Mobility Devices Product Manual Effective Date - November 02, 2020

Mobility Devices
Product Manual
Effective Date : November 02, 2020
Assistive Devices Program

Ministry of Health
Accessible format of this document can be requested by e-mail at adp@ontario.ca.
Printed Date: Nov 2, 2020 Page: 1 of 135

Ministry of Health
Mobility Devices Effective From: November 02, 2020
Ambulation Aids
Device Type Manufacturer Device Device Code Max Approved
Allowed Price
Qty.
Adult Wheeled Walker Type 1 Airway Surgical Top Release 5051/5051-J MW1AR0005 1 $82.00
Walker type most suitable for Drive Medical 10263KDR Travel Folding Walker AA0000560 1 $82.00
use on hard, flat surfaces. ADP
price includes frame, two or four Deluxe Folding Wheeled Walker MW1GM0010 1 $82.00
small wheels (less than 6" One Button Or Dual Trigger MW1D50005 1 $82.00
diameter) and braking system (if Release
available). See Ambulation Aids
Guardian Red Dot Extra Wide G07767 MW1GU0020 1 $82.00
Options Chart if heavy duty
frame and/or forearm Red Dot G07756 MW1GU0035 1 $82.00
attachments required. Red Dot Standard G07755 & MW1GU0015 1 $82.00
G07756
Invacare Adult MW1IN0010 1 $82.00
Lumex Dual Release Adult/Junior MW1LU0020 1 $82.00
Lightweight Adult/Junior MW1LU0010 1 $82.00
Rubbermaid Deluxe MW1C60010 1 $82.00
Sunrise Medical Breezy Everyday Folding Walking AA0001152 1 $82.00
Frame with wheels
Adult Wheeled Walker Type 2 Airway Surgical 5314 MW2AR0010 1 $324.00
Walker type most suitable for Drive Medical Airgo Adventure 6 MW2GM0040 1 $324.00
price includes frame, four small Airgo Excursion 6 X20 AA0001355 1 $324.00
wheels (less than 6" diameter), Airgo Ultra Light MW2GM0050 1 $324.00
hand braking system, seat, and
Duet 795b Rollator MW2D00010 1 $324.00
back support. See Ambulation
Aids Options Chart if heavy duty Go-Lite Deluxe MW2D50005 1 $324.00
frame and/or forearm Evolution Medical Challenger Grande MW2EV0025 1 $324.00
attachments required.
Challenger Mini MW2EV0010 1 $324.00
Sprite & Sprite Mini MW2EV0005 1 $324.00
Sprite Grande MW2EV0020 1 $324.00
Xpresso Companion Two AA0001309 1 $324.00
Xpresso Trillium Two AA0001306 1 $324.00
Human Care Nexus 1 (Cable Brake) MW2DG0050 1 $324.00
Page: 2 of 135
Ministry of Health
Ambulation Aids
Allowed Price
Qty.
Adult Wheeled Walker Type 2 Canada Inc. Nexus One Adult Type 2 Rollator AA0001810 1 $324.00
Walker type most suitable for Invacare Rollite 65100 MW2IN0050 1 $324.00
price includes frame, four small MEDLINE Translator AA0000459 1 $324.00
wheels (less than 6" diameter), INDUSTRIES INC.
hand braking system, seat, and Nighthawk Ats 902 Handi Lite MW2NM0005 1 $324.00
back support. See Ambulation
Ats 903 Handi Lite MW2NM0010 1 $324.00
Aids Options Chart if heavy duty
frame and/or forearm Ats 904 Handi Lite MW2NM0015 1 $324.00
attachments required. Ovation Compact 807-6 MW2NM1005 1 $324.00
Parsons Adl 4200 Dx MW2DG0010 1 $324.00
4200 Lx MW2DG0005 1 $324.00
Prode3 ProDe3 Victr/ 17,19 21 inches AA0000320 1 $324.00
Sunburst Medical Freedom Plus MW22S0005 1 $324.00
Freedom Plus Short MW22S0010 1 $324.00
Adult Wheeled Walker Type 3 Access Vital As Active MW3V80005 1 $417.00
Walker type most suitable for Breeze MW3V80010 1 $417.00
active use on most terrains. ADP
price includes frame,four large Airway Surgical 5305 Adult Type 3 Walker AA0000315 1 $417.00
wheels (6"/8" diameter), hand 5307 Rollator AA0000460 1 $417.00
braking system, seat, and back
Amg Medical Airgo Vista V20 AA0001338 1 $417.00
support. See Ambulation Aids
Options Chart if heavy duty Amysystems Stella Rollator (18, 20, 23 & HD) AA0001580 1 $417.00
frame and/or forearm Dolomite Alpha Advanced MW3DO1085 1 $417.00
Alpha Basic MW3DO1080 1 $417.00
Jazz MW3DO2000 1 $417.00
Opal Futura Symphony MW3DO1055 1 $417.00
Opal Legacy MW3DO1040 1 $417.00
Opal Maxi / Maxi+ MW3DO1035 1 $417.00
Soprano MW3DO1095 1 $417.00
Drive Medical AIRGO EXCURSION XWD AA0000124 1 $417.00
Airgo Adventure 8 MW3GM0060 1 $417.00
Page: 3 of 135
Ministry of Health
Ambulation Aids
Allowed Price
Qty.
Adult Wheeled Walker Type 3 Drive Medical Airgo Comfort Plus Xwd MW3GM0055 1 $417.00
Walker type most suitable for Airgo Comfort-Plus MW3GM0050 1 $417.00
price includes frame,four large Airgo Duo MW3GM0040 1 $417.00
wheels (6"/8" diameter), hand Airgo Excursion MW3GM0065 1 $417.00
braking system, seat, and back
Airgo Fusion Rollator AA0000694 1 $417.00
Options Chart if heavy duty Airgo Navigator MW3GM0015 1 $417.00
frame and/or forearm Diamond 740r Rollator MW3D50010 1 $417.00
Nitro AA0001036 1 $417.00
Nitro HD Hemi Height Rollator AA0001475 1 $417.00
Nitro HD Rollator AA0001238 1 $417.00
Nitro Hemi AA0001193 1 $417.00
Nitro Tall AA0001194 1 $417.00
Enkatsu Solutions Prima Rollator MW3EH0005 1 $417.00
Evolution Medical Challenger Low Wide MW3EV0035 1 $417.00
Challenger Wide MW3EV0030 1 $417.00
Evolution Dx, Ldx, Wdx, Lwdx MW3EV0005 1 $417.00
Horizon Dx, Wdx, Lwdx, Tdx MW3EV0010 1 $417.00
Piper Dx, Mdx, Smdx, Tdx MW3EV0020 1 $417.00
Xpresso Companion AA0001308 1 $417.00
Xpresso Trillium AA0001307 1 $417.00
Xpresso Wide & Low Wide AA0001283 1 $417.00
Xpresso Zero, Zero Mini & Zero AA0001282 1 $417.00
Tall
Xpresso, Xpresso Lite MW3EV0040 1 $417.00
GF HEALTH HYBRID LX Rollator AA0000453 1 $417.00
PRODUCTS
Human Care Nexus Ii (Cable Brake) MW3DG0040 1 $417.00
Canada Inc.
Nexus Iii (Cable Free Braking MW3DG0045 1 $417.00
Page: 4 of 135
Ministry of Health
Ambulation Aids
Allowed Price
Qty.
Adult Wheeled Walker Type 3 Human Care System)
Walker type most suitable for Canada Inc.
active use on most terrains. ADP Nighthawk Ats 906 0vation MW3NM0015 1 $417.00
price includes frame,four large
wheels (6"/8" diameter), hand Ovation Compact 805-8 MW3NM1005 1 $417.00
braking system, seat, and back Ovation Compact 806-8 MW3NM1010 1 $417.00
Parsons Adl 4200swx MW3DG0035 1 $417.00
Options Chart if heavy duty
frame and/or forearm 4200wx MW3DG0030 1 $417.00
attachments required. Prode3 ProDe3 Aurora 19/21/23 inches AA0000321 1 $417.00
ProDe3 Balius/21 wide AA0000319 1 $417.00
Sunburst Medical Freedom All Terrain MW32S0010 1 $417.00
Freedom Xl MW32S0015 1 $417.00
Freedom Xls MW32S0005 1 $417.00
Mirage 4900 MW32S0030 1 $417.00
Mirage 4925 MW32S0040 1 $417.00
Mirage 4950 MW32S0035 1 $417.00
Shopper 4700 MW32S0020 1 $417.00
Titan MW32S0050 1 $417.00
Sunrise Medical Gemino AA0001082 1 $417.00
Gemino 60 AA0001236 1 $417.00
Topro Olympos MW3TV0020 1 $417.00
Troja MW3TV0010 1 $417.00
Triumph Mobility Escape AA0001084 1 $417.00
Inc
Wheelzahead Wheelzahead Track III Rollator AA0001235 1 $417.00
USA, LLC
Forearm Crutches Approved ADP Forearm Crutches MKZND0005 1 $121.00
1 Pair of Forearm Crutches from Manufacturers
the following manufacturers may Only
be billed under this code.
Page: 5 of 135
Ministry of Health
Ambulation Aids
Allowed Price
Qty.
Paediatric Specific Walking Can-Dan Rehatec Buddy Roamer AA0001101 1 $2,578.00
Frame
Meywalk 3, Meywalk 4 MW6CD0045 1 $2,578.00
ADP price includes frame, four
wheels, hand grips (including Meywalk, Medium & Large MW6CD0040 1 $2,578.00
arm supports), and built in sitting Mini-Meywalk MW6CD0050 1 $2,578.00
support (e.g. sling/saddle seat).
Hoggi Flux Gait Trainer MW6K20005 1 $2,578.00
See Ambulation Aids Options
Chart for adolescent sizes. Ormesa Dynamico MW6R80055 1 $2,578.00
Grillo MW6OA0005 1 $2,578.00
Prime Engineering Kidwalk MW62P0005 1 $2,578.00
Rifton Equipment Pacer Gait Trainer MW6RF0005 1 $2,578.00
Snug Seat Inc. Bronco,Sizes 0,1,2 MW6R80060 1 $2,578.00
Crocodile Reverse Walker MW6R80070 1 $2,578.00
Gator MW6R80005 1 $2,578.00
Mustang Gait Trainer AA0000693 1 $2,578.00
Pony,Size 0 MW6R80040 1 $2,578.00
Pony,Size 1 MW6R80045 1 $2,578.00
Pony,Size 2 MW6R80050 1 $2,578.00
Pony,Size 3 MW6R80052 1 $2,578.00
Paediatric Specific Wheeled Drive Medical Nimbo KA1200N (KA1200-2GCR, AA0000110 1 $220.00
Walker Type 1 KA1200-2GKB, KA1200-2GWP)
Walker type most suitable for Nimbo KA2200N (KA2200-2GCR, AA0000111 1 $220.00
use on hard, flat surfaces. ADP KA2200-2GKB, KA2200-2GWP)
price includes frame, two or four
small wheels, and braking system Nimbo KA3200N (KA3200-2GCR, AA0000112 1 $220.00
(if available). See Ambulation KA3200-2GKB, KA3200-2GWP)
Aids Options Chart for Nimbo KA4200N (KA4200-2GCR, AA0000105 1 $220.00
adolescent sizes. KA4200-2GKB, KA4200-2GWP)
Guardian Strider Tweener G07783 MW4GU0035 1 $220.00
Strider Tyke G07782 MW4GU0030 1 $220.00
Tyke G07751 MW4GU0010 1 $220.00
Page: 6 of 135
Ministry of Health
Ambulation Aids
Allowed Price
Qty.
Paediatric Specific Wheeled Kaye Adolescent 2 Wheels MW4KY0065 1 $220.00
Walker Type 1
Adolescent 4 Wheels MW4KY0070 1 $220.00
Walker type most suitable for
use on hard, flat surfaces. ADP Adolescent 4 Wheels/Swivel MW4KY0075 1 $220.00
price includes frame, two or four Child 2 Wheels MW4KY0020 1 $220.00
small wheels, and braking system
Child 4 Wheels MW4KY0025 1 $220.00
(if available). See Ambulation
Aids Options Chart for Child 4 Wheels/Swivel MW4KY0030 1 $220.00
adolescent sizes. Child Small 2 Wheels MW4KY0005 1 $220.00
Child Small 4 Wheels MW4KY0010 1 $220.00
Child Small 4 Wheels/Swivel MW4KY0015 1 $220.00
Pre-Adolescent 2 Wheels MW4KY0050 1 $220.00
Pre-Adolescent 4 Wheels MW4KY0055 1 $220.00
Pre-Adolescent 4 Wheels/Swivel MW4KY0060 1 $220.00
Youth 2 Wheels MW4KY0035 1 $220.00
Youth 4 Wheels MW4KY0040 1 $220.00
Youth 4 Wheels/Swivel MW4KY0045 1 $220.00
Paediatric Specific Wheeled Sunrise Medical Gemino S AA0001303 1 $417.00
Walker Type 2
Walker type most suitable for
price includes all components
and options.
Paediatric Standing Frame Type 1 Ki Mobility Leckey Totstander AA0001369 1 $1,219.00
ADP price includes frame,
positioning straps, trunk, pelvic, Otto Bock Vertical Stander MS1HY0005 1 $1,219.00
knee and foot supports, and tray.
See Ambulation Aids Options Prime Engineering Up-Right Stander MS12P0015 1 $1,219.00
Chart for adolescent sizes.
Paediatric Standing Frame Type 2 Altimate Medical Easy Stand 5000&7000 Magician MS2HC0005 1 $3,285.00
ADP price includes frame, Easy Stand Bantam MS2HC0015 1 $3,285.00
positioning straps, trunk, pelvic,
knee and foot supports, and tray. Easy Stand Evolv MS2HC0010 1 $3,285.00
Page: 7 of 135
Ministry of Health
Ambulation Aids
Allowed Price
Qty.
See Ambulation Aids Options Altimate Medical Easystand Zing AA0001304 1 $3,285.00
Chart for adolescent sizes.
Convaid Toucan AA0001572 1 $3,285.00
Ki Mobility Leckey Horizon Stander AA0001371 1 $3,285.00
Leckey Freestander AA0001368 1 $3,285.00
Leckey Mygo Stander AA0000692 1 $3,285.00
Leckey Pronestander AA0001370 1 $3,285.00
Squiggle Stander AA0000700 1 $3,285.00
Squiggles+ AA0001650 1 $3,285.00
Ormesa Dondolino, Size 1 MS2OA0010 1 $3,285.00
Dondolino, Size 2 MS2OA0015 1 $3,285.00
Dondolino, Size 3 MS2OA0020 1 $3,285.00
Mini Standy MS2OA0030 1 $3,285.00
Standy MS2OA0035 1 $3,285.00
Prime Engineering Kidstand & Grandstand 111 MS22P0010 1 $3,285.00
Superstand,Small & Youth MS22P0005 1 $3,285.00
Symmetry Standing Frame MS22P0015 1 $3,285.00
R82 Meerkat AA0001581 1 $3,285.00
Snug Seat Inc. Buffalo/ Caribou, all sizes MS2R80005 1 $3,285.00
Gazelle,Size 1 MS2R80020 1 $3,285.00
Gazelle,Size 2 MS2R80025 1 $3,285.00
Gazelle,Size 3 MS2R80030 1 $3,285.00
Synetik ErgoCare Vertiflex 60 AA0001721 1 $3,285.00
Vertiflex S1, S2 & S3 MS2JP0010 1 $3,285.00
Page: 8 of 135
Ministry of Health
Ambulation Aids
OPTIONS:
Allowed Price
Qty.
AA - Custom Modifications MOCM 1
The MOCM code may be used
when custom modifications are
required to an ADP listed
ambulation aid or paediatric
stander, and there is no ADP
code with assigned funding
available. The following
documentation must be
submitted: 1. Authorizer must
provide clinical rationale to
support the request. 2. Vendor
must provide a breakdown of
the cost of labour (not to exceed
$40.00/hour), and parts.
Adolescent Size Paediatric AA5 1 $100.00
Specific Walker
Additional funding for
adolescent sized paediatric
walkers. Authorizer must
document clinical requirements.
Selected device must meet size
requirements.
Standing Frame
standing frames (device type
ms1 & ms2). Authorizer must
requirements.
Walking Frame
Page: 9 of 135
Ministry of Health
Ambulation Aids
OPTIONS:
Allowed Price
Qty.
walking frames (device type
mw6). Authorizer must
requirements.
Extra Wide Adult Wheeled AA8 1 $100.00
Walker
Extra wide adult wheeled walker
(greater than 18" between push
handles) due to client stature.
Client weight less than 275lbs.
Authorizer must document
client's requirements.
Forearm Attachments AA1 2 $200.00
Forearm attachments for
wheeled walkers. Authorizer
must provide clinical rationale to
support request (maximum 2).
Heavy Duty Package Client AA2 1 $100.00
Weight 275-350 lbs
Heavy duty package for wheeled
walkers, client weight 275-350
lbs. Authorizer must document
client weight. Selected device
must meet weight requirements.
Weight 350-400 lbs
walkers, client weight 350-400
lbs. Authorizer must document
client weight. Selected device
must meet weight requirements.
Page: 10 of 135
Ministry of Health
Ambulation Aids
OPTIONS:
Allowed Price
Qty.
Weight Exceeded 400 lbs
walkers, client weight exceeds
400lbs. Authorizer must
document client weight.
Selected device must meet
weight requirements.
Unilateral Hand Brake AA9 1 $100.00
Unilateral hand brake. allows
locking/braking of both brakes
using one hand. Authorizer must
(max 1)
Page: 11 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Back Support Action Products Twister Cb Back 15"-16" Width X SEBAN0005 1 $388.00
11"-16" Height
Twister Cb Back 15"-16" Width X SEBAN0025 1 $388.00
17"-21" Height
11"-16" Height
17"-21" Height
11"-16" Height
17"-21" Height
11"-16" Height
17"-21" Height
Adaptive DROP-IN R-BACK CURVED - SUN- SEBE10035 1 $201.00
Engineering Lab MATE OR PUDGEE FOAM
Drop-In R-Back Curved With 1.5" Poly SEBE10030 1 $192.00
Foam
Drop-In R-Back Curved With Sun- SEBE10040 1 $230.00
Mate Or Pudgee Foam
Drop-In R-Back With 1" Poly Foam SEBE10005 1 $153.00
Drop-In R-Back With 1.5" Poly Foam SEBE10010 1 $168.00
Drop-In R-Back With Sun-Mate Or SEBE10020 1 $168.00
Pudgee Foam
Drop-In T-Back Curved - Sun-Mate Or SEBE10075 1 $249.00
Pudgee Foam
Drop-In T-Back Curved With Sun- SEBE10080 1 $219.00
Mate Or Pudgee Foam
Drop-In T-Back With Sun-Mate Or SEBE10060 1 $216.00
Pudgee Foam
Page: 12 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Back Support Adaptive Adjustable Bi-Angular Solid Back SEB2L1025 1 $378.00
Equipment Insert,
Includes
T-Nuts
Systems (Aes) & Adjustment Brackets.

