width.

10.3. Seat Dimension - Width PackageREQUIRED with seat selection. Minimum seat with is 14". Width and depth package part: See XRef: TB3SPACK

10.5. Seat Dimension - Depth PackageREQUIRED with seat selection. Width and depth package part: See XRef: TB3SPACK

10.4. Seat Dimension - DepthREQUIRED with seat selection. Minimum seat depth is 14". Part number is SETDPTH plus number following # below.

14” D(#1004)

15” D(#1005)

16” D(#1006)

17” D(#1007)

18” D(#1008)

19” D(#1009)

20” D(#1010)

14” W(#1004)

15” W(#1005)

16” W(#1006)

17” W(#1007)

18” W(#1008)

19” W(#1009)

20” W(#1010)

12”-16” Width Package 14”-16” Width Package 16”-20” Width Package

12”-16” Depth Package 14”-16” Depth Package 16”-20” Depth Package

10.6. Back Type SelectionREQUIRED. Match choice in this section with the options in the following back cushion configuration section.

10.7. Back Cane SelectionREQUIRED when Back Cane Option is selected above. Select type and height of back canes.

TRU-Balance 3 Back Assembly (Static Back)Part: Configuration selectionSelect a back cushion configuration in the subsequent section.

Back Cane OptionPart: Configuration selectionAvailable only with TRU-Balance 3 Static Seat and Power Tilt (1 actua-tor) selections. Select cane type, back cane height, and back cushion configuration below.

Flip Forward Back......................................................... $150Part without Lift: MEC131957Available with Static Seat and Power Tilt (1 actuator). Only available with 2-post, flip back or pediatric armrests. Not available with 12”-14” width or with attendant manual recline. Select a back cushion type in the subsequent section.

Angle Adjustable ................................................... No ChargePart: MEC140266

Flip Forward .................................................................$25Part: MEC140272

1” Endo........................................................................$70Part: MEC141455

2” Endo .......................................................................$70Part: MEC141456

2. Back Cane Height

1. Back Cane Type

16”H CanePart: FRMASMB15834






10. TRU-BALANCE® 3 SEATING - Quantum Intelligent Systems™REQUIRED. Maximum seat size is 20"W x 20"D. Seat to floor is only available at 16.75".



10.8. Back Cushion Configuration - TypeREQUIRED. Select a configuration type and applicable dimensions. See the Sport, Q-Back, and TRU-Comfort back availability chart for stock order back size ranges. Other size backs may be available with special order and extended lead time.

10.9. Back Cushion Configuration - Back Width PackageREQUIRED except when Omit Back Pan/Cushion is selected. Available with +/-4” of seat width.

Sport Back ........................................................... No ChargePart: See XRefComplete following width package and size.

ADI Q-Back, Active Contour ............................................ $525Part: See XRef. HCPCS: E2613Complete following width package and size.

ADI Q-Back, Deep Contour .............................................. $595Part: See XRef. HCPCS: E2615Complete following width package and size.

ADI Q-Back, Extra Deep Contour ...................................... $650Part: See XRef. HCPCS: E2620Complete following width package and size. 20" Wide Extra Deep Contour is not compatible with Gel and Water-fall Armpads, Endo/Meso Downposts, 2 Post Arms, or Ottobock arm blocks unless wider arm bars are installed on the chair.

TRU-Comfort 2 Back, 20” Width or less ............................. $675Part: See XRef. HCPCS: E2620Complete following width package and size.

TRU-Comfort 2 Back, 22” Width or greater ......................... $775Part: See XRef. HCPCS: E2621Complete following width package and size.

Omit Back Pan/Cushion ........................................... No ChargePart: PTOINDV1287Select a following width package.

After-market Back Interface ........................................... $200Part 16"W to 20"W: SET131920. Part 20"W: SET131921Enter the set width below, range of 16"-24". Overall seat depth may need to be adjusted to accommodate certain backs. May interfere with gel/waterfall armpads and arm through. Does not include brack-ets to mount after-market backs. A Special Order is required on back widths less than 16”.

10.11. Back Cushion Configuration - Overall Back HeightStatic Seat and Power Tilt available height range: 14”-25”H. Odd heights include 4” gap and even heights include 3” gap between seat pan and bottom of back cushion. Power Recline available height range: 19”-28”H. Odd heights include 6” gap and even heights include 7” gap. See the Sport and TRU-Comfort back availability chart for stock order back size ranges.

10.10. Back Cushion Configuration - Back WidthREQUIRED except when Omit Back Pan/Cushion is selected. Part number is PTOINDV plus number following # below. Available with +/-4” of seat width.

Match Seat Width SelectionsPart: PTOINDV3468

10”W-14”W PackagePart: Configuration selection, back cushions



Tilt or Static Width Recline Width

Sport, Q-Back, and TRU-Comfort 2 Back Availability Chart

Ove

rall

Hei

ght

Sport or TRU-Comfort 2 BackSport BackSport, Q-Back, or TRU-Comfort 2 Back

12” W(#3562)

14” W(#3563)

16” W(#3564)

17” W(#3565)

18” W(#3566)

19” W(#3567)

20” W(#3568)

21” W(#3569)

22” W(#3570)

24” W(#3571)

14” HeightPart: SETHGHT1027















10.12. TRU-Balance 3 Back ShroudREQUIRED. The back shroud is a feature of the TRU-Balance 3 seating system and is available in matching shroud colors. The back shroud is not available when Omit Back Pan/Cushion is selected. Reference colors shown in section 2.

Candy Apple RedPart: DGN130026

Viper BluePart: DGN130025

Onyx BlackPart: DGN130024

Pearl PinkPart: DGN130032

Sunburst OrangePart: DGN130028

TRU-Comfort Lateral Positioning Wedge, pair ........................$30Part: SET123465Available with TRU-Comfort backs. Not available on power tilt backs 16”-17”H with limited adjustability on 18” H. Not available on power recline back 19”-20”H with limited adjustability on 21”H.

Privacy Flap, 9.75” .........................................................$35Part: DWR1044E456BStandard on recline seating systems.

Privacy Flap, 12.75” .......................................................$35Part: DWR1044E456AStandard on recline seating systems.

10.13. Additional TRU-Balance 3 Back OptionsOptional.

10. TRU-BALANCE 3 SEATING continued



11.1a. TRU-Balance 3 Flip-Back ArmrestsChoose a left and right TRU-Balance 3 armrest and set height in the following section. An optional downpost is also available. Different left (L) and right (R) armrest height packages are allowed. Not available with Back Cane Option.

TRU-Balance 3 Flip-Back, 8”-12”H .......................... StandardPart: See XRef

TRU-Balance 3 Flip-Back, 12”-16”H ......................... StandardPart: See XRef

2-Post, Flip Back, Height Adjustable, and Removable Armrests (9”-13” Height) .................................................... $150 ea. or No Charge*Part: See XRef. HCPCS: E0973*No charge with Power Seating. Not available with a depth less than 16”. Required with flip forward back and lap trays.

TRU-Balance 3 Armrest Downpost (Pair) .......................................................................................................................$87.50 ea.Part: See XRefAvailable up to 2” difference between seat and back width via endomorph or mesomorph configuration. Not available on 14” Width seat or back.

8”-12”H, Single Post, Height Adjustable, ........................$75 ea.Removable, Heavy Duty (Sold as pair) Part: See XRef. HCPCS: E0973

10”-14”H, Single Post, Height Adjustable, .......................$75 ea.Removable, Heavy Duty (Sold as pair) Part: See XRef. HCPCS: E0973

11.1b. Two-Post ArmrestsSelect the armrest and set the left and right heights in the following section. These armrests may interfere with offset backs/ back canes.

11.1c. Heavy Duty, Removable ArmrestsSelect a type of HD removable armrests and the set height in the following section. Only one height package is selectable as a normal configuration. Payer coding, coverage, and bundling guidelines may apply.

11.2. Armrest HeightREQUIRED. Set left and right armrest height. Note the available height range in the option description.

8” HPTOINDV3535

9” HPTOINDV3536

10” HPTOINDV3537

11” HPTOINDV3538

12” HPTOINDV3539

13” HPTOINDV3540

14” HPTOINDV3541

15” HPTOINDV3542

16” HPTOINDV3543

8” HPTOINDV3450

9” HPTOINDV3451

10” HPTOINDV3452

11” HPTOINDV3453

12” HPTOINDV3454

13” HPTOINDV3455

14” HPTOINDV3456

15” HPTOINDV3457

16” HPTOINDV3458

11.3. Armrest SizeREQUIRED. Select a left (L) and right (R) armrest size. This also affects armpad selection.

1. Left Armrest Height

2. Right Armrest Height

11. TRU-BALANCE 3 ARMRESTSREQUIRED. Select the desired type of armrest below. Please read notes to ensure seating compatibility. Be sure to also select an armrest size and armpad type.

14” Full LengthPart: Configuration selection

10” Desk LengthPart: Configuration selection

12.1b. Gel ArmpadsSold only in pairs. Armpads are 3” wide. Manufacturer part number for full length is 314G and desk length is 310G.a. Falcon Gel Armpads for TRU-Balance 3 Armrests

b. Falcon Gel Armpads for Tube Style Armrests

12.1a. Foam Armpads

12. TRU-BALANCE 3 ARMPADSREQUIRED. Select to omit an armpad selection or select a left and right armpad type. Please note that waterfall and gel armpads may cause interference with the seat back.

