quantum q6 edge hd light rehab seating order form · deep purple lime light grey street midnight...
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Page 1 of 13INFINFB3573/RevG/02JUL2018
Q6 Edge® HD Order Form with Contoured and Synergy Seating
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 3 power base. 450 lb. weight capacity with standard 4.7 mph programmable motors, 8 amp off board charger, and unoccupied transit loops. Dimensions of base without legrests: 26”Wx36.75”L.
Quantum Q6 Edge 3HD-SS .............................................$8,595Part: Q6 EDGEHD 3HD-SS. HCPCS: K0850Solid seat pan standard with no power option.
Quantum Q6 Edge 3HD-C ..............................................$8,595Part: Q6 EDGEHD 3HD-C. HCPCS: K0851Contoured Seat (Captain) Standard.
Page 2 of 13INFINFB3573/RevG/02JUL2018
Base Mounted Foot Platform ...................................... StandardPart: FRMASMB16077
Base Mounted, Bell Shaped Foot Platform ................... No ChargePart: RIGASMB7120041
Omit base mounted foot platform ............................. No ChargePart: PTOINDV3674
3" x 14” Run Flat Tires .............................................. StandardPart: PTOINDV3510
3" x 14” Flat Free Tires ........................................... No ChargePart: WHL124116 x2
3" x 14” Pneumatic Tires ......................................... No ChargePart: WHL124117 x2
4”W Flat Free, Knobby, Extended ........................... $275.50 ea.Traction TiresPart: WHL121698 x2
4”W Pneumatic, Knobby, Extended ......................... $275.50 ea.Traction TiresPart: WHL121703 x2
Account Number: ___________ Date: ________________ Marked for: _____________________________________2. BASE COLORREQUIRED. Select one shroud color. Colors shown here may differ from actual product depending on monitor/printer calibration used.
Red CorvettePart: DGN169178-PRD1
Electric BluePart: DGN169178-PBU9
Back in BlackPart: DGN169178-PBK1
White SatinPart: DGN169178-PWT2
Pretty in PinkPart: DGN169178-PPK3
Deep PurplePart: DGN169178-PPR5
Lime LightPart: DGN169178-PGN7
Grey StreetPart: DGN169178-PSL3
Silver BulletPart: DGN169178-PSL7
Midnight BluePart: DGN169178-PBU10
Orange CrushPart: DGN169178-POR6
Yellow BlazePart: DGN169178-PYL3
Military GreenPart: DGN169178-PGN8
To Be DeterminedPart: N/A
3. BASE MOUNTED FOOT PLATFORMREQUIRED. Select a foot platform option. May interfere with seat mounted legrests.
4. DRIVE WHEELSREQUIRED. Select a type of drive wheels and accent color. Knobby tires increase overall base width by 1.5”.
4.2. Drive Wheel Accent ColorOptional. Not available with knobby tires. Sold in Pairs (parts below will be quantity of 2).
4.1. Drive Wheels
Match to Base ColorPart: Configuration selection, see specific part below
Non-matching ColorPart: Configuration selection, see specific part below
Back in Black ........................ $24.98 ea.Part: DGN164245-PBK1 x2
Red Corvette ........................ $24.98 ea.Part: DGN164245-PRD1 x2
Electric Blue ........................ $24.98 ea.Part: DGN164245-PBU9 x2
White Satin .......................... $24.98 ea.Part: DGN164245-PWH2 x2
Pretty in Pink ....................... $24.98 ea.Part: DGN164245-PPK3 x2
Deep Purple ......................... $24.98 ea.Part: DGN164245-PPR5 x2
Lime Light ........................... $24.98 ea.Part: DGN164245-PGN7 x2
Grey Street .......................... $24.98 ea.Part: DGN164245-PSL3 x2
Silver Bullet ......................... $24.98 ea.Part: DGN164245-PSL7 x2
Midnight Blue ....................... $24.98 ea.Part: DGN164245-PBU10 x2
Orange Crush ....................... $24.98 ea.Part: DGN164245-POR6 x2
Yellow Blaze ......................... $24.98 ea.Part: DGN164245-PYL3 x2
Military Green ...................... $24.98 ea.Part: DGN164245-PGN8 x2
To Be DeterminedFollow-up required.
7. FENDER LIGHTSOptional. Fender lights operate by pressing included single switch button. Fender lighting is not available with NE 4-Key Joystick or Single Actuator Control through Toggle Box.
5. POWER BASE CONFIGURATION FOR CONTOURED SEAT, SEAT TO FLOORREQUIRED with contoured seating.
6. OCCUPIED TRANSIT, WC-19Optional. Synergy Seating only with widths 20" to 24".
Fender Light Switch Mount TypeSide Rail/Track Mount Bracket .................................. No ChargePart: MEC1800866Allows the egg switch to be mounted to seating side rails using a t-nut assembly. This may also be mounted to TRU-Balance 3 flip-back arm-rest and other seat or accessory bar rails. Not available with con-toured seating.
Under Armrest Mounting Bracket ......................................$25*Part: MEC1802726*No charge with contoured seating. Allows the egg switch to mount to a joystick tube-style bracket mounted to any armrest. Includes joystick mounting bracket.
8. FULL LIGHT PACKAGEOptional. Not available with contoured seating. Requires NE+ 8 Key or Q-Logic 3 Joystick for Full Light Package.
Switch Fender Lights ......................................................................................................................................................$250Part: DGN154117
Lowest Seat to FloorPart: PTOINDV3558
Middle Seat to FloorPart: PTOINDV3559
High Seat to FloorPart: PTOINDV3560
WC-19 Occupied Transit Option ........................................ $275Part: KITASMB1830
To determine if your chair is WC-19 compliant (occupied), please re-fer to this website: http://wc-transportation-safety.umtri.umich.edu/crash-tested-product-lists/wheelchairs
Seat Mounted, LED, Full Light Package ...............................................................................................................................$995Part: ELE131477
Page 3 of 13INFINFB3573/RevG/02JUL2018
Account Number: ___________ Date: ________________ Marked for: _____________________________________
NE+ 6 Key Joystick
NE 4-Key Joystick ....................................StandardPart: CTLDC1554No actuator control.
NE+ 6-Key Joystick (2 Actuators) .....................$200Part: CTLDC1560Control up to 2 actuators through joystick.
NE+ 8-Key Joystick (2 Actuators) ......................$400Part: CTLDC1561Control up to 2 actuators and LED, Full Light Package through joystick.
No Joystick, Setup for NE+ Joystick ...........No ChargePart: Configuration selection
Q-Logic 3 EX Controller Module .......................$695Part: See XRef. HCPCS: E2377
Q-Logic 3 Expandable Controller ......................$425Harness Part: HAR144005. HCPCS: E2313
Q-Logic 3 EX Joystick .................................................... $700Part: CTL167724
Q-Logic 3 EX Joystick for LED, Full Light Package ................. $700Part: CTL167725
No Joystick, Setup for Q-Logic 3Part: Configuration selection.
Black, Soft Touch ....................StandardPart: DGN124307
Non-matching Shroud ......................$50Part: PTOINDV3422Select color below
Match Shroud ................................$50Part: PTOINDV3421
Red CorvettePart: DGN124336-PRD1
Electric BluePart: DGN124336-PBU9
Back in BlackPart: DGN124336-PBK1
White SatinPart: DGN124336-PWH2
Pretty in PinkPart: DGN124336-PPK3
Deep PurplePart: DGN124336-PPR5
Lime LightPart: DGN124336-PGN7
Grey StreetPart: DGN124336-PSL3
Silver BulletPart: DGN124336-PSL7
Midnight BluePart: DGN124336-PBU10
Orange CrushPart: DGN124336-POR6
Yellow BlazePart: DGN124336-PYL3
Q-Logic 3 EX Joystick
9.1a. Non-Expandable ControlsSelect a joystick below or omit selection if another controller type is desired. Non-expandable does not allow supplementary drive controllers.
1. Q-Logic 3 Required ComponentsQ-Logic 3 expandable controls require the controller module and expandable harness below. If a Q-Logic joystick or specialty control is selected later in this form, Customer Service will quote the order with these items.
9.1b. Expandable Controls - Quantum Intelligent Systems™Select expandable controls or omit selection if another controller type is desired. Expandable controls allow multiple or specialized controllers.
2. Q-Logic 3 Joystick
3. Q-Logic 3 Joystick ArmorREQUIRED with Q-Logic 3 EX Joystick selection above. Reference colors shown in section 2.
9.2. SCIM ModuleOptional.
SCIM Module Kit for Q-Logic 3......................................................................................................... $525Part: CTL168055Allows use of joystick display for specialty devices. Available with Q-Logic 3 EX Joystick selection above. Up to 5 profiles to control drive, seat, and auxiliary functions, excluding sip-n-puff and single switch functions. A switch is required to operate the input device attached to the SCIM module. SCIM Module
10. JOYSTICK HANDLESOptional. The NE/NE Plus joysticks are standard with a carrot handle (See A in image). The standard Q-Logic 3 joystick knob can be seen in the image in section 7.1b. 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 3 Carrot Handle (A) .....................No ChargePart: DGN124308
9. ELECTRONICSREQUIRED. Select a type of drive control from the following sections. The No Joystick option is used to omit the joystick and utilize another control, such as a specialty control at the end of this form or found on the Alternative Controls and Electronics Order Forms.
Page 4 of 13INFINFB3573/RevG/02JUL2018
Account Number: ___________ Date: ________________ Marked for: _____________________________________
Omit Joystick Mounting Bracket
Fixed, In-line, Bracket .............................................. StandardQ-Logic Part: FRMASMB10617. NE/NE+ Part: FRMASMB12744
Left Side MountPart: PTOINDV1225
Right Side MountPart: PTOINDV1226
Swing-away, Inline, Left Side Mount ..................$245Part: See XRef. HCPCS: E1028
Swing-away, Inline, Right Side Mount ................$245Part: See XRef. HCPCS: E1028
Swing-away, 1” Offset, Left Side Mount .............$245Part: See XRef. HCPCS: E1028
Swing-away, 1” Offset, Right Side Mount ............$245Part: See XRef. HCPCS: E1028
Left Side MountPart: PTOINDV1225
Right Side MountPart: PTOINDV1226
11.1b. 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 track/TRU-Balance 3 style 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.
11.1a. Fixed, In-line Joystick Bracket
11. JOYSTICK MOUNTING BRACKETSOptional. Select a mount to be used with a joystick selected in previous section.
11.1c. Specialty Joystick MountsSelect a bracket and side to mount it.
Specialty Mount Side
Retract4 Mount ............................................$350NE/NE+ Part: MEC138876. HCPCS: E1028Q-Logic Part: MEC138860. 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: E1028Q-Logic Part: ACC131216. HCPCS: E1028Allows height adjustment of joystick.