I Or T Or Curved Syle Solid Back SEB2L1015 1 $236.00
Insert, Includes T-Nuts.
Oversize Upcharge For Backs Over 2o" SEB2L1040 1 $69.00
But Less Than 28".
Quick-Fit Contour/Bi-Angular Solid SEB2L1030 1 $519.00
Back
Insert,
Incudes T-Nuts.
Sculptured Solid Back Insert, Includes SEB2L1035 1 $862.00
T-Nuts.
Sculpturefit Back W/Attaching SEB2L0015 1 $1,066.00
Hardware, Custom.
Solid Back Insert Package W/Universal SEB2L0005 1 $555.00
Hardware
Or
E-Z
Mount
Mount Hardware & Rotating Hold

Downs.
Solid Back Insert Package, Li'L Kiddos, SEB2L0020 1 $632.00
14" Wide Or Less.
Solid Back Insert Package, Li'L Kiddos, SEB2L0025 1 $775.00
Contoured, 14" Wide.
Solid Back Insert, Includes T-Nuts, Li'L SEB2L1010 1 $213.00
Kiddos,
14" Wide Or Less.

Solid Back Insert, Includes T-Nuts. SEB2L1005 1 $158.00
Solid Back W/Drop Hooks & Fixed SEB2L0010 1 $230.00
Hold Downs.
Advanced Contoured Back SEBAO0040 1 $259.00
Mobility
Deep "U" Back SEBAO0035 1 $293.00
Systems Corp
Ez Back Basic SEBAO0060 1 $304.00
Ez Back System Complete SEBAO0055 1 $354.00
Page: 13 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Back Support Advanced Pro Back Support SEBAO0065 1 $449.00
Mobility
Systems Corp U Form Deep Contour Back Support SEBAO0050 1 $744.00
Amysystems Contour Back Support For Heavy Duty SEB4P0020 1 $825.00

Contour Back Support, Non-Standard SEB4P0015 1 $524.00
Sizes
Contour Back Support, Standard Sizes SEB4P0010 1 $442.00
Blake Medical Silverback Max - Deep Contour SE0001687 1 $943.00
16/18/20" wide
Silverback Max - Extra Deep Contour SE0001689 1 $990.00
16/18/20" wide
Silverback Max 16/18/20" wide SE0001109 1 $872.00
Silverback Prime - Deep Contour SE0001688 1 $817.00
16/18/20" wide
Silverback Prime - Extra Deep Contour SE0001690 1 $863.00
16/18/20" wide
Silverback Prime 16/18/20" wide SE0001108 1 $742.00
Body Ryzm Life JazzRX SE0001205 1 $63.00
Sciences /
Perspectis, Inc.
Broda Back Pad SEBB-0010 1 $58.00
Custom Back With Permanent Lateral SEBCF114L 1 $561.00
Fabricated Supports,
Vinyl
Cover,
Without Mounting Hardware

Complex
Indirect
Molded
Back,
SEBCF118L 1 $1,259.00
Without Cover And Mounting
Hardware
Complex Molded Back (Foam In SEBCF117L 1 $1,122.00
Place),

Hardware
Contoured Back (Foam On Rigid SEBCF112L 1 $431.00
Page: 14 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Back Support Custom Base),
Minimal
Trunk
Support,
Fabricated Vinyl Cover, Without Mounting

Hardware
Custom Contoured Back, Moderate SEBCF113L 1 $673.00
Trunk
Support,
Vinyl Cover, Without Mounting

Hardware
Custom Shaped Sculptured Back, SEBCF115L 1 $819.00
Includes
Cover,

Flat
Back/Planar
Design,
Vinyl
Cover
SEBCF110L 1 $259.00
Simple
Molded
Back
(Foam
In
Place),
SEBCF116L 1 $810.00
Hardware
Dynamic Health Armadillo Back Support 14" - 24" SE0001130 1 $687.00
Care Solutions
Armadillo Back Support with Vicair SE0001280 1 $893.00
Technology Cushion
Classic Deep Pelvic Back 22" SE0001495 1 $566.00
Classic Deep Pelvic Back Support SE0000341 1 $579.00
Classic Pelvic Back 22" SE0001494 1 $497.00
Classic Pelvic Back Support SE0000340 1 $496.00
Cushion Size 14" - 21" SEBD30005 1 $475.00
Cushion Sizes 14" - 21" SEBD30015 1 $579.00
NXT ACT Back, Cushion Size 14"- 21" SEBD30010 1 $496.00
NXT HA SC 22" SE0000334 1 $496.00
NXT SC BACK 12" TO 20" SE0000339 1 $475.00
NXT VC BACK SE0000120 1 $756.00
Nxt Carbon Fiber FHAC Back, FM SE0001221 1 $756.00
Optima Carbon Deep Thoracic Back SE0001281 1 $824.00
Support
Page: 15 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Back Support Dynamic Health Optima Carbon Thoracic Back SE0001222 1 $756.00
Care Solutions Support
Optima Deep Thoracic Back Support SE0001219 1 $545.00
22"
23" - 29"
Optima Thoracic Back Support SE0001217 1 $476.00
Optima Thoracic Back Support 22" SE0001215 1 $497.00
Optima Thoracic Back Support 23" - SE0001347 1 $497.00
29"
UFit Customizable Pelvic Back Support SE0001343 1 $618.00
14" - 20"
UFit Customizable Pelvic Back Support SE0001344 1 $687.00
22" - 24"
UFit Deep Customizable Pelvic Back SE0001345 1 $687.00
Support 14" - 20" Wide
UFit Deep Customizable Pelvic Back SE0001346 1 $825.00
Support 22" - 24" Wide
UFit II Back 14" - 20" SE0001490 1 $652.00
UFit II Back 22" SE0001491 1 $687.00
UFit II Deep Back 14" - 20" SE0001492 1 $721.00
UFit II Deep Back 22" SE0001493 1 $825.00
Xtend Deep Height Adjustable Back SE0000336 1 $475.00
Support 16" - 20"
Xtend Deep Height Adjustable Back SE0000338 1 $496.00
Support 22" -24"
Xtend Height Adjustable Back Support SE0000335 1 $475.00
16" - 20"
Xtend Height Adjustable Back Support SE0001182 1 $497.00
22 " - 24"
Page: 16 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Back Support Dynamic Health Xtend Kids Height Adjustable Back SE0001129 1 $476.00
Care Solutions Support 10" - 14"
Xtend Low Deep Height Adjustable SE0001328 1 $475.00
Back Support 12" - 20"
Xtend Low Deep Height Adjustable SE0001329 1 $496.00
Back Support 22" - 24"
Xtend Low Height Adjustable Back SE0001326 1 $475.00
Support 12" - 20"
Xtend Low Height Adjustable Back SE0001327 1 $497.00
Support 22" - 24"
nxt HA SC Back 16" to 20" SE0000337 1 $475.00
Future Mobility Custom Lunar Back SE0000684 1 $656.00
Custom Lunar Back HD SE0000685 1 $1,242.00
Full Back - Sizes From 14" To 22" - SEBFM3040 1 $549.00
Lateral
Full Back - Sizes From 14" To 22" - SEBFM3050 1 $590.00
Ultra Lateral
Full Back - Sizes From 18" To 24" No SEBFM3020 1 $507.00
Lateral
Full Back Style Heavy Duty SEBFM3060 1 $725.00
Low Back - Sizes From 14" To 22" - SEBFM3035 1 $483.00
Lateral
Low Back - Sizes From 16" To 20" - No SEBFM3010 1 $431.00
Lateral
Lunar Slim Back SE0001243 1 $431.00
Lunar Slim Back (Bariatric) SE0001244 1 $690.00
Mid Back - Sizes From 14" To 22" - SEBFM3030 1 $531.00
Lateral
Mid Back - Sizes From 14" To 22" - SEBFM3045 1 $573.00
Ultra Lateral
Mid Back - Sizes From 16" To 20" - No SEBFM3015 1 $490.00
Page: 17 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Back Support Future Mobility Lateral
Mid Back Style Heavy Duty SEBFM3055 1 $690.00
Orion Back SEBFM3005 1 $400.00
Prism Air Back - Custom Sizes SEBFM0045 1 $742.00
Prism Air Back - Non Standard Sizes SEBFM0040 1 $656.00
Prism Air Back Fits 16,18,20" Wide SEBFM0035 1 $552.00
W/C
Prism Bariatric Air Back 21x16 Though SEBFM2025 1 $828.00
24x20
Prism Bariatric Air Back- Custom Size SEBFM2030 1 $914.00
Prism Bariatric Basic Back - Custom SEBFM2010 1 $742.00
Size
Prism Bariatric Basic Back 21x16 SEBFM2005 1 $690.00
Through 42x20
Prism Bariatric Ultra Back 21x16 SEBFM2015 1 $697.00
Through 24x20
Prism Bariatric Ultra Back- Custom SEBFM2020 1 $794.00
Size
Prism Basic Back - Custom Sizes SEBFM0015 1 $569.00
Prism Basic Back - Non Standard Sizes SEBFM0010 1 $518.00
Prism Basic Back Fits 16,18,20" Wide SEBFM0005 1 $424.00
W/C
Prism Max Back - Upcharge SEBFM0150 1 $86.00
Prism Phantom Back 12-18" Width X SEBFM0070 1 $275.00
7" Height
Prism Super Back For Kids - Custom SEBFM0090 1 $569.00
Sizes
Prism Super Back For Kids - Non SEBFM0085 1 $493.00
Standard Sizes
Prism Super Back For Kids Fits 10, 12, SEBFM0080 1 $431.00
14 And 16" Wide W/C
Page: 18 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Back Support Future Mobility Prism Truefitt Back - Bariatric Sizes SEBFM0060 1 $863.00
Prism Truefitt Back - Custom Sizes SEBFM0065 1 $707.00
Prism Truefitt Back - Non Standard SEBFM0055 1 $638.00
Sizes
Prism Truefitt Back Fits 16,18,20" SEBFM0050 1 $604.00
Wide W/C
Prism Ultra Back - Custom Sizes SEBFM0030 1 $697.00
Prism Ultra Back - Non Standard Sizes SEBFM0025 1 $621.00
Prism Ultra Back Fits 16,18,20" Wide SEBFM0020 1 $535.00
W/C
Hoggi Back Cushion Shaped SE0000469 1 $272.00
Back Cushion trough Shaped SE0000466 1 $322.00
Xps Adaptive Back Cushion SEBK20050 1 $259.00
Innovators 1993 K Special Back-Custom SEBI30020 1 $152.00
Inc
K Special Back-Standard SEBI30010 1 $130.00
K-Combo Back SEBI30060 1 $173.00
K-Combo Back Custom SEBI30065 1 $191.00
Key-Hole Back SEBI30030 1 $152.00
Key-Hole Back Custom SEBI30040 1 $169.00
Key-Hole Back Custom Adjustable Top SEBI30045 1 $169.00
Invacare Contour U Back Includes All SEBNS1030 1 $1,156.00
Modifications & Vacuum/Vinyl
Upholstery
Curved Back Fits 10" To 20" Wide W/C SEBNS0030 1 $432.00
Curved Back Pneumatic Fits 10" To SEBNS0040 1 $474.00
20" Wide W/C
Curved Back Pneumatic Special Size & SEBNS0045 1 $562.00
Modifications
Curved Back Special Size & SEBNS0035 1 $519.00
Modifications
Page: 19 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Back Support Invacare Naked Contour U Back, Includes All SEBNS1035 1 $1,375.00
Modifications
& Vacuum/Moisture Proof

Coating/Removable
Cover
& Cover Pattern.