No Armpads ......................................................... No ChargePart: Configuration selection

Straight, Armpad ................................................ StandardPart: See XRef

Waterfall, Armpad ............................................ No ChargePart: See XRef

Falcon Gel, Full Length Left and Right ............................... $185Part: ARM136417

Falcon Gel, Full Length Left, Desk Length Right ............... $162.50Part: ARM136426

Falcon Gel, Desk Length Left, Full Length Right ............... $162.50Part: ARM136418

Falcon Gel, Desk Length Left and Right ............................. $140Part: ARM136416

Falcon Gel, Full Length Left and Right ........................... $296.40Part: ARM136438

Falcon Gel, Full Length Left, Desk Length Right ............... $274.22Part: ARM136442

Falcon Gel, Desk Length Left, Full Length Right ............... $274.22Part: ARM136439

Falcon Gel, Desk Length Left and Right ......................... $252.40Part: ARM136437



Stealth’s Worlds Best Removable ..................$220.50Headrest Bracket (TWB485-1) (C)Part: FRMASMB15999. HCPCS: E1028

Stealth Multi-Axis Removable Headrest .......... $160.50Bracket (HMO475P) (D)Part: HDWASMB1084. HCPCS: E1028

Stealth 8” Comfort Plus (CP450) ................... $151.94Part: POS148484. HCPCS: E0955

Stealth 10” Comfort Plus (CP250)(A) ............. $151.94Part: SETHEAD1057. HCPCS: E0955

Stealth 14” Comfort Plus (CP150) ................. $151.94Part: INDPART2327. HCPCS: E0955

Pediatric Comfort Plus (6”Wx4.5”H) ............. $151.94(CPN350)Part: SETHEAD1069. HCPCS: E0955

Stealth Small Contoured (9.75”Wx3”H) .............$64.20(STL-OTSM250)Part: SETHEAD1052. HCPCS: E0955

Stealth Large Contoured (11”Wx6”H) (B) ........... $80.25(STL-OTLG150)Part: SETHEAD1053. HCPCS: E0955

Headrests

Height AdjustableReceiver (Track Arm)

Height AdjustableReceiver (Tube Arm)

Standard Fixed Receiver ........................................... StandardPart: ACC123525

Stealth Height Adjustable Receiver ................................... $214Tube Arm Part: ST-ARM250C-Q. HCPCS: K0108TRU-Balance 3 Arm Part: ST-ARM250T-Q. HCPCS: K0108

13. TRU-BALANCE 3 JOYSTICK BRACKET RECEIVERREQUIRED.

14. TRU-BALANCE 3 HEADRESTSOptional. Select a headrest pad and bracket.

14.1. Headrest Pads

14.2. Headrest Brackets

15. LAP BELTSREQUIRED. Select a lap belt below.15.1a. Standard Lap Belts

15.1b. Optional Lap Beltsi-Fit 60” Single Pull, Push Button, Medium ...........................$86(7.5”) Padded, 1.5” Belt (IFPB5213)Part: ST-IFPB5213-Q

i-Fit 60” Single Pull, Push Button, Large ..............................$86Padded (9.5”), 2” Belt (IFPB5314)Part: ST-IFPB5314-Q

i-Fit 60” Single Pull, Push Button, Extra Large ......................$86Padded (11.5”), 2” Belt (IFPB5315)Part: ST-IFPB5315-Q

38” Lap BeltPart: ACCBELT1006






16. TRU-BALANCE 3 MANUFACTURER INSTALLED ACCESSORIESOptional.

Push Handles (pair) ........................................................$175Part: ACC147772Not available with oxygen holder or back cane option. Required with attendant manual recline.

Accessory Bar .............................................................. $100Part: MEC125098Standard with the oxygen holder. May be added to mount additional accessory to back of unit. Not available with back cane option.

17. TRU-BALANCE 3 POWER POSITIONING ELECTRONICSREQUIRED, except with Static Seat without power options.

17.1a. Tilt Only through Toggle

Single Actuator Control Through NE+ 6-Key Joystick ........... $1,895Part: See XRef. HCPCS: E2310

Two Actuator Control Through NE+ 6-Key Joystick .............$2,895Part: See XRef. HCPCS: E2311

Single Actuator Control, Through Toggle (Power Tilt Only) ...............................................................................................No ChargePart: See XRefOnly available with Power Tilt only. Manual recline is not available with NE Tilt through toggle. Select toggle side.

Left Side Toggle Right Side TogglePart PTOINDV1838 Part: PTOINDV1839

17.1b. NE+ 6 Key Controls through Joystick


70° Drop-In Legrests, 12"-14.5" Length (pair) ...................... $420Part: FRMASMB4762

70° Drop-In Legrests, 14.5"-20" Length (pair) ...................... $420Part: FRMASMB4853

80° Drop-In Legrests, 12"-14.5" Length (pair) ...................... $420Part: FRMASMB4762

80° Drop-In Legrests, 14.5"-20" Length (pair) ...................... $420Part: FRMASMB4854

1. Heavy Duty, Drop-In Legrest Upper

18.2. Heavy Duty, Drop-In, LegrestsAvailable in pairs only. Select legrest uppers and footplates.


Power Articulating Foot Platform .................. $2,995Part: PTOINDV3754. HCPCS: E1012

Manually Adjustable Center Mount Foot Platform ... $2508"-12" extension part: RIG1802138.Other extensions: RIG1710345

18.1. Center Mount Foot PlatformIf power articulating foot platform is selected, be sure power legrest control has been selected in earlier section. Select legrest length in following section.

2. Lower Extension and Footplates

1. Foot Platform Assembly

Power ArticulatingFoot Platform

8"-12" Extension, 5"x6" FootplatesPart: RIG152577Not available with power AFP.

8"-12" Extension, 5"x8" FootplatesPart: RIG152578Not available with power AFP.

10"-16" Extension, 5"x6" FootplatesPart: RIG150206



Small Calf Pads (pair) 6”Wx6”H ........................................ $150*Part: RIGASMB7120018

Large Calf Pads (pair) 8” taper to 6”Wx8”H ........................ $150*Part: RIGASMB7120019

Small Calf Panel 18”Wx8”H ............................................. $150Part: FRMASMB7110012

Large Calf Panel 24”Wx8”H ............................................ $200Part: RIG123824Only available on widths of 20” or greater.

3. Center Mount Calf Support*Calf pads are standard with a power articulating foot platform. Select calf pads covers for additional charge. Calf pad and panel covers include 1/2” of soft visco foam.

4. Modular Footplate Extension ComponentsOptional. Assembly required. May require seating configuration adjustments to avoid front caster interference.

5. Additional Accessories

Width Extension for 8”D Footplates ...................................$50Part: RIG152517

Width Extension for 11”D Footplates ..................................$50Part: RIG152518

2” Bell-Shaped Length Extension .......................................$50Part: RIG152519Not compatible with width extensions. Can be used with 6” outside edge with 11” footplates.

4” Outside Edge (pair) .....................................................$50Part: RIG152510Only available with 6”D footplates and 8”D footplate extension.

6” Outside Edge (pair) .....................................................$50Part: RIG152516Available with 8”D and 11”D footplates and 11”D footplate extension.

Reversed Dartex Calf Pad Cover (pair) ............................... $150Small part: RIG133717. Large part: RIG133719

Reversed Dartex Panel Cover (pair) .................................. $150Small part: RIG134673. Large part: RIG134744

Wheel Bumpers (pair) ............................................. $12.50 ea.Part: WHLASMB1578

Footplate Connector ....................................................... $15Part: RIGASMB7120023

Legrests section continued on following page.

Wheel Bumper .......................................................................................................................................................$12.50 ea.Part: WHLASMB1578

5"Wx8"D Angle Adjustable (pair) .......................................$170Part: FRMASMB4735

6"Wx8"D Angle Adjustable (pair) .......................................$170Part: FRMASMB4738

6"Wx11"D Angle Adjustable (pair) ......................................$170Part: FRMASMB4741

8"Wx11"D Angle Adjustable (pair) ......................................$170Part: FRMASMB4744

2. Angle Adjustable Footplate(s) with Heel Loops¹The 6”x11” footplates may cause interference with seat widths less than 18”. ²The 8”x11” footplates may cause interference with seat widths less than 20”.

3. Heavy Duty Drop-In Legrest Accessories

1. Pediatric Legrests Upper

2. Angle Adjustable Footplate(s) with Heel Loops

3. Accessories

90°, Pediatric, Swing-Away Legrest (7"-10" Length Extension) ...................................................................................$81 ea.Pair part: FRMASMB8808. Left: FRMASMB8809. Right: FRMASMB8810

18.3. 90° Pediatric, Swing-Away LegrestsPair (P), left (L), and right (R) configurations are selected by checking the appropriate boxes.

4”Wx6”D Angle Adjustable .................................$85 ea.Pair part: FRMASMB8812. Left: RIG133537. Right: RIG133560


Wheel Bumper(s) .........................................................................................................................................$12.50 ea.Pair part: WHL169508. Left: WHL169510. Right: WHL169511

18. LEGRESTSOptional. All efforts will be made to accommodate legrest length selection, but minor changes may need to be made to meet shipping guidelines. Some adjustments may be needed upon receipt of the unit. Reference the section’s compatibility matrix for legrest interference.



18.4. 60°-90° Swing-Away LegrestsSelect a legrest upper, a lower extension, and type of footplate. Pair (P), left (L), and right (R) configurations are selected by checking the appropriate boxes.1. 60°-90° Swing-Away Legrest UppersAdjustable in 5° increments.

7.25”Wx6”D Extruded Footplate ........................ StandardPart pair: FRMASMB7847. Left: FRMASMB7861Right: FRMASMB7862

8.5”Wx6”D Extruded Footplate ......................... StandardPart pair: FRMASMB7848. Left: FRMASMB7863 Right: FRMASMB7864May cause interference on seat widths less than 18.”

60°-90° Swing-Away Legrest, Short ...................... $81 ea.Pair part: RIG136481. Left: RIG132607. Right: RIG132609Not available with 13"-16.5" extensions.

60°-90° Swing-Away Legrest ............................... $81 ea.Pair part: RIG120062. Left: FRMASMB17558. Right: FRMASMB17559Not available with 11"-13" extensions.

11”-13” LengthPart: See XRefN/A with Multi-axis.

11”-16.5” LengthPart: See XRefN/A with Angle Adjustable.

13”-16.5” LengthPart: See XRefN/A with Multi-Axis.

3a. Extruded Footplate(s)

3b. Angle Adjustable Footplate(s)¹The 6”x11” footplates may cause interference with seat widths less than 18”. ²The 8”x11” footplates may cause interference with seat widths less than 20”.

