Invacare IVC Tracer SX5 Parts List

®
Invacare IVC™ Tracer
Price List and Order Form
For ease of ordering, contact Customer Service Toll Free at:
800-333-6900 Fax: 800-678-4682
To order Literature: 800-828-6282
Company Name ______________________________________________________Account # ____________________________________________
Phone ________________________ P.O. # ________________________________Date_________________________________________________
Ship to Name & Address ____________________________________________________________________________________________________
HCPCS codes are not intended to be, nor should be considered billing or legal advice. Providers are responsible for determining the appropriate billing codes when
submitting claims to the Medicare Program and should consult an attorney or other advisor to discuss specific situations in further detail.
NOTE: Existing base information (serial #) will need to be supplied to Customer Service to ensure correct configuration.
FRAME & SEAT
CHAIR TYPE
TRSX5 Tracer SX5 Builder Wheelchair (K0003) ............ 678.00
1
FRAME TYPE
ADULT Adult 19.5 ....................................................... No Charge
HEMI Hemi 17.5 ....................................................... No Charge
FRAME WIDTH & DEPTH
WD46 14" Wide X 16" Deep (K0108) ...................... No Charge
WD66 16" Wide X 16" Deep..................................... No Charge
WD86 18" Wide X 16" Deep..................................... No Charge
WD06 20" Wide X 16" Deep (K0006/E2201) .......... No Charge
WD26 22" Wide X 16" Deep (K0006/E2201) ................ 142.00
ARM & BACK
3
ARM TYPE
18FB Full Length Fixed Ht. Flip-Back 10" ............. No Charge
19FB Full Length Adj. Ht. Flip-Back 10"-14" .............. 130.00
28FB Desk Lng Fxd Ht. Flip-Back 10" (E0973) ..... No Charge
29FB Desk Lng Adj. Ht. Flip-Back 10"-14" (E0973) ... 130.00
BACK TYPE
BH16 Back Height 16" .............................................. Standard
BH18 Back Height 18" ............................................. No Charge
COLORS
UPHOLSTERY COLORS
U240 Black Nylon Upholstery.................................. Standard
U550 Midnight Blue Vinyl Uph .............................. No Charge
U67 Black Vinyl..................................................... No Charge
U86 Ruby Red Vinyl.............................................. No Charge
CASTERS
CASTER OPTIONS
AT902 6" Composite Urethane 3 Spoke .................... No Charge
AT903 8" X 1.25" Composite Urethane..................... No Charge
1255 8" X 1" Solid Rubber Dark Grey .................... Standard
1228 8" X 1.75" Semi Pneumatic Casters Lt Grey ......... 56.00
FOOTNOTES
1
Based on 24" wheels and 8" casters, see seat-to-floor matrix.
2
20" and 22" widths have 300 lb wt limit, standard with 1228 casters, 24" rear
wheels and CHDRM handrims.
3
Arms are Flipback non-removable.
®
SX5 Wheelchair (Builders)
Effective July 1, 2008
NOTE: All specifications and dimensions are approximate.
For the most current pricing information go to www.invacare.com.
www.invacare.com
Special Note
WHEEL OPTIONS
U1763BK 20" Composite Urethane Tires ............................. 113.00
U1764BK 22" Composite Urethane Tires ............................. 113.00
2244BK 24" Composite Pneumatic Tires ........................... 140.00
4244BK 24" Comp Pneumatic w/FF Inserts (E2213) ........ 225.00
U2222 24" Composite Urethane Tires ........................ Standard
U2244BK 24" Composite Urethane Treaded Tires ............... 120.00
WHEEL OPTIONS (ONE ARM DRIVE)
99457R One Arm Drive w/2244BK/FF RH (E0958) ........ 589.00
99458L One Arm Drive w/2244BK/FF LH (E0958) ........ 589.00
2
9456L One Arm Drive w/U2222 LH (E0958)................. 606.00
9456R One Arm Drive w/U2222 RH (E0958) ................ 606.00
2
HANDRIMS OPTIONS
AHDRM Aluminum Handrims .....................................No Charge
CHDRM Chrome Plated Handrims................................No Charge
COM Composite Handrims ....................................... Standard
L8702 Omit Handrims ..............................................Less 15.00
WHEEL LOCKS
9690B Pull To Lock Whl Locks (Std on Hemi) ........No Charge
9691B Push To Lock Whl Locks (Std on Adult).......No Charge
9690 Pull To Lock Disk Wheel Locks ....................No Charge
9691 Push To Lock Disk Wheel Locks...................No Charge
POSITIONING STRAPS
SEAT POSITIONING STRAPS
1515 Push Button Style Buckle Seat Pos Strap (E0978) ....... 50.00
1321BK Hook &Loop Seat Positioning Strap (E0978)........ 40.00
FOOTNOTES
4
Not available with amputee attachment.
5
Not available with U2222 rear wheels.
6
Available with 24" rear wheels only.
WHEELS
4
5
6
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