Invacare® IVC™ Tracer® SX5 Wheelchair (Builders)
Price List and Order Form
Effective July 1, 2008
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 ____________________________________________________________________________________________________
Special Note
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
WHEELS
CHAIR TYPE
WHEEL OPTIONS
‰ TRSX5
Tracer SX5 Builder Wheelchair (K0003) ............ 678.00
‰ U1763BK
‰ U1764BK
‰ 2244BK
‰ 4244BK
‰ U2222
20" Composite Urethane Tires ............................. 113.00
22" Composite Urethane Tires ............................. 113.00
24" Composite Pneumatic Tires........................... 140.00
24" Comp Pneumatic w/FF Inserts (E2213) ........ 225.00
24" Composite Urethane Tires ........................ Standard
24" Composite Urethane Treaded Tires............... 120.00
FRAME TYPE 1
‰ ADULT
‰ HEMI
Adult 19.5.......................................................No Charge
Hemi 17.5 .......................................................No Charge
‰ U2244BK
FRAME WIDTH & DEPTH
WHEEL OPTIONS (ONE ARM DRIVE)
‰ WD46
‰ WD66
‰ WD86
‰ WD06
‰ WD26
14" Wide X 16" Deep (K0108)......................No Charge
‰ 99457R
‰ 99458L
‰ 9456L
‰ 9456R
One Arm Drive w/2244BK/FF RH (E0958)........ 589.00
16" Wide X 16" Deep.....................................No Charge
18" Wide X 16" Deep.....................................No Charge
20" Wide X 16" Deep (K0006/E2201) ..........No Charge
22" Wide X 16" Deep (K0006/E2201) ................ 142.00
One Arm Drive w/2244BK/FF LH (E0958) ........ 589.00
One Arm Drive w/U2222 LH (E0958)................. 606.00
One Arm Drive w/U2222 RH (E0958) ................ 606.00
HANDRIMS OPTIONS
ARM & BACK
‰ AHDRM
‰ CHDRM
‰ COM
Aluminum Handrims .....................................No Charge
Chrome Plated Handrims................................No Charge
Composite Handrims ....................................... Standard
Omit Handrims ..............................................Less 15.00
ARM TYPE 3
‰ 18FB
‰ 19FB
‰ 28FB
Full Length Fixed Ht. Flip-Back 10" .............No Charge
Full Length Adj. Ht. Flip-Back 10"-14" .............. 130.00
Desk Lng Fxd Ht. Flip-Back 10" (E0973).....No Charge
Desk Lng Adj. Ht. Flip-Back 10"-14" (E0973) ... 130.00
‰ L8702
WHEEL LOCKS
‰ 29FB
‰ 9690B
‰ 9691B
‰ 9690
Pull To Lock Whl Locks (Std on Hemi) ........No Charge
Push To Lock Whl Locks (Std on Adult).......No Charge
Pull To Lock Disk Wheel Locks ....................No Charge
Push To Lock Disk Wheel Locks...................No Charge
BACK TYPE
‰ BH16
‰ BH18
Back Height 16" .............................................. Standard
Back Height 18" .............................................No Charge
‰ 9691
POSITIONING STRAPS
COLORS
SEAT POSITIONING STRAPS
UPHOLSTERY COLORS
‰ 1515
Push Button Style Buckle Seat Pos Strap (E0978) ....... 50.00
Hook &Loop Seat Positioning Strap (E0978)........ 40.00
‰ U240
‰ U550
‰ U67
‰ U86
Black Nylon Upholstery.................................. Standard
‰ 1321BK
Midnight Blue Vinyl Uph ..............................No Charge
Black Vinyl.....................................................No Charge
Ruby Red Vinyl..............................................No Charge
CASTERS
CASTER OPTIONS
‰ AT902
‰ AT903
‰ 1255
6" Composite Urethane 3 Spoke ....................No Charge
8" X 1.25" Composite Urethane.....................No Charge
8" X 1" Solid Rubber Dark Grey .................... Standard
8" X 1.75" Semi Pneumatic Casters Lt Grey......... 56.00
‰ 1228
FOOTNOTES
1 Based on 24" wheels and 8" casters, see seat-to-floor matrix.
FOOTNOTES
4 Not available with amputee attachment.
5 Not available with U2222 rear wheels.
6 Available with 24" rear wheels only.
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.
NOTE: All specifications and dimensions are approximate.
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