2. Lower Extension




6”Wx8”D1 Angle Adjustable ................................$85 ea.Pair part: FRMASMB10567. Left: RIG133540. Right: RIG133563

6”Wx11”D1 Angle Adjustable...............................$85 ea.Pair part: FRMASMB10568. Left: RIG133541. Right: RIG133564

8”Wx11”D2 Angle Adjustable ..............................$85 ea.Pair part: FRMASMB10569. Left: RIG133542. Right: RIG133565

4”Wx6”D Multi-Axis .................................... $247.50 ea.Pair part: FRMASMB9456. Left: RIG133531. Right: RIG133552



6”Wx8”D1 Multi-Axis ................................... $247.50 ea.Pair part: FRMASMB9459. Left: RIG133534. Right: RIG133555

6”Wx11”D1 Multi-Axis ................................. $247.50 ea.Pair part: FRMASMB9460. Left: RIG133535. Right: RIG133558

8”Wx11”D2 Multi-Axis ................................. $247.50 ea.Pair part: FRMASMB9461. Left: RIG133536. Right: RIG133559

Heel Loops (pair) ............................................................$50Part: FRMASMB7873. HCPCS: E0951Standard on angle adjustable and multi-axis footplates.

Wheel Bumper ...................................................... $12.50 ea.Part: See XRef

Gel Neoprene Footrest Sleeve (pair) ...................................$80Part: INDPART2243. HCPCS: K0108

3c. Multi-Axis Footplate(s)¹The 6”x11” footplates may cause interference with seat widths less than 18”. ²The 8”x11” footplates may cause interference with seat widths less than 20”.

4. Swing-Away Legrest Accessories

18. LEGRESTS continued

3a. Reinforced Cast Footplate(s)

3b. Angle Adjustable Footplate(s) with Heel Loops¹The 6” wide footplates may cause interference with seat widths less than 18”. ²The 8” wide footplates may cause interference with seat widths less than 20”. 4"x6" and 5"x6" footplates are only available in pairs.

1. Elevating Legrests Upper

2. Lower Extension

18.5. Elevating LegrestsSelect a legrest upper, a legrest extension, and type of footplate. Pair (P), left (L), and right (R) configurations are selected by checking the appropriate boxes. Select legrest length in following section.

Elevating Legrest Assembly ........................................................................................................................... $162.50 ea.Pair part: FRMASMB6483. Left: RIG138012. Right: RIG138013. HCPCS for K0835 base: E0990. HCPCS for K0822 base: K0195Select lower extension and footplates.

11”-14” LengthPair: FRMASMB4755Left: RIG138026Right: RIG138030For reinforced only

12”-14.5” LengthPart: See XRefFor angle adjustable only

14”-17” LengthPair: FRMASMB4756Left: RIG138033Right: RIG138035For reinforced only

14.5”-18” LengthPart: See XRefFor angle adjustable only

7.25”Wx6”D Reinforced Footplate ...................... StandardPair part: FRMASMB4748. Left: RIG138055. Right: RIG138056

8.5”Wx6”D Reinforced Footplate ....................... StandardPair part: FRMASMB4747. Left: RIG138060. Right: RIG138062May cause interference on seat widths less than 18.”

4”Wx6”D Angle Adjustable .................................$85 ea.Pair parts: FRMASMB8812 x2.

5”Wx6”D Angle Adjustable .................................$85 ea.Pair parts: FRMASMB8811 x2.

5”Wx8”D Angle Adjustable .................................$85 ea.Pair part: FRMASMB4735. Left: RIG137791. Right: RIG137792.

6”Wx8”D1 Angle Adjustable ................................$85 ea.Pair part: FRMASMB4738. Left: RIG137793. Right: RIG137795.

6”Wx11”D1 Angle Adjustable...............................$85 ea.Pair part: FRMASMB4741. Left: RIG137796. Right: RIG137797.

8”Wx11”D2 Angle Adjustable ..............................$85 ea.Pair part: FRMASMB4744. Left: RIG137798. Right: RIG137799.

Legrests section continued on following page.


Heel Loops (pair) ............................................................$50Part: FRMASMB7873. HCPCS: E0951Standard on angle adjustable footplates.

Wheel Bumper ...................................................... $12.50 ea.Part: See XRefAvailable on angle adjustable footplates.

Falcon Gel Padded Knee Adductor Buttons (KBE) (pair) ..........$125Part: INDPART2242. HCPCS: E0953^^Please verify the appropriate billing code to be used for this item with all third-party payors.


4. Elevating Legrest Accessories18. LEGRESTS continued

TRU-Comfort 2 SPP CushionSkin protection and positioning with 4-way stretch, breathable cover.

E2607, 16"W to 20" W ...........................$400

Part series: ST-TC2SPPXXYY

Simplicity G CushionGeneral use with 2-way stretch, breathable cover.

E2601, 16"W to 20" W ........................... $110Part series: ST-SIMGXXYY

19. QUICK STEALTH CUSHION CONFIGURATIONOptional. Specific cushion/component sizes available, part numbers, and special order cushions can be found on the complete Stealth Cushion Order Form. This section allows a quick selection of a single cushion. The XXYY portion of the part number directly relates to the dimensions of the cushion, where XX represents the width and YY represents the depth.

19.1. Cushion Dimensions

19.2. Cushion Model Selection

19.3. Additional Fluid Proof LinersFluid Proof Urethane Liner ......................................... $50-$70Part: URL1709070-XXYYNot available with Simplicity and TRU-Comfort 2.

Fluid Proof Polyurethane Liner .............................. Coming soonNot available with Simplicity.

Solution SPP CushionSkin protection and positioning with 4-way stretch, breathable cover. Includes urethane liner.

E2607, 14"W to 20" W ........................... $375

Part series: ST-SOLSPPXXYY

Spectrum Gel SPP CushionPositioning with 4-way stretch, breathable cover. Includes urethane liner.Part series: ST-SPCGSPPXXYY

E2607, 14"W to 20" W ...........................$460

Spectrum Foam SPP CushionSkin protection and positioning with 4-way stretch, breathable cover.Part series: ST-SPCFSPPXXYY

E2607, 16"W to 20" W ...........................$460

14” W 16" W 17" W 18" W 19" W 20" W 14” D 16" D 17" D 18" D 19" D 20" D"

Cushion Width Cushion Depth

20. PROVIDER INSTALLED ACCESSORIESOptional. Multiple accessories can be mounted along the various tracks but some interference may occur.

TRU-Balance 3 Cup Holder .......................No ChargePart: ACC125003For use with TRU-Balance 3 (track style) armrests.

Cup Holder (Tube-style Armrest) ...............No ChargePart: ACCASMB2634For use with tube-style armrests.

TRU-Balance 3 Backpack Holder (Pair) (A) ........... $50Part: ACC147774Not available with back cane option.

TRU-Balance 3 Hydration System (B) .................$200Part: ACC125010

TRU-Balance 3 Glove Box (C) ........................... $125Part: ACC125011

TRU-Balance 3 Transfer Bar, ...........................$200Quick Release (Pair) (D) Part: ACC147773. HCPCS: E0705

TRU-Balance 3 Front Mounted .......................... $50Cell Phone/ Media Holder (E)Part: ACC155835

Large, Black, Weather Cover ...........................$202Part: ACCCOVR1021

TRU-Balance 3 Reflector Kit ............................. $50Part: ACC124670

TRU-Balance 3 Personal Item Hook .................... $50Part: ACC125008Not available with back cane option.

TRU-Balance 3 Rear View Mirror ....................... $50Part: ACC155833

TRU-Balance 3 Oxygen Holder .........................$200Part: ACC125006. HCPCS: E2208

TRU-Balance 3 Clothing Guard (Pair) .................$200Part: ACC125007

Quantum Backpack ........................................ $75Part: ACCINDV1102

Stealth Large Tablet Holder ............................$375Part: ACC7120005

Stealth Cell Phone/Media Device Holder ............ $195Part: ACC7120006

TRU-Balance 3Accessories

https://www.pridemobility.com/pdf/order-forms/seating/us_stealth_cushions_order_form.pdf



U-1, Interceptor Batteries ..........................................$133 ea.Part: BAT1704611 x2 qty. HCPCS: E2365

No Batteries ......................................................... No ChargePart: Configuration selection

21. PROVIDER INSTALLED ACCESSORIESREQUIRED. The powerchair requires 2 batteries and will be installed if ordered.

Air Force Army Coast Guard Marines Navy Purple Heart

Air Force Patch ..............................$20Part: ACC140240

Army Patch ...................................$20Part: ACC140241

Coast Guard Patch ..........................$20Part: ACC140239

Marines Patch ................................$20Part: ACC140243

Navy Patch ...................................$20Part: ACC140244

Purple Heart Patch .........................$20Part: ACC140238

22. BRANCH PATCHESOptional.

1. Bracket

2. Pads

3. Installation

Swing-away, Rail Mounts, pair (TWBTLTC) ...................................................................................................................... $472.50Part: INDPART2677. HCPCS: E1028

Curved Pads, 3”x5”, pair (TWBL-3X5) ................................ $210Part: INDPART2663. HCPCS: E0956

Curved Pads, 4”x6”, pair (TWBL-4X6) ................................ $210Part: INDPART2664. HCPCS: E0956

Install LateralsPart: PTOINDV3499

Do Not InstallPart: PTOINDV3500

23.1. Stealth Thoracic LateralsSwing-away laterals may interfere with TRU-Balance 3 armrests and 2-post, flip up armrests. These laterals are not available with the back cane option.

23. MANUFACTURER INSTALLED POSITIONING COMPONENTSOptional. Not available with contoured seating. More options are available on the Positioning Components Order Form.

Flip Down Bracket (TWBTLADD-HW) ................... $236.25 ea.Part: INDPART2804. HCPCS: E1028

Removable Bracket (LP430) ............................... $262.50 ea.Part: INDPART2805. HCPCS: E1028

Removable Bracket with 1” Offset .......................... $400 ea. (LP430 & LHW-121)

Part: INDPART2854. HCPCS: E1028

Flip Down with LEFT Full Surface Contact ................. $236.25 ea.Feature (TWBADD-L & LPHW407)Part: POS140428. HCPCS: E1028

Flip Down with RIGHT Full Surface Contact ................ $236.25 ea.Feature (TWBADD-R & LPHW407)Part: POS140429. HCPCS: E1028

1. Pelvic/Thigh Guide Bracket

2. Pelvic/Thigh Guide Adapter

23.2. Stealth Pelvic/Thigh GuidesPelvic/thigh guides may interfere with the joystick receiver block and down posts. Please provide quantity next to check box.

