Pride Mobility Maxima Owner's manual

Page 1 of 3INFINFB3728/RevD/13AUG2020

Maxima

Order Form — 3-Wheel and 4-Wheel Scooter

Pride

Mobility Products Corporation

401 York Avenue, Duryea, PA 18642

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: ______

COLOR

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

Candy Apple Red

3-Wheel Part: DGN144625

4-Wheel Part: DGN133697

Viper Blue

3-Wheel Part: DGN144626

4-Wheel Part: DGN136707

MODEL

REQUIRED. Weight capacity: 500 lbs. Find more specications at pridemobility.com/maxima-3-wheel and pridemobility.com/maxima-4-wheel.

Maxima 3-Wheel ............................................................. $4,099

Part: SC900. HCPCS: K0802, Group 1-Very Heavy Duty

Maxima 4-Wheel ............................................................. $4,499

Part: SC940. HCPCS: K0808, Group 2-Very Heavy Duty

Standard Features

• Two 55Ah AGM NF-22 batteries

• 5-amp o-board charger

• Front basket

• 22″ × 18″ medium-back seat

• Light package

• Rearview mirror

Power Elevating Seat ........................................................................................................................................................................$1,100

Part: MEC144637

POWER ELEVATING SEAT

Optional. Only available with the Maxima 3-wheel. Requires U-1 batteries (see below).

BATTERIES

REQUIRED. The Maxima requires two batteries.

NF-22 ............................................................................ Standard

Par t: BATASMB1004

Not available with Power Elevating Seat

U-1 .................................................................................. $133 ea.

Part: BAT120002

Required with Power Elevating Seat

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 Service for accurate parts ordering.

Thank you for choosing Pride

Mobility Products!

INTRODUCTION

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

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Account Number: ___________ Date: ________________ Marked for: _____________________________________

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

Forearm Crutch Holder ................. $98

Part: ACCASMB1019

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

Part: ACCINDV1058

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

Part: ACCINDV1019

ACCESSORIES

Optional.

Medium Black Weather Cover ......$158

Part: ACCCOVR1019

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

Part: ACCCOVR1018

Cane Clip ......................................... $51

Part: ACCASMB1980

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

Part: ACCASMB2287

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

Part: DWR1020D010

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

Part: ACCASMB1907

Rearview Mirror (additional)......... $25

Part: ACC134496

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

Part: ACC1704791

Rear Basket (15.25″ × 9.75″ × 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.

LAP BELTS

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

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

SEATING

Optional. The Maxima comes standard with a 22″W × 18″D medium-back seat. Other seats may be selected below. Sliders not available on any

Maxima seating.

Deluxe Contour, Medium-Back

1 8 ″ W × 18″ D ................................... $600

Part: SET134626

2 2″ W × 1 8″ D ................................... $600

Part: SET134630

2 2″ W × 2 0 ″ D ................................... $600

Part: SET134631

Deluxe Contour, High-Back

2 0″ W × 1 8 ″ D ................................... $150

Part: SET134621

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

Page 3 of 3INFINFB3728/RevD/13AUG2020

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Pride

Mobility Products Corporation

401 York Avenue, Duryea, PA 18642

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

Account Number: ___________ Date: ________________ Marked for: _____________________________________

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