Stealth Swing-Away/Flip Down Bracket ........... $294.25SAJ Part: ST-TWBM480CJ-Q. HCPCS: E1028Q-Logic Part: ST-TWBM480QL-Q. HCPCS: E1028Not available with contoured seat. Allows the joystick to pivot to side of armrest, or flip-down if bracket is ad-justed.
Swing Away JoystickInline Mount (Right)
Swing Away JoystickOffset Mount (Right)
Multi-Axis JoystickMount
Retract4
Swing-Away/Flip DownBracket (Stand Alone
Hardware Shown)
12. ELECTRONICS ACCESSORIESOptional.
Q-Logic EX/NE Programmer ............................................ $545Part: ELEASMB6976
Q-Logic PC Programming Disk with Cable ........................... $750Part: ELEASMB5216
20”Wx16”D .......................... No ChargePart: SETASMB2780
20”Wx22”D ......................... No ChargePart: SETASMB4889
20”Wx24”D ......................... No ChargePart: SETASMB2380
22”Wx16”D .......................... No ChargePart: SETASMB2381
22”Wx18”D .......................... No ChargePart: SETASMB2171
22”Wx20”D ......................... No ChargePart: SETASMB2382
22”Wx22”D ......................... No ChargePart: SETASMB2383
22”Wx24”D ......................... No ChargePart: SETASMB2384
24”Wx16”D .......................... No ChargePart: SETASMB2385
24”Wx18”D .......................... No ChargePart: SETASMB2386
24”Wx20”D ......................... No ChargePart: SETASMB2387
24”Wx22”D ......................... No ChargePart: SETASMB2388
24”Wx24”D ......................... No ChargePart: SETASMB2389
20”Wx18”-20”D with 60" Lap Belt ............................. No ChargePart: SETASMB6896
22”Wx20”-22”D with 70" Lap Belt ............................. No ChargePart: SETASMB6897
13. CONTOURED SEATINGOptional. Select only one seating system. Special order seat sizes can be requested by checking the seat type and writing in the seat size in the special order seat size.
13.1a. Captain Style Seating1a. Depth Adjustable High Back with Limited Recline Full length armrests must be selected with a depth adjustable high back.
1b. High Back with Limited Recline
1c. Pinchless Hinge High Back
1d. Heavy Duty High BackSeat includes a lumber cutout, static hinges, and a Synergy Seat frame.
26”Wx18”D .................................$450Part: SETASMB4565
26”Wx20”D.................................$450Part: SETASMB4566
26”Wx22”D .................................$450Part: SETASMB4567
26”Wx24”D .................................$450Part: SETASMB4568
26”Wx26”D .................................$450Part: SETASMB4569
26”Wx28”D .................................$450Part: SETASMB4570
28”Wx18”D .................................$450Part: SETASMB4571
28”Wx20”D ................................$450Part: SETASMB4572
28”Wx22”D ................................$450Part: SETASMB4573
28”Wx24”D ................................$450Part: SETASMB4574
28”Wx26”D .................................$450Part: SETASMB4575
28”Wx28”D ................................$450Part: SETASMB4576
Contoured seating section continued on following page.
Page 5 of 13INFINFB3573/RevG/02JUL2018
Account Number: ___________ Date: ________________ Marked for: _____________________________________
20”Wx24”D ......................... No ChargePart: SETASMB2982
22”Wx16”D .......................... No ChargePart: SETASMB2983
22”Wx18”D .......................... No ChargePart: SETASMB2984
22”Wx20”D ......................... No ChargePart: SETASMB2985
22”Wx22”D ......................... No ChargePart: SETASMB2986
22”Wx24”D ......................... No ChargePart: SETASMB2987
24”Wx16”D .......................... No ChargePart: SETASMB2988
24”Wx18”D .......................... No ChargePart: SETASMB2989
24”Wx20”D ......................... No ChargePart: SETASMB2990
24”Wx22”D ......................... No ChargePart: SETASMB2991
24”Wx24”D ......................... No ChargePart: SETASMB2992
13.1b. Contoured Seat with Solid Seat Pan1a. High Back with Limited Recline and Solid Seat Pan
1b. Pinchless Hinge High Back with Solid Seat Pan
20”Wx16”D .......................... No ChargePart: SETASMB3183
20”Wx18”D .......................... No ChargePart: SETASMB3184
20”Wx20”D ......................... No ChargePart: SETASMB3185
20”Wx22”D ......................... No ChargePart: SETASMB5008
26”Wx18”D ............................... $1000Part: SETASMB5478
26”Wx20”D............................... $1000Part: SETASMB5479
26”Wx22”D ............................... $1000Part: SETASMB5480
26”Wx24”D ............................... $1000Part: SETASMB5481
26”Wx26”D ............................... $1000Part: SETASMB5482
26”Wx28”D ............................... $1000Part: SETASMB5483
28”Wx18”D ............................... $1000Part: SETASMB8484
28”Wx20”D .............................. $1000Part: SETASMB8485
28”Wx22”D .............................. $1000Part: SETASMB8486
28”Wx24”D .............................. $1000Part: SETASMB5487
28”Wx26”D ............................... $1000Part: SETASMB5488
28”Wx28”D .............................. $1000Part: SETASMB5489
1c. Heavy Duty High Back with Solid Seat PanSeat includes a lumber cutout, static hinges, and a Synergy Seat frame.
2. Armpads for Bariatric/Heavy Duty ArmrestsRequired with bariatric or heavy duty armrests
1. Bariatric/Heavy Duty Armrests
13.1c. Special Order Contoured SeatComplete information below. Contact inside sales specialist for pricing.
Depth:______Width:______Type of Seat:____________________________________________________
13.2. Contoured Seat Flip-Up, Height Adjustable, Removable ArmrestsREQUIRED and only available with non-heavy duty, High-Back seat. Depth Adjustable High-Back must select full length armrests. Select a Left and Right Armrest or to Omit them.
13.3. Heavy Duty, Contoured Seat, Removable ArmrestsREQUIRED and only available with heavy duty High-Back seats. Select armrests and armpads. Heavy duty armrests are sold in pairs.
Full Length, Left Armrest .................................................$85Part: FRMASMB8614. HCPCS: E0973
Desk Length, Left Armrest ................................................$85Part: FRMASMB8612. HCPCS: E0973
No Armrest ............................................................ StandardPart: N/A
Full Length, Right Armrest ................................................$85Part: FRMASMB8615. HCPCS: E0973
Desk Length, Right Armrest ..............................................$85Part: FRMASMB8613. HCPCS: E0973
Bariatric, HD, Height Adjustable, Full Length, ............... StandardRemovable 8"H-12"HLeft part: FRMASMB6728. Right part: FRMASMB6729
Bariatric, HD, Height Adjustable, Full Length, ................ StandardRemovable 10"H-14"HLeft part: FRMASMB6730. Right part: FRMASMB6731
Heavy Duty, Height Adjustable, Full Length, ...................$85 ea.Removable 8"H-12"HLeft part: FRMASMB9982. Right part: FRMASMB9983. HCPCS: E0973
Heavy Duty, Height Adjustable, Full Length, ...................$85 ea.Removable 10"H-14"HLeft part: FRMASMB9986. Right part: FRMASMB9987. HCPCS: E0973
Bariatric Armpads ................................................. No ChargePart: UPSASMB1027Only for use with Bariatric Armrests.
No Armpad .......................................................... No ChargePart: N/A
Straight Armpads ................................................... No ChargePart: UPSASMB1021Only for use with Heavy Duty Armrests
Waterfall Armpads ................................................. No ChargePart: UPSASMB1024Only for use with Heavy Duty Armrests
14. SYNERGY SEATING SYSTEMOptional. Widths, depths, and heights are available in 1" increments in the noted ranges. Maximum seat size 28"W x 32"D.
14.1. Synergy Frame Selection
14.2. Seat Dimension - WidthREQUIRED with Synergy seating. Part number is SETWDTH plus number following # below.
Synergy Seating Frame ...................................................................................................................................................$434Part: PTOINDV2995
20” Wide(#1010)
21” Wide(#1011)
22” Wide(#1012)
23” Wide(#1013)
24” Wide(#1014)
25” Wide(#1056)
26” Wide(#1054)
27” Wide(#1057)
28” Wide(#1055)
Synergy seating section continued on following page.
13. CONTOURED SEATING continued
Page 6 of 13INFINFB3573/RevG/02JUL2018
Account Number: ___________ Date: ________________ Marked for: _____________________________________
14.3. Seat Dimension - Width PackageREQUIRED with Synergy seating.
20”-24” Width PackagePart: MEC120262
24”-26” Width PackagePart: MEC120263
26”-28” Width PackagePart: MEC120264
14.5. Seat Dimension - Depth PackageREQUIRED with Synergy seating.
14.4. Seat Dimension - DepthREQUIRED with Synergy seating. Part number is SETDPTH plus number following # below.
15”-20” Depth PackagePart: FRMASMB7732
20”-24” Depth PackagePart: FRMASMB7733
24”-28” Depth PackagePart: FRMASMB6605
15” Deep(#1005)
16” Deep(#1006)
17” Deep(#1007)
18” Deep(#1008)
19” Deep(#1009)
20” Deep(#1010)
21” Deep(#1011)
22” Deep(#1012)
23” Deep(#1013)
24” Deep(#1014)
25” Deep(#1060)
26” Deep(#1061)
27” Deep(#1062)
28” Deep(#1063)
14.6. Synergy Back OptionsREQUIRED with Synergy seating. See the Synergy and TRU-Comfort back availability chart for stock order back size ranges. Back widths larger or smaller than seat widths on the availablity chart are allowed with endomorph or mesomorph back canes.1. Back Selection
Synergy Back ............................................................... $275Part: See XRefSelect a back cane type and height and back height.
TRU-Comfort 4-way Stretch, 20” Width or less .................... $675Part: See XRef. HCPCS: E2620Select back height.
TRU-Comfort 4-way Stretch, 22” Width or greater ............... $775Part: See XRef. HCPCS: E2621Select back height.
HD Sling Back ................................................................$98Part: See XRefSelect a back height. Available with 24"-28" Width and 18"-25" overall heights. Back cane height must match back height. Not available with flip up cantilever arms.
Omit Back ............................................................ No ChargePart: PTOINDV1287Select a back cane type and height in following section.
Back Width
Synergy and TRU-Comfort Back Availability Chart
Ove
rall
Hei
ght
Synergy Back Synergy/TRU-Comfort BackTRU-Comfort Back
2. Back Cane Selection
3. Synergy Push HandlesPush Handles .......................................................... StandardPart: Configuration selection with back cane height
Back Canes without Push Handles (pair) .....................$62.50 ea.Part: Configuration selection with back cane heightNot available with Sling Back. Minimum cane height is 16".
Synergy Back Cane ................................................ No ChargePart: FRMASMB15844. Sling part: FRMASMB17096. Transit Part: FRMASMB15845Select a back cane height. Back width will be the same as seat width.