2” Height Adapter Plate (LHW-122) .................................$26.25Part: INDPART2821. HCPCS: K0108Height adapter is needed with TRU-Comfort seat cushions. Not avail-able with the flip down bracket.

2 1/4” Adapter Plate (LHW-129) .....................................$53.50Part: POS140430. HCPCS: K0108Only available with the flip down full surface bracket.

3. Pelvic/Thigh Guide Pad^Please verify the appropriate billing code to be used for this item with all third-party payors.

4. Pelvic/Thigh Guide Installation

Short Pad, 4”x4” (TWBADD-4X4) ..............................$75 ea.Part: INDPART2801. HCPCS: E0953^

Medium Pad, 4”x8” (TWBADD-4X8) ...........................$75 ea.Part: INDPART2802. HCPCS: E0953^

Long Pad, 4”x12” (TWBADD-4X12) ............................$75 ea.Part: INDPART2803. HCPCS: E0953^

Install on LeftPart: PTOINDV3585

Install on RightPart: PTOINDV3586

Do Not InstallPart: PTOINDV3719

http://www.quantumrehab.com/resources/downloadorderforms.php?f=seating/us_positioning_components_order_form.pdf



24.1. Stealth Foot Boxes^Please verify the appropriate billing code to be used for this item with all third-party payors.

24.2. Stealth Padded Shoe Holder

Stealth Small Foot Boxes, 5"Wx8"Dx7"H ......................... $498.75(SPLE107) (pair)Part: INDPART2786. HCPCS: E0954^

Stealth Medium Foot Boxes, 6"Wx10"Dx9"H .................... $498.75(SPLE108) (pair)Part: INDPART2787. HCPCS: E0954^

Stealth Large Foot Boxes, 7"Wx12"Dx11"H ...................... $498.75(SPLE109) (pair)Part: INDPART2788. HCPCS: E0954^

Stealth Small Padded Shoe Holder 3.75"Wx6.25"D ................ $266(SPLE111) (pair)Part: INDPART2783

Stealth Medium Padded Shoe Holder, 4"Wx8.25"D ................ $266(SPLE112) (pair)Part: INDPART2784

Stealth X-Large Padded Shoe Holder, 5"Wx10.75"D ............... $266(SPLE114) (pair)Part: INDPART2785

2. Elbow Support Pad

1. Elbow Support Bracket24.3. Stealth Elbow Support

Left,Swing-Away, Elbow Support ........ $183.75 ea. Bracket Tube Style Arms (ARMS-ES-L)

Part: POS124064. HCPCS: E1028

Left, Fixed Elbow Support Bracket ...... $183.75 ea. TRU-Balance 3 Arms (ARMS-ESFTB3-L)

Part: POS133465

Right, Swing-Away, Elbow Support ...... $183.75 ea. Bracket Tube Style Arms (ARMS-ES-R)

Part: POS124066. HCPCS: E1028

Right, Fixed Elbow Support Bracket .... $183.75 ea. TRU-Balance 3 Arms (ARMS-ESFTB3-R)

Part: POS133466

3"Wx3"H Elbow Pad (ARMS-ES-3X3) .......................$52.50 ea.Part: POS124065. HCPCS: K0108

4"Wx4"H Elbow Pad (ARMS-ES-4X4) .......................$52.50 ea.Part: POS124067. HCPCS: K0108

Elbow Supports

24.4. Stealth i-Fit Chest HarnessUpper Classic, Medium (IFPS1103) ............... $142 ea.Part: ST-IFPS1103-Q. HCPCS: E0960

Upper Classic, Large (IFPS1104) .................. $142 ea.Part: ST-IFPS1104-Q. HCPCS: E0960

Upper Contour, Medium (IFPS2103) .............. $142 ea.Part: ST-IFPS2103-Q. HCPCS: E0960

Upper Contour, Large (IFPS2104) ................ $142 ea.Part: ST-IFPS2104-Q. HCPCS: E0960

Contoured and ClassicChest Harness

24. PROVIDER INSTALLED POSITIONING COMPONENTSOptional. Not available with contoured seating. More options are available on the Positioning Components Order Form.

24.5. Stealth i-Fit Chest StrapsChest Strap, Medium w/ Belt Anchor ............. $90 ea.(IFCS4113)Part: ST-IFCS4113-Q. HCPCS: E0960

Chest Strap, Large w/ Belt Anchor ................ $90 ea.(IFCS4114)Part: ST-IFCS4114-Q. HCPCS: E0960

Chest Strap

25. REFERENCE ORDER FORMSOptional. Select below to note that additional order forms will accompany this order form. This will also be a link in interactive forms.

Positioning Components Order Form

©2018 Quantum Rehab - A Pride Mobility Products Corporation company. All rights reserved.

Quantum® Rehab401 York Ave., Duryea, PA 18642Phone: 866-800-2002 | Fax: 866-707-3422 | Email: [email protected]

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http://www.quantumrehab.com/resources/downloadorderforms.php?f=seating/us_positioning_components_order_form.pdf

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Section NameOption Name MSRP Part Number Manufacturer Extended DescriptionTRU-BALANCE 3 SEATING : Seat Dimensions Seat TypeTB3SPACK: Seat width package, depth package, and transit kit section generate one part assembly.

No Charge SET130931 SEAT BASE,ASSY,12"W-16"W,12"D-16"D,SEAT ONLY,TRU-BALANCE 3

SET130932 SEAT BASE,ASSY,12"W-16"W,16"D-20"D,SEAT ONLY,TRU-BALANCE 3 SET130933 SEAT BASE,ASSY,16"W-20"W,12"D-16"D,SEAT ONLY,TRU-BALANCE 3 SET130934 SEAT BASE,ASSY,16"W-20"W,16"D-20"D,SEAT ONLY,TRU-BALANCE 3 SET1710459 SEAT BASE,ASSY,12"W-16"W,12"D-16"D,TILT ONLY,TRU-BALANCE 3.5,J6 SET1710462 SEAT BASE,ASSY,12"W-16"W,16"D-20"D,TILT ONLY,TRU-BALANCE 3.5,J6 SET1710463 SEAT BASE,ASSY,16"W-20"W,12"D-16"D,TILT ONLY,TRU-BALANCE 3.5,J6 SET1710466 SEAT BASE,ASSY,16"W-20"W,16"D-20"D,TILT ONLY,TRU-BALANCE 3.5,J6

TRU-BALANCE 3 SEATING : Back Cushion ConfigurationSport Back No Charge SET130247 SEAT BACK,ASSY,14"W,10"W-14"W,11"H,SPORT BACK,TRU-BALANCE 3

SET130249 SEAT BACK,ASSY,16"W,16"W-20"W,13"H,SPORT BACK,TRU-BALANCE 3SET130250 SEAT BACK,ASSY,16"W,16"W-20"W,15"H,SPORT BACK,TRU-BALANCE 3SET130251 SEAT BACK,ASSY,16"W,16"W-20"W,17"H,SPORT BACK,TRU-BALANCE 3SET130252 SEAT BACK,ASSY,16"W,16"W-20"W,19"H,SPORT BACK,TRU-BALANCE 3SET130253 SEAT BACK,ASSY,16"W,16"W-20"W,21"H,SPORT BACK,TRU-BALANCE 3SET130255 SEAT BACK,ASSY,17"W,16"W-20"W,15"H,SPORT BACK,TRU-BALANCE 3SET130257 SEAT BACK,ASSY,17"W,16"W-20"W,19"H,SPORT BACK,TRU-BALANCE 3SET130258 SEAT BACK,ASSY,17"W,16"W-20"W,21"H,SPORT BACK,TRU-BALANCE 3SET130259 SEAT BACK,ASSY,18"W,16"W-20"W,13"H,SPORT BACK,TRU-BALANCE 3SET130260 SEAT BACK,ASSY,18"W,16"W-20"W,15"H,SPORT BACK,TRU-BALANCE 3SET130261 SEAT BACK,ASSY,18"W,16"W-20"W,17"H,SPORT BACK,TRU-BALANCE 3SET130262 SEAT BACK,ASSY,18"W,16"W-20"W,19"H,SPORT BACK,TRU-BALANCE 3SET130263 SEAT BACK,ASSY,18"W,16"W-20"W,21"H,SPORT BACK,TRU-BALANCE 3SET130267 SEAT BACK,ASSY,19"W,16"W-20"W,19"H,SPORT BACK,TRU-BALANCE 3SET130268 SEAT BACK,ASSY,19"W,16"W-20"W,21"H,SPORT BACK,TRU-BALANCE 3SET130269 SEAT BACK,ASSY,20"W,16"W-20"W,13"H,SPORT BACK,TRU-BALANCE 3SET130270 SEAT BACK,ASSY,20"W,20"W-24"W,13"H,SPORT BACK,TRU-BALANCE 3SET130271 SEAT BACK,ASSY,20"W,16"W-20"W,15"H,SPORT BACK,TRU-BALANCE 3SET130272 SEAT BACK,ASSY,20"W,20"W-24"W,15"H,SPORT BACK,TRU-BALANCE 3SET130275 SEAT BACK,ASSY,20"W,16"W-20"W,19"H,SPORT BACK,TRU-BALANCE 3SET130276 SEAT BACK,ASSY,20"W,20"W-24"W,19"H,SPORT BACK,TRU-BALANCE 3SET130277 SEAT BACK,ASSY,20"W,16"W-20"W,21"H,SPORT BACK,TRU-BALANCE 3SET130278 SEAT BACK,ASSY,20"W,20"W-24"W,21"H,SPORT BACK,TRU-BALANCE 3SET130292 SEAT BACK,ASSY,21"W,20"W-24"W,19"H,SPORT BACK,TRU-BALANCE 3SET130293 SEAT BACK,ASSY,21"W,20"W-24"W,21"H,SPORT BACK,TRU-BALANCE 3SET130294 SEAT BACK,ASSY,22"W,20"W-24"W,13"H,SPORT BACK,TRU-BALANCE 3SET130297 SEAT BACK,ASSY,22"W,20"W-24"W,19"H,SPORT BACK,TRU-BALANCE 3SET130298 SEAT BACK,ASSY,22"W,20"W-24"W,21"H,SPORT BACK,TRU-BALANCE 3SET130299 SEAT BACK,ASSY,24"W,20"W-24"W,13"H,SPORT BACK,TRU-BALANCE 3SET130300 SEAT BACK,ASSY,24"W,24"W-28"W,13"H,SPORT BACK,TRU-BALANCE 3SET130303 SEAT BACK,ASSY,24"W,20"W-24"W,17"H,SPORT BACK,TRU-BALANCE 3SET130304 SEAT BACK,ASSY,24"W,24"W-28"W,17"H,SPORT BACK,TRU-BALANCE 3SET130305 SEAT BACK,ASSY,24"W,20"W-24"W,19"H,SPORT BACK,TRU-BALANCE 3SET130306 SEAT BACK,ASSY,24"W,24"W-28"W,19"H,SPORT BACK,TRU-BALANCE 3SET130308 SEAT BACK,ASSY,24"W,20"W-24"W,21"H,SPORT BACK,TRU-BALANCE 3SET130309 SEAT BACK,ASSY,24"W,24"W-28"W,21"H,SPORT BACK,TRU-BALANCE 3

