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INFINFB3717/RevD/18JUN2019
This form is interactive when viewed with 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 ap-
propriate billing codes when submitting for insurance reimbursement. Payer coding, coverage, and bundling guidelines may apply. All prices are MSRP.
Prices, specications, part numbers, and availability are subject to change without notice. Prices and part numbers as shown are only available when
congured as a complete power lift recliner. Pride Providers may contact Technical Services for accurate parts ordering. Options noted with XRef have
multiple possible part numbers based on system conguration. Please see cross-reference spreadsheet for the XRef part numbers.
Thank you for choosing Pride
®
Mobility Products!
Introduction
Innity Collection
375 lb. weight capacity, true-innite position* chaise lounger.
LC-525iS ..........................................................................$1,649
Part: LC525ISMODEL
Height Range: 5′3″ and below. Seat Width: 19″.
HCPCS: E0627 - seat lift mechanism, electric, any type.
LC-525iM .........................................................................$1,699
Part: LC525IMMODEL
Height Range: 5′4″ to 6′. Seat Width: 20″.
HCPCS: E0627 - seat lift mechanism, electric, any type.
LC-525iL ..........................................................................$1,699
Part: LC525ILMODEL
Height Range: 5′9″ to 6′2″. Seat Width: 22″.
HCPCS: E0627 - seat lift mechanism, electric, any type.
LC-525iPW ......................................................................$1,699
Part: LC525IPWMODEL
Height Range: 5′2″ and below. Seat Width: 24″.
HCPCS: E0627 - seat lift mechanism, electric, any type.
Innity Collection Quick Ship Order Form
Pride Mobility Products Corp.
182 Susquehanna Ave., Exeter, PA 18643
Phone: 1-800-800-8586 | Fax: 1-800-800-1636 | Email: prideorders@pridemobility.com
LC-525iM
Shown in Lexis Sta-Kleen Mushroom
Deep Sky ................................................. Standard
Part: FABPDSK
Ember ......................................................Standard
Part: FABPEMB
Oat ............................................................Standard
Part: FABPOAT
Timber .....................................................Standard
Part: FABPTIM
Select a Fabric Color
See Page 2 for more fabrics.
DuraSoft Fabrics
Quick Ship fabrics.
Account Number: ___________ Date: ________________
Provider Name: __________________________________
Contact: ________________________________________
Phone: ___________________ Fax: _________________
Email: __________________________________________
PO Number: _____________________________________
Marked for: _____________________________________
Ship to Address: _________________________________
City: _____________________ State: ______ Zip: ______
* See Power Lift Recliner Position Reference on Page 2.
Black ................................................................ $150
Part: FABSKB
Mushroom ....................................................... $150
Part: FABSKM
Burgundy ........................................................ $150
Part: FABSKG
Chestnut .......................................................... $150
Part: FABSKC
Lexis Sta-Kleen Fabrics
Not a Quick Ship fabric. May increase lead time.