MATRX POSITIONING ACCESSORIES
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1 INVACARE MATRX ACCESSORIES US PRICE LIST/ORDER FORM Effective March 1, 2018 Date of Order: Ship to Address: Dealer Name: Dealer Account #: City: PO #: State: Zip: Tag: Comments: Purchasing Contact: Phone: Fax: Positioning Accessories 4 Page Elan Headrest Supports 2/3 Arm Accessories 4/5 Calf Straps and Lap Belts 1 Calf Straps & Lap Belts 4 HCPCS Code: E0995 q QTY BP-CS-M Air Mesh Calf Strap Medium $ " High and fits chairs 15" 18" Wide q QTY BP-CS-L Air Mesh Calf Strap Large $ " High and fits chairs 18" 22" Wide q QTY BP-CP-MD Air Mesh Calf Panel Medium $ " High x 35.5" Wide and fits chairs 15" 18" Wide q QTY BP-CP-LG Air Mesh Calf Panel Large $ " High x 38.5" Wide and fits chairs 18" 22" Wide 4 HCPCS Code: E0978 q QTY BP-PLB2 Padded Lap Belt 2 Point $ Center Pull, push button, padded lap belt Fits hip widths 13" 19" q QTY BP-PLB4 Padded Lap Belt 4 Point $ Center Pull, push button, padded lap belt Fits hip widths 13" 19" FAX: of 5 TRD0367 REV F
2 MATRX ELAN HEADREST PAD OPTIONS n Aluminum plate can be formed to shape n Dual layer molded foam n Tailored, zippered removable cover n Standard Startex or reversed Startex (Infection Control) outer covers. Startex Outer Cover Infection Control Outer Cover Elan Headrest Supports 4 HCPCS Code: Pad/Hardware E0955/E0128 q QTY ESP6 Matrx Elan Standard Pad - 6"W x 3.5"H $235 q QTY ESP6-IC Matrx Elan Standard Pad - 6"W x 3.5"H $235 q QTY ESP10 Matrx Elan Standard Pad - 10"W x 5"H $235 q QTY ESP10-IC Matrx Elan Standard Pad - 10"W x 5"H $235 q QTY ESP14 Matrx Elan Standard Pad - 14"W x 5"H $235 q QTY ESP14-IC Matrx Elan Standard Pad - 14"W x 5"H $235 q QTY EOP9 Matrx Elan Occipital Pad - 9"W x 7"H $235 q QTY EOP9-IC Matrx Elan Occipital Pad - 9"W x 7"H $235 q QTY EOP12 Matrx Elan Occipital Pad - 12"W x 8"H $235 q QTY EOP12-IC Matrx Elan Occipital Pad - 12"W x 8"H $235 NEW q QTY E4PTSM Matrx Elan 4 Point Pad - 9"W x 7"H (Small) $325 q QTY E4PTSM-IC Matrx Elan 4 Point Pad - 9"W x 7"H $325 q QTY E4POINT Matrx Elan 4 Point Pad - 11"W x 10"H (Large) $325 q QTY E4POINT-IC Matrx Elan 4 Point Pad - 11"W x 10"H (Large) $ FAX: of 5 TRD0367 REV F
3 POSITIONING MATRX ELAN ACCESSORIES HEADREST PAD COVERS Elan Headrest Pad Covers MODEL DESCRIPTION MSRP q ESC Startex Pad Cover $45.00 q ESC-IC Infection Control Pad Cover $45.00 NEW q EC4PTSM 4 Point - (Small) Startex Pad Cover $75.00 NEW q EC4PTSM-IC 4 Point - (Small) Infection Control Pad Cover $75.00 q EC4POINT 4 Point - (Large) Startex Pad Cover $75.00 q EC4POINT-IC 4 Point - (Large) Infection Control Pad Cover $75.00 SPECIFY: MODEL NUMBER q QTY POSITIONING MATRX ELAN ACCESSORIES HEADREST HARDWARE OPTIONS Headrest Hardware q QTY MAHU Multi-Axis Hardware $ Depth & Height Adjustable through horizontal slide bar. Dual pivot ball for pad orientation Elan Headrest Hardware q QTY MEHW Matrx Elan Hardware $220 Infinitely adjustable through pivot ball and multi disk locking plates, standard vertical post 15 q QTY MEMH Matrx Elan MINI Hardware $220 Infinitely adjustable through pivot ball and multi disk locking plates, mini vertical post FAX: of 5 TRD0367 REV F