ADI Q-Back, Active Contour $525 ALBR16SAQ Q-BACK,AL SERIES,ACTIVE CONTOUR,16"W,16"H,(ADI)ALBR16TAQ Q-BACK,AL SERIES,ACTIVE CONTOUR,16"W,18"H,(ADI)ALBR18SAQ Q-BACK,AL SERIES,ACTIVE CONTOUR,18"W,16"H,(ADI)ALBR18TAQ Q-BACK,AL SERIES,ACTIVE CONTOUR,18"W,18"H,(ADI)

J6 Cross Reference Spreadsheet - TRU-Balance 3 Postioning

Page 1 of 7

Section NameOption Name MSRP Part Number Manufacturer Extended Description


ALBR20SAQ Q-BACK,AL SERIES,ACTIVE CONTOUR,20"W,16"H,(ADI)ALBR20TAQ Q-BACK,AL SERIES,ACTIVE CONTOUR,20"W,18"H,(ADI)

ADI Q-Back, Deep Contour $595 ALBR16SDQ Q-BACK,AL SERIES,DEEP CONTOUR,16"W,16"H,(ADI)ALBR16TDQ Q-BACK,AL SERIES,DEEP CONTOUR,16"W,18"H,(ADI)ALBR18SDQ Q-BACK,AL SERIES,DEEP CONTOUR,18"W,16"H,(ADI)ALBR18TDQ Q-BACK,AL SERIES,DEEP CONTOUR,18"W,18"H,(ADI)ALBR20SDQ Q-BACK,AL SERIES,DEEP CONTOUR,20"W,16"H,(ADI)ALBR20TDQ Q-BACK,AL SERIES,DEEP CONTOUR,20"W,18"H,(ADI)

ADI Q-Back, Extra Deep Contour $650 ALBR16S6Q Q-BACK,AL SERIES,EXTRA DEEP CONTOUR,16"W,16"H,(ADI)ALBR16T6Q Q-BACK,AL SERIES,EXTRA DEEP CONTOUR,16"W,18"H,(ADI)ALBR18S6Q Q-BACK,AL SERIES,EXTRA DEEP CONTOUR,18"W,16"H,(ADI)ALBR18T6Q Q-BACK,AL SERIES,EXTRA DEEP CONTOUR,18"W,18"H,(ADI)ALBR20S6Q Q-BACK,AL SERIES,EXTRA DEEP CONTOUR,20"W,16"H,(ADI)ALBR20T6Q Q-BACK,AL SERIES,EXTRA DEEP CONTOUR,20"W,18"H,(ADI)

TRU-Comfort 4-way Stretch, 20" Width or less $675 SET123622 SEAT BACK,ASSY,12"W,10"W-14"W,11"H,TRU-COMFORT 2,4 WAY STRETCHSET123623 SEAT BACK,ASSY,14"W,10"W-14"W,13"H,TRU-COMFORT 2,4 WAY STRETCHSET123631 SEAT BACK,ASSY,16"W,16"W-20"W,13"H,TRU-COMFORT 2,4 WAY STRETCHSET123633 SEAT BACK,ASSY,16"W,16"W-20"W,15"H,TRU-COMFORT 2,4 WAY STRETCHSET123635 SEAT BACK,ASSY,16"W,16"W-20"W,17"H,TRU-COMFORT 2,4 WAY STRETCHSET123637 SEAT BACK,ASSY,16"W,16"W-20"W,19"H,TRU-COMFORT 2,4 WAY STRETCHSET123639 SEAT BACK,ASSY,17"W,16"W-20"W,13"H,TRU-COMFORT 2,4 WAY STRETCHSET123641 SEAT BACK,ASSY,17"W,16"W-20"W,15"H,TRU-COMFORT 2,4 WAY STRETCHSET123651 SEAT BACK,ASSY,17"W,16"W-20"W,17"H,TRU-COMFORT 2,4 WAY STRETCHSET123653 SEAT BACK,ASSY,17"W,16"W-20"W,19"H,TRU-COMFORT 2,4 WAY STRETCHSET123655 SEAT BACK,ASSY,18"W,16"W-20"W,13"H,TRU-COMFORT 2,4 WAY STRETCHSET124576 SEAT BACK,ASSY,18"W,16"W-20"W,15"H,TRU-COMFORT 2,4 WAY STRETCHSET124578 SEAT BACK,ASSY,18"W,16"W-20"W,17"H,TRU-COMFORT 2,4 WAY STRETCHSET124597 SEAT BACK,ASSY,18"W,16"W-20"W,19"H,TRU-COMFORT 2,4 WAY STRETCHSET124599 SEAT BACK,ASSY,18"W,16"W-20"W,21"H,TRU-COMFORT 2,4 WAY STRETCHSET124601 SEAT BACK,ASSY,19"W,16"W-20"W,13"H,TRU-COMFORT 2,4 WAY STRETCHSET124602 SEAT BACK,ASSY,19"W,16"W-20"W,15"H,TRU-COMFORT 2,4 WAY STRETCHSET124603 SEAT BACK,ASSY,19"W,16"W-20"W,17"H,TRU-COMFORT 2,4 WAY STRETCHSET124605 SEAT BACK,ASSY,19"W,16"W-20"W,19"H,TRU-COMFORT 2,4 WAY STRETCHSET124606 SEAT BACK,ASSY,20"W,16"W-20"W,13"H,TRU-COMFORT 2,4 WAY STRETCHSET124607 SEAT BACK,ASSY,20"W,20"W-24"W,13"H,TRU-COMFORT 2,4 WAY STRETCHSET124609 SEAT BACK,ASSY,20"W,16"W-20"W,15"H,TRU-COMFORT 2,4 WAY STRETCHSET124610 SEAT BACK,ASSY,20"W,20"W-24"W,15"H,TRU-COMFORT 2,4 WAY STRETCHSET124611 SEAT BACK,ASSY,20"W,16"W-20"W,17"H,TRU-COMFORT 2,4 WAY STRETCHSET124612 SEAT BACK,ASSY,20"W,20"W-24"W,17"H,TRU-COMFORT 2,4 WAY STRETCHSET124613 SEAT BACK,ASSY,20"W,16"W-20"W,19"H,TRU-COMFORT 2,4 WAY STRETCHSET124618 SEAT BACK,ASSY,20"W,20"W-24"W,19"H,TRU-COMFORT 2,4 WAY STRETCHSET124619 SEAT BACK,ASSY,20"W,16"W-20"W,21"H,TRU-COMFORT 2,4 WAY STRETCHSET124623 SEAT BACK,ASSY,20"W,20"W-24"W,21"H,TRU-COMFORT 2,4 WAY STRETCH

TRU-Comfort 4-way Stretch, 22" Width or greater $775 SET124624 SEAT BACK,ASSY,22"W,20"W-24"W,13"H,TRU-COMFORT 2,4 WAY STRETCHSET124625 SEAT BACK,ASSY,22"W,20"W-24"W,15"H,TRU-COMFORT 2,4 WAY STRETCHSET124626 SEAT BACK,ASSY,22"W,20"W-24"W,17"H,TRU-COMFORT 2,4 WAY STRETCHSET124627 SEAT BACK,ASSY,22"W,20"W-24"W,19"H,TRU-COMFORT 2,4 WAY STRETCHSET124628 SEAT BACK,ASSY,24"W,20"W-24"W,13"H,TRU-COMFORT 2,4 WAY STRETCHSET130059 SEAT BACK,ASSY,24"W,24"W-28"W,13"H,TRU-COMFORT 2,4 WAY STRETCHSET124629 SEAT BACK,ASSY,24"W,20"W-24"W,15"H,TRU-COMFORT 2,4 WAY STRETCHSET130060 SEAT BACK,ASSY,24"W,24"W-28"W,15"H,TRU-COMFORT 2,4 WAY STRETCHSET124630 SEAT BACK,ASSY,24"W,20"W-24"W,17"H,TRU-COMFORT 2,4 WAY STRETCHSET130061 SEAT BACK,ASSY,24"W,24"W-28"W,17"H,TRU-COMFORT 2,4 WAY STRETCHSET124631 SEAT BACK,ASSY,24"W,20"W-24"W,19"H,TRU-COMFORT 2,4 WAY STRETCH

Page 2 of 7



SET130062 SEAT BACK,ASSY,24"W,24"W-28"W,19"H,TRU-COMFORT 2,4 WAY STRETCH

ARMRESTS : TRU-Balance 3 Flip-Back ArmrestsTRU-Balance 3 Flip-Back, 8"-12"H, Left Standard ARM147696 ARMREST,ASSY,12"W-20"W,8''H-12''H,FULL LENGTH,VERSION 2,TRU-BALANCE 3,LEFT