2” Mesomorph (1” per side) Back Cane ...............................$195Part: FRMASMB16387. Transit part: FRMASMB12067 Select a cane height. Back width will be 2" larger than seat width.
4” Mesomorph (2” per side) Back Cane ...............................$195Part: FRMASMB16390. Transit part: FRMASMB12091Select a cane height. Back with will be 4" larger than seat width.
2” Endomorph (1” per side) Back Cane ...............................$195Part: FRMASMB16393. Transit part: FRMASMB12115Select a cane height. Back width will be 2" smaller than seat width.
4” Endomorph (2” per side) Back Cane ...............................$195Part: FRMASMB16396. Transit part: FRMASMB12139Select a cane height. Back width will be 4" smaller than seat width.
5. Synergy Overall Back HeightRefer to the Synergy and TRU-Comfort back availability chart for stock order back size ranges. Parts: See XRef, configuration selection with back selection.
4. Synergy Accessory BarAccessory Bar ............................................................................................................................................................... $10012"W-16"W Part: MEC145955. 16"W-20"W Part: MEC143975. 20"W-22"W Part: MEC146018
17” H 18” H 19” H 20” H 21” H 22” H 23” H 24” H 25” H 27” H 28” H
Synergy seating section continued on following page.
14. SYNERGY SEATING SYSTEM continued
Page 7 of 13INFINFB3573/RevG/02JUL2018
Account Number: ___________ Date: ________________ Marked for: _____________________________________
14.7. Synergy ArmrestsREQUIRED with Synergy seating. Left (L) and right (R) boxes may be checked to configure different size arms within one section arm type.
6. Synergy Back Cane HeightOmit this selection if a TRU-Comfort back is selected. 16" and 17" back canes are not available with a Synergy Back and cane mounted, flip up armrests. 14" and 15" back canes are not available without push handles. Parts: See XRef, configuration selection with push handles selection.
14” High Canes15” High Canes
16” High Canes17” High Canes
18” High Canes19” High Canes
20” High Canes21” High Canes
22” High Canes23” High Canes
24” High Canes25” High Canes
Full Length, Heavy Duty Armrests, 8"-12" H ................$85 ea.Left part: FRMASMB9982. Right part: FRMASMB9983.HCPCS: E0973
Desk Length, Heavy Duty Armrests, 8"-12"H ................$85 ea.Left part: FRMASMB9984. Right part: FRMASMB9985.HCPCS: E0973
Full Length, Bariatric Armrests, 8"-12" H ................ No ChargeLeft part: FRMASMB6728. Right part: FRMASMB6729
Full Length, Bariatric Armrests, 10"-14"H ............... No ChargeLeft part: FRMASMB6730. Right part: FRMASMB6731.
Full Length, Heavy Duty Armrests, 10"-14"H ................$85 ea.Left part: FRMASMB9986. Right part: FRMASMB9987.HCPCS: E0973
Desk Length, Heavy Duty Armrests, 10"-14"H ..............$85 ea.Left part: FRMASMB9988. Right part: FRMASMB9989.HCPCS: E0973
Full Length, Cantilever Armrests .......................... $97.50 ea.Left part: FRMASMB16188. Right part: FRMASMB16189
Desk Length, Cantilever Armrests ......................... $97.50 ea.Left part: FRMASMB16190. Right part: FRMASMB16191
1a. Bariatric, Single Post, Heavy Duty, Height Adjustable, Removable ArmrestsOnly available with bariatric armpads.
1b. Single-Post, Heavy Duty, 8"-12" Height Adjustable, Removable Armrests
1c. Single-Post, Heavy Duty, 10"-14" Height Adjustable, Removable Armrests
1d. Height Adjustable, Cantilever ArmrestsHeight adjustment from 11"-17" depends on cane height. Not available with manual recline, flip forward back canes, or cane clamp pushbar.
14.8. Synergy ArmpadsREQUIRED with armrest selection above. Waterfall armpads may cause interference with the seat back. Armpads are configured as pairs.
14.9. Joystick Bracket ReceiverREQUIRED.
Bariatric Armpads ................................................. No ChargePart: UPSASMB1025.Only available with Bariatric Armrests.
Straight Armpads ................................................... No ChargeDesk/Desk part: UPSASMB1022. Full/Full part: UPSASMB1021. Desk/Full part: UPSASMB1023Not available with bariatric armrests.
Waterfall Armpads ................................................. No ChargeDesk/Desk part: UPSASMB1025. Full/Full part: UPSASMB1024. Desk/Full part: UPSASMB1026May cause interence with seat back. Not available with bariatric arm-rests.
Omit Synergy Armpads ........................................... No ChargePart: PTOINDV1373
Standard Fixed Receiver ........................................... StandardPart: FRMASMB16062
Stealth Height Adjustable Receiver ................................... $214Tube Arm Part: ST-ARM250C-Q. HCPCS: K0108
Height AdjustableReceiver (Track Arm)
Height AdjustableReceiver (Tube Arm)
14.10. Synergy Seat to FloorREQUIRED with Synergy seating.
16.5”Part: PTOINDV1888
17.5”Part: PTOINDV1889
18.5”Part: PTOINDV1890
15.1a. Standard Lap Belts38” Lap BeltPart: ACCBELT1006
50” Lap BeltPart: ACCBELT1000
60” Lap BeltPart: ACCBELT1002
70” Lap BeltPart: ACCBELT1003
80” Lap BeltPart: ACCBELT1004
90” Lap BeltPart: ACCBELT1001
i-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
60” Sure-Lok Lap Belt (Non-retractable) ............................ $120Required with WC-19 Transit Option.Part: ACCBELT1016
15.1b. Optional Lap BeltsNot available with contoured seating.
15. LAP BELTSREQUIRED except with select contoured seats with included lap belt. Select one lap belt below.
14. SYNERGY SEATING SYSTEM continued
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Account Number: ___________ Date: ________________ Marked for: _____________________________________
Stealth’s Worlds Best Removable ..................$220.50Headrest Bracket (C)Part: FRMASMB15999. HCPCS: E1028
Stealth Removable Headrest Bracket (D) .......... $160.50Part: HDWASMB1084. HCPCS: E1028
Pediatric Offset (HMO475P-17) (E) ................$160.50Part: HDWASMB1166. HCPCS: E1028
Stealth 8” Comfort Plus ............................. $151.94Part: POS148484. HCPCS: E0955
Stealth 10” Comfort Plus (A) ....................... $151.94Part: SETHEAD1057. HCPCS: E0955
Stealth 14” Comfort Plus ............................ $151.94Part: INDPART2327. HCPCS: E0955
Pediatric Comfort Plus (6”Wx4.5”H) ............. $151.94Part: SETHEAD1069. HCPCS: E0955
Stealth Small Contoured (9.75”Wx3”H) ........... $64.20Part: SETHEAD1052. HCPCS: E0955
Stealth Large Contoured (11”Wx6”H) (B) ...........$80.25Part: SETHEAD1053. HCPCS: E0955
Headrests
16.1. Headrest Pads
16.2. Headrest Brackets
16. HEADRESTSOptional. Select a headrest pad and bracket. Not available with contoured seating.
17. SYNERGY SEAT WITH POWER AFP OPTION ELECTRONICSREQUIRED for Synergy Seat with articulating foot platform.
One Actuator Control (Articulating Foot Platform) .............. $1,895through NE+ JoystickPart: ELEASMB6430. HCPCS: E2310
One Actuator Control (Articulating Foot Platform) .............. $1,895Through Q-Logic 3 ElectronicsNo fender lights part: ELE1705592. With fender lights part: ELE1705562. HCPCS: E2310
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. Not available with contoured seating.1. Foot Platform Assembly
Power ArticulatingFoot Platform
No interference issues at this seat-to-floor height.
May have less than 1.75” clearance when fully extended and may interfere with the ground or reduce obstacle climbing ability.
Center Mount Foot Platform Compatibility Matrix
Synergy SeatLow Medium High
10”-16” Length Extension
13”-19” Length Extension
Power Articulating Foot Platform .................. $2,995Part: PTOINDV3754. HCPCS: E1012
Manually Adjustable Center Mount ...................$250Foot PlatformPart: RIG163640
2. Lower Extension and Footplates
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.
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
10"-16" Extension, 5"x8" FootplatesPart: RIG150203
10"-16" Extension, 5"x11" FootplatesPart: RIG150212
13"-19" Extension, 5"x6" FootplatesPart: RIG151505
13"-19" Extension, 5"x8" FootplatesPart: RIG151506
13"-19" Extension, 5"x11" FootplatesPart: RIG151508
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.
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.
5. Additional AccessoriesReversed 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.
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.
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18.2. Heavy Duty, Drop-In, Swing-Away LegrestsSelect a configuration, a legrest with extension, and type of footplate. Pair (P), left (L), and right (R) configurations are selected by checking the appropriate boxes.1. Drop-In Legrest Selection
2. Angle Adjustable Footplate(s) with Heel Loops
3. Accessories
70° HD Drop-in with 12"-14.5" ........................ No Charge Length Lower Extension
Pair part: FRMASMB4762. Left: RIG137706. Right: RIG137707
70° HD Drop-in with 14.5-18" ......................... No Charge Length Lower Extension
Pair part: FRMASMB4853. Left: RIG137708. Right: RIG137709
6”Wx8”D1 ......................................................$85 ea.Pair part: FRMASMB4738. Left: RIG137793. Right: RIG137795.HCPCS: K0040
6”Wx11”D1 .....................................................$85 ea.Pair part: FRMASMB4741. Left: RIG137796. Right: RIG137797.HCPCS: K0040May cause interference on seat widths less than 18".
8”Wx11”D2 .....................................................$85 ea.Pair part: FRMASMB4744. Left: RIG137708. Right: RIG137709.HCPCS: K0040May cause interference on seat widths less than 20".
Wheel Bumper(s) ..........................................................................................................................................$12.50 ea.Pair part: WHLASMB1578. Left part: WHL169510. Right part: WHL169511
1. Heavy Duty, Elevating Legrest Selection
2. Lower Extension
3. Reinforced Footplates(s)
4. Angle Adjustable Footplates(s) with Heel Loops
18.3. Heavy Duty, Elevating LegrestsSelect a configuration, a legrest with extension, and type of footplate. Pair (P), left (L), and right (R) configurations are selected by checking the appropriate boxes.