4 Arm Accessories q QTY CAP-IDL Modular, Integral Foam Arm Pad Desk (each) $85.00 Desk Length 4" 10", Left q QTY CAP-IDR Modular, Integral Foam Arm Pad Desk (each) $85.00 Desk Length 4" 10", Right q QTY CAP-IFL Modular, Integral Foam Arm Pad Full (each) $95.00 Full Length 4" 14", Left q QTY CAP-IFR Modular, Integral Foam Arm Pad Full (each) $95.00 Full Length 4" 14", Right q QTY CAP-VDL Modular, Visco Foam/Startex Arm Pad Desk (each) $95.00 Desk Length 4" 10", Left q QTY CAP-VDR Modular, Visco Foam/Startex Arm Pad Desk (each) $95.00 Desk Length 4" 10", Right q QTY CAP-VFL Modular, Visco Foam/Startex Arm Pad Full (each) $ Full Length 4" 14", Left q QTY CAP-VFR Modular, Visco Foam/Startex Arm Pad Full (each) $ Full Length 4" 14", Right q QTY MPA-D Multi Position Arm Pad Desk (each) $85.00 Desk Length 3" 10" q QTY MPA-F Multi Position Arm Pad Full (each) $85.00 Full Length 3" 14" q QTY GAP-N Gel Arm Pad Narrow (each) $75.00 Narrow width 2" 12" q QTY GAP-W Gel Arm Pad Wide (each) $75.00 Wide width 3.5" 12" q QTY GAP-L Gel Arm Pad Long (each) $90.00 Long width 3.5" 14" q QTY MACES-EA Multi-Axis Armrest Mount (each) $ For use with EAH, EAT or MPA Allows infinite adjustment of angle and rotation or arm pad q QTY MACES-GA Multi-Axis Armrest Mount (each) $ For use with GAP-W and GAP-L Allows infinite adjustment of angle and rotation or arm pad q QTY JOY-MACES-EA Joystick mounting bar for Multi-Axis Armrest $ With EAH, EAT or MPA q QTY JOY-MACES-GA Joystick mounting bar for Multi-Axis Armrest $ With GAP-N, GAP-W or GAP-L FAX: of 5 TRD0367 REV F
5 Arm Accessories 4 HCPCS Code: E2209 q QTY EAH-R 1, 3 Ergonomic Arm Trough/Hand Pad Kit (each) $ Users Right Hand Side q QTY EAH-L 1, 3 Ergonomic Arm Trough/Hand Pad Kit (each) $ Users Left Hand Side q QTY EAT-R 2 Ergonomic Arm Trough (each) $ Users Right Hand Side q QTY EAT-L 2 Ergonomic Arm Trough (each) $ Users Left Hand Side q QTY EHP 1,3 Hand Pad Kit (each) $ Users Right and Left Hand Side q QTY EMH Arm Trough/Hand Pad Mounting Hardware (each)$40.00 For Matrx Hand Pad q QTY EMO Arm Trough/Hand Pad Mounting Hardware (each)$38.00 For OttoBock Hand Pad 1 IHCPCS: K0106 for Ergonomic Arm Trough only 2 Does not include mounting hardware to connect to hand pad, must order EMH or EMO; or complete set EAH R or EAH L 3 Includes Arm Trough/Hand Pad Mounting Hardware (EMH) FAX: of 5 TRD0367 REV F
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