Pride Mobility Jazzy Elite ES-1 Owner's manual

Brand: Pride Mobility

Model: Jazzy Elite ES-1

Type: Owner's manual

Page 1 of 3INFINFB3770/RevE/03FEB2020

Jazzy

Elite ES-1 Quick Ship Order Form

Account Number: ___________ Date: ________________

Provider Name: __________________________________

Contact: ________________________________________

Phone: ___________________ Fax: _________________

Email: __________________________________________

PO Number: _____________________________________

Marked for: _____________________________________

Ship to Address: _________________________________

City: _____________________ State: ______ Zip: ______

Jazzy Elite ES-1 1S-C ......................................................$5,099

Part: JELITEES-1S-C. HCPCS: K0816

Contoured Seat (Captain) Standard

Standard Features

• Front-wheel drive

• GC3 joystick

• In-line joystick mounting bracket

• 3-amp o-board charger

BASE MODEL

REQUIRED. Select a power base. Weight capacity: 300 lbs. Find more details and specications at pridemobility.com/jazzy-elite-es-1.

INTRODUCTION

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 power chair. Pride Providers may contact Technical Services for accurate parts ordering.

Thank you for choosing Pride Mobility Products!

1 6″ W × 1 6″ – 18″ D ................... Standard

With 60″ Lap Belt

Part: SET131843

1 8″ W × 1 8″ – 2 0″ D ................... Standard

With 60″ Lap Belt

Part: SET131844

2 0″ W × 1 8 ″ – 2 0″ D ................... Standard

With 60″ Lap Belt

Part: SET131845

CONTOURED SEATING

Optional. Select one seat. Seats come with a lap belt.

1 8″ W × 1 6″ D ............................................................................................................................................................................................$450

With 60″ Lap Belt

Part: SETASMB2775

Depth-Adjustable, Comfort Seat, Limited Recline, High Back

Deluxe Contour, Limited Recline, High Back

Additional lead time may apply.

Pride

Mobility Products Corporation

182 Susquehanna Ave., Exeter, PA 18643

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

Candy Apple Red

Part: DGN1702485

Viper Blue

Part: DGN1702484

BASE COLOR

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

Page 2 of 3INFINFB3770/RevE/03FEB2020

Account Number: ___________ Date: ________________ Marked for: _____________________________________

Weather Cover, Medium, Black .........................................$168

Part: ACCCOVR1022

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

Part: DWR1020D010

Cup Holder ............................................................................. $20

Style C, Comfort part: ACCASMB2288

Style B, Deluxe Contour part: ACCASMB2287

Flag Holder ............................................................................$25

Comfort part: ACCASMB2629

Deluxe Contour part: ACCASMB1930

PP1 Programmer ................................................................. $423

Part: CTLDC1388

Height-Adjustable Foot Platform Bracket .........................$50

Part: ACCASMB2580

USB XLR Charger .................................................................$38

Part: ACC1704791

Unoccupied Transit Kit ......................................................$100

Part: KIT1805521

Used on Comfort Seats only — see SEATING on Page 1.

ACCESSORIES

Optional.

Rear Basket (15.25″ × 9.75″ × 9.5″) ...................................... $118

Deluxe Contour part: ACCASMB1914. Comfort part: ACCASMB2537

Cane/Crutch Holder ............................................................ $110

Comfort part: ACCASMB2540. Deluxe Contour part: ACCASMB2294

HCPCS: E2207

Oxygen Tank Holder ........................................................... $118

Comfort part: ACCASMB2651. Deluxe Contour part: ACCASMB2292

HCPCS: E2208

Walker Holder ...................................................................... $103

Comfort part: ACCASMB1912. Deluxe Contour part: ACCASMB2541

Back-Mounted Accessories

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

Elevating Leg Rests with 7.25″ × 6″ Foot Plates (pair)......$325

Part: KIT124479 HCPCS: K0195

Elevating Leg Rests with 8.5″ × 6″ Foot Plates (pair) .....$325

Part: KIT124480 HCPCS: K0195

Elevating Leg Rests

Residual Limb Support ..........................................$325 ea.

Left part: FRMASMB5301. Right part: FRMASMB5300

HCPCS: E1020

Heel Loops (pair) ...................................................................$50

ELR part: FRMASMB1503. S/A part: FRMASMB7873

HCPCS: E0951

Leg Rest Accessories

Swing-Away Leg Rest with 7.25″ × 6″ Foot Plates (pair) .... $162

Part: RIG133656

Swing-Away Leg Rest with 8.5″ × 6″ Foot Plates (pair) .... $162

Part: RIG133659

60° – 9 0 ° Swing-Away Leg Rests

Adjustable in 5° increments.

LEG RESTS

Optional.

ARMRESTS

REQUIRED. The armrests are automatically selected with a Quick Ship order based on seat selection.

Flip-up, Height-Adjustable, Full-Length Armrests ................................................................................................................. $85 ea.

Comfort Seat Left part: FRMASMB16315. Right: FRMASMB16316

Deluxe Contour Left part: FRMASMB8614. Right: FRMASMB8615

HCPCS: E0973

BATTERIES

REQUIRED. The Power Chair requires two batteries. The batteries are automatically selected with a Quick Ship order.

U-1, 27Ah .......................................................................................................................................................................................... $133 ea.

Part: BATLIQ1026. HCPCS: E2365

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

Part: ACC140240

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

Part: ACC140241

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

Part: ACC140239

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

Part: ACC140243

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

Part: ACC140244

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

Part: ACC140238

Page 3 of 3INFINFB3770/RevE/03FEB2020

Account Number: ___________ Date: ________________ Marked for: _____________________________________

BRANCH PATCHES

Optional.

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

Part: ACC140240

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

Part: ACC140241

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

Part: ACC140239

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

Part: ACC140243

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

Part: ACC140244

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

Part: ACC140238

Pride

Mobility Products Corporation

182 Susquehanna Ave., Exeter, PA 18643

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

youtube.com/

pridemobility

facebook.com/

PrideMobilityProductsCorp

twitter.com/

pridemobility

instagram.com/

PrideMobilityProducts

REFERENCE ORDER FORMS

Optional. Select below to note that additional order forms will accompany this order form.

Synergy Seat (May increase lead time)

NOTES

Swing-Away, In-line ......................................................$245

Left part: ACC148364. Right part: ACC148365

HCPCS: E1028

Swing-Away, 1″ Oset ..................................................$245

Left part: ACC148366. Right part: ACC148367

HCPCS: E1028

JOYSTICK MOUNTING BRACKETS

Optional. The power chair comes standard with an in-line joystick mounting bracket. Additional brackets may be selected below.

Swing-Away Joystick

In-line Mount (Right)

Swing-Away Joystick

Offset Mount (Right)

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

Part: ACCBELT1000

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

Part: ACCBELT1003

80″ Lap Belt ......................................................................$39.90

Part: ACCBELT1004

90″ Lap Belt ......................................................................$39.90

Part: ACCBELT1001

LAP BELTS

Optional. Seats come with a 60″ lap belt. An additional lap belt size may be selected below.

Pride Mobility Jazzy Elite ES-1 Owner's manual

Brand: Pride Mobility

Model: Jazzy Elite ES-1

Type: Owner's manual

Download PDF

report

Pride Mobility Jazzy Elite ES-1 Owner's manual

Pride Mobility Jazzy Elite ES-1 Owner's manual

Related papers

Other documents