Heavy Duty, Elevating Legrest(s) with Calf Pad(s) ................................................................................................ $162.50 ea.Pair part: FRMASMB6702. Left: FRMASMB8444. Right: FRMASMB8445. HCPCS: E0990
7.25”Wx6”D Extruded Footplate ........................ StandardPart pair: FRMASMB4748. Left: RIG138055. Right: RIG138056
8.5”Wx6”D Extruded Footplate ......................... StandardPart pair: FRMASMB4747. Left: RIG138060. Right: RIG138062
6”Wx8”D .......................................................$85 ea.Pair part: FRMASMB4738. Left: RIG137793. Right: RIG137795.HCPCS: K0040
6”Wx11”D ......................................................$85 ea.Pair part: FRMASMB4741. Left: RIG137796. Right: RIG137797.HCPCS: K0040
8”Wx11”D ......................................................$85 ea.Pair part: FRMASMB4744. Left: RIG137798. Right: RIG137799.HCPCS: K0040May cause interference with seat widths less than 20"
11”-14” LengthPart: FRMASMB4755. Left: RIG138026. Right: RIG138030For reinforced footplates only.
12”-14.5” LengthPart: FRMASMB4752. Left: FRMASMB5391. Right: FRMASMB4723For angle adjustable footplates only.
14”-17” LengthPart: FRMASMB4756. Left: RIG138033. Right: RIG138035For reinforced footplates only.
14.5”-18” LengthPart: FRMASMB4753. Left: FRMASMB4724. Right: FRMASMB5392For angle adjustable footplates only.
8” L(#3472)
8.5” L(#3473)
9” L(#3474)
9.5” L(#3475)
10” L(#3476)
10.5” L(#3477)
11” L(#3478)
11.5” L(#3479)
12” L(#3480)
12.5” L(#3481)
13” L(#3482)
13.5” L(#3483)
14” L(#3484)
14.5” L(#3485)
15” L(#3486)
15.5” L(#3487)
16” L(#3488)
16.5” L(#3489)
17” L(#3490)
19. SET LEGREST LENGTHREQUIRED with matching left and right legrest configuration. 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. Non-matching or individual legrest configurations lengths are not set by the manufacturer.
18. LEGRESTS continued
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20. 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. 20.1. Cushion Dimensions
20.2. Cushion Model Selection
20.3. Additional Fluid Proof LinersFluid Proof Urethane Liner ......................................... $50-$70Part: URL1709070-XXYY
Fluid Proof Polyurethane Liner .............................. Coming soon
20" W 22" W 24" W 26" W 28" W 16" D 18" D 20" D 22" D 24" D 26" D 28" D
Cushion DepthCushion Width
TRU-Comfort 2 SPP CushionSkin protection and positioning with 4-way stretch, breathable cover. 450 lb. weight capacity.
E2607, 20" W ......................................$400
E2608, 22"W ......................................$500
Part series: ST-TC2SPPXXYY
Simplicity G CushionGeneral use with 2-way stretch, breathable cover. 350 lb. weight capacity.
E2601, 20" W ...................................... $110E2602, 22"W to 24" W .......................... $165
Solution SPP CushionSkin protection and positioning with 4-way stretch, breath-able cover. Includes urethane liner. 350 lb weight capacity.
E2607, 20" W ...................................... $375E2608, 22"W to 24" W .......................... $430
Part series: ST-SOLSPPXXYYPart series: ST-SIMGXXYY
Spectrum Gel SPP CushionPositioning with 4-way stretch, breathable cover. Includes urethane liner. 350 lb. weight capacity. Part series: ST-SPCGSPPXXYY
E2607, 20" W ......................................$460
E2608, 22"W to 24" W .......................... $530
Spectrum Foam SPP CushionSkin protection and positioning with 4-way stretch, breathable cover. 650 lb. weight capacity.Part series: ST-SPCFSPPXXYY
E2607, 20" W ......................................$460E2608, 22"W to 24" W .......................... $530E2608, 26"W to 28" W .......................... $590
21. PROVIDER INSTALLED ACCESSORIESOptional. Multiple accessories can be mounted along the various tracks but some interference may occur.
Medium, Black, Weather Cover ........................................ $168Part: ACCCOVR1022
Large, Black, Weather Cover ........................................... $202Part: ACCCOVR1021
Synergy Seat Oxygen Holder ........................................... $150Not available with Synergy Manual Recline. Part: FRMASMB7030. HCPCS: E2208
Contoured Seat Oxygen Holder .........................................$118Part: FRMASMB2292. HCPCS: E2208
Contoured Seat Cup Holder...............................................$20 Non-bariatric part: ACCASMB2287. Bariatric arm part: ASSASMB2632
Synergy Seat Cup Holder ......................................... No ChargePart: ACCASMB2634
Rear Basket .................................................................$118Contoured seat part: ACCASMB1914Synergy part: FRMASMB4821
Walker Holder ............................................................. $103Synergy part: FRMASMB7031
Saddle Bag ....................................................................$35Part: DWR1020D010
Flag Holder ...................................................................$25Contoured seat part: ACCASMB1930Synergy part: ACCASMB2415
Cane/Crutch Holder .......................................................$110Contoured Seat part: ACCASMB2294. HCPCS: E2207Synergy part: FRMASMB4822. HCPCS: E2207
Stealth Large Tablet Holder ............................................ $375Part: ACC7120005
Stealth Cell Phone/Media Device Holder .............................$195Part: ACC7120006
22. BATTERIESREQUIRED. The powerchair requires 2 batteries and will be installed if ordered.
Group 24, 70 Amp Gel Cell, Interceptor Battery ............. $365 ea.Part: BAT1704614. HCPCS: E2363
No batteries. Provider will assume responsibility of batteries.Part: Configuration selection
Group 24, 70 Amp Gel Cell, MK Battery ........................ $410 ea.Part: BATGEL1009. HCPCS: E2363
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23. BRANCH PATCHESOptional.
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
1. Bracket
2. Pads
3. Installation
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
24.1. 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.
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
24.2. 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
25.1. Stealth Foot Boxes^Please verify the appropriate billing code to be used for this item with all third-party payors.
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^
25. PROVIDER INSTALLED POSITIONING COMPONENTSOptional. Not available with contoured seating. More options are available on the Positioning Components Order Form.
25.2. Stealth Padded Shoe HolderStealth 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.
Provider installed positioning components section continued on following page.
Swing-away, Rail Mounts, pair (TWBTLTC) ......................$472.50Part: INDPART2896. HCPCS: E1028
24. MANUFACTURER INSTALLED POSITIONING COMPONENTSOptional. Not available with contoured seating. More options are available on the Positioning Components Order Form.
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2. Elbow Support Pad
1. Elbow Support Bracket25.3. Stealth Elbow Support
Left,Swing-Away, Elbow Support Bracket ..............$183.75 ea. Tube Style Arms (ARMS-ES-L)
Part: POS124064. HCPCS: E1028
Right, Swing-Away, Elbow Support Bracket ............$183.75 ea. Tube Style Arms (ARMS-ES-R)
Part: POS124066. HCPCS: E1028
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
25.4. Stealth i-Fit Chest Harness
25.5. Stealth i-Fit Chest Straps
Upper 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
Chest 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
Contoured and ClassicChest Harness
Chest Strap
1" Ball Kit for Facial Laterals (TWB-1BK) (D) ..... $80.25Part: POS150532Required with facial laterals to mount to comfort head-rest brackets.
Egg Switch Mount (ESM) (A) ................ $52.50 ea.Part: INDPART2815
Figure 8 Bracket with 13" Rod ............ $267.50 ea. and Egg Switch Mount (B)
Part: ST-F8675-13-Q
Facial Pad, 4"x2" (900-Q)................... $53.50 ea.Part: ST-900-Q. HCPCS: K0108
Facial Pad, 6"x2" (920-Q) ................... $53.50 ea.Part: ST-920-Q. HCPCS: K0108
Swing-Away Joystick Mount, ..................$250 ea. 18" Rod (C)
Part: ST-SUS18-Q Allows mounting of facial pads and attaches to the headrest
Facial Lateral Pads and Accessories
25.6. Stealth Swing-Away Headrest MountsThese swing-away headrest mounts are only available with the Stealth Comfort Series headrests. The 1" ball kit must be selected to mount the facial lateral to the headrest bracket. Also select a facial pad(s) with the facial lateral(s).
Facial Lateral for Comfort Series .............$294.25 ea.Right Side (CPS9-R-HW)Part: INDPART2647. HCPCS: E1028
Facial Lateral for Comfort Series .............$294.25 ea.Left Side (CPS9-L-HW)Part: INDPART2648. HCPCS: E1028
Facial Laterals for Comfort Series ........... $347.75 ea.Left and Right Side (CPS9-B-HW)Part: INDPART2649. HCPCS: E1028
Left and Right FacialLateral with Pads
Headrest Accessories
25. PROVIDER INSTALLED POSITIONING COMPONENTS continued
26.1. Enhanced Display
Q-Logic 3 Enhanced Display ShroudRequired with Q-Logic 3 Enhanced Display selection above. Reference colors shown on page 2.
26. SPECIALTY CONTROLSOptional. Only available with the Synergy Seating system. Select a type of specialty controls below or to refer to the specialty controls order form.
Enhanced Display
Q-Logic 3 Enhanced Display Kit .....................................................................................................$1,720Part: CTL167726Select a color option below. Includes enhanced display, flexible gooseneck and mounting bracket. Features: 3.5” LCD display; up to 5 profiles to control drive, seat, and auxiliary functions; Bluetooth connectivity for mobile devices and mouse emulation; integrated single switch scanner; IR controls.
Red CorvettePart: DGN137729-PRD1
Electric BluePart: DGN137729-PBU9
Back in BlackPart: DGN137729-PBK1
White SatinPart: DGN137729-PWH2
Pretty in PinkPart: DGN137729-PPK3
Deep PurplePart: DGN137729-PPR5
Lime LightPart: DGN137729-PGN7
Grey StreetPart: DGN137729-PSL3
Silver BulletPart: DGN137729-PSL7
Midnight BluePart: DGN137729-PBU10
Orange CrushPart: DGN137729-POR6
Yellow BlazePart: DGN137729-PYL3
Black, Soft Touch ....................................StandardPart: DGN137728
Non-matching Joystick Shroud.......................... $50Select color below
Match Joystick Shroud to Base Color .................. $50Part: See color below
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EX SAJ
Q-Logic 3 EX SAJ .........................................................................................................................$700Part: CTL143980Must be used in conjunction with Enhanced Display or Q-Logic 3 Joystick.
ModuleAdult Pro-Series
Sip & Puff Module
Stealth Sip & Puff
Adult, i-Drive Tri-Array Series, 3-Switch ......... $4,414Head Array (IDHBT200-1)Part: ST-IDHBT200-1-Q. HCPCS: E2330Features bluetooth, head support, 3 non-proportional proximity sensors for drive control, an egg switch for re-set mode change, and i-Drive smart box.
Adult, i-Drive Pro Series Head Array .............. $4,461(IDHBT300-1)Part: ST-IDHBT300-1-Q. HCPCS: E2330Features bluetooth, head support with occipital pad and 2 swing-away spot pads for left and right side, 3 non-pro-portional proximity sensors, an egg switch for reset mode change, and i-Drive smart box.
Stealth Sip and Puff for Comfort Series, ............$294.25Left Mount (SP625-CL)Part: ST-SP625-CL-Q Includes straw and mounting hardware. Use with Stealth Comfort Plus headrests.