Personal Back Bariatric Builder Size SEBNS0058 1 $657.00
Personal Back Fits 16", 18", 20" Wide SEBNS0052 1 $444.00
W/C
Personal Back Plus - Bariatric Builder SEBNS0088 1 $771.00
Size
Personal Back Plus - Fits 16", 18", 20" SEBNS0062 1 $558.00
Wide W/C
Silhoutte Back Support SEBNS1020 1 $545.00
Invacare - Matrx Deep Heavy Duty Posture Back, All SEB1M0020 1 $922.00
Seating Sizes
Deep Posture Back, All Sizes SEB1M0015 1 $681.00
Genera Back SEB1M0050 1 $382.00
Heavy
Duty
Posture
Back
Fits
W/C
SEB1M0010 1 $801.00
20"-25" Width & 16"-20" Height
Matrx Elite HD, greater than 24" SE0001052 1 $1,113.00
Matrx Elite HD, up to 24" SE0001051 1 $703.00
Matrx Elite TR - Adult SE0001214 1 $596.00
Matrx High Back Fits W/C 16" - 21" SEB1M1005 1 $560.00
Width & 20" - 30" Height
Matrx MX1 Superlite, 12" SE0001054 1 $785.00
Matrx Mini - Paediatric SE0001213 1 $583.00
PB Elite Deep All Sizes SEB1M0026 1 $618.00
PB Extra Wide Deep Heavy Duty Backs SEB1M0040 1 $1,239.00
From 16 To 20 Inches
Page: 20 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Back Support Invacare - Matrx PB Extra Wide Heavy Duty Backs Sizes SEB1M0035 1 $1,133.00
Seating 16 To 20 Inches
PB Posture Back Elite, Posture Back SEB1M0025 1 $584.00
Elite Full Back, All Sizes
Posture Back Fits W/C 13"-20" Width SEB1M0005 1 $560.00
& 12"-20"Height
Trx Rehab Back, Fits W/C 18" - 25" SEB1M1050 1 $204.00
Width
Jay Medical Foam Back SEBJA5040 1 $99.00
J2 Deep Contour Back 14w-19w, SEBJA7000 1 $523.00
Includes
Mounting
Hardware, Cover, Lumbar Supports &

Lateral Wedges
J2 Deep Contour Back 20wx20h, SEBJA7005 1 $557.00
Includes
Mounting
Hardware, Cover, Lumbar Supports &

Lateral Wedges
J3 Lower Thoracic Back, All Sizes SEBJA0900 1 $380.00
J3 Mid Thoracic Back, All Sizes SEBJA0905 1 $511.00
J3 Shoulder Height Back, All Sizes SEBJA0915 1 $618.00
J3 Upper Thoracic Back, All Sizes SEBJA0910 1 $600.00
JAY 2 Plus 20-23", 23-26" J2 Back SEBJA0300 1 $982.00
Assembly
For 0 Or 8 Degree Backposts

JAY Zip Back All Sizes SE0000640 1 $587.00
Jay 2 Back Includes Mounting SEBJA0100 1 $501.00
Hardware
(""K""
Or
""G""
Type),
Cover & Lumbar Supports (14""-19"")

Jay 2 Back Includes Mounting SEBJA0105 1 $501.00
Hardware,
Cover
& Lumbar Supports (12"/13")

Jay 2 Back- Includes Mounting SEBJA0110 1 $560.00
Page: 21 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Back Support Jay Medical Hardware
(""K""
Or
""G""
Type),
Cover & Lumbar Supports (20"")

Jay 2 Plus 20-23", 23-26" Back SEBJA0310 1 $1,052.00
Assembly For 0 To 8 Degree
Backposts,
With Headrest Mounting Kit

Jay 2 Tall Back- Includes Mounting SEBJA0130 1 $662.00
Hardware, Cover & Lumbar Supports
(20")
Jay 2 Tall Back- Includes Mounting SEBJA0120 1 $574.00
Hardware,
Cover
& Lumbar Supports (14"/16"/17"/18")

Jay Active Back 18"-14" Quick Release SEBJA1010 1 $364.00
Mount
Jay Active Back 18"-14" Rigid Mount SEBJA1015 1 $337.00
Jay Active Back 18"/16" Tall Quick SEBJA1012 1 $396.00
Release Mount
Jay Active Back 20" Tall SEBJA1014 1 $464.00
Jay Active Back With Permanent SEBJA1019 1 $432.00
Mount (Large)
Jay Basic Back, Fixed Clamp Style, All SEBJA2025 1 $350.00
Sizes
Jay Basic Back, Fixed Strap Style, All SEBJA2020 1 $322.00
Sizes
Jay Care Back 15-18" Wide SEBJA5000 1 $440.00
Jay Care Back 19-20" Plus Width SEBJA5010 1 $527.00
Jay Care Back Foam Large Size SEBJA5045 1 $136.00
Jay Care Back Shell Large Size SEBJA5055 1 $282.00
Jay Encompass Back SEBJA8200 1 $311.00
Jay Fit Back Adjustable Contour Back SEBJA4005 1 $290.00
For
10"
Or
12"
Frame
Width,
Various Back Heights
Page: 22 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Back Support Jay Medical Jay Fit Back Adjustable Contour Back SEBJA4010 1 $328.00
For
14"
Or
16"
Frame
Width,

Jay Fit Back Adjustable Contour Back SEBJA4015 1 $366.00
For
18"
Frame
Width,

Jay Focus Point Back, All Sizes SEBJA8100 1 $540.00
Jay Modual Back Custom Contoured SEBJA3050 1 $602.00
Insert 18"/16"/14"
Jay Modual Back Custom Contoured SEBJA3055 1 $695.00
Insert 20"
Jay Modual Back Standard Insert SEBJA3005 1 $359.00
18"/16"/14"
Jay Modual Back Standard Insert 20" SEBJA3010 1 $469.00
Jay Modular Back Adjustable SEBJA3002 1 $640.00
Aluminum Shell 20"
Jay Modular Back Adjustable SEBJA3000 1 $552.00
Aluminum Shell (18",16",14")
Jay Union Back Standard with 4 point SE0000644 1 $620.00
hardware
Jay Union Back Standard with SE0000643 1 $586.00
standard hardware
Jay Union Back Tall with 4 point SE0000646 1 $703.00
Hardware
Jay Union Back Tall with Standard SE0000645 1 $668.00
Hardware
Kaji OWL Comfort Back (16" x 16" - 20" x SE0001657 1 $1,001.00
Corporation 16")
OWL Comfort Back (20" x 18" - 20" x SE0001658 1 $1,035.00
20")
OWL Comfort Back (Custom Size) SE0001659 1 $1,087.00
OWL Fusion Back (16" x 16" - 20" x SE0001654 1 $863.00
Page: 23 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Back Support Kaji 16")
Corporation
OWL Fusion Back (20" x 18" - 20" x SE0001655 1 $897.00
20")
OWL Fusion Back (Custom Size) SE0001656 1 $1,018.00
Ki Mobility Axiom CS Back (Bi-Angular) SE0001780 1 $696.00
Axiom CS Back (I-Back and T-Back) SE0001779 1 $395.00
Axiom CS Back Cushion SE0001715 1 $242.00
Axiom CS Pediatric Solid Back Cushion SE0001712 1 $261.00
Axiom CS Pediatric Solid Back SE0001714 1 $247.00
Interface
Axiom CS Solid Back Cushion SE0001711 1 $271.00
Axiom CS Solid Back Interface SE0001713 1 $247.00
Axiom Deep Lateral Back 12" - 20" SE0001628 1 $831.00
Axiom Deep Lateral Back 22" SE0001629 1 $883.00
Axiom Posterior Back 12" - 20" SE0001624 1 $629.00
Axiom Posterior Back 22" SE0001625 1 $863.00
Axiom Posterior Lateral Back 12" - 20" SE0001626 1 $721.00
Axiom Posterior Lateral Back 22" SE0001627 1 $963.00
Kid Kart I-Back Cushion Tlc SEBKT2015 1 $101.00
Xpress T-Back 1" Short, Regular, Or SEBKT2025 1 $112.00
Tall
Xpress T-Back 2.5" Short, Regular, Or SEBKT2030 1 $112.00
Tall
Lpa Medical Inc. Adjustable Tension Back SEBO12010 1 $172.00
Contour Back Cushion SEBO12005 1 $93.00
Maple Leaf Contour Padded Personal Back SEBWM0005 1 $248.00
Wheelchair
ML Deep SE0001085 1 $419.00
ML Kyphothic SE0001089 1 $574.00
Page: 24 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Back Support Maple Leaf ML Mid SE0001086 1 $483.00
Wheelchair
ML Shallow SE0001087 1 $375.00
ML Shape SE0001088 1 $566.00
ML Slim Custom SE0001337 1 $600.00
ML Slim Short SE0001336 1 $525.00
ML Slim Standard SE0001334 1 $500.00
ML Slim Tall SE0001335 1 $525.00
The Fusion Essential (Bariatric) SE0001364 1 $833.00
The Fusion Essential (Non-Standard, SE0001363 1 $764.00
All Sizes)
The Fusion Essential (Standard, All SE0001362 1 $695.00
Sizes)
The Fusion1 (Bariatric) SE0001361 1 $633.00
The Fusion1 (Non-Standard, All Sizes) SE0001360 1 $564.00
The Fusion1 (Standard, All Sizes) SE0001359 1 $495.00
The Fusion2 (Bariatric, All Sizes) SE0001586 1 $575.00
The Fusion3 (Bariatric, All Sizes) SE0001589 1 $610.00
Motion Invacare Matrx E2 Back (18" - 20" SE0001776 1 $687.00
Concepts high)
Invacare Matrx E2 Back (6" - 16" high) SE0001775 1 $666.00
Invacare Matrx E2 Deep Back (18" - SE0001778 1 $797.00
20" high)
Invacare Matrx E2 Deep Back (6" - 16" SE0001777 1 $776.00
high)
MX1 Dual Mount 14-18 wide x 9 hgh SE0000135 1 $825.00
Page: 25 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Back Support Motion MX1 Dual Mount 14-18 x 16 high SE0000137 1 $960.00
Concepts
MX1 Dual mount 14-18 wide x 12 high SE0000136 1 $894.00
MX1 Mono Mount 14-18 wide x 16 SE0000134 1 $928.00
high
MX1 Mono Mount 14-18 wide x 9 SE0000132 1 $790.00
high
MX1 Mono mount 14-18 wide x 12 SE0000133 1 $859.00
high
MX1 Quick Release Dual Mount 14-18 SE0000140 1 $980.00
wide x 16 high
x 12 high
x 9 high
Matrx MX2 Back (14" x 12 ", 15" x 12", SE0001462 1 $825.00
16" x 12", 17" x 12", 18" x 12") with
fixed mounting or quick release
hardware
16" x 16", 17" x 16", 18" x 16") with
fixed mounting or quick release
hardware
16" x 6", 17" x 6", 18" x 6") with fixed
mounting or quick release hardware
16" x 9", 17" x 9", 18" x 9") with fixed
mounting or quick release hardware
Trx Contour Back, For Trx Systems, 16, SEBZG0005 1 $237.00
18,
22"
Wide
Wheelchairs, Height Adjustable 18-26"

Trx Onyx Contour Back & Trx Single SEBZG0020 1 $318.00
Post
Cloth
Contour
Back,
Page: 26 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Back Support Motion For Trx Systems
Concepts
Trx Single Post Onyx Contour Back For SEBZG0025 1 $318.00
Trx Systems
Nighthawk Key-Hole Back SEBNM0050 1 $197.00
Relaxed Back High SEBNM0010 1 $159.00
Relaxed Back High With Flap SEBNM0020 1 $168.00
Relaxed Back Low SEBNM0005 1 $159.00
Orthofab High Profile Contoured 14-20"Width, SEBOF2005 1 $367.00
16-20" Height
High Profile Contoured Non Standard SEBOF2010 1 $407.00
Sizes
High Profile Tall Contoured 14-20" SEBOF2015 1 $345.00
Width, 18-22" Height
High Profile Tall Contoured Non SEBOF2020 1 $407.00
Standard Sizes & Options
Low Profile Contoured 14-20" Width, SEBOF2025 1 $345.00
16-20" Height
Low Profile Contoured Non Standard SEBOF2030 1 $407.00
Sizes
Modular Mild Or Deep Contour SEBOF1005 1 $449.00
14-20" Width & 16,18,20" Height
Modular Mild Or Deep Contour Non SEBOF1010 1 $497.00
Standard Sizes
Otto Bock Back System 1, 15" To 17" & 18" To SEBOB9555 1 $342.00
20"
Back System 2, 15" To 17" & 18" To SEBOB9600 1 $438.00
20"
Back System 3, 15" To 17" & 18" To SEBOB9605 1 $523.00
20"
Back System 4, 15" - 20" Sizes SEBOB9610 1 $684.00
Back-Finished With Spray SEBOB9650 1 $1,710.00
Page: 27 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Back Support Otto Bock Coating,Cover,Sewing Pattern
Back-Itemized Cushion (Unfinished) SEBOB9655 1 $1,253.00
OBSS Ortho-Shape Back (All Sizes) SE0001375 1 $2,539.00
Performance V-Trak Ax-Sb Back Support Connisting SEBP00015 1 $555.00
Health Products Of 1 Insert, All Sizes
V-Trak Ax-Sb Back Support Consisting SEBP00020 1 $876.00
Of 2 Inserts, All Sizes
V-Trak Ax-Sb Back Support Consisting SEBP00025 1 $1,152.00
Of 3 Inserts, All Sizes
V-Trak Axh Back Support, All Sizes SEBP00010 1 $752.00
V-Trak Axs Back Support, All Sizes SEBP00005 1 $673.00
Permobil Ergo Back - Fixed - All Sizes SEB1P0005 1 $692.00
Ergo Back - Recline - All Sizes SEB1P0010 1 $692.00
ROHO Agility Carbon Back System SE0001373 1 $1,208.00
with Air Only (items greater than
10¿ high)
ROHO Agility Carbon Back System SE0001372 1 $966.00
with Air Only (items up to 10¿ high)
Rectangular Back - All Sizes SEB1P0015 1 $1,052.00
Physipro HP2 Back Support, all models, all sizes SE0001071 1 $480.00
Premium Back Support, all sizes SE0001072 1 $480.00
Positech BACKUS (oversize) with SE0001437 1 $1,550.00
Innovation Inc. detachable/waterproof foam cushion
backrest (all sizes) including laterals
and standard or swing-away anchors
BACKUS with detachable/waterproof SE0001436 1 $1,425.00
foam cushion backrest (all sizes)
including laterals and standard or
swing-away anchors
CURVUS (oversize) with SE0001439 1 $1,675.00
detachable/waterproof foam cushion
Page: 28 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Back Support Positech backrest (all sizes) including laterals
Innovation Inc. and standard or swing-away anchors
CURVUS with detachable waterproof SE0001438 1 $1,550.00
foam cushion backrest (all sizes)
including laterals and standard or
swing-away anchors
FLEXUS (complete system, one-size- SE0001440 1 $2,800.00
fits-all) with height adjustable foam
cushion backrest including laterals
and standard or swing-away anchors
Power Plus Relax Form Fit SEBWM0026 1 $707.00
Mobility
Relax Full Fit SEBWM0010 1 $524.00
Relax Full Fit (custom) SEBWM0015 1 $621.00
Relax Gentle Fit SEBWM0020 1 $469.00
Relax Gentle Fit (Custom) SEBWM0025 1 $524.00
Relax Personal Fit Back (All Sizes) SE0001590 1 $535.00
Relax Snug Fit SEBWM0027 1 $604.00
Relax Spiral Fit SEBWM0030 1 $718.00
Upcharge For Custom Height SEBWM0040 1 $152.00
Upcharge For Custom Width SEBWM0035 1 $152.00
Precision Rehab Back Sewn Cover Waterproof Foam, SEBWB0010 1 $1,476.00
Manufacturing Includes
Labour
For
Digitizing Or Plastering
Back Vacuum Formed, Includes SEBWB0005 1 $1,241.00
Labour
For
Digitizing
Or
Plastering
Base Cushion Back, Includes All SEBWB0015 1 $1,793.00
Modifications
&
Labour
For Digitizing Or Plastering