ARM147744 ARMREST,ASSY,12"W-20"W,8''H-12''H,DESK LENGTH,VERSION 2,TRU-BALANCE 3,LEFTARM147810 ARMREST,ASSY,20"W-24"W,8''H-12''H,FULL LENGTH,VERSION 2,TRU-BALANCE 3,LEFTARM147811 ARMREST,ASSY,20"W-24"W,8''H-12''H,DESK LENGTH,VERSION 2,TRU-BALANCE 3,LEFT

TRU-Balance 3 Flip-Back, 8"-12"H, Right Standard ARM147738 ARMREST,ASSY,12"W-20"W,8''H-12''H,FULL LENGTH,VERSION 2,TRU-BALANCE 3,RIGHTARM147746 ARMREST,ASSY,12"W-20"W,8''H-12''H,DESK LENGTH,VERSION 2,TRU-BALANCE 3,RIGHTARM147743 ARMREST,ASSY,20"W-24"W,8''H-12''H,FULL LENGTH,VERSION 2,TRU-BALANCE 3,RIGHTARM147812 ARMREST,ASSY,20"W-24"W,8''H-12''H,DESK LENGTH,VERSION 2,TRU-BALANCE 3,RIGHT

TRU-Balance 3 Flip-Back, 12"-16"H, Left Standard ARM147740 ARMREST,ASSY,12"W-20"W,12''H-16''H,FULL LENGTH,VERSION 2,TRU-BALANCE 3,LEFTARM147748 ARMREST,ASSY,12"W-20"W,12''H-16''H,DESK LENGTH,VERSION 2,TRU-BALANCE 3,LEFTARM147747 ARMREST,ASSY,20"W-24"W,12''H-16''H,FULL LENGTH,VERSION 2,TRU-BALANCE 3,LEFTARM147813 ARMREST,ASSY,20"W-24"W,12''H-16''H,DESK LENGTH,VERSION 2,TRU-BALANCE 3,LEFT

TRU-Balance 3 Flip-Back, 12"-16"H, Right Standard ARM147742 ARMREST,ASSY,12"W-20"W,12''H-16''H,FULL LENGTH,VERSION 2,TRU-BALANCE 3,RIGHTARM147797 ARMREST,ASSY,12"W-20"W,12''H-16''H,DESK LENGTH,VERSION 2,TRU-BALANCE 3,RIGHTARM147749 ARMREST,ASSY,20"W-24"W,12''H-16''H,FULL LENGTH,VERSION 2,TRU-BALANCE 3,RIGHTARM147817 ARMREST,ASSY,20"W-24"W,12''H-16''H,DESK LENGTH,VERSION 2,TRU-BALANCE 3,RIGHT

TRU-Balance 3 Armrest Downpost $87.50 MEC140975 DOWN POST,ASSY,8"H-11"H,STRAIGHT,LEFT,TRU-BALANCE 3MEC140977 DOWN POST,ASSY,12"H,STRAIGHT,LEFT,TRU-BALANCE 3MEC140979 DOWN POST,ASSY,13"H-14"H,STRAIGHT,LEFT,TRU-BALANCE 3MEC140981 DOWN POST,ASSY,15"H,STRAIGHT,LEFT,TRU-BALANCE 3MEC140983 DOWN POST,ASSY,16"H,STRAIGHT,LEFT,TRU-BALANCE 3MEC140976 DOWN POST,ASSY,8"H-11"H,STRAIGHT,RIGHT,TRU-BALANCE 3MEC140978 DOWN POST,ASSY,12"H,STRAIGHT,RIGHT,TRU-BALANCE 3MEC140980 DOWN POST,ASSY,13"H-14"H,STRAIGHT,RIGHT,TRU-BALANCE 3MEC140982 DOWN POST,ASSY,15"H,STRAIGHT,RIGHT,TRU-BALANCE 3MEC140984 DOWN POST,ASSY,16"H,STRAIGHT,RIGHT,TRU-BALANCE 3MEC140410 DOWN POST,ASSY,8"H-11"H,ENDOMORPH,LEFT,TRU-BALANCE 3MEC140416 DOWN POST,ASSY,12"H,ENDOMORPH,LEFT,TRU-BALANCE 3MEC140417 DOWN POST,ASSY,13"H-14"H,ENDOMORPH,LEFT,TRU-BALANCE 3MEC140418 DOWN POST,ASSY,15"H,ENDOMORPH,LEFT,TRU-BALANCE 3MEC140419 DOWN POST,ASSY,16"H,ENDOMORPH,LEFT,TRU-BALANCE 3MEC140990 DOWN POST,ASSY,8"H-11"H,ENDOMORPH,RIGHT,TRU-BALANCE 3MEC140991 DOWN POST,ASSY,12"H,ENDOMORPH,RIGHT,TRU-BALANCE 3MEC140992 DOWN POST,ASSY,13"H-14"H,ENDOMORPH,RIGHT,TRU-BALANCE 3MEC140993 DOWN POST,ASSY,15"H,ENDOMORPH,RIGHT,TRU-BALANCE 3MEC140994 DOWN POST,ASSY,16"H,ENDOMORPH,RIGHT,TRU-BALANCE 3MEC166424 DOWN POST,ASSY,8"H-11"H,MESOMORPH,LEFT,TRU-BALANCE 3MEC166429 DOWN POST,ASSY,12"H,MESOMORPH,LEFT,TRU-BALANCE 3MEC166430 DOWN POST,ASSY,13"H-14"H,MESOMORPH,LEFT,TRU-BALANCE 3MEC166431 DOWN POST,ASSY,15"H,MESOMORPH,LEFT,TRU-BALANCE 3MEC166432 DOWN POST,ASSY,16"H,MESOMORPH,LEFT,TRU-BALANCE 3MEC166433 DOWN POST,ASSY,8"H-11"H,MESOMORPH,RIGHT,TRU-BALANCE 3MEC166435 DOWN POST,ASSY,12"H,MESOMORPH,RIGHT,TRU-BALANCE 3MEC166436 DOWN POST,ASSY,13"H-14"H,MESOMORPH,RIGHT,TRU-BALANCE 3MEC166437 DOWN POST,ASSY,15"H,MESOMORPH,RIGHT,TRU-BALANCE 3MEC166438 DOWN POST,ASSY,16"H,MESOMORPH,RIGHT,TRU-BALANCE 3

ARMRESTS : Two-Post Armrests

Page 3 of 7



2-Post, Flip Back, Height Adjustable, removable Armrests (9"-13" Height)

No Charge($150 with Static seat)

FRMASMB7062 ARMREST,ASSY,ADULT TWO POST FLIP-UP HEIGHT ADJUSTABLE,FULL LENGTH,VERSION 2,LEFT,SYNERGY,TEXTURED

FRMASMB7063 ARMREST,ASSY,ADULT TWO POST FLIP-UP HEIGHT ADJUSTABLE,FULL LENGTH,VERSION 2,RIGHT,SYNERGY,TEXTURED

FRMASMB7060 ARMREST,ASSY,ADULT TWO POST FLIP-UP HEIGHT ADJUSTABLE,DESK LENGTH,VERSION 2,LEFT,SYNERGY,TEXTURED

FRMASMB7061 ARMREST,ASSY,ADULT TWO POST FLIP-UP HEIGHT ADJUSTABLE,DESK LENGTH,VERSION 2,RIGHT,SYNERGY,TEXTURED

ARMRESTS : Heavy Duty, Removable Armrests8"-12"H, Single Post, Height Adjustable, Removable, Heavy Duty $75 ea. ARM138631 ARMREST,ASSY,HD REMOVABLE,8"H-12"H,DESK LENGTH,TRU-BALANCE 3,LEFT,SHORT INSERT

ARM138632 ARMREST,ASSY,HD REMOVABLE,8"H-12"H,DESK LENGTH,TRU-BALANCE 3,RIGHT,SHORT INSERT

ARM138629 ARMREST,ASSY,HD REMOVABLE,8"H-12"H,FULL LENGTH,TRU-BALANCE 3,LEFT,SHORT INSERT

ARM138630 ARMREST,ASSY,HD REMOVABLE,8"H-12"H,FULL LENGTH,TRU-BALANCE 3,RIGHT,SHORT INSERT

10"-14"H, Single Post, Height Adjustable, Removable, Heavy Duty $75 ea. ARM138627 ARMREST,ASSY,HD REMOVABLE,10"H-14"H,DESK LENGTH,TRU-BALANCE 3,LEFT,SHORT INSERT

ARM138628 ARMREST,ASSY,HD REMOVABLE,10"H-14"H,DESK LENGTH,TRU-BALANCE 3,RIGHT,SHORT INSERT

ARM138625 ARMREST,ASSY,HD REMOVABLE,10"H-14"H,FULL LENGTH,TRU-BALANCE 3,LEFT,SHORT INSERT

ARM138626 ARMREST,ASSY,HD REMOVABLE,10"H-14"H,FULL LENGTH,TRU-BALANCE 3,RIGHT,SHORT INSERT

ARMPADSStraight, Armpad Standard ARM130236 ARMPAD,ASSY,STRAIGHT,DESK LENGTH/DESK LENGTH COMBO,TRU-BALANCE 3 ARMREST

ARM130237 ARMPAD,ASSY,STRAIGHT,FULL LENGTH/FULL LENGTH COMBO,TRU-BALANCE 3 ARMREST

ARM130289 ARMPAD,ASSY,STRAIGHT,FULL LENGTH RIGHT/DESK LENGTH LEFT COMBO,TRU-BALANCE 3 ARMREST

ARM130288 ARMPAD,ASSY,STRAIGHT,FULL LENGTH LEFT/DESK LENGTH RIGHT COMBO,TRU-BALANCE 3 ARMREST

ARM134254 ARMPAD,ASSY,STRAIGHT,DESK LENGTH/DESK LENGTH COMBO,TUBE STYLE ARMRESTARM134275 ARMPAD,ASSY,STRAIGHT,FULL LENGTH/FULL LENGTH COMBO,TUBE STYLE ARMRESTARM134280 ARMPAD,ASSY,STRAIGHT,FULL LENGTH RIGHT/DESK LENGTH LEFT COMBO,TUBE STYLE