Stealth Sip and Puff for Comfort Series, ............$294.25Right Mount (SP622-CR)Part: ST-SP625-CR-QIncludes straw and mounting hardware. Use with Stealth Comfort Plus headrests.
Stealth Sip and Puff for Stealth Ultra, ............ $294.253-Switch Head Array (SP625-U)Part: ST-SP625-U-Q Includes straw and mounting hardware. Use with Stealth i-Drive Head Arrays.
Sip and Puff Module for Q-Logic 3 ..................................................................................................$1,895Part: CTL168056 Includes module and mounting hardware.
26.2. Q-Logic 3 SAJ
26.3. Head Array
26.5. Egg Switches and Switch Adapter
26.4. Sip and Puff DriveStraw and Mount
Red Egg Switch (ESRED) ..................... $80.85 ea. Part: SWTMCRO1077
Blue Egg Switch (ESBLU) .................... $80.85 ea.Part: SWTMCRO1079
Black Egg Switch (ESBLK) ................... $80.85 ea.Part: SWTMCRO1081
Green Egg Switch (ESGRN) ................. $80.85 ea.Part: SWTMCRO1078
Yellow Egg Switch (ESYEL) ................. $80.85 ea.Part: SWTMCRO1080
2 to 1 Switch Adapter ..................................$13.39Part: DWR1361H037Connects 2 single switches to a stereo jack to act as a dual switch.
27. TRU-BALANCE 3 MULTIPLIER HARNESSREQUIRED. Multiple controllers or power accessories may require an additional multiplier harness or special order. Reference the chart below to determine the appropriate selection. The rows refer to the total amount of arm mounted devices and the columns refer to the total amount of back mounted devices. The online order configurator will automatically make this selection under specialty controls.
No Additional Multiplier (NA) .................................... No ChargePart: Configuration selection
Secondary Multiplier (SM) ........................................... $221.21Part: HAR144004
Special Order Configuration (SOF)Part: Configuration selection
1 Arm 2 Arm 3+ Arm
1 Back0 Back
2 Back3+ Back
NANA No additional MultiplierSecondary MultiplierSpecial Order Required
NASM
SM
SOFSOF
SMSMSMSOF
SOFSOFSOFSOF
Q-Logic 3 Multiplier with Synergy Seat Chart
Arm
Mou
nts Joystick (Hand Control)
Enhanced DisplayiAccessUSB ChargerSAJ Ba
ck M
ount
s
Attendant ControlSCIMSip n PuffECU
Alternative Controls & Electronics Order Form Positioning Components Order Form
28. 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.
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Quantum® Rehab401 York Ave., Duryea, PA 18642Phone: 866-800-2002 | Fax: 866-707-3422 | Email: [email protected]
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Egg Switch
26. SPECIALTY CONTROLS continued
Page 1 of 7
Option Name MSRP Part Number Manufacturer Extended DescriptionELECTRONICSQ-Logic 3 EX Controller Module $695 ELE1705058 ELECTRONIC,ASSY,Q-LOGIC 3,64 HAMMER II MOTORS,Q6EDGE HD,STATIC SEATING
ELE1705059 ELECTRONIC,ASSY,Q-LOGIC 3,64 HAMMER II MOTORS,Q6EDGE HD,STATIC SEATING,W/POWER
ELE1705061 ELECTRONIC,ASSY,Q-LOGIC 3,64 HAMMER II MOTORS,Q6EDGE HD,STATIC SEATING,W/PTO
ELE1705062 ELECTRONIC,ASSY,Q-LOGIC 3,64 HAMMER II MOTORS,Q6EDGE HD,STATIC SEATING,W/POWER,W/PTO
JOYSTICK MOUNTING BRACKETSSwing-away, Inline, Left Side Mount $245 ACC142526 JOYSTICK MOUNTING BRACKET,ASSY,SWING AWAY,INLINE,LEFT,NE/NE PLUS
ACC148360 JOYSTICK MOUNTING BRACKET,ASSY,SWING AWAY ,INLINE,LEFT,NE/NE PLUS,CAPTAINS SEAT
ACC142524 JOYSTICK MOUNTING BRACKET,ASSY,SWING AWAY,INLINE,LEFT,Q-LOGIC ACC148356 JOYSTICK MOUNTING BRACKET,ASSY,SWING AWAY,INLINE,LEFT,Q-LOGIC,CAPTAINS SEAT
Swing-away, Inline, Right Side Mount $245 ACC142527 JOYSTICK MOUNTING BRACKET,ASSY,SWING AWAY,INLINE,RIGHT,NE/NE PLUSACC148361 JOYSTICK MOUNTING BRACKET,ASSY,SWING AWAY ,INLINE,RIGHT,NE/NE PLUS,CAPTAINS SEAT
ACC142525 JOYSTICK MOUNTING BRACKET,ASSY,SWING AWAY,INLINE,RIGHT,Q-LOGIC ACC148357 JOYSTICK MOUNTING BRACKET,ASSY,SWING AWAY,INLINE,RIGHT,Q-LOGIC,CAPTAINS SEAT
Swing-away, 1" Offset, Left Side Mount $245 ACC142747 JOYSTICK MOUNTING BRACKET,ASSY,SWING AWAY,OFFSET,LEFT,NE/NE PLUSACC148362 JOYSTICK MOUNTING BRACKET,ASSY,SWING AWAY,OFFSET,LEFT,NE/NE PLUS,CAPTAINS SEAT
ACC142525 JOYSTICK MOUNTING BRACKET,ASSY,SWING AWAY,OFFSET,LEFT,Q-LOGICACC148358 JOYSTICK MOUNTING BRACKET,ASSY,SWING AWAY,OFFSET,LEFT,Q-LOGIC,CAPTAINS SEAT
Swing-away, 1" Offset, Right Side Mount $245 ACC142748 JOYSTICK MOUNTING BRACKET,ASSY,SWING AWAY,OFFSET,RIGHT,NE/NE PLUSACC148363 JOYSTICK MOUNTING BRACKET,ASSY,SWING AWAY,OFFSET,RIGHT,NE/NE PLUS,CAPTAINS SEAT
ACC142743 JOYSTICK MOUNTING BRACKET,ASSY,SWING AWAY,OFFSET,RIGHT,Q-LOGICACC148359 JOYSTICK MOUNTING BRACKET,ASSY,SWING AWAY,OFFSET,RIGHT,Q-LOGIC,CAPTAINS SEAT
SYNERGY BACK OPTIONS - Synergy Back SelectionSynergy Back $275 SETASMB6448 SEAT BACK,ASSY,SYNERGY STANDARD BACK,12"W,15"H,W/CUSHION,(12"W X 12"H BACK)
SETASMB6624 SEAT BACK,ASSY,SYNERGY STANDARD BACK,12"W,16"H,W/CUSHION,(12"W X 12"H BACK)
SETASMB6447 SEAT BACK,ASSY,SYNERGY STANDARD BACK,14"W,13"H,W/CUSHION,(14"W X 10"H BACK)
SETASMB6623 SEAT BACK,ASSY,SYNERGY STANDARD BACK,14"W,14"H,W/CUSHION,(14"W X 10"H BACK)
SETASMB6449 SEAT BACK,ASSY,SYNERGY STANDARD BACK,14"W,15"H,W/CUSHION,(14"W X 12"H BACK)
SETASMB6625 SEAT BACK,ASSY,SYNERGY STANDARD BACK,14"W,16"H,W/CUSHION,(14"W X 12"H BACK)
SETASMB6461 SEAT BACK,ASSY,SYNERGY STANDARD BACK,14"W,17"H,W/CUSHION,(14"W X 14"H BACK)
SETASMB6637 SEAT BACK,ASSY,SYNERGY STANDARD BACK,14"W,18"H,W/CUSHION,(14"W X 14"H BACK)
SETASMB6472 SEAT BACK,ASSY,SYNERGY STANDARD BACK,14"W,19"H,W/CUSHION,(14"W X 16"H BACK)
SETASMB6648 SEAT BACK,ASSY,SYNERGY STANDARD BACK,14"W,20"H,W/CUSHION,(14"W X 16"H BACK)
SETASMB6491 SEAT BACK,ASSY,SYNERGY STANDARD BACK,14"W,21"H,W/CUSHION,(14"W X 18"H BACK)
SETASMB6667 SEAT BACK,ASSY,SYNERGY STANDARD BACK,14"W,22"H,W/CUSHION,(14"W X 18"H BACK)
SETASMB6510 SEAT BACK,ASSY,SYNERGY STANDARD BACK,14"W,23"H,W/CUSHION,(14"W X 20"H BACK)
SETASMB6686 SEAT BACK,ASSY,SYNERGY STANDARD BACK,14"W,24"H,W/CUSHION,(14"W X 20"H BACK)
SETASMB6529 SEAT BACK,ASSY,SYNERGY STANDARD BACK,14"W,25"H,W/CUSHION,(14"W X 22"H BACK)
SETASMB6462 SEAT BACK,ASSY,SYNERGY STANDARD BACK,15"W,17"H,W/CUSHION,(15"W X 14"H BACK)
SETASMB6638 SEAT BACK,ASSY,SYNERGY STANDARD BACK,15"W,18"H,W/CUSHION,(15"W X 14"H BACK)
SETASMB6473 SEAT BACK,ASSY,SYNERGY STANDARD BACK,15"W,19"H,W/CUSHION,(15"W X 16"H BACK)
Section NameQ6 Edge HD Cross Reference Spreadsheet - Contoured and Synergy Seating
Page 2 of 7
Option Name MSRP Part Number Manufacturer Extended DescriptionSection Name
Q6 Edge HD Cross Reference Spreadsheet - Contoured and Synergy Seating
SETASMB6649 SEAT BACK,ASSY,SYNERGY STANDARD BACK,15"W,20"H,W/CUSHION,(15"W X 16"H BACK)
SETASMB6492 SEAT BACK,ASSY,SYNERGY STANDARD BACK,15"W,21"H,W/CUSHION,(15"W X 21"H BACK)
SETASMB6668 SEAT BACK,ASSY,SYNERGY STANDARD BACK,15"W,22"H,W/CUSHION,(15"W X 18"H BACK)
SETASMB6511 SEAT BACK,ASSY,SYNERGY STANDARD BACK,15"W,23"H,W/CUSHION,(15"W X 20"H BACK)