Precision - Fit Back Cushion Upcharge, SEBWB0022 1 $207.00
Extra
Wide Or Extra Tall, 20" - 24"
Page: 29 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Back Support Precision Rehab Precision - Fit Back Cushion, Subtle, SEBWB0020 1 $930.00
Manufacturing Moderate
Or
Aggresive
Positioning. Includes Hinged Or Fixed

Laterals And Cover.
Pride Mobility Synergy Standard Back Support, up to SE0000971 1 $311.00
Products 20". For additional sizing see
SEBND0015.
Synergy Tru Comfort Back Standard, SEBX10025 1 $518.00
Reclining
Or
Tilt
And
Recline Back Greater Than 20" Wide

Synergy Tru-Comfort Back Synergy SEBX10020 1 $480.00
Tru Comfort Back Standard, Reclining
Or Tilt And Recline Back Up To 20"
Wide
TRU-Comfort 4 and Sport Back (16" - SE0001755 1 $714.00
20" wide)
TRU-Comfort 4 and Sport Back (over SE0001756 1 $852.00
20" wide)
TRU-Comfort 4 and Sport Back (under SE0001754 1 $576.00
16" wide)
Quickie BREEZY RELAX2 COMFORT BACK SE0000117 1 $1,722.00
ANATOMICAL SHAPE
Contour Back - Tilt Fx SEBQU0400 1 $359.00
Ride Designs Corbac Adjustable Contour Back SEBR40005 1 $338.00
Support,
All Sizes
Ride Custom Back Support SEBR40010 1 $2,254.00
Ride Decaf, all sizes SE0001045 1 $542.00
Ride Java Back 12", 14", 15", 18" SE0001242 1 $542.00
Ride Java Back Grande SE0001144 1 $561.00
Ride Java Back Grande Deep SE0001145 1 $638.00
Ride Java Back Regular/Tall Deep SE0001143 1 $618.00
Page: 30 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Back Support Roho Agility Back - Custom Design - All SE0001167 1 $1,439.00
Variation
Agility Back Support SE0000970 1 $636.00
Agility Max Contour Back - all sizes SE0001118 1 $822.00
Low Back (10" Height) All Standard SEBRO3010 1 $1,031.00
Sizes 14" - 18"
Lumbar Support Cushion (Made To SEBRO2015 1 $341.00
Order)
Recliner Wheelchair Cushion Made To SEBRO2005 1 $1,035.00
Order
(One Piece Back & Seat- 2 Sections,2

Valves)
Recliner
Wheelchair
Cushion-Custom
SEBRO2010 1 $1,208.00
(More Than 2 Sections And/Or 2
Halves)
Standard Back (16" Height) All SEBRO3005 1 $1,289.00
Standard Sizes 14" - 18"
Starkey - Butterfly Back System SEBV10005 1 $293.00
Viennatone
Stealth Products ADI - AL and AFT Backrest - Active SE0001290 1 $595.00
Contour, all sizes
ADI - AL and AFT Backrest - Deep, SE0001291 1 $658.00
Contour, all sizes
ADI - AL and AFT Backrest - Extra SE0001292 1 $721.00
Deep contour, all sizes
ADI - CF Backrest - Active Contour, all SE0001293 1 $774.00
sizes
ADI - CF Backrest - Deep Contour, all SE0001294 1 $838.00
sizes
Stealth ADI Q-Back 2.0 Active (16" to SE0001737 1 $790.00
20" wide)
Stealth ADI Q-Back 2.0 Active (greater SE0001738 1 $897.00
Page: 31 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Back Support Stealth Products than 20" wide)
Stealth ADI Q-Back 2.0 Active (less SE0001736 1 $680.00
than 16" wide)
Stealth ADI Q-Back 2.0 Adjustable SE0001743 1 $973.00
(16" to 20" wide)
Stealth ADI Q-Back 2.0 Adjustable SE0001744 1 $1,080.00
(greater than 20" wide)
Stealth ADI Q-Back 2.0 Adjustable SE0001742 1 $845.00
(less than 16" wide)
Stealth ADI Q-Back 2.0 Deep (16" to SE0001740 1 $914.00
20" wide)
Stealth ADI Q-Back 2.0 Deep (greater SE0001741 1 $1,025.00
than 20" wide)
Stealth ADI Q-Back 2.0 Deep (less SE0001739 1 $790.00
than 16" wide)
Tarta Original (4 Vertebra) including SE0001504 1 $1,691.00
mounting hardware and pads
Tarta Original Central Spine (4 SE0001507 1 $773.00
Vertebra up to 8 Ribs)
Tarta Original Central Spine (5 SE0001508 1 $963.00
Tarta Original Central Spine (6 SE0001509 1 $1,152.00
Sunrise Medical Back Cushion 16x20,18x20, 20x20 SEBM90005 1 $169.00
Backrest "Plush", Deep Or Active SEBM90020 1 $459.00
Contour
Comfi Back Support (10¿x12¿ to SE0001516 1 $1,425.00
18¿x23¿)
Page: 32 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Back Support Sunrise Medical Comfi Back Support (20"x18" to SE0001517 1 $1,535.00
20"x23")
JAY Syncra Back (all sizes) SE0001678 1 $863.00
Jay J3 Plus Backrest - Mid Thoracic SE0001763 1 $1,254.00
(MT) with or without Vanity Shell
Extension - All sizes
Jay J3 Plus Backrest - Shoulder Height SE0001765 1 $1,361.00
(SH) - All Sizes
Jay J3 Plus Backrest - Upper Thoracic SE0001764 1 $1,250.00
(UT) - All Sizes
Lateral Support Backrest 16x20,18x20 SEBM90010 1 $297.00
Mid Thoracic Posterior Deep Jay 3 SEBJA8205 1 $1,052.00
Back
-
Sizes
12
Height
To
26
Width
Sizes 15 Height To 26 Width

Sedeo Pro-Comfort Backrest 16"w to SE0000655 1 $518.00
18"w x 20"h
Sedeo Pro-Comfort Backrest 20"w x SE0000656 1 $552.00
20"h
Sedeo Pro-comfort Backrest 22"w x SE0000657 1 $587.00
20" h
Sedeo Pro-deep Backrest 16"w to SE0000658 1 $587.00
18"w x to 20"h
Sedeo Pro-deep Backrest 20"w x 20"h SE0000659 1 $620.00
Sedeo Pro-deep Backrest, Active cut SE0000661 1 $587.00
16"w to 18"w x 20"h
20" w x 20"h
22"w x 20" h
Sedeo Pro-deep backrest 22"w x 20 h SE0000660 1 $656.00
Shoulder Height Posterior Deep Jay 3 SEBJA8215 1 $1,221.00
Back
Page: 33 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Back Support Sunrise Medical Smartsit Comfort Back - All Sizes SEBM90100 1 $549.00
Spex Adjustable Back Support SE0001511 1 $1,646.00
(14"x16" to 18"x23")
Spex Adjustable Back Support SE0001512 1 $1,973.00
(20"x18" to 20"x23")
Spex Kidz Adjustable Back Support (all SE0001510 1 $1,580.00
sizes)
SuperShape KIDZ Back Support SE0001513 1 $2,063.00
(10"x12" to 12"x18")
Supershape Back Support (14"x14" to SE0001514 1 $2,194.00
18"x23")
Supershape Back Support (20"x16" to SE0001515 1 $2,525.00
20"x23")
Upper Thoracic Posterior Deep Jay 3 SEBJA8210 1 $1,121.00
Back - Sizes 18 Height To 24 Width
Supracor Stimulite Lumbar Support SEBRR0010 1 $110.00
Symmetric Free Form Custom Back Kit (Large) SE0001648 1 $3,981.00
Designs including mount hardware
Free Form Custom Back Kit (Medium) SE0001647 1 $3,478.00
including mount hardware
Free Form Custom Back Kit (Small) SE0001646 1 $2,967.00
including mount hardware
Free Form Custom Low Back Kit SE0001645 1 $2,967.00
(Large) including mount hardware
(Medium) including mount hardware
(Small) including mount hardware
The Comfort Acta Relief Back - All Variations SE0001168 1 $877.00
Company
Acta-Back, All Variations, All Sizes SEB7C0010 1 $650.00
Acta-Back, All Variations, Custom SEB7C0015 1 $1,155.00
Page: 34 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Back Support The Comfort Sizes
Company
Incrediback, Modable, Tall, Deep, Tall- SEB7C0025 1 $1,311.00
Deep,
Custom Sizes
Incrediback, Moldable, Tall, Deep, SEB7C0020 1 $644.00
Tall-Deep,
All Sizes
Toronto Tops Back Cushion (10" & 12" Width) SEBTP0005 1 $212.00
Orthopedic Ltd.
Varilite Medical Evolution Back - Regular SEBVP0050 1 $674.00
Products
Evolution Back - Regular Bariatric SEBVP0055 1 $942.00
Evolution Back - Tall SEBVP0060 1 $746.00
Evolution Deep Back - All Sizes SEBVP0070 1 $978.00
Icon Back - Bariatric SEBVP0120 1 $965.00
Icon Back - Deep SEBVP0115 1 $884.00
Icon Back - Low SEBVP0100 1 $618.00
Icon Back - Tall SEBVP1110 1 $724.00
Icon Back -Mid SEBVP0105 1 $643.00
Junior Backs SE0001147 1 $643.00
Talon Back - All Sizes SEBVP0080 1 $479.00
Vision Viscount Tall Back Support For 16' Or SEBVC0030 1 $1,036.00
Wheelchair 18" W/C
Seating Systems
Viscount Tall Back Support, Custom SEBVC0035 1 $1,308.00
Inc.
Sizes
Viva
Contoured
Postural
Back
SEBVC0015 1 $198.00
14"-16" W/C Or 16"-18" W/C
Complete Assembly Adaptive Contoured
Seat
System
SECE10020 1 $1,057.00
Engineering Lab (Includes Seat, Back, Support Pads,
Hardware)
Adaptive Basis Contoured Seat & Back Including SEC2L0010 1 $742.00
Equipment Connecting
Hinge
Page: 35 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Complete Assembly Systems (Aes) (Select Type). Does Not Include
Mounting Hardware.
Basis Contoured Seat & Back Including SEC2L0020 1 $897.00
Connecting
Hinge
Package. Li'L Kiddos,14" Wide Or Less.

Does
Not
Include
Mounting Hardware.
Basis Seat & Back Including SEC2L0005 1 $511.00
Connecting
Hinge
(Select
Type).
Does Not Include Mounting

Hardware.
Basis Seat & Back Including SEC2L0015 1 $595.00
Connecting
Hinge
Package.
Li'L
Kiddos,14" Wide Or Less. Does Not

Include Mounting Hardware.
Amysystems Bariatric Power Recline With SEC4P0065 1 $6,999.00
Integrated Shear Reduction (Isr)
Broda Hsp
Padding
Package
SECB-0005 1 $486.00
(Includes Short Wing Cover, Extended
Shoulder
Bolsters,
Full Extension Foot Pad, F-2 Foot Rest,

Thigh Belt)
Custom Modify Or Refurbish Existing Custom SEMCF900L 1 $431.00
Fabricated Seating
System.
Includes
Parts,Hardware,Labour
Changes To Head Rest,Back

Support,Seat, & Footrest Etc.
Hoggi Adjustible Height Back System Planar SE0000467 1 $272.00
Back Cushion
Bingo Ius Or Xps Seat Frame Size 1 SECK20005 1 $1,352.00
Bingo Ius Or Xps Seat Frame Size 2 SECK20010 1 $1,373.00
Configurable Adjustible Height I Back SE0000468 1 $272.00
System
Ius
Adaptive
Seat
And
Back
Cushions
SECK20105 1 $607.00
Page: 36 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Complete Assembly Hoggi With Airflex
Ius Adaptive Seat And Back Cushions - SECK20100 1 $224.00
Breathable
Invacare Kinesthetic Seating System Fits 10" To SECNS0005 1 $1,131.00
14"
Wide
W/C,
(Includes Basic Headrest, Lateral

Supports,
Padded
Lap
Belt,
Ulti-Mate Base, Curved Back & Growth

Bracket)
Kinesthetic Seating System Fits 16" To SECNS0010 1 $1,131.00
20"
Wide
W/C,
(Includes Basic Headrest, Lateral

Supports,
Padded
Lap
Belt,
Ulti-Mate Base & Curved Back)

Ki Mobility Mygo
Seat
Shell
Size
1
SECOB4015 1 $1,559.00
Includes Seat Shell And Cushions
Mygo
Seat
Shell
Size
2
SECOB4020 1 $1,793.00
Includes Seat Shell Cushions And
Shoulder Support
Squiggle Seating System SE0000701 1 $1,477.00
Kid Kart Tlc Shell Assembly With Contour SECKT2010 1 $990.00
Seating
Tlc Shell Assembly With Planar Seating SECKT2005 1 $790.00
Xpress Adjustable Contour Seating SECKT3005 1 $773.00
Package
Xpress Shell Assembly With Contour SECKT3015 1 $773.00
Seating
Xpress Shell Assembly With Planar SECKT3010 1 $555.00
Seating
Otto Bock Kimba Spring Multifunctional Seating SECOB3005 1 $1,308.00
Unit
-
Size
1
Includes Elevating Legrests, Flip-Up

Footrest,
Laterals,
Adjustable Hip Pads & Padding.
Page: 37 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Complete Assembly Otto Bock Kimba Spring Multifunctional Seating SECOB3010 1 $1,377.00
Unit
-
Size
2

Footrest,
Laterals,

Kimba Spring Plus Adjustable Seating SECOB4005 1 $1,256.00
System
-
Size
1
Includes Armrests, Elevating Legrests,

Adjustable
Footplates & Recline.