ARMRESTARM134281 ARMPAD,ASSY,STRAIGHT,FULL LENGTH LEFT/DESK LENGTH RIGHT COMBO,TUBE STYLE

ARMRESTWaterfall, Armpad No Charge ARM130287 ARMPAD,ASSY,WATERFALL,DESK LENGTH/DESK LENGTH COMBO,TRU-BALANCE 3 ARMREST

ARM130238 ARMPAD,ASSY,WATERFALL,FULL LENGTH/FULL LENGTH COMBO,TRU-BALANCE 3 ARMREST

ARM130291 ARMPAD,ASSY,WATERFALL,FULL LENGTH RIGHT/DESK LENGTH LEFT COMBO,TRU-BALANCE 3 ARMREST

ARM130290 ARMPAD,ASSY,WATERFALL,FULL LENGTH LEFT/DESK LENGTH RIGHT COMBO,TRU-BALANCE 3 ARMREST

ARM130706 ARMPAD,ASSY,WATERFALL,DESK LENGTH RIGHT/STRAIGHT,DESK LENGTH LEFT COMBO,TRU-BALANCE 3 ARMREST

ARM130705 ARMPAD,ASSY,WATERFALL,DESK LENGTH LEFT/STRAIGHT,DESK LENGTH RIGHT COMBO,TRU-BALANCE 3 ARMREST

ARM130710 ARMPAD,ASSY,WATERFALL,DESK LENGTH RIGHT/STRAIGHT,FULL LENGTH LEFT COMBO,TRU-BALANCE 3 ARMREST

ARM130709 ARMPAD,ASSY,WATERFALL,DESK LENGTH LEFT/STRAIGHT,FULL LENGTH RIGHT COMBO,TRU-BALANCE 3 ARMREST

Page 4 of 7



ARM130704 ARMPAD,ASSY,WATERFALL,FULL LENGTH RIGHT/STRAIGHT,FULL LENGTH LEFT COMBO,TRU-BALANCE 3 ARMREST

ARM130349 ARMPAD,ASSY,WATERFALL,FULL LENGTH LEFT/STRAIGHT,FULL LENGTH RIGHT COMBO,TRU-BALANCE 3 ARMREST

ARM130708 ARMPAD,ASSY,WATERFALL,FULL LENGTH RIGHT/STRAIGHT,DESK LENGTH LEFT COMBO,TRU-BALANCE 3 ARMREST

ARM130707 ARMPAD,ASSY,WATERFALL,FULL LENGTH LEFT/STRAIGHT,DESK LENGTH RIGHT COMBO,TRU-BALANCE 3 ARMREST

ARM134282 ARMPAD,ASSY,WATERFALL,DESK LENGTH/DESK LENGTH COMBO,TUBE STYLE ARMREST

ARM134285 ARMPAD,ASSY,WATERFALL,FULL LENGTH/FULL LENGTH COMBO,TUBE STYLE ARMRESTARM134288 ARMPAD,ASSY,WATERFALL,FULL LENGTH RIGHT/DESK LENGTH LEFT COMBO,TUBE STYLE

ARMRESTARM134289 ARMPAD,ASSY,WATERFALL,FULL LENGTH LEFT/DESK LENGTH RIGHT COMBO,TUBE STYLE

ARMRESTARM134290 ARMPAD,ASSY,WATERFALL,DESK LENGTH RIGHT/STRAIGHT,DESK LENGTH LEFT COMBO,TUBE

STYLE ARMRESTARM134291 ARMPAD,ASSY,WATERFALL,DESK LENGTH LEFT/STRAIGHT,DESK LENGTH RIGHT COMBO,TUBE

STYLE ARMRESTARM134292 ARMPAD,ASSY,WATERFALL,DESK LENGTH RIGHT/STRAIGHT,FULL LENGTH LEFT COMBO,TUBE

STYLE ARMRESTARM134293 ARMPAD,ASSY,WATERFALL,DESK LENGTH LEFT/STRAIGHT,FULL LENGTH RIGHT COMBO,TUBE

STYLE ARMRESTARM134294 ARMPAD,ASSY,WATERFALL,FULL LENGTH RIGHT/STRAIGHT,FULL LENGTH LEFT COMBO,TUBE

STYLE ARMRESTARM134295 ARMPAD,ASSY,WATERFALL,FULL LENGTH LEFT/STRAIGHT,FULL LENGTH RIGHT COMBO,TUBE

STYLE ARMRESTARM134296 ARMPAD,ASSY,WATERFALL,FULL LENGTH RIGHT/STRAIGHT,DESK LENGTH LEFT COMBO,TUBE

STYLE ARMRESTARM134297 ARMPAD,ASSY,WATERFALL,FULL LENGTH LEFT/STRAIGHT,DESK LENGTH RIGHT COMBO,TUBE

STYLE ARMREST

Single Actuator Control, Through Toggle (Power Tilt Only) No Charge ELE130021 ELECTRONIC,ASSY,Q-LOGIC/NE PLUS,THRU HIGH POWER TOGGLE,W/MANUAL RECLINE,TRU-BALANCE 3

ELE130022 ELECTRONIC,ASSY,REMOTE PLUS/Q-LOGIC//VSI/VR2/NE+/NE,THRU HIGH POWER TOGGLE,TRU-BALANCE 3

ELE1611928 ELECTRONIC,ASSY,REMOTE PLUS/Q-LOGIC//VSI/VR2/NE+/NE,THRU HIGH POWER TOGGLE,W/MANUAL RECLINE,TRU-BALANCE 3

POWER POSITIONING ELECTRONICSSingle Actuator Control, Through NE+ 6-Key Joystick $1,895 ELE130739 ELECTRONIC,ASSY,NE PLUS,INDEPENDENT LEGS,TRU-BALANCE 3 SEAT,(CONFIGURATION # 01)

ELE130740 ELECTRONIC,ASSY,NE PLUS,COMBINED LEGS,TRU-BALANCE 3 SEAT,(CONFIGURATION # 02)

ELE130741 ELECTRONIC,ASSY,NE PLUS/Q-LOGIC THRU AM1,POWER ARTICULATING FOOT PLATFORM,TRU-BALANCE 3 SEAT,(CONFIGURATION # 03)

ELE130742 ELECTRONIC,ASSY,NE PLUS/Q-LOGIC THRU AM1,TRU-BALANCE 3 LIFT,(CONFIGURATION # 04)

ELE151798 ELECTRONIC,ASSY,NE PLUS/Q-LOGIC TRU-BALANCE 3 POWER ADJUSTABLE SEAT LIFT,(CONFIGURATION # 04)

ELE130744 ELECTRONIC,ASSY,NE PLUS/Q-LOGIC THRU AM1,TRU-BALANCE 3 POWER TILT(CONFIGURATION # 20)

ELE130746 ELECTRONIC,ASSY,NE PLUS,TRU-BALANCE 3 POWER TILT THRU JSTK W/MANUAL RECLINE,(CONFIGURATION # 20)

ELE130010 ELECTRONIC,ASSY,NE PLUS,TRU-BALANCE 3 POWER RECLINE,RECLINE ONLY,(CONFIGURATION # 08)

POWER POSITIONING ELECTRONICS : Tilt Only through Toggle (Power Tilt Only)

Page 5 of 7



Two Actuator Control, Through NE+ 6-Key Joystick $2,895 ELE130743 ELECTRONIC,ASSY,NE PLUS,TRU-BALANCE 3 LIFT/POWER ARTICULATING FOOT PLATFORM,(CONFIGURATION # 07)

ELE151800 ELECTRONIC,ASSY,NE PLUS,TRU-BALANCE 3 POWER ADJUSTABLE SEAT LIFT/POWER ARTICULATING FOOT PLATFORM,(CONFIGURATION # 07)

ELE130747 ELECTRONIC,ASSY,NE PLUS,TRU-BALANCE 3 POWER TILT,AFP,THRU JOYSTICK,(CONFIGURATION # 23)

ELE130011 ELECTRONIC,ASSY,NE PLUS,TRU-BALANCE 3 POWER RECLINE,RECLINE/POWER AFP,W/INDEPENDENTLY CONTROLLED POWER AFP,(CONFIGURATION # 11)

ELE130023 ELECTRONIC,ASSY,NE PLUS,TRU-BALANCE 3 LIFT & TILT,THRU JOYSTICK,(CONFIGURATION # 24)

ELE151802 ELECTRONIC,ASSY,NE PLUS,TRU-BALANCE 3 POWER ADJUSTABLE SEAT LIFT & TILT,THRU JOYSTICK,(CONFIGURATION # 24)

ELE130012 ELECTRONIC,ASSY,NE PLUS,TRU-BALANCE 3 LIFT & RECLINE,(CONFIGURATION # 14)ELE151804 ELECTRONIC,ASSY,NE PLUS,TRU-BALANCE 3 POWER ADJUSTABLE SEAT LIFT &

RECLINE,(CONFIGURATION # 14)ELE130008 ELECTRONIC,ASSY,NE PLUS,TRU-BALANCE 3 POWER TILT &

RECLINE,TILT/RECLINE,(CONFIGURATION # 28)LEGRESTS : 60-90 Swing-Away LegrestsP: 11"-13" Length No Charge FRMASMB8053 FOOTREST,ASSY,S/A #8,LOWER EXTENSION,11"-13",C-1010-179P: 11"-13" Length FRMASMB10557 LEGREST,ASSY,LOWER EXTENSION,11"-13",ANGLE ADJUSTABLE,LONG,PAIR

P: 11"-13" Length FRMASMB10558 LEGREST,ASSY,LOWER EXTENSION,11"-13",ANGLE ADJUSTABLE,SHORT,PAIR

L: 11"-13" Length RIG136570 LEGREST,ASSY,S/A #8,LOWER EXTENSION,11"-13",LEFTL: 11"-13" Length FRMASMB10014 LEGREST,ASSY,LOWER EXTENSION,11"-13",ANGLE ADJUSTABLE,LONG,LEFT,E-1010-655L: 11"-13" Length FRMASMB10016 LEGREST,ASSY,LOWER EXTENSION,11"-13",ANGLE ADJUSTABLE,SHORT,LEFT,E-1010-656

R: 11"-13" Length RIG136571 LEGREST,ASSY,S/A #8,LOWER EXTENSION,11"-13",RIGHTR: 11"-13" Length FRMASMB10015 LEGREST,ASSY,LOWER EXTENSION,11"-13",ANGLE ADJUSTABLE,LONG,RIGHT,E-1010-657