SETASMB6687 SEAT BACK,ASSY,SYNERGY STANDARD BACK,15"W,24"H,W/CUSHION,(15"W X 20"H BACK)
SETASMB6530 SEAT BACK,ASSY,SYNERGY STANDARD BACK,15"W,25"H,W/CUSHION,(15"W X 22"H BACK)
SETASMB6463 SEAT BACK,ASSY,SYNERGY STANDARD BACK,16"W,17"H,W/CUSHION,(16"W X 14"H BACK)
SETASMB6639 SEAT BACK,ASSY,SYNERGY STANDARD BACK,16"W,18"H,W/CUSHION,(16"W X 14"H BACK)
SETASMB6474 SEAT BACK,ASSY,SYNERGY STANDARD BACK,16"W,19"H,W/CUSHION,(16"W X 16"H BACK)
SETASMB6650 SEAT BACK,ASSY,SYNERGY STANDARD BACK,16"W,20"H,W/CUSHION,(16"W X 16"H BACK)
SETASMB6493 SEAT BACK,ASSY,SYNERGY STANDARD BACK,16"W,21"H,W/CUSHION,(16"W X 18"H BACK)
SETASMB6669 SEAT BACK,ASSY,SYNERGY STANDARD BACK,16"W,22"H,W/CUSHION,(16"W X 18"H BACK)
SETASMB6512 SEAT BACK,ASSY,SYNERGY STANDARD BACK,16"W,23"H,W/CUSHION,(16"W X 20"H BACK)
SETASMB6688 SEAT BACK,ASSY,SYNERGY STANDARD BACK,16"W,24"H,W/CUSHION,(16"W X 20"H BACK)
SETASMB6531 SEAT BACK,ASSY,SYNERGY STANDARD BACK,16"W,25"H,W/CUSHION,(16"W X 22"H BACK)
SETASMB6464 SEAT BACK,ASSY,SYNERGY STANDARD BACK,17"W,17"H,W/CUSHION,(17"W X 14"H BACK)
SETASMB6640 SEAT BACK,ASSY,SYNERGY STANDARD BACK,17"W,18''D,W/CUSHION,(17"W X 14"H BACK)
SETASMB6475 SEAT BACK,ASSY,SYNERGY STANDARD BACK,17"W,19"H,W/CUSHION,(17"W X 16"H BACK)
SETASMB6651 SEAT BACK,ASSY,SYNERGY STANDARD BACK,17"W,20"H,W/CUSHION,(17"W X 16"H BACK)
SETASMB6494 SEAT BACK,ASSY,SYNERGY STANDARD BACK,17"W,21"H,W/CUSHION,(17"W X 18"H BACK)
SETASMB6670 SEAT BACK,ASSY,SYNERGY STANDARD BACK,17"W,22"H,W/CUSHION,(17"W X 18"H BACK)
SETASMB6513 SEAT BACK,ASSY,SYNERGY STANDARD BACK,17"W,23"H,W/CUSHION,(17"W X 20"H BACK)
SETASMB6689 SEAT BACK,ASSY,SYNERGY STANDARD BACK,17"W,24"H,W/CUSHION,(17"W X 20"H BACK)
SETASMB6532 SEAT BACK,ASSY,SYNERGY STANDARD BACK,17"W,25"H,W/CUSHION,(17"W X 22"H BACK)
SETASMB6465 SEAT BACK,ASSY,SYNERGY STANDARD BACK,18"W,17"H,W/CUSHION,(18"W X 14"H BACK)
SETASMB6641 SEAT BACK,ASSY,SYNERGY STANDARD BACK,18"W,18"H,W/CUSHION,(18"W X 14"H BACK)
SETASMB6476 SEAT BACK,ASSY,SYNERGY STANDARD BACK,18"W,19"H,W/CUSHION,(18"W X 16"H BACK)
SETASMB6652 SEAT BACK,ASSY,SYNERGY STANDARD BACK,18"W,20"H,W/CUSHION,(18"W X 16"H BACK)
SETASMB6495 SEAT BACK,ASSY,SYNERGY STANDARD BACK,18"W,21"H,W/CUSHION,(18"W X 18"H BACK)
SETASMB6671 SEAT BACK,ASSY,SYNERGY STANDARD BACK,18"W,22"H,W/CUSHION,(18"W X 18"H BACK)
SETASMB6514 SEAT BACK,ASSY,SYNERGY STANDARD BACK,18"W,23"H,W/CUSHION,(18"W X 20"H BACK)
SETASMB6690 SEAT BACK,ASSY,SYNERGY STANDARD BACK,18"W,24"H,W/CUSHION,(18"W X 20"H BACK)
SETASMB6533 SEAT BACK,ASSY,SYNERGY STANDARD BACK,18"W,25"H,W/CUSHION,(18"W X 22"H BACK)
SETASMB6466 SEAT BACK,ASSY,SYNERGY STANDARD BACK,19"W,17"H,W/CUSHION,(19"W X 14"H BACK)
SETASMB6642 SEAT BACK,ASSY,SYNERGY STANDARD BACK,19"W,18"H,W/CUSHION,(19"W X 14"H BACK)
SETASMB6477 SEAT BACK,ASSY,SYNERGY STANDARD BACK,19"W,19"H,W/CUSHION,(19"W X 16"H BACK)
SETASMB6653 SEAT BACK,ASSY,SYNERGY STANDARD BACK,19"W,20"H,W/CUSHION,(19"W X 16"H BACK)
SETASMB6496 SEAT BACK,ASSY,SYNERGY STANDARD BACK,19"W,21"H,W/CUSHION,(19"W X 18"H BACK)
SETASMB6672 SEAT BACK,ASSY,SYNERGY STANDARD BACK,19"W,22"H,W/CUSHION,(19"W X 18"H BACK)
SETASMB6515 SEAT BACK,ASSY,SYNERGY STANDARD BACK,19"W,23"H,W/CUSHION,(19"W X 20"H BACK)
SETASMB6691 SEAT BACK,ASSY,SYNERGY STANDARD BACK,19"W,24"H,W/CUSHION,(19"W X 20"H BACK)
SETASMB6534 SEAT BACK,ASSY,SYNERGY STANDARD BACK,19"W,25"H,W/CUSHION,(19"W X 22"H BACK)
SETASMB6467 SEAT BACK,ASSY,SYNERGY STANDARD BACK,20"W,17"H,W/CUSHION,(20"W X 14"H BACK)
SETASMB6643 SEAT BACK,ASSY,SYNERGY STANDARD BACK,20"W,18"H,W/CUSHION,(20"W X 14"H BACK)
SETASMB6478 SEAT BACK,ASSY,SYNERGY STANDARD BACK,20"W,19"H,W/CUSHION,(20"W X 16"H BACK)
SETASMB6654 SEAT BACK,ASSY,SYNERGY STANDARD BACK,20"W,20"H,W/CUSHION,(20"W X 16"H BACK)
SETASMB6497 SEAT BACK,ASSY,SYNERGY STANDARD BACK,20"W,21"H,W/CUSHION,(20"W X 18"H BACK)
Page 3 of 7
Option Name MSRP Part Number Manufacturer Extended DescriptionSection Name
Q6 Edge HD Cross Reference Spreadsheet - Contoured and Synergy Seating
SETASMB6673 SEAT BACK,ASSY,SYNERGY STANDARD BACK,20"W,22"H,W/CUSHION,(20"W X 18"H BACK)
SETASMB6516 SEAT BACK,ASSY,SYNERGY STANDARD BACK,20"W,23"H,W/CUSHION,(20"W X 20"H BACK)
SETASMB6692 SEAT BACK,ASSY,SYNERGY STANDARD BACK,20"W,24"H,W/CUSHION,(20"W X 20"H BACK)
SETASMB6535 SEAT BACK,ASSY,SYNERGY STANDARD BACK,20"W,25"H,W/CUSHION,(20"W X 22"H BACK)
SETASMB6468 SEAT BACK,ASSY,SYNERGY STANDARD BACK,21"W,17"H,W/CUSHION,(21"W X 14"H BACK)
SETASMB6644 SEAT BACK,ASSY,SYNERGY STANDARD BACK,21"W,18"H,W/CUSHION,(21"W X 14"H BACK)
SETASMB6479 SEAT BACK,ASSY,SYNERGY STANDARD BACK,21"W,19"H,W/CUSHION,(21"W X 16"H BACK)
SETASMB6655 SEAT BACK,ASSY,SYNERGY STANDARD BACK,21"W,20"H,W/CUSHION,(21"W X 16"H BACK)
SETASMB6498 SEAT BACK,ASSY,SYNERGY STANDARD BACK,21"W,21"H,W/CUSHION,(21"W X 18"H BACK)
SETASMB6674 SEAT BACK,ASSY,SYNERGY STANDARD BACK,21"W,22"H,W/CUSHION,(21"W X 18"H BACK)
SETASMB6517 SEAT BACK,ASSY,SYNERGY STANDARD BACK,21"W,23"H,W/CUSHION,(21"W X 20"H BACK)
SETASMB6693 SEAT BACK,ASSY,SYNERGY STANDARD BACK,21"W,24"H,W/CUSHION,(21"W X 20"H BACK)
SETASMB6536 SEAT BACK,ASSY,SYNERGY STANDARD BACK,21"W,25"H,W/CUSHION,(21"W X 22"H BACK)
SETASMB6469 SEAT BACK,ASSY,SYNERGY STANDARD BACK,22"W,17"H,W/CUSHION,(22"W X 14"H BACK)
SETASMB6645 SEAT BACK,ASSY,SYNERGY STANDARD BACK,22"W,18"H,W/CUSHION,(22"W X 14"H BACK)
SETASMB6480 SEAT BACK,ASSY,SYNERGY STANDARD BACK,22"W,19"H,W/CUSHION,(22"W X 16"H BACK)
SETASMB6656 SEAT BACK,ASSY,SYNERGY STANDARD BACK,22"W,20"H,W/CUSHION,(22"W X 16"H BACK)
SETASMB6499 SEAT BACK,ASSY,SYNERGY STANDARD BACK,22"W,21"H,W/CUSHION,(22"W X 18"H BACK)
SETASMB6675 SEAT BACK,ASSY,SYNERGY STANDARD BACK,22"W,22"H,W/CUSHION,(22"W X 18"H BACK)
SETASMB6518 SEAT BACK,ASSY,SYNERGY STANDARD BACK,22"W,23"H,W/CUSHION,(22"W X 20"H BACK)
SETASMB6694 SEAT BACK,ASSY,SYNERGY STANDARD BACK,22"W,24"H,W/CUSHION,(22"W X 20"H BACK)
SETASMB6537 SEAT BACK,ASSY,SYNERGY STANDARD BACK,22"W,25"H,W/CUSHION,(22"W X 22"H BACK)
TRU-Comfort 4-way Stretch, 20" Width or less $675 SETASMB7082 SEAT BACK,ASSY,BLACK,16"W,20"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
SETASMB7151 SEAT BACK,ASSY,BLACK,16"W,21"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
SETASMB7085 SEAT BACK,ASSY,BLACK,16"W,22"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
SETASMB7154 SEAT BACK,ASSY,BLACK,16"W,23"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
SETASMB7090 SEAT BACK,ASSY,BLACK,16"W,24"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
SETASMB7159 SEAT BACK,ASSY,BLACK,16"W,25"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
SETASMB7097 SEAT BACK,ASSY,BLACK,16"W,27"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
SETASMB7166 SEAT BACK,ASSY,BLACK,16"W,28"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
SETASMB7086 SEAT BACK,ASSY,BLACK,17"W,22"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