Kimba Spring Plus Adjustable Seating SECOB4010 1 $1,415.00
System
-
Size
2
Includes Armrests, Elevating Legrests,

Adjustable
Footplates & Recline.

Kimbo Neo Basic Seat - Size 1 - SE0001158 1 $1,394.00
Footrest,
Laterals,

OBSS Ortho-Shape SE0001046 1 $3,723.00
OBSS Ortho-Shape, greater than 20" SE0001047 1 $4,033.00
wide and/or deep
OBSS Ortho-Shape, including SE0001048 1 $3,964.00
additional liner for growth
Spenco Silicore Wheelchair Seat With Back SECSO0010 1 $105.00
and Sides
Symmetric Free Form Full Body FIT Kit (includes SE0001604 1 $6,519.00
Designs basic headrest, mounting hardware
and universal mounting plate)
Free Form Full Body FIT Kit (includes SE0001618 1 $6,921.00
basic headrest, mounting hardware,
universal mounting plate and rotary
interface)
Synetik SEGO Seating System SE0001568 1 $2,352.00
ErgoCare
Page: 38 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Complete Assembly THOMASHILFEN EasyS or EasyS Modular SE0001026 1 $1,377.00
Thevo Twist SE0001025 1 $1,477.00
Toronto Tops
Seating
System
SECTP0005 1 $1,347.00
Orthopedic Ltd. Includes Butterfly Chest Strap,
Combination
Head/Neckrest
Tilt Tray, Stroller Interface, Back And

Seat
Headrest/Neckrest Adaptive Curved Headrest SEHE10015 1 $88.00
Engineering Lab
Tri-Pad Headrest SEHE10005 1 $272.00
Adaptive Curved Hr Pad Or Contoured Hr Pad SEH2L0035 1 $455.00
Equipment Or
Bell
Curved
Hr
Pad,
Systems (Aes) Cobra Headrest Bracket, Flip-Down.

Curved Hr Pad Or Contoured Hr Pad SEH2L0030 1 $381.00
Or
Bell
Curved
Hr
Pad,
Cobra Headrest Bracket.

Lateral-Posterior Head Support, SEH2L0015 1 $355.00
Adjustable
Depth
Bracket,
6-1/2"W X 7"H.
Adjustable
Depth
Bracket,
Hinged.
Adjustable
Depth
Bracket,
Paediatric 4" X 4" Or 5"X 5" Or 6"X 6".

Lateral-Posterior Head Support, Cobra SEH2L0020 1 $464.00
Headrest
Bracket,
5" X 5"Or 6" X 6" Or 7" X 7"Or 8" X

8".
Lateral-Posterior Head Support, Cobra SEH2L0025 1 $536.00
Style
Headrest
Bracket, Flip-Down 5" X 5"Or 6"X6"

Or 7"X7" Or 8" X8".
Advanced Custom Headrest SEHAO0015 1 $173.00
Mobility
Page: 39 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Headrest/Neckrest Systems Corp Deep "U" Headrest SEHAO0020 1 $135.00
Large Padded Headrest SEHAO0025 1 $100.00
Macintosh Oxbow Headrest SEHAO0010 1 $173.00
STA-RITE Adjustable Forehead SE0001745 1 $342.00
Stabilizer
STA-RITE Gel Headrest Pad (1" Ball SE0001757 1 $193.00
Clamp M/A Adapter, 5X10")
Clamp M/A Adapter, 5X10") with
Adjustable Forehead Stabilizer
So Soft Oval Headrest SEHAO0030 1 $135.00
Standard Curved Padded Headrest SEHAO0005 1 $100.00
Amysystems Curved Headrest, All Sizes SEH4P0010 1 $161.00
Blake Medical Geo-Matrix Headrest Pad (Curve) SE0001533 1 $147.00
Geo-Matrix Headrest Pad (Custom SE0001536 1 $178.00
Removable)
Geo-Matrix Headrest Pad (Flat) SE0001535 1 $155.00
Geo-Matrix Headrest Pad (Sweet SE0001534 1 $150.00
Spot)
Broda Neckrest Cushion SEHB-0010 1 $41.00
Custom Adjustable Headrest With Neckrest, SEHCF080L 1 $362.00
Page: 40 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Headrest/Neckrest Fabricated Vinyl
Cover,
Without Hardware
Complex Headrest/Contoured Or SEHCF060L 1 $267.00
Molded,
Vinyl
Cover,
Without Hardware
Contoured Headrest/Curved Surface, SEHCF050L 1 $173.00
Vinyl
Cover,
Without Hardware
Flat Headrest/Planar Head Support, SEHCF040L 1 $108.00
Vinyl
Cover,
Without Hardware
Head Or Neckrest Incorporated With SEHCF090L 1 $267.00
Mobility
Switches,
Vinyl Cover, Without Hardware

Neckrest With Vinyl Cover, Without SEHCF070L 1 $164.00
Hardware
Daher Specialty Combination Headrest SEHDH0010 1 $50.00
Foam Products
Full Support Headrest SEHDH0015 1 $66.00
Large Headrest SEHDH0005 1 $50.00
Dynamic Health MultiFit Headrest SE0001131 1 $155.00
Care Solutions
Future Mobility Large Headrest With Multi-Axial SEHFM0015 1 $245.00
Hardware
Large Padded Headrest SEHFM0005 1 $190.00
Small Headrest With Multi-Axial SEHFM0020 1 $242.00
Hardware
Small Padded Headrest SEHFM0010 1 $186.00
Hoggi Ius Headrest SEHK20005 1 $248.00
Invacare Basic Headrest - Adult SEHNS1010 1 $191.00
Basic Headrest - Child SEHNS1005 1 $191.00
Curved Adjustable Headrest System SEHNS1030 1 $284.00
Page: 41 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Headrest/Neckrest Invacare Large Adjustable Headrest System SEHNS1020 1 $305.00
Small Adjustable Headrest System SEHNS1015 1 $305.00
Two Step Adjustable Headrest System SEHNS1025 1 $284.00
Invacare - Matrx Matrx Elan 4 Point Headrest Pad (w/ SE0001325 1 $473.00
Seating Infection Control) with removable
cover
Matrx Elan 4 Point Headrest Pad with SE0001324 1 $448.00
standard removable cover
Matrx Elan Occipital Headrest Pad w/ SE0001323 1 $366.00
removable Infection Control cover 9"
x 7" or 12" x 8"
Matrx Elan Occipital Headrest Pad SE0001322 1 $341.00
with removable cover - 9" x 7" or 12"
x 8"
Matrx Elan Standard Headrest Pad SE0001321 1 $335.00
with removable Infection Control
cover - 6" x 3.5", 10" x 5" or 14" x 5"
Matrx Elan Standard Headrest Pad SE0001320 1 $310.00
with removable cover - 6" x 3.5", 10" x
5" or 14" x 5"
Jay Medical Four Pad Headrest - Junior SEHJA0016 1 $254.00
Four Pad Rotational Headrest - Junior SEHJA0018 1 $380.00
Four Pad Rotational Headrest - SEHJA0017 1 $380.00
Standard
Full Width Headrest SEHJA0020 1 $127.00
Single Pad Headrest - Large SEHJA0006 1 $72.00
Single Pad Headrest - Small SEHJA0005 1 $72.00
Three Pad Headrest - Large SEHJA0011 1 $181.00
Three Pad Headrest - Large Junior SEHJA0013 1 $181.00
Three Pad Headrest - Small SEHJA0010 1 $181.00
Three Pad Headrest - Small Junior SEHJA0012 1 $181.00
Page: 42 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Headrest/Neckrest Jay Medical Three Pad Rotational Headrest - Large SEHJA0027 1 $304.00
Three Pad Rotational Headrest - Large SEHJA0029 1 $304.00
Junior
Three Pad Rotational Headrest - Small SEHJA0026 1 $304.00
Three Pad Rotational Headrest - Small SEHJA0028 1 $304.00
Junior
Ki Mobility Adjustable Wing Headrest (Size 1 & 2) SEHOB6020 1 $485.00
Contoured Headrest (Size 1 & 2) SEHOB6010 1 $138.00
Fixed Wing Headrest (Size 1 & 2) SEHOB6015 1 $342.00
Headrest Support (Size 1 & 2) SEHOB6005 1 $247.00
Kid Kart Xpress Micro Adjustable Head SEHKT3010 1 $211.00
Support
Xpress Planar Head Support SEHKT3015 1 $138.00
Xpress Tri-Wing Adjustable Head SEHKT3005 1 $107.00
Support
Lpa Medical Inc. Cervical Support SEHO12005 1 $36.00
Contour Headrest SEHO12010 1 $86.00
Maple Leaf ML Contour SE0001133 1 $179.00
Wheelchair
Metalcraft Contoured Headrest With Mounting SEHNG0005 1 $260.00
Industries Hardware
Small, Large, Xlarge

Occipital Ring With Mounting SEHNG0015 1 $298.00
Hardware
Small & Large Child Or Adult

Occipital Ring, Add-On, With SEHNG0020 1 $260.00
Mounting
Hardware
Small & Large Child Or Adult

Motion Onyx Auto Style Headrest SEHZG0005 1 $161.00
Concepts
Orthofab Padded Contour Support Without SEHOF1005 1 $91.00
Page: 43 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Headrest/Neckrest Mounting
Hardware,
Small, Medium, Or Large

Otto Bock Headrest - Combination SEHOB0010 1 $72.00
Headrest - Large/Small SEHOB0100 1 $72.00
Headrest - Lateral Control SEHOB0050 1 $117.00
Neckrest - All Sizes SEHOB0250 1 $82.00
Soft Headrest - Large/Small SEHOB0110 1 $104.00
X-Style Headrest/Neckrest SEHOB0015 1 $108.00
Combination,
Adult
&
Paediatric Sizes.
Performance V-Trak Headrest, All Sizes, All SEHP00005 1 $311.00
Health Products Configurations
Permobil Headrest - For Ergo Back SEH1P0005 1 $405.00
Physipro Headrest SE0001073 1 $147.00
Symbio Headrest Support with SE0001803 1 $613.00
Adjustable Lateral Pad 6" x 4", 7" x 5",
8" x 6" (Double Extension)
Adjustable Lateral Pad 6" x 4", 7" x 5",
8" x 6" (Left or Right Extension)
Symbio Headrest Support with Head SE0001800 1 $500.00
Neck Pad 6" x 4.5", 7" x 5", 8" x 6"
Integrated Adjustable Lateral Control
Pad 5" x 4.5", 6" x 6.25"
Standard Pad 7" x 4", 8" x 5", 9" x 6"
Positech SUMMUS (all sizes) including SE0001446 1 $500.00
Innovation Inc. hardware (support holder and
fastener)
Power Plus Contour Headrest Including Brackets SEHWM0005 1 $221.00
Mobility
Page: 44 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Headrest/Neckrest Power Plus Relax Multi-Axis Headrest System SE0001542 1 $449.00
Mobility
Precision Rehab Headreast - Large (14") Or Small (10") SEHWB0010 1 $104.00
Manufacturing Pad
Pride Mobility TRU-Comfort 2 Including Mounting SE0001153 1 $243.00
Products Hardware
Stealth Products Stealth Combo Headrest With Multi SEHNS2050 1 $462.00
Axis
Hardware,
Large & Small Sizes

Stealth Comfort Plus Large 14" SEHNS3015 1 $142.00
Comfort Pad Only (With Ring)
Stealth Comfort Plus Medium 10" SEHNS3025 1 $142.00
Comfort Pad Only (With Ring)
Stealth Comfort Plus, Large 14" SEHNS3020 1 $292.00
Pad /Multi Axis Hardware
Stealth Comfort Plus, Large 14" SEHNS3005 1 $242.00
Pad/Standard Hardware
Stealth Comfort Plus, Medium 10" SEHNS3030 1 $292.00
Pad/Multi Axis Hardware
Stealth Comfort Plus, Medium 10" SEHNS3010 1 $242.00
Pad/Standard Hardware
Stealth Comfort Plus, Swingaway Both SEHNS3060 1 $426.00
Sides,
Standard
Lateral Pad/Spot Pad/Long Lateral Pad

Stealth Comfort Plus, Swingaway Left SEHNS3070 1 $323.00
Side,
Standard

Stealth Comfort Plus, Swingaway Right SEHNS3065 1 $323.00
Side,
Standard

Stealth I2i Headrest System - All Sizes SEHNS2060 1 $709.00
Stealth Occipital/Sub Occipital & SEHNS2005 1 $977.00
Laterals,
Page: 45 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Headrest/Neckrest Stealth Products Adult & Paediatric Sizes (Specify
Swingaway)
Stealth Otto Bock Style, Swing Away SEHNS3075 1 $480.00
Both
Sides,
Standard

Stealth Otto Bock Style, Swingaway SEHNS3085 1 $367.00
Left
Side,
Standard

Stealth Otto Bock Style, Swingaway SEHNS3080 1 $367.00
Right
Side,
Standard

Stealth Ultra Channel With Ring, Large SEHNS2020 1 $558.00
& Small Sizes
Stealth Ultra Large Combo With Large SEHNS2007 1 $885.00
Sub Occipital
Stealth
Ultra
Occipital
&
Laterals,
SEHNS2015 1 $693.00
Small & Large Sizes (Specify
Swingaway)
Stealth Ultra Occipital Large/Small SEHNS2030 1 $285.00
Stealth Ultra Small & Occipital/Sub SEHNS2010 1 $568.00
Occipital
Stealth Ultra Small Combo With Large SEHNS2009 1 $885.00
Sub Occipital
Stealth Ultra Sub Occipital SEHNS2025 1 $285.00
Large/Small
Stealth Ultra Swing Both Sides, SEHNS2035 1 $409.00
Standard
Lateral
Pad/Spot Pad/Long Lateral Pad