R: 11"-13" Length FRMASMB10017 LEGREST,ASSY,LOWER EXTENSION,11"-13",ANGLE ADJUSTABLE,SHORT,RIGHT,E-1010-658

P: 11"-16.5" Length FRMASMB9159 LEGREST,ASSY,MULTI-AXIS LOWER,11"-16.5" EXT,LONG,PAIRP: 11"-16.5" Length FRMASMB9168 LEGREST,ASSY,MULTI-AXIS LOWER,11"-16.5" EXT,SHORT,PAIRL: 11"-16.5" Length FRMASMB9160 LEGREST,ASSY,MULTI-AXIS LOWER,11"-16.5" EXT,LONG,LEFT,E-1010-641L: 11"-16.5" Length FRMASMB9169 LEGREST,ASSY,MULTI-AXIS LOWER,11"-16.5" EXT,SHORT,LEFT,E-1010-642R: 11"-16.5" Length FRMASMB9161 LEGREST,ASSY,MULTI-AXIS LOWER,11"-16.5" EXT,LONG,RIGHT,E-1010-643R: 11"-16.5" Length FRMASMB9170 LEGREST,ASSY,MULTI-AXIS LOWER,11"-16.5" EXT,SHORT,RIGHT,E-1010-644P: 13"-16" Length FRMASMB7844 FOOTREST,ASSY,S/A #8,LOWER EXTENSION,13"-16.5",E-1010-415P: 13"-16" Length FRMASMB10559 LEGREST,ASSY,LOWER EXTENSION,13"-16.5",ANGLE ADJUSTABLE,LONG,PAIR

P: 13"-16" Length FRMASMB10560 LEGREST,ASSY,LOWER EXTENSION,13"-16.5",ANGLE ADJUSTABLE,SHORT,PAIR

L: 13"-16" Length RIG133473 LEGREST,ASSY,S/A #8,LOWER EXTENSION,13"-16.5",LEFTL: 13"-16" Length FRMASMB10018 LEGREST,ASSY,LOWER EXTENSION,13"-16.5",ANGLE ADJUSTABLE,LONG,LEFT,E-1010-659

L: 13"-16" Length FRMASMB10020 LEGREST,ASSY,LOWER EXTENSION,13"-16.5",ANGLE ADJUSTABLE,SHORT,LEFT,E-1010-660

R: 13"-16" Length RIG133476 LEGREST,ASSY,S/A #8,LOWER EXTENSION,13"-16.5",RIGHTR: 13"-16" Length FRMASMB10019 LEGREST,ASSY,LOWER EXTENSION,13"-16.5",ANGLE ADJUSTABLE,LONG,RIGHT,E-1010-661

Page 6 of 7



R: 13"-16" Length FRMASMB10021 LEGREST,ASSY,LOWER EXTENSION,13"-16.5",ANGLE ADJUSTABLE,SHORT,RIGHT,E-1010-662

P: 15.5"-19.5" Length FRMASMB7845 FOOTREST,ASSY,S/A #8,LOWER EXTENSION,15.5"-19.5",E-1010-381P: 15.5"-19.5" Length FRMASMB10561 LEGREST,ASSY,LOWER EXTENSION,15.5"-19.5",ANGLE ADJUSTABLE,LONG,PAIRP: 15.5"-19.5" Length FRMASMB10562 LEGREST,ASSY,LOWER EXTENSION,15.5"-19.5",ANGLE ADJUSTABLE,SHORT,PAIRP: 15.5"-19.5" Length FRMASMB9162 LEGREST,ASSY,MULTI-AXIS LOWER,15.5"-19.5" EXT,LONG,PAIRP: 15.5"-19.5" Length FRMASMB9171 LEGREST,ASSY,MULTI-AXIS LOWER,15.5"-19.5" EXT,SHORT,PAIRL: 15.5"-19.5" Length RIG133474 LEGREST,ASSY,S/A #8,LOWER EXTENSION,15.5"-19.5",LEFTL: 15.5"-19.5" Length FRMASMB10022 LEGREST,ASSY,LOWER EXTENSION,15.5"-19.5",ANGLE ADJUSTABLE,LONG,LEFT,E-1010-663

L: 15.5"-19.5" Length FRMASMB10024 LEGREST,ASSY,LOWER EXTENSION,15.5"-19.5",ANGLE ADJUSTABLE,SHORT,LEFT,E-1010-664

L: 15.5"-19.5" Length FRMASMB9163 LEGREST,ASSY,MULTI-AXIS LOWER,15.5"-19.5" EXT,LONG,LEFT,E-1010-487L: 15.5"-19.5" Length FRMASMB9172 LEGREST,ASSY,MULTI-AXIS LOWER,15.5"-19.5" EXT,SHORT,LEFT,E-1010-645R: 15.5"-19.5" Length RIG133477 LEGREST,ASSY,S/A #8,LOWER EXTENSION,15.5"-19.5",RIGHTR: 15.5"-19.5" Length FRMASMB10023 LEGREST,ASSY,LOWER EXTENSION,15.5"-19.5",ANGLE ADJUSTABLE,LONG,RIGHT,E-1010-665

R: 15.5"-19.5" Length FRMASMB10025 LEGREST,ASSY,LOWER EXTENSION,15.5"-19.5",ANGLE ADJUSTABLE,SHORT,RIGHT,E-1010-666

R: 15.5"-19.5" Length FRMASMB9164 LEGREST,ASSY,MULTI-AXIS LOWER,15.5"-19.5" EXT,LONG,RIGHT,E-1010-488R: 15.5"-19.5" Length FRMASMB9173 LEGREST,ASSY,MULTI-AXIS LOWER,15.5"-19.5" EXT,SHORT,RIGHT,E-1010-646LEGRESTS : Elevating LegrestsP: 12"-14.5" Length No Charge FRMASMB4752 LEGREST,ASSY,ANGLE ADJUSTABLE LOWER,12"-14.5" EXT,PAIRP: 12"-14.5" Length FRMASMB7922 LEGREST,ASSY,ANGLE ADJUSTABLE,LOWER,12"-14.5" EXT,FOR SHORT BLOCK,PAIRL: 12"-14.5" Length FRMASMB5391 LEGREST,ASSY,ANGLE ADJUSTABLE,LOWER,12"-14.5" EXT,LEFT,C-1000-340L: 12"-14.5" Length FRMASMB6279 LEGREST,ASSY,ANGLE ADJUSTABLE,LOWER,12"-14.5" EXT,FOR SHORT BLOCK,LEFT,C-1000-353

R: 12"-14.5" Length FRMASMB4723 LEGREST,ASSY,ANGLE ADJUSTABLE,LOWER,12"-14.5" EXT,RIGHT,C-1000-287R: 12"-14.5" Length FRMASMB5136 LEGREST,ASSY,ANGLE ADJUSTABLE,LOWER,12"-14.5" EXT,FOR SHORT BLOCK,RIGHT,C-1000-318

P: 14.5"-18" Length FRMASMB4753 LEGREST,ASSY,ANGLE ADJUSTABLE,LOWER,14.5"-18" EXT,PAIRP: 14.5"-18" Length FRMASMB7923 LEGREST,ASSY,ANGLE ADJUSTABLE,LOWER,14.5"-18" EXT,FOR SHORT BLOCK,PAIRL: 14.5"-18" Length FRMASMB4724 LEGREST,ASSY,ANGLE ADJUSTABLE,LOWER,14.5"-18" EXT,LEFT,C-1000-288L: 14.5"-18" Length FRMASMB6280 LEGREST,ASSY,ANGLE ADJUSTABLE,LOWER,14.5"-18" EXT,FOR SHORT BLOCK,LEFT,C-1000-354

R: 14.5" -18" Length FRMASMB5392 LEGREST,ASSY,ANGLE ADJUSTABLE,LOWER,14.5"-18" EXT,RIGHT,C-1000-341R: 14.5" -18" Length FRMASMB5137 LEGREST,ASSY,ANGLE ADJUSTABLE,LOWER,14.5"-18" EXT,FOR SHORT BLOCK,RIGHT,C-1000-319

LEGRESTS : 60-90 Swing-Away Legrest AccessoriesWheel Bumper $12.50 ea WHL133585 WHEEL,ASSY,BUMPER,ANGLE ADJUSTABLE FOOTPLATE,LEFT

WHL133587 WHEEL,ASSY,BUMPER,S/A #8 EXTRUDED FOOTPLATE,LEFT WHL169510 WHEEL,ASSY,BUMPER,PEDIATRIC ANGLE ADJUSTABLE FOOTPLATE,LEFTWHL133586 WHEEL,ASSY,BUMPER,ANGLE ADJUSTABLE FOOTPLATE,RIGHT WHL133589 WHEEL,ASSY,BUMPER,S/A #8 EXTRUDED FOOTPLATE,RIGHT WHL169511 WHEEL,ASSY,BUMPER,PEDIATRIC ANGLE ADJUSTABLE FOOTPLATE,RIGHTWHLASMB1578 WHEEL,ASSY,BUMPER,ANGLE ADJUSTABLE FOOTPLATE WHLASMB1727 WHEEL,ASSY,BUMPER,S/A #8 EXTRUDED FOOTPLATE WHL169508 WHEEL,ASSY,BUMPER,PEDIATRIC,ANGLE ADJUSTABLE FOOTPLATE

LEGRESTS : Elevating Legrest AccessoriesWheel Bumper $12.50 ea WHL133585 WHEEL,ASSY,BUMPER,ANGLE ADJUSTABLE FOOTPLATE,LEFT

WHL133586 WHEEL,ASSY,BUMPER,ANGLE ADJUSTABLE FOOTPLATE,RIGHT WHLASMB1578 WHEEL,ASSY,BUMPER,ANGLE ADJUSTABLE FOOTPLATE WHL169508 WHEEL,ASSY,BUMPER,PEDIATRIC,ANGLE ADJUSTABLE FOOTPLATE

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j6 with tru-balance 3 positioning order form · infinfb3950/reva/01ma2018 page 1 of 14 j6 with...

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