SETASMB7155 SEAT BACK,ASSY,BLACK,17"W,23"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
SETASMB7091 SEAT BACK,ASSY,BLACK,17"W,24"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
SETASMB7160 SEAT BACK,ASSY,BLACK,17"W,25"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
SETASMB7098 SEAT BACK,ASSY,BLACK,17"W,27"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
SETASMB7167 SEAT BACK,ASSY,BLACK,17"W,28"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
SETASMB7083 SEAT BACK,ASSY,BLACK,18"W,20"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
Page 4 of 7
Option Name MSRP Part Number Manufacturer Extended DescriptionSection Name
Q6 Edge HD Cross Reference Spreadsheet - Contoured and Synergy Seating
SETASMB7152 SEAT BACK,ASSY,BLACK,18"W,21"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
SETASMB7087 SEAT BACK,ASSY,BLACK,18"W,22"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
SETASMB7156 SEAT BACK,ASSY,BLACK,18"W,23"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
SETASMB7092 SEAT BACK,ASSY,BLACK,18"W,24"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
SETASMB7161 SEAT BACK,ASSY,BLACK,18"W,25"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
SETASMB7099 SEAT BACK,ASSY,BLACK,18"W,27"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
SETASMB7168 SEAT BACK,ASSY,BLACK,18"W,28"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
SETASMB7088 SEAT BACK,ASSY,BLACK,19"W,22"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
SETASMB7157 SEAT BACK,ASSY,BLACK,19"W,23"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
SETASMB7093 SEAT BACK,ASSY,BLACK,19"W,24"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
SETASMB7162 SEAT BACK,ASSY,BLACK,19"W,25"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
SETASMB7100 SEAT BACK,ASSY,BLACK,19"W,27"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
SETASMB7169 SEAT BACK,ASSY,BLACK,19"W,28"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
SETASMB7084 SEAT BACK,ASSY,BLACK,20"W,20"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
SETASMB7153 SEAT BACK,ASSY,BLACK,20"W,21"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
SETASMB7089 SEAT BACK,ASSY,BLACK,20"W,22"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
SETASMB7158 SEAT BACK,ASSY,BLACK,20"W,23"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
SETASMB7094 SEAT BACK,ASSY,BLACK,20"W,24"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
SETASMB7163 SEAT BACK,ASSY,BLACK,20"W,25"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
SETASMB7101 SEAT BACK,ASSY,BLACK,20"W,27"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
SETASMB7170 SEAT BACK,ASSY,BLACK,20"W,28"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
TRU-Comfort 4-way Stretch, 22" Width or greater $775 SETASMB7095 SEAT BACK,ASSY,BLACK,22"W,24"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
SETASMB7164 SEAT BACK,ASSY,BLACK,22"W,25"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
SETASMB7102 SEAT BACK,ASSY,BLACK,22"W,27"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
SETASMB7171 SEAT BACK,ASSY,BLACK,22"W,28"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
SETASMB7096 SEAT BACK,ASSY,BLACK,24"W,24"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
SETASMB7165 SEAT BACK,ASSY,BLACK,24"W,25"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
SETASMB7103 SEAT BACK,ASSY,BLACK,24"W,27"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
Page 5 of 7
Option Name MSRP Part Number Manufacturer Extended DescriptionSection Name
Q6 Edge HD Cross Reference Spreadsheet - Contoured and Synergy Seating
SETASMB7172 SEAT BACK,ASSY,BLACK,24"W,28"H,TRU-COMFORT SEAT,SYNERGY SEAT/TRU-BALANCE POWER TILT
HD Sling Back $98 SETASMB5304 SEAT BACK,ASSY,SLING,HEAVY DUTY,24"W,18"H,(24"W X 15"H BACK),SYNERGY SEAT SETASMB5305 SEAT BACK,ASSY,SLING,HEAVY DUTY,24"W,19"H,(24"W X 15"H BACK),SYNERGY SEAT SETASMB5306 SEAT BACK,ASSY,SLING,HEAVY DUTY,24"W,20"H,(24"W X 17"H BACK),SYNERGY SEAT SETASMB5307 SEAT BACK,ASSY,SLING,HEAVY DUTY,24"W,21"H,(24"W X 17"H BACK),SYNERGY SEAT SETASMB5308 SEAT BACK,ASSY,SLING,HEAVY DUTY,24"W,22"H,(24"W X 19"H BACK),SYNERGY SEAT SETASMB5309 SEAT BACK,ASSY,SLING,HEAVY DUTY,24"W,23"H,(24"W X 19"H BACK),SYNERGY SEAT SETASMB5310 SEAT BACK,ASSY,SLING,HEAVY DUTY,24"W,24"H,(24"W X 21"H BACK),SYNERGY SEAT SETASMB5311 SEAT BACK,ASSY,SLING,HEAVY DUTY,24"W,25"H,(24"W X 21"H BACK),SYNERGY SEAT SETASMB5312 SEAT BACK,ASSY,SLING,HEAVY DUTY,25"W,18"H,(25"W X 15"H BACK),SYNERGY SEAT SETASMB5313 SEAT BACK,ASSY,SLING,HEAVY DUTY,25"W,19"H,(25"W X 15"H BACK),SYNERGY SEAT SETASMB5314 SEAT BACK,ASSY,SLING,HEAVY DUTY,25"W,20"H,(25"W X 17"H BACK),SYNERGY SEAT SETASMB5315 SEAT BACK,ASSY,SLING,HEAVY DUTY,25"W,21"H,(25"W X 17"H BACK),SYNERGY SEAT SETASMB5316 SEAT BACK,ASSY,SLING,HEAVY DUTY,25"W,22"H,(25"W X 19"H BACK),SYNERGY SEAT SETASMB5317 SEAT BACK,ASSY,SLING,HEAVY DUTY,25"W,23"H,(25"W X 19"H BACK),SYNERGY SEAT SETASMB5318 SEAT BACK,ASSY,SLING,HEAVY DUTY,25"W,24"H,(25"W X 21"H BACK),SYNERGY SEAT SETASMB5319 SEAT BACK,ASSY,SLING,HEAVY DUTY,25"W,25"H,(25"W X 21"H BACK),SYNERGY SEAT SETASMB5320 SEAT BACK,ASSY,SLING,HEAVY DUTY,26"W,18"H,(26"W X 15"H BACK),SYNERGY SEAT SETASMB5321 SEAT BACK,ASSY,SLING,HEAVY DUTY,26"W,19"H,(26"W X 15"H BACK),SYNERGY SEAT SETASMB5322 SEAT BACK,ASSY,SLING,HEAVY DUTY,26"W,20"H,(26"W X 17"H BACK),SYNERGY SEAT SETASMB5323 SEAT BACK,ASSY,SLING,HEAVY DUTY,26"W,21"H,(26"W X 17"H BACK),SYNERGY SEAT SETASMB5324 SEAT BACK,ASSY,SLING,HEAVY DUTY,26"W,22"H,(26"W X 19"H BACK),SYNERGY SEAT SETASMB5325 SEAT BACK,ASSY,SLING,HEAVY DUTY,26"W,23"H,(26"W X 19"H BACK),SYNERGY SEAT SETASMB5326 SEAT BACK,ASSY,SLING,HEAVY DUTY,26"W,24"H,(26"W X 21"H BACK),SYNERGY SEAT SETASMB5327 SEAT BACK,ASSY,SLING,HEAVY DUTY,26"W,25"H,(26"W X 21"H BACK),SYNERGY SEAT SETASMB5328 SEAT BACK,ASSY,SLING,HEAVY DUTY,27"W,18"H,(27"W X 15"H BACK),SYNERGY SEAT SETASMB5329 SEAT BACK,ASSY,SLING,HEAVY DUTY,27"W,19"H,(27"W X 15"H BACK),SYNERGY SEAT SETASMB5330 SEAT BACK,ASSY,SLING,HEAVY DUTY,27"W,20"H,(27"W X 17"H BACK),SYNERGY SEAT SETASMB5331 SEAT BACK,ASSY,SLING,HEAVY DUTY,27"W,21"H,(27"W X 17"H BACK),SYNERGY SEAT SETASMB5332 SEAT BACK,ASSY,SLING,HEAVY DUTY,27"W,22"H,(27"W X 19"H BACK),SYNERGY SEAT SETASMB5333 SEAT BACK,ASSY,SLING,HEAVY DUTY,27"W,23"H,(27"W X 19"H BACK),SYNERGY SEAT SETASMB5334 SEAT BACK,ASSY,SLING,HEAVY DUTY,27"W,24"H,(27"W X 21"H BACK),SYNERGY SEAT SETASMB5335 SEAT BACK,ASSY,SLING,HEAVY DUTY,27"W,25"H,(27"W X 21"H BACK),SYNERGY SEAT SETASMB5336 SEAT BACK,ASSY,SLING,HEAVY DUTY,28"W,18"H,(28"W X 15"H BACK),SYNERGY SEAT SETASMB5337 SEAT BACK,ASSY,SLING,HEAVY DUTY,28"W,19"H,(28"W X 15"H BACK),SYNERGY SEAT SETASMB5338 SEAT BACK,ASSY,SLING,HEAVY DUTY,28"W,20"H,(28"W X 17"H BACK),SYNERGY SEAT SETASMB5339 SEAT BACK,ASSY,SLING,HEAVY