Stealth
Ultra
Swingaway
SEHNS2045 2 $323.00
Standard & Long Lateral Pad, Or Spot
Pad
Stealth Ultra-Ac Adjustable Channel SEHNS2040 1 $270.00
Sunrise Medical Adjust-A-Plush Headrest (all sizes) SE0001684 1 $267.00
Page: 46 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Headrest/Neckrest Sunrise Medical Emineo Advanced Headrest SEHM90105 1 $311.00
Emineo Basic Headrest SEHM90100 1 $204.00
Large Headrest SEHM90015 1 $128.00
Lateral Support Headrest SEHM90010 1 $121.00
Offset Headrest Large SEHM90030 1 $183.00
Offset Headrest Lateral SEHM90025 1 $176.00
Offset Headrest Small SEHM90020 1 $169.00
Plush Headrest (all sizes) SE0001683 1 $230.00
SEDEO Pad Flexible SE0001681 1 $221.00
SEDEO Pad Flexible (including Multi- SE0001682 1 $428.00
Position Headrest Mount)
SEDEO Pad Small (w/ cover including SE0001680 1 $386.00
Multi-Position Headrest Mount)
SEDEO Pad Small (w/ cover) SE0001679 1 $179.00
Sedeo Pro Flexible Headrest Pad SE0000665 1 $93.00
Sedeo Pro Large Headrest Pad SE0000666 1 $100.00
Sedeo Pro small headrest pad SE0000664 1 $69.00
Small Headrest Assesmbly SEHM90005 1 $114.00
Symmetric Savant Headrest SE0001617 1 $344.00
Designs
The Comfort Headrest - Moldable, Includes Cover SEH7C0015 1 $188.00
Company
Vision Vector Head N Neck Support, 11"W X SEHVC0005 1 $200.00
Wheelchair 8"D Pad
Seating Systems
Vector Head N Neck Support, Custom SEHVC0010 1 $283.00
Inc.
Pad
Whitmyer 10" Plush Occipital Pad & Single Sub- SEHWH7005 1 $361.00
Biomechanix Occipital
Pad
With Linx Vertical/Horizontal Mount

10" Plush Occipital Pad & Single Sub- SEHWH7020 1 $339.00
Page: 47 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Headrest/Neckrest Whitmyer Occipital
Pad
Biomechanix With Onyx Vertical/Horizontal Mount

10" Plush Occipital Pad & Single Sub- SEHWH7035 1 $371.00
Occipital
Pad
With Pro Verticial/Horizontal Mount

14" Plush Pad With Linx SEHWH5010 1 $197.00
Vertical/Horizontal Mount
14" Plush Pad With Onyx SEHWH5030 1 $197.00
14" Plush Pad With Pro SEHWH5040 1 $210.00
19" Plush Pad With Link SEHWH5015 1 $288.00
19" Plush Pad With Onyx SEHWH5032 1 $260.00
19" Plush Pad With Pro SEHWH5045 1 $292.00
4"X6" Occipital Pad & Single Sub- SEHWH7025 1 $288.00
Occipital
Pad
With Onyx Vertical/Horizontal Mount

4"X6" Occipital Pad & Single Sub- SEHWH7040 1 $320.00
Occipital
Pad
With Pro Vertical/Horizontal Mount

4"X6"Occipital Pad & Single Sub- SEHWH7010 1 $316.00
Occipital
Pad
With Lynx Vertical/Horizontal Mount

4"X6"Occipital Pad With Size 1/2 Sub- SEHWH7050 1 $380.00
Occipital
Pads

Occipital
Pads

Page: 48 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Headrest/Neckrest Whitmyer Occipital
Pads
Biomechanix With Pro Vertical/Horizontal Mount

8"
Or
10"
Plush
Pad
With
Lightweight
SEHWH5020 1 $188.00
8" Or 10" Plush Pad With Linx SEHWH5005 1 $188.00
8" Or 10" Plush Pad With Onyx SEHWH5025 1 $188.00
8" Or 10" Plush Pad With Pro SEHWH5035 1 $202.00
8"/10" Plush Occipital Pad With Size 1 SEHWH7085 1 $467.00
Sub-Occipital
Pads
With Pro Vertical/Horizontal Mount

8"/10" Plush Occipital Pad With Size SEHWH7055 1 $430.00
1sub-Occipital
Pads

8"/10" Plush Occipital Pad With Size SEHWH7070 1 $453.00
1sub-Occipital
Pads

Adjust-A-Plush Headrest System SEHWH7260 1 $235.00
Bilateral Lfc With Pads And Interface SEHWH7235 1 $398.00
Plate
For Plush & Contoured Cradle Systems

Heads
Up
Pad
All
Sizes
-
SE0001099 1 $207.00
Add On Occipital Pads Optional
Large Pad With Lightweight SEHWH5075 1 $142.00
Large Pad With Linx SEHWH5060 1 $142.00
Large Pad With Onyx SEHWH5090 1 $183.00
Large Pad With Pro SEHWH5110 1 $197.00
Page: 49 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Headrest/Neckrest Whitmyer Lateral Facial Component With Pad SEHWH7250 2 $183.00
Biomechanix
Medium Pad With Lightweight SEHWH5070 1 $133.00
Vertical/Horizontal Mount, LWS-CCS3
Medium Pad With Lightweight SEHWH5085 1 $174.00
Vertical/Horizontal Mount, ONYX-
CCS3
Medium Pad With Linx SEHWH5055 1 $133.00
Medium Pad With Pro SEHWH5105 1 $151.00
Occipital Pad With Size 3/4 Sub- SEHWH7105 1 $380.00
Occipital
Pads
1"X4",4"X6",1"X4" With Lynx

Occipital
Pads
1"X4",4"X6",1"X4" With Onyx

Occipital
Pads
1"X4",4"X6",1"X4" With Pro

Single Pad Dynamic Forehead Strap SEHWH7200 1 $252.00
System All Sizes
Single Pad Static Forehead Strap SEHWH7205 1 $266.00
System All Sizes
Small Pad With Lightweight SEHWH5065 1 $123.00
Small Pad With Linx SEHWH5050 1 $123.00
Small Pad With Onyx SEHWH5080 1 $165.00
Small Pad With Pro SEHWH5095 1 $142.00
Page: 50 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Headrest/Neckrest Whitmyer Vertical/Horizontal Mount
Biomechanix
T-Bar Occipital Pads & Single Sub- SEHWH7015 1 $562.00
Occipital
Pad
2.25"X7" & 2.25"X5" With Linx

Occipital
Pad
2.25"X7" & 2.25"X5" With Onyx

Occipital
Pad
2.25"X7" & 2.25"X5" With Pro

T-Bar Occipital Pads With Size 1 Sub- SEHWH7090 1 $636.00
Occipital
Pads
2.25"X7" With Pro Vertical/Horizontal

Mount
T-Bar Occipital Pads With Size 1sub- SEHWH7060 1 $599.00
Occipital
Pads
2.25"X7" With Linx Vertical/Horizontal

Mount
T-Bar Occipital Pads With Size 1sub- SEHWH7075 1 $612.00
Occipital
Pads
2.25"X7" With Onyx

T-Bar Occipital Pads With Size 3 Single SEHWH7110 1 $599.00
Sub-Occipital
Pads
2.25"X5" With Linx Vertical/Horizontal

Mount
Sub-Occipital
Pads
2.25"X5" With Onyx

Sub-Occipital
Pads
Page: 51 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Headrest/Neckrest Whitmyer 2.25"X5" With Pro Vertical/Horizontal
Biomechanix Mount
Unilateral Lfc With Pads And Interface SEHWH7230 1 $216.00
Plate
For Plush & Contoured Cradle Systems

Seat Cushion 5 Minds ACe Comfort II Cushion 14¿x14¿, SE0001428 1 $590.00
Mobility Inc. 14¿x16¿
ACe Comfort II Cushion 16¿x16¿, SE0001429 1 $604.00
16¿x18¿, 18¿x16¿, 18¿x18¿
ACe Comfort II Cushion 16¿x20¿, SE0001430 1 $618.00
18¿x20¿, 20¿x16¿, 20¿x18¿
ACe Comfort II Cushion 20¿x20¿ SE0001431 1 $631.00
ACe Comfort II Cushion SE0001432 1 $645.00
22¿x16¿,22¿x18¿
ACe Comfort II Cushion 22¿x20¿ SE0001433 1 $652.00
ACe Comfort and ACe Contour SE0001264 1 $376.00
Cushions
ACe Complete Cushion 16¿x16¿, SE0001349 1 $790.00
16¿x18¿, 18¿x16¿, 18¿x18¿
ACe Complete Cushion 16¿x20¿, SE0001350 1 $804.00
18¿x20¿, 20¿x16¿, 20¿x18¿
ACe Complete Cushion 20¿x20¿ SE0001351 1 $818.00
ACe Complete Cushion Dual Valve SE0001410 1 $838.00
(Bariatric) 22" x 16", 22" x 18"
(Bariatric) 22" x 20", 24" x 16", 24" x
18"
(Bariatric) 24" x 20"
(Paediatric) 12¿x10¿, 12¿x12¿, 12"x14¿
Page: 52 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Seat Cushion 5 Minds (Paediatric) 14¿x10¿, 14¿x12¿, 14"x14¿
Mobility Inc.
ACe Complete Cushion Single Valve SE0001405 1 $825.00
(Bariatric) 22" x 16", 22" x 18"
(Bariatric) 22" x 20", 24" x 16", 24" x
18"
(Bariatric) 24" x 20"
(Paediatric) 12¿x10¿, 12¿x12¿, 12"x14¿
(Paediatric) 14¿x10¿, 14¿x12¿, 14"x14¿
ACe Complete Dual Valve Cushion SE0001413 1 $804.00
16¿x16¿, 16¿x18¿, 18¿x16¿, 18¿x18¿
16¿x20¿, 18¿x20¿, 20¿x16¿, 20¿x18¿
20¿x20"
ACe Contour VF Modular Cushion SE0001423 1 $624.00
(Bariatric) 22¿x16¿, 22¿x18"
(Bariatric) 22¿x20¿
(Bariatric) 24¿x16¿, 24¿x18¿
(Bariatric) 24¿x20¿, 20¿x22¿, 22¿x22¿
(Bariatric) 24¿x22¿
(Paediatric) 10¿x10¿
(Paediatric) 10¿x12¿, 12¿x10¿
Page: 53 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Seat Cushion 5 Minds ACe Contour VF Modular Cushion SE0001419 1 $555.00
Mobility Inc. (Paediatric) 12¿x12"
(Paediatric) 12¿x14¿, 14¿x10¿
16¿x16¿, 16¿x18¿, 18¿x16¿, 18¿x18¿
16¿x20¿, 18¿x20¿, 20¿x16¿, 20¿x18¿
20¿x20¿
Action Products ACTION XACT LP2 SE0000329 1 $598.00
Action Xact LP2 SIZES XP: WIDTH: SE0000570 1 $599.00
16"/18"/20"/22" DEPTH: 16"/18"/20"
Action Xact LP2 XP: SIZES: XP 1818 TO SE0000571 1 $686.00
22X20
Centurian Cushion SESAN2205 1 $229.00
16x16,16x81,18x16,18x18
Centurian Cushion 18x20,20x18,20x20 SESAN2210 1 $404.00
Centurian Cushion Large Custom Sizes SESAN2225 1 $423.00
Centurian Cushion Small Custom Sizes SESAN2215 1 $347.00
Centurian Cushion Xlarge Custom SESAN2230 1 $539.00
Sizes
Commuter Cushion SESAN4405 1 $207.00
16x16,16x18,18x16,18x18
Commuter Cushion SESAN4410 1 $404.00
Page: 54 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Seat Cushion Action Products 18x20,20x18,20x20
Commuter Cushion Large Custom SESAN4425 1 $396.00
Sizes
Commuter Cushion Medium Custom SESAN4420 1 $351.00
Sizes
Commuter Cushion Small Sizes SESAN4415 1 $319.00
Pilot Cushion SESAN3305 1 $267.00
16x16,16x18,18x16,18x18
Pilot Cushion 18x20,20x18,20x20 SESAN3310 1 $372.00
Pilot Cushion Large Custom Sizes SESAN3325 1 $481.00
Pilot Cushion Medium Custom Sizes SESAN3320 1 $416.00
Pilot Cushion Small Custom Sizes SESAN3315 1 $361.00
Pilot Cushion Xlarge Sizes SESAN3330 1 $558.00
Pilot Cushion Xxxlarge Custom Sizes SESAN3340 1 $790.00
Professional Cushion SESAN1105 1 $354.00
16x16,16x18,18x16,18x18
Professional Cushion SESAN1115 1 $574.00
18x20,20x18,20x20
Professional Cushion Large Custom SESAN1130 1 $602.00
Sizes
Professional Cushion Medium Custom SESAN1125 1 $515.00
Sizes
Shear Smart Pad SESAN5505 1 $181.00
16x16,16x18,18x16,18x18
Shear Smart Pad 18x20, 20x18, 20x20 SESAN5510 1 $216.00
Xact Classic Cushion SESAN9905 1 $599.00
10x10,16x14,17x17,16x20,18x20,20x20
Xact Classic Cushion SESAN9910 1 $513.00
16x16,16x18,18x16,18x18
Xact Individual Cushion All Custom SESAN9915 1 $1,031.00
Sizes
Page: 55 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Seat Cushion Action Products Xact Individual Cushion Custom Sizes SESAN9920 1 $1,031.00
Xact Integrated Cushion With Drop SESAN9010 1 $647.00
Seat 16x20,18x20, 20x20
Xact Integrated Drop Base Sizes 10x10 SESAN9005 1 $599.00
To 18x18
Xact Lite Cushion 16x16 - 18x18 SESAN9015 1 $367.00
Xact Lite Cushion 18x20 - 20x20 SESAN9020 1 $427.00
Xact Soft Foam Cushion 16x16, 16x18, SESAN9980 1 $513.00
18x16, 18x18
Xact Soft Foam Cushion 16x20,18x20, SESAN9985 1 $647.00
20x16, 20x18, 20x20
Xact Soft Foam Cushion With SESAN9990 1 $729.00
Integrated Drop Seat, All Sizes
Adaptive Drop-In Seat With 1.5" Sun-Mate Or SESE10030 1 $184.00
Engineering Lab Pudgee Foam
Drop-In Seat With Contour One Foam SESE10035 1 $261.00
Drop-In Seat With Poly Foam SESE10020 1 $167.00
Full-Width Seat With 1.5" Sun-Mate SESE10065 1 $324.00
Or Pudgee Foam
Full-Width Seat With 1.5" Un-Mate Or SESE10055 1 $184.00
T-Foam
Full-Width Seat With Contour-One SESE10070 1 $261.00
Foam
Adaptive Full Width Solid Seat Package With J SES2L0010 1 $559.00
Equipment Or
Flush
Or
Drop
Hooks
Systems (Aes) & Hold Downs.

