Pride Mobility Victory LX Sport Owner's manual

Brand: Pride Mobility

Model: Victory LX Sport

Type: Owner's manual

Page 1 of 2INFINFB3823/RevA/03FEB2020

Victory

LX Sport 4-Wheel Scooter Quick Ship Order Form

Pride

Mobility Products Corporation

182 Susquehanna Ave., Exeter, PA 18643

Phone: 1-800-800-8586 | Fax: 1-800-800-1636 | Email: prideorders@pridemobility.com

Account Number: ___________ Date: ________________

Provider Name: __________________________________

Contact: ________________________________________

Phone: ___________________ Fax: _________________

Email: __________________________________________

PO Number: _____________________________________

Marked for: _____________________________________

Ship to Address: _________________________________

City: _____________________ State: ______ Zip: ______

1 8″ W × 18″ D ........................... Standard

With Sliders

Par t: SET147133

2 0″ W × 2 0″ D ................................... $300

No Sliders

Part: SET1800951

2 2 ″ W × 1 8 ″ D ................................... $350

No Sliders

Part: SET151622

SEATING — LIMITED RECLINE, HIGH BACK, BLACK VINYL

REQUIRED. Select one seat.

COLOR

REQUIRED. Colors shown here may dier from actual product depending on monitor/printer calibration.

Candy Apple Red

Part: DGN138560

True Blue

Part: DGN143071

ACCESSORIES

Optional.

Large Weather Cover ................... $202

Part: ACCCOVR1018

Saddle Bag (12.5″ × 9.875″) ........... $35

Part: DWR1020D010

Safety Flag ...................................... $38

Part: ACCASMB2079

Cup Holder, Style B ....................... $20

Used on SET1800951 and SET1515622 seats

Part: ACCASMB2287

Cup Holder, Style D ....................... $20

Used on SET147133 seat

Par t: ACC120041

Rearview Mirror (Additional) ........ $25

Part: LGTRMIR1003

Cell Phone Holder .......................... $70

Part: ACC1804467

USB Charger Port .......................... $38

Part: ACC1704791

This form is interactive when viewed in Adobe Acrobat Reader and may not function correctly if opened with applications other than Acrobat.

HCPCS codes provided should not be considered as legal advice and do not guarantee reimbursement. DME providers are responsible for determining

the appropriate billing codes when submitting for insurance reimbursement. Payer coding, coverage, and bundling guidelines may apply. All prices are

MSRP. Prices, specications, part numbers, and availability are subject to change without notice. Prices and part numbers as shown are only available

when congured as a complete scooter. Pride Providers may contact Technical Services for accurate parts ordering.

Thank you for choosing Pride Mobility Products!

INTRODUCTION

MODEL

REQUIRED. Weight capacity: 400 lbs. Find more details and specications at pridemobility.com/victory-lx-sport-4-wheel.

Victory LX Sport with CTS Suspension ...................... $3,359

Part: S710LXW. HCPCS: K0899, Power mobility device, not coded

by DME PDAC or does not meet criteria.

Standard Features

• CTS suspension

• Low/high speed control

• Two 50Ah AGM batteries

• 5-amp o-board charger

• Full light package

• Front basket

• One rearview mirror

• Delta tiller

Page 2 of 2INFINFB3823/RevA/03FEB2020

Pride

Mobility Products Corporation

182 Susquehanna Ave., Exeter, PA 18643

Phone: 1-800-800-8586 | Fax: 1-800-800-1636 | Email: prideorders@pridemobility.com

Account Number: ___________ Date: ________________ Marked for: _____________________________________

COMMENTS

BRANCH PATCHES

Optional.

Air Force Patch ............................... $20

Part: ACC140240

Army Patch ..................................... $20

Par t: ACC140241

Coast Guard Patch ........................ $20

Par t: ACC140239

Marines Patch ................................. $20

Par t: ACC140243

Navy Patch ...................................... $20

Par t: ACC140244

Purple Heart Patch ........................ $20

Part: ACC140238

CANE/CRUTCH HOLDER

Optional. Only one cane/crutch holder can be used at a time.

Wishbone Crutch Holder .................................................... $98

Part: FRMASMB2358

Quad Cane Holder ............................................................... $98

Part: ACCASMB1931

Single Rear Mount, 3″...........................................................$70

Part: ACCINDV1058

Double Rear Mount, 3″ .........................................................$70

Part: ACCINDV1019

LAP BELTS

Optional.

50″ Lap Belt ...............................$39.90

Part: ACCBELT1000

60″ Lap Belt ............................... $39.90

Part: ACCBELT1002

70″ Lap Belt ................................ $39.90

Part: ACCBELT1003

Rear Basket (15 . 2 5″ × 9 . 7 5 ″ × 9 . 5 ″ ) ..$80

Part: ACCBSKT1010

Oxygen Tank Holder ...................... $98

Part: ACCASMB1017

Walker Holder ................................. $98

Part: ACCASMB1018

BACK-MOUNTED ACCESSORIES

Optional. Only one back-mounted accessory can be used at a time. Includes mounting bracket and hardware.

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Pride Mobility Victory LX Sport Owner's manual

Brand: Pride Mobility

Model: Victory LX Sport

Type: Owner's manual

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Pride Mobility Victory LX Sport Owner's manual

Pride Mobility Victory LX Sport Owner's manual

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