DUTY,28"W,21"H,(28"W X 17"H BACK),SYNERGY SEAT SETASMB5340 SEAT BACK,ASSY,SLING,HEAVY DUTY,28"W,22"H,(28"W X 19"H BACK),SYNERGY SEAT SETASMB5341 SEAT BACK,ASSY,SLING,HEAVY DUTY,28"W,23"H,(29''W X 19''H BACK),SYNERGY SEAT SETASMB5342 SEAT BACK,ASSY,SLING,HEAVY DUTY,28"W,24"H,(28"W X 21"H BACK),SYNERGY SEAT SETASMB5343 SEAT BACK,ASSY,SLING,HEAVY DUTY,28"W,25"H,(28"W X 21"H BACK),SYNERGY SEAT SETASMB5344 SEAT BACK,ASSY,SLING,HEAVY DUTY,29''W,18"H,(29''W X 15''H BACK),SYNERGY SEAT SETASMB5345 SEAT BACK,ASSY,SLING,HEAVY DUTY,29''W,19"H,(29''W X 15''H BACK),SYNERGY SEAT SETASMB5346 SEAT BACK,ASSY,SLING,HEAVY DUTY,29''W,20"H,(29''W X 17''H BACK),SYNERGY SEAT SETASMB5347 SEAT BACK,ASSY,SLING,HEAVY DUTY,29''W,21"H,(29''W X 17''H BACK),SYNERGY SEAT SETASMB5348 SEAT BACK,ASSY,SLING,HEAVY DUTY,29''W,22"H,(29''W X 19''H BACK),SYNERGY SEAT SETASMB5349 SEAT BACK,ASSY,SLING,HEAVY DUTY,29''W,23"H,(29''W X 19''H BACK),SYNERGY SEAT SETASMB5350 SEAT BACK,ASSY,SLING,HEAVY DUTY,29''W,24"H,(29''W X 21''H BACK),SYNERGY SEAT SETASMB5351 SEAT BACK,ASSY,SLING,HEAVY DUTY,29''W,25"H,(29''W X 21''H BACK),SYNERGY SEAT SETASMB5352 SEAT BACK,ASSY,SLING,HEAVY DUTY,30''W,18"H,(30''W X 15''H BACK),SYNERGY SEAT SETASMB5353 SEAT BACK,ASSY,SLING,HEAVY DUTY,30''W,19"H,(30''W X 15''H BACK),SYNERGY SEAT SETASMB5354 SEAT BACK,ASSY,SLING,HEAVY DUTY,30''W,20"H,(30''W X 17''H BACK),SYNERGY SEAT
Page 6 of 7
Option Name MSRP Part Number Manufacturer Extended DescriptionSection Name
Q6 Edge HD Cross Reference Spreadsheet - Contoured and Synergy Seating
SETASMB5355 SEAT BACK,ASSY,SLING,HEAVY DUTY,30''W,21"H,(30''W X 17''H BACK),SYNERGY SEAT SETASMB5356 SEAT BACK,ASSY,SLING,HEAVY DUTY,30''W,22"H,(30''W X 19''H BACK),SYNERGY SEAT SETASMB5357 SEAT BACK,ASSY,SLING,HEAVY DUTY,30''W,23"H,(30''W X 19''H BACK),SYNERGY SEAT SETASMB5358 SEAT BACK,ASSY,SLING,HEAVY DUTY,30''W,24"H,(30''W X 21''H BACK),SYNERGY SEAT SETASMB5359 SEAT BACK,ASSY,SLING,HEAVY DUTY,30''W,25"H,(30''W X 21''H BACK),SYNERGY SEAT SETASMB5360 SEAT BACK,ASSY,SLING,HEAVY DUTY,31''W,18"H,(31''W X 15''H BACK),SYNERGY SEAT SETASMB5361 SEAT BACK,ASSY,SLING,HEAVY DUTY,31''W,19"H,(31''W X 15''H BACK),SYNERGY SEAT SETASMB5362 SEAT BACK,ASSY,SLING,HEAVY DUTY,31''W,20"H,(31''W X 17''H BACK),SYNERGY SEAT SETASMB5363 SEAT BACK,ASSY,SLING,HEAVY DUTY,31''W,21"H,(31''W X 17''H BACK),SYNERGY SEAT SETASMB5364 SEAT BACK,ASSY,SLING,HEAVY DUTY,31''W,22"H,(31''W X 19''H BACK),SYNERGY SEAT SETASMB5365 SEAT BACK,ASSY,SLING,HEAVY DUTY,31''W,23"H,(31''W X 19''H BACK),SYNERGY SEAT SETASMB5366 SEAT BACK,ASSY,SLING,HEAVY DUTY,31''W,24"H,(30''W X 21''H BACK),SYNERGY SEAT SETASMB5367 SEAT BACK,ASSY,SLING,HEAVY DUTY,31''W,25"H,(31''W X 21''H BACK),SYNERGY SEAT SETASMB5368 SEAT BACK,ASSY,SLING,HEAVY DUTY,32''W,18"H,(32''W X 15''H BACK),SYNERGY SEAT SETASMB5369 SEAT BACK,ASSY,SLING,HEAVY DUTY,32''W,19"H,(32''W X 15''H BACK),SYNERGY SEAT SETASMB5370 SEAT BACK,ASSY,SLING,HEAVY DUTY,32''W,20"H,(32''W X 17''H BACK),SYNERGY SEAT SETASMB5371 SEAT BACK,ASSY,SLING,HEAVY DUTY,32''W,21"H,(32''W X 17''H BACK),SYNERGY SEAT SETASMB5372 SEAT BACK,ASSY,SLING,HEAVY DUTY,32''W,22"H,(32''W X 19''H BACK),SYNERGY SEAT SETASMB5373 SEAT BACK,ASSY,SLING,HEAVY DUTY,32''W,23"H,(32''W X 19''H BACK),SYNERGY SEAT SETASMB5374 SEAT BACK,ASSY,SLING,HEAVY DUTY,32''W,24"H,(32''W X 21''H BACK),SYNERGY SEAT SETASMB5375 SEAT BACK,ASSY,SLING,HEAVY DUTY,32''W,25"H,(32''W X 21''H BACK),SYNERGY SEAT
SYNERGY BACK OPTIONS - Synergy Back Cane Height14" High Canes Standard FRMASMB15832 BACK CANE,ASSY,W/SHORT PUSH HANDLE,14"H,6 HOLE,SYNERGY,TEXTURED
Standard FRMASMB17097 BACK CANE,ASSY,W/SHORT PUSH HANDLE,14"H,SLING,SYNERGY,TEXTURED15" High Canes Standard FRMASMB15833 BACK CANE,ASSY,W/SHORT PUSH HANDLE,15"H,6 HOLE,SYNERGY,TEXTURED
Standard FRMASMB17098 BACK CANE,ASSY,W/SHORT PUSH HANDLE,15"H,SLING,SYNERGY,TEXTURED16" High Canes Standard FRMASMB15834 BACK CANE,ASSY,W/SHORT PUSH HANDLE,16"H,6 HOLE,SYNERGY,TEXTURED
Standard FRMASMB17099 BACK CANE,ASSY,W/SHORT PUSH HANDLE,16"H,SLING,SYNERGY,TEXTURED$62.50 x 2qty FRMASMB15774 BACK CANE,ASSY,W/NO PUSH HANDLE,STRAIGHT,16"H,6 HOLE,SYNERGY,TEXTURED
17" High Canes Standard FRMASMB15835 BACK CANE,ASSY,W/SHORT PUSH HANDLE,17''H,6 HOLE,SYNERGY,TEXTUREDStandard FRMASMB17100 BACK CANE,ASSY,W/SHORT PUSH HANDLE,17''H,SLING,SYNERGY,TEXTURED
$62.50 x 2qty FRMASMB15775 BACK CANE,ASSY,W/NO PUSH HANDLE,STRAIGHT,17''H,6 HOLE,SYNERGY,TEXTURED18" High Canes Standard FRMASMB15836 BACK CANE,ASSY,W/SHORT PUSH HANDLE,18"H,6 HOLE,SYNERGY,TEXTURED
Standard FRMASMB17101 BACK CANE,ASSY,W/SHORT PUSH HANDLE,18"H,SLING,SYNERGY,TEXTURED$62.50 x 2qty FRMASMB15776 BACK CANE,ASSY,W/NO PUSH HANDLE,STRAIGHT,18"H,6 HOLE,SYNERGY,TEXTURED
19" High Canes Standard FRMASMB15837 BACK CANE,ASSY,W/SHORT PUSH HANDLE,19"H,6 HOLE,SYNERGY,TEXTUREDStandard FRMASMB17102 BACK CANE,ASSY,W/SHORT PUSH HANDLE,19"H,SLING,SYNERGY,TEXTURED
$62.50 x 2qty FRMASMB15777 BACK CANE,ASSY,W/NO PUSH HANDLE,STRAIGHT,19"H,6 HOLE,SYNERGY,TEXTURED20" High Canes Standard FRMASMB15838 BACK CANE,ASSY,W/SHORT PUSH HANDLE,20"H,6 HOLE,SYNERGY,TEXTURED
Standard FRMASMB17103 BACK CANE,ASSY,W/SHORT PUSH HANDLE,20"H,SLING,SYNERGY,TEXTURED$62.50 x 2qty FRMASMB15778 BACK CANE,ASSY,W/NO PUSH HANDLE,STRAIGHT,20"H,6 HOLE,SYNERGY,TEXTURED
21" High Canes Standard FRMASMB15839 BACK CANE,ASSY,W/SHORT PUSH HANDLE,21''H,6 HOLE,SYNERGY,TEXTUREDStandard FRMASMB17104 BACK CANE,ASSY,W/SHORT PUSH HANDLE,21''H,SLING,SYNERGY,TEXTURED
$62.50 x 2qty FRMASMB15779 BACK CANE,ASSY,W/NO PUSH HANDLE,STRAIGHT,21''H,6 HOLE,SYNERGY,TEXTURED22" High Canes Standard FRMASMB15840 BACK CANE,ASSY,W/SHORT PUSH HANDLE,22''H,6 HOLE,SYNERGY,TEXTURED
Standard FRMASMB17105 BACK CANE,ASSY,W/SHORT PUSH HANDLE,22''H,SLING,SYNERGY,TEXTURED$62.50 x 2qty FRMASMB15780 BACK CANE,ASSY,W/NO PUSH HANDLE,STRAIGHT,22''H,6 HOLE,SYNERGY,TEXTURED
23" High Canes Standard FRMASMB15841 BACK CANE,ASSY,W/SHORT PUSH HANDLE,23"H,6 HOLE,SYNERGY,TEXTUREDStandard FRMASMB17106 BACK CANE,ASSY,W/SHORT PUSH HANDLE,23"H,SLING,SYNERGY,TEXTURED
$62.50 x 2qty FRMASMB15781 BACK CANE,ASSY,W/NO PUSH HANDLE,STRAIGHT,23"H,6 HOLE,SYNERGY,TEXTURED24" High Canes Standard FRMASMB15842 BACK CANE,ASSY,W/SHORT PUSH HANDLE,24"H,6 HOLE,SYNERGY,TEXTURED
Standard FRMASMB17107 BACK CANE,ASSY,W/SHORT PUSH HANDLE,24"H,SLING,SYNERGY,TEXTURED$62.50 x 2qty FRMASMB15782 BACK CANE,ASSY,W/NO PUSH HANDLE,STRAIGHT,24"H,6 HOLE,SYNERGY,TEXTURED
Page 7 of 7
Option Name MSRP Part Number Manufacturer Extended DescriptionSection Name
Q6 Edge HD Cross Reference Spreadsheet - Contoured and Synergy Seating
25" High Canes Standard FRMASMB15843 BACK CANE,ASSY,W/SHORT PUSH HANDLE,25''H,6 HOLE,SYNERGY,TEXTUREDStandard FRMASMB17108 BACK CANE,ASSY,W/SHORT PUSH HANDLE,25''H,SLING,SYNERGY,TEXTURED
$62.50 x 2qty FRMASMB15783 BACK CANE,ASSY,W/NO PUSH HANDLE,STRAIGHT,25''H,6 HOLE,SYNERGY,TEXTURED