Offset, T Style, I Style, Anti-Thrust Or SES2L1015 1 $232.00
Medial
Thigh
Support Solid Seat Insert, Includes T-

Nuts.
Oversize Upcharge For Seats Over 2o" SES2L1035 1 $69.00
But Less Than 28".
Page: 56 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Seat Cushion Adaptive Quick Fit Anti-Thrust Or Contour SES2L1020 1 $423.00
Equipment Solid
Seat
Insert,
Includes
Systems (Aes) T-Nuts.

Quick-Fit Contoured, Adjustable Split, SES2L1030 1 $491.00
Or
Foam
Form
Solid
Seat Insert, Incudes T-Nuts.

Sculptured Solid Set Insert, Includes SES2L1025 1 $862.00
T-Nuts, Custom.
Sculpturefit Seat Package 2/Attaching SES2L0015 1 $1,066.00
Hardware, Custom.
Solid Seat Insert Package, Li'L Kiddos, SES2L0020 1 $548.00
14" Wide Or Less.
Solid Seat Insert Package, Li'L Kiddos, SES2L0025 1 $708.00
Contoured,
14"
Wide
Or Less.
Solid Seat Insert, Includes T-Nuts, Li'L SES2L1010 1 $213.00
Kiddos,
14" Wide Or Less.

Solid Seat Insert, Includes T-Nuts. SES2L1005 1 $158.00
Solid Seat Package W/Universal Or E-Z SES2L0005 1 $467.00
Mount Hardware.
Advanced AMS AIRpad (All Sizes) SE0001593 1 $358.00
Mobility
All Star Cushion Custom Sizes Includes SESAO0080 1 $503.00
Systems Corp
Cover
All
Star
Cushion
Includes
SESAO0085 1 $445.00
Cover And Sizes 16x16 16x18 16x18
17x17 18x16 18x18
All
Star
Drop
Base,
Includes
SESAO0090 1 $496.00
Cover, Base, 4 Drop Hooks
Comfort Contoured Cushion SESAO0030 1 $121.00
Gel Flotation Pad SESAO0110 1 $279.00
Pro Custom Cushion With Built In SESAO0070 1 $530.00
Page: 57 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Seat Cushion Advanced Drop Base
Mobility
Pro-Custom Cushion With Covers SESAO0075 1 $486.00
Systems Corp
Superstar
Cushion
Includes
SESAO0100 1 $518.00
Cover 16x16, 16x18, 18x16, 18x18
Superstar Drop Base, Size 17x17, SESAO0105 1 $604.00
Includes
Cover, Base, 4 Drop Hooks

Upcharge For Custom Sizes Other SESAO0115 1 $68.00
Than 17x17
Amoena Amovida Motion AV400 SE0000959 1 $189.00
Medizin
Amovida Motion Comfort + AV500 SE0000960 1 $229.00
Amysystems CG Air Deluxe 10 x 10 - 20 x 20 SE0001384 1 $635.00
(includes 3D mesh or incontinence
covers)
CG Air Deluxe 10 x 10 - 20 x 20 SE0001383 1 $568.00
(includes standard covers)
CG Air Deluxe 22" - 24" wide SE0001386 1 $664.00
(including 3D mesh or incontinence
covers)
CG Air Deluxe 22" - 24" wide SE0001385 1 $635.00
(including standard covers)
CG Air Deluxe 26"+ wide (includes 3D SE0001388 1 $733.00
mesh or incontinence covers)
CG Air Deluxe 26"+ wide (including SE0001387 1 $704.00
standard covers)
CG Air Single or Dual Valve 10 x 10 - SE0001378 1 $511.00
20 x 20 (includes 3D mesh or
incontinence covers 2", 3", 4" high)
CG Air Single or Dual Valve 10 x 10 - SE0001377 1 $435.00
20 x 20 (includes standard covers 2",
3", 4" high)
CG Air Single or Dual Valve 22" - 24" SE0001380 1 $664.00
Page: 58 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Seat Cushion Amysystems wide (includes 3D mesh or
incontinence covers 2", 3", 4" high)
CG Air Single or Dual Valve 22" - 24" SE0001379 1 $664.00
wide (includes standard covers 2", 3",
4" high)
CG Air Single or Dual Valve 26"+ SE0001381 1 $704.00
(includes standard covers 2", 3", 4"
high)
CG Air Single or Dual Valve 26"+ wide SE0001382 1 $733.00
(includes 3D mesh or incontinence
covers 2", 3", 4" high)
Contour Seat Cushion For Heavy Duty SES4P0020 1 $618.00
Contour Seat Cushion, Non-Standard SES4P0015 1 $524.00
Sizes
Contour Seat Cushion, Standard Sizes SES4P0010 1 $442.00
Bioform Reha Foundation Cushion - All Sizes SESZB0005 1 $417.00
Blake Medical Geo-Matrix Bold (26" and under) SE0001608 1 $828.00
Geo-Matrix Bold (27" and over) SE0001609 1 $897.00
Geomatrix Bronze SESG00005 1 $368.00
Geomatrix Gold, Gold+ SESG00015 1 $529.00
Geomatrix Gold, Gold+ Custom Sizes SESG00020 1 $621.00
Geomatrix Hybrid Or Hybrid Deep SESG00030 1 $562.00
Geomatrix Platinum SESG00025 1 $752.00
Geomatrix Silver SESG00010 1 $483.00
PC Cutback (size 22") SE0001538 1 $500.00
PC Cutback (sizes up to 20") SE0001537 1 $447.00
Zentury, all sizes SE0000996 1 $242.00
Body Ryzm Life SambaMD SE0001204 1 $149.00
Sciences /
Perspectis, Inc.
Page: 59 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Seat Cushion Broda Seat Pad SESB-0010 1 $53.00
Clearview Debbonair Dynamics/Cushionair SESGC0015 1 $583.00
Healthcare Cushion
Products - Greater Than 20" Width Or Depth

Debbonair Dynamics/Cushionair SESGC0005 1 $471.00
Cushion
- Standard Sizes
Debbonair Dynamics/Cushionair SESGC0010 1 $503.00
Cushion
- Up To 20" Width Or Depth

Custom Complex Indirect Molded Seat, SESCF105L 1 $1,259.00
Fabricated Without
Cover
& Mounting Hardware

Contoured Seat, Includes Cover, SESCF103L 1 $518.00
Without Hardware
Flat Seat/Rigid Base, Includes Cover, SESCF101L 1 $259.00
Without Hardware
Sculptured Seat, Includes Cover, SESCF104L 1 $621.00
Without Hardware
Wedged Seat (Thigh Bar), Includes SESCF102L 1 $388.00
Cover, Without Hardware
Dynamic Health Nxt BioFit Cushion, all sizes SE0001037 1 $411.00
Care Solutions
Nxt KulFit Cushion, all sizes SE0001039 1 $376.00
Nxt NuFit Cushion, all sizes SE0001038 1 $376.00
nxt BioFit Cushion (20", 22" and 24" x SE0001434 1 $431.00
22")
nxt BioFit Cushion (26" wide) SE0001691 1 $480.00
Future Mobility Prism Elite Cushion 16x16-20x20 SESFM0060 1 $259.00
Prism Elite Cushion Custom Sizes SESFM0065 1 $293.00
Prism Ideal Cushion All Sizes SESFM0050 1 $159.00
Prism Supreme Air Cushion 18x18 SESFM0030 1 $500.00
Page: 60 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Seat Cushion Future Mobility Through 20x20
Prism Supreme Air Cushion 18x19 SESFM0035 1 $518.00
Through 20x19
Prism Supreme Air Cushion Custom SESFM0040 1 $542.00
Sizes
Prism Supreme Cushion 14x14 SESFM0015 1 $397.00
Through 18x20
Prism Supreme Cushion 15x16 SESFM0020 1 $414.00
Through 20x20
Prism Supreme Cushion Custom Sizes SESFM0025 1 $473.00
Prism Supreme Gel Cushion 14x14 SESFM0110 1 $466.00
Through 18x20
Prism Supreme Gel Cushion 15x16 SESFM0115 1 $483.00
Through 20x20
Prism Supreme Gel Cushion Custom SESFM0120 1 $535.00
Sizes
Prism Supreme Heavy Duty Cushion SESFM0125 1 $552.00
Prism Supreme Ii Plus Cushion 14x14 SESFM0070 1 $397.00
Through 18x20
Prism Supreme Ii Plus Cushion 15x16 SESFM0075 1 $414.00
Through 20x20
Prism Supreme Ii Plus Cushion Custom SESFM0080 1 $473.00
Sizes
Serene Champion SE0001226 1 $311.00
Serene Paramount SE0001227 1 $311.00
Serene Paramount Gel SE0001229 1 $362.00
Serene Paramount Visco SE0001228 1 $342.00
Serene Prime SE0001225 1 $97.00
Super Cushion For Kids 10x10 SESFM0090 1 $397.00
Through 16x16
Super Cushion For Kids 10x12 SESFM0095 1 $414.00
Page: 61 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Seat Cushion Future Mobility Through 16x12
Super Cushion For Kids Custom Sizes SESFM0100 1 $473.00
Hoggi Non Standard Seat Width SE0000464 1 $200.00
Standard Seat Width SE0000463 1 $132.00
Swingbo Plus Seat Cushion SE0000465 1 $174.00
Xps Adaptive Seat Cushion SESK20050 1 $269.00
Invacare Absolute Fits 16" To 20" Wide W/C SESNS0005 1 $74.00
Airflo Cushion Custom Sizes SESNS2015 1 $558.00
Airflo Cushion Fits 14 To 18" Wide SESNS2005 1 $489.00
W/C
Airflo Cushion Fits 20" To 22" Wide SESNS2010 1 $495.00
W/C
Comfort -Mate Extra - Special Size SESNS0039 1 $143.00
Modifications
Comfort-Mate Extra - Fits 14" To 22" SESNS0037 1 $143.00
Wide W/C
Contour U Seat Includes All SESNS0075 1 $1,156.00
Modifications & Vacuum/Vinyl
Upholstery
Invacare Matrx Flovair Cushion - SE0000967 1 $449.00
Gentle/Max Contour
Invacare Matrx Stabilite Cushion SE0000966 1 $317.00
MATRX
PS
POSTURE
SEAT
SE0000131 1 $638.00
Pediatric Sizes 1010/1012/1014
Naked Contour U Seat, Includes All SESNS0080 1 $1,375.00
Modifications
& Vacuum/Moisture Proof

Coating/Removable
Cover
& Cover Pattern.

Silhouette Seat Cushion SESNS0070 1 $545.00
Single Density Cushion, Non Standard SESNS0015 1 $91.00
Page: 62 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Seat Cushion Invacare Size
Ulti-mate Base Fits 10" To 14" Wide SESNS1040 1 $416.00
W/C
Ulti-mate Base Special Adult Size & SESNS1035 1 $578.00
Modifications
Ulti-mate Base Special Junior Size & SESNS1045 1 $578.00
Modifications
Ulti-mate Cushion Fits 10" To 14" SESNS0050 1 $302.00
Wide W/C
Ulti-mate Cushion Fits 16" To 20" SESNS0040 1 $373.00
Wide W/C
Ulti-mate Cushion Special Adult Size & SESNS0045 1 $458.00
Modifications
Ulti-mate Cushion Special Junior Size SESNS0055 1 $387.00
& Modifications
Ulti-mate Fits 16" To 20" Wide W/C SESNS1030 1 $456.00
Invacare - Matrx Flo-Tech Cushion Fits W/C 16" - 19" SES1M0030 1 $551.00
Seating Width & 16" - 21" Depth
Flo-Tech Cushion Fits W/C 20" - 24 SES1M0040 1 $744.00
Width & 20" - 22" Depth
Flo-Tech Cushion Fits W/C 20" Width SES1M0035 1 $632.00
& 16" - 18" Depth
Kidabra Base Fits W/C 12"-14" Width SES1M2005 1 $584.00
& 12"-15" Depth
Kidabra Fits W/C 11"-14" Width & SES1M0015 1 $439.00
12"-15" Depth
Matrx Libra - Heavy Duty SE0001237 1 $707.00
Matrx Libra - Standard SE0001212 1 $514.00
Matrx Libra Adjust Heavy-Duty (All SE0001694 1 $873.00
Sizes)
Matrx Libra Adjust Standard (14" x SE0001692 1 $680.00
Page: 63 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Seat Cushion Invacare - Matrx 12", 13" - 20" x 20", 21")
Seating
Matrx Libra Adjust Standard (16" x SE0001693 1 $873.00
22", 23" - 20" x 22", 23")
Matrx PSP SE0001583 1 $445.00
Matrx Posture Seat (PS Cushion) SES1M0066 1 $687.00
23x30 Width To 21x30 Deep
Matrx Posture Seat(PS Cushion), All SES1M0060 1 $383.00
Sizes
Matrx Vi Base Fits W/C 16"-20" Width SES1M1005 1 $584.00
& 16"-19" Depth
Matrx Vi Cushion Bariatric Sizes, Client SES1M0011 1 $640.00
Weight
Exceeds 300lbs
Matrx Vi Cushion Fits W/C 14"-18" SES1M0005 1 $475.00
Width & 15"-21" Depth
Matrx Vi Wide Cushion Fits W/C SES1M0010 1 $519.00
19"-22" Width & 16"-21" Depth
Matrx Wide Cushion Fits W/C 20" SES1M1010 1 $616.00
Width & 16"-19" Depth
PS Cushion with Visco Foam Upgrade SES1M0070 1 $452.00
All Sizes
Posture Seat (PS Cushion) 11-12 SES1M0065 1 $382.00
Inches Wide To 20-21 Inches Deep
Jay Medical J-Gel Base SESJA6830 1 $186.00
J-Gel Cushion 16" & 18" Deep SESJA0700 1 $370.00
J-Gel Cushion 20" Deep SESJA0705 1 $370.00
J2 Base Large Sizes SESJA6810 1 $226.00
J2 Base Standard Sizes SESJA6800 1 $179.00
J2 Plus Cushion Foam Base SESJA6835 1 $143.00
J2 Plus Cushion, Ae Cover With SESJA0755 1 $595.00
Custom Foam Kit
Page: 64 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Seat Cushion Jay Medical J2 Plus Cushion, Ae Cover With Fluid SESJA0760 1 $745.00
Pad
J2 Plus Cushion, Ae Cover With Foam SESJA0750 1 $566.00
Kit
J2 Plus Cushion, Ls Inc. Cover With SESJA0770 1 $597.00
Custom Foam Kit
Fluid Pad
Foam Kit
J3 Cushion SESJA0800 1 $604.00
Jay 2 17x17 SESJA0485 1 $471.00
Jay 2 17x17 With Incontinent Cover SESJA0462 1 $474.00
Jay 2 17x17 With Air Exchange Cover SESJA0442 1 $481.00
Jay 2 18x20, 15.5x20 With Air SESJA0450 1 $552.00
Exchange Cover
Jay 2 18x20, 15.5x20 With Incontinent SESJA0470 1 $543.00
Cover
Jay 2 20x16 SESJA0480 1 $543.00
Jay 2 20x16, 20x18 With Air Exchange SESJA0441 1 $552.00
Cover
Jay 2 20x16, 20x18 With Incontinent SESJA0461 1 $543.00
Cover
Jay 2 20x18 SESJA0490 1 $533.00
Jay 2 Cushion 14x16 With Standard SESJA0425 1 $471.00
Cover
Page: 65 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Seat Cushion Jay Medical Jay 2 Cushion 15.5x 16, 15.5 X 18 With SESJA0420 1 $471.00
Standard Cover
Jay 2 Cushion 18x16, 18x18 With SESJA0400 1 $471.00
Standard Cover
Cover
Cover
Jay 2 Cushion18x20, 15.5x20 With SESJA0410 1 $543.00
Standard Cover
Jay 2 Deep Contour 20x16, 20x18, SESJA0505 1 $535.00
16x20, 18x20
Jay 2 Deep Contour 20x20, 22x16, SESJA0507 1 $619.00
22x18
Jay 2 Deep Contour 24x18 SESJA0510 1 $654.00
Jay 2 Deep Contour Standard Sizes SESJA0500 1 $492.00
Jay 2 Deep Contourn with Solid Drop SESJA0605 1 $574.00
Seat 20x16, 20x18, 16x20, 18x20, Solid
Drop Seat Attached
Seat 20x20, 22x16, 22x18, Solid Drop
Seat Attached
Seat Standard Sizes With Solid Drop
Seat
Jay 2 Standard Sizes With Air Exchange SESJA0440 1 $481.00
Cover
Jay 2 Standard Sizes With Incontinent SESJA0460 1 $474.00
Cover
Jay 3 Air Cushion - Dual Valve SESJA9910 1 $618.00
Jay 3 Air Cushion - Single Valve SESJA9905 1 $607.00
Jay 3 Air Cushion -Width X Depth SESJA9915 1 $752.00
Page: 66 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Seat Cushion Jay Medical Greater Than 21 Inches
Jay 3 Air Cushion- Dual Valve -Width X SESJA9920 1 $762.00
Depth .gt.21 Inches
Jay Active Cushion 18x16, 16x16, SESJA2010 1 $523.00
14x16
Jay Active Cushion 18x18, 16x18 SESJA2100 1 $523.00
Jay Active Cushion 20x18, 18x20, SESJA2200 1 $574.00
16x20, With Adductor Wedges
Jay Active Foam Base 20" Deep SESJA6325 1 $226.00
Jay Basic Pro Cushion SE0001016 1 $121.00
Jay Care Cushion 18x16, 18x8, 16x16, SESJA5500 1 $350.00
16x18
Jay Combi Base 18x16 To 15.5x20 SESJA6400 1 $37.00
Jay Combi Base 20x18 SESJA6500 1 $71.00
Jay Combi Cushion 14x14/12x12 With SESJA3200 1 $194.00
Back Support
Jay Combi Cushion 18x16 To 15.5x20 SESJA3010 1 $194.00
Jay Combi Cushion 20x18 With Back SESJA3100 1 $183.00
Support
Jay Combi With Lumbar Support SESJA3326 1 $153.00
14x14, 12x12
18x20, 16x20
20x18
Jay Combi With Lumbar Support, SESJA3320 1 $183.00
Narrow
Adult Soft 15.5x16

Jay Combi With Lumbar Support, SESJA3310 1 $183.00
Regular
Adult Short 18x16
Page: 67 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Seat Cushion Jay Medical Jay Combi With Lumbar Support, SESJA3315 1 $183.00
Regular Adult
Jay Combi Without Lumbar Support SESJA3346 1 $154.00
14x14, 12x12
16x20, 18x20
20x18
Jay Combi Without Lumbar Support, SESJA3340 1 $154.00
Narrow
Adult Short 15.5x16

Narrow Adult 15.5x18
Regular
Adult Short 18x16

Regular
Adult Soft 18x18

Jay Cushion 18x16, 15.5x16, 14x16 SESJA0010 1 $528.00
Jay Cushion 18x18, 15.5x18, SESJA0100 1 $528.00
Jay Cushion 18x20, 15.5x20 SESJA0250 1 $585.00
Jay Cushion 20x20, 24x20 SESJA0200 1 $704.00
Jay Cushion Sizes 18x16 To 10x10 With SESJA0350 1 $540.00
Incontinent Cover
Jay Cusion Sizes 18x16 To 10x10 With SESJA0325 1 $550.00
Air Exchange Cover
Jay Duo Cushion 16x16,16x18, 18x16, SESJA8005 1 $354.00
18x18
Includes Solid Seat, 2 Covers &

Hardware
Jay Duo Cushion 17x16, 17x18 SESJA8017 1 $354.00
Page: 68 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Seat Cushion Jay Medical Includes Solid Seat, 2 Covers &
Hardware
Jay Duo Cushion 20x16 Includes Solid SESJA8015 1 $400.00
Seat, 2 Covers & Hardware
Jay Duo Cushion Foam Cushion 16x16, SESJA8040 1 $165.00
16x18, 18x16, 18x18
Jay Duo Cushion Foam Cushion 17x16, SESJA8057 1 $165.00
17x18
Jay Duo Cushion Foam Cushion 20x16 SESJA8055 1 $194.00
Jay Duo Cushion Foam Cushion 20x18 SESJA8050 1 $194.00
Jay
Duo
Cushion
Large
Adult
20x18
SESJA8010 1 $392.00
Hardware
Jay Duo Cushion Narrow Pan 16x16, SESJA8020 1 $347.00
16x18,
18x16,
18x18
Includes Cushion, 2 Covers &

Hardware
Jay Duo Cushion Narrow Pan 17x16, SESJA8027 1 $354.00
17x18

Hardware
Jay Duo Cushion Narrow Pan 20x16 SESJA8025 1 $392.00
Hardware
Jay
Duo
Cushion
Narrow
Pan
20x18
SESJA8030 1 $392.00
Includes Cushion, 2 Covers &
Hardware
Jay Easy Cushion With Flat Or Curved SESJA9805 1 $387.00
Bottom Sizes 14x16 Through 18x18
Jay Easy Cushion With Flat Or Curved SESJA9810 1 $405.00
Bottom Sizes 18x20 Through 20x20
Jay Easy Foam Base With Flat Or SESJA9815 1 $102.00
Curved
Bottom
Sizes
14x16
Page: 69 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Seat Cushion Jay Medical Through 18x18
Jay Easy Foam Base With Flat Or SESJA9820 1 $116.00
Curved
Bottom
Sizes
18x20
Through 20x20
Jay Fit Cushion Adjustable Contour SESJA9700 1 $308.00
Seat
For
10"
Or
12"
Frame
Width,
Various Seat Depths

Seat
For
14"
Or
16"
Frame
Width,
Various Seat Depths

Seat
For
18"
Frame
Width,
Various Seat Depths

Jay Foam Base 20" Deep SESJA6050 1 $203.00
Jay Fusion Air Single Valve Regular size SE0000953 1 $604.00
Jay Fusion Air Single Valve width of SE0000954 1 $677.00
22" or more OR Jay Fusion Air Single
Valve depth of 22" or more
Jay Fusion Cushion AIR Dual Valve SE0000956 1 $614.00
regular size
Jay Fusion Cushion AIr Dual Valve SE0000957 1 $688.00
width of 22" or more OR Jay Fusion
Cushion AIr Dual Valve depth of 22"
or more
Jay Fusion Cushion AIr Dual Valve with SE0000958 1 $762.00
width AND depth greater than 22"
Jay Fusion Cushion Air Single Valve SE0000955 1 $750.00
with width AND depth greater than
22"
Jay Fusion Cushion Fluid width and SE0000952 1 $750.00
depth of 22" or more
Jay Fusion Cushion Fluid width of 22" SE0000951 1 $677.00
or more OR Jay Fusion Cushion Fluid
Page: 70 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Seat Cushion Jay Medical depth of 22" or more
Jay Fusion Cushion regular size SE0000950 1 $604.00
Jay GO SE0000350 1 $172.00
Jay GS SESJA5000 1 $512.00
10x13,12x15,14x17,16x19,18x20
Jay GS Cushion Pressure Relief Pad SESJA5010 1 $594.00
With Air Exchange Cover
Jay GS Cushion Pressure Relief Pad SESJA5005 1 $605.00
With Incontinent Cover
Jay Go - 19X15 to 24X24 SE0000324 1 $193.00
Jay
Go
Cushion
Adult
and
Paediatric
SE0000323 1 $173.00
JGO14x14 to 18X24
Jay ION SE0000348 1 $379.00
Jay Lite Cushion - All Sizes SESJA4200 1 $483.00
Jay Recline Cushion 20x20 SESJA9505 1 $685.00
Jay Recline Cushion 24x20 SESJA9515 1 $725.00
Jay Recline Cushion Large Sizes SESJA9510 1 $594.00
Jay Recline Cushion Standard Sizes SESJA9500 1 $519.00
Jay Recliner Cushion 18/15.5x20 With SESJA1375 1 $607.00
Incontinent Cover
Jay Recliner Cushion 18x16 To 10x10 SESJA1350 1 $552.00
With Incontinent Cover
Jay Recliner Cushion 18x16, 18x18, SESJA1010 1 $550.00
15.5x16, 15.5x18, 14x16
Jay Recliner Cushion 18x20, 15.5x20 SESJA1100 1 $619.00
Jay Recliner Cushion 20x20 With SESJA1400 1 $690.00
Incontinent Cover
Jay Recliner Cushion 20x20,24x20 SESJA1200 1 $737.00
With Quadrant Pads
Jay Recliner Cushion 24x20 With SESJA1425 1 $723.00
Page: 71 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Seat Cushion Jay Medical Incontinent Cover
Jay Solution With Solid Drop Seat, SESJA0370 1 $549.00
Sizes
14
X
14
-
18
X
20,
Includes Cover
Jay Solution With Solid Drop Seat, SESJA0375 1 $587.00
Sizes
19
X
18
-
20
X
18,
Includes Cover
Jay Solution, Sizes 14 X 14 -17 X 18, SESJA0360 1 $413.00
Includes Cover
Jay Solution, Sizes 18 X 16 - 20 X 18, SESJA0365 1 $430.00
Includes Cover
Jay Triad Cushion 16x16, 16x18, SESJA9120 1 $299.00
18x16,18x18,20x18 With Solid Drop
Base
Jay Triad Cushion 20x18 SESJA9106 1 $299.00
Jay Triad Cushion 20x18 With Solid SESJA9125 1 $391.00
Drop Seat
Jay Triad Cushion Standard Sizes SESJA9105 1 $299.00
Jay Union Cushion 14X14 TO 18X18 SE0000352 1 $440.00
Jay Union Cushion 18X19 TO 24X24 SE0000353 1 $465.00
Jay Union Cushion with additional SE0000354 1 $475.00
cover size 14X14 TO 18X18
Jay Union Cushion with additional SE0000355 1 $499.00
cover size 18X19 TO 24X24
Jay Xtreme Cushion 14x14 To 18x18 SESJA9020 1 $428.00
With 2 Covers
Jay Xtreme Cushion 16x20, 18x20 With SESJA9040 1 $366.00
2 Covers
Jay Xtreme Cushion 20x20 With 2 SESJA9030 1 $563.00
Covers
Jay Zip Cushion, All Sizes SESJA5550 1 $411.00
Page: 72 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Seat Cushion Jay Medical Tlc Contoured Seat Cushion SESKT2010 1 $990.00
Xpress
Standard
Seat
Cushion
-
SESKT2020 1 $173.00
Specify Short (900020/1) Or Long
(900022/3)
Kaji Exgel OWL Active Cushion (all sizes) SE0001642 1 $949.00
Corporation
Exgel OWL Cushion Contour (all sizes) SE0001478 1 $620.00
Exgel OWL Cushion Deep Contour (all SE0001479 1 $620.00
sizes)
Exgel OWL Cushion Deep Contour SE0001480 1 $638.00
Slim (all sizes)
Exgel OWL Cushion High (all sizes) SE0001477 1 $638.00
Exgel OWL Cushion Regular (all sizes) SE0001476 1 $604.00
Exgel OWL Kids SE0001518 1 $742.00
Exgel Standard Cushion (anti-thrust, SE0001521 1 $638.00
all sizes)
Exgel Standard Cushion (high, all SE0001520 1 $604.00
sizes)
Exgel Standard Cushion (regular, all SE0001519 1 $587.00
sizes)
OWL Kids Adjustable (all sizes) SE0001616 1 $845.00
Ki Mobility Axiom CS Cushion (Contoured) SE0001781 1 $616.00
Axiom CS Pediatric Solid Seat Cushion SE0001717 1 $261.00
Axiom CS Pediatric Solid Seat SE0001719 1 $247.00
Interface
Axiom CS Seat Cushion SE0001720 1 $242.00
Axiom CS Solid Seat Cushion SE0001716 1 $271.00
Axiom CS Solid Seat Interface SE0001718 1 $247.00
Axiom G Cushion 14 x 14 - 20 x 20 SE0001389 1 $135.00
Axiom G Cushion 22 x 18 - 22 x 20 SE0001390 1 $190.00
Axiom P Cushion 14 x 14 - 20 x 20 SE0001391 1 $397.00
Page: 73 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Seat Cushion Ki Mobility Axiom S Cushion 14 x 14 - 20 x 20 SE0001393 1 $186.00
Axiom S Cushion 22 x 18 - 22 x 20 SE0001394 1 $276.00
Axiom SP Cushion Fluid 14 x 14 - 20 x SE0001395 1 $480.00
20
Axiom SP Cushion Fluid 21 x 18 - 22 x SE0001396 1 $573.00
20
Axiom SP Cushion Visco 14 x 14 - 20 x SE0001397 1 $442.00
20
Axiom SP Cushion Visco 21 x 18 - 22 x SE0001398 1 $535.00
20
Kid Kart Xpress
Contour
Adjustable
Cushion
-
SESKT2030 1 $348.00
Specify Short (900312-28) Or Long
(900329-36)
Xpress
Ledge
Seat
Cushion
-
SESKT2026 1 $319.00
(900030/1)
Xpress
Wedge
Seat
Cushion
-
SESKT2025 1 $66.00
(900026/7)
Lpa Medical Inc. Contour Seat Cushion With Perineal SESO12005 1 $93.00
Abductor
Pre-Cure Cushion SESO12010 1 $155.00
Maple Leaf ML Bariatric SE0001092 1 $541.00
Wheelchair
ML Cozy SE0001090 1 $331.00
ML Extreme Comfort SE0001091 1 $431.00
Nylon/Leatherette 2" Foam Cushion SESWM0001 1 $55.00
Nylon/Leatherette 3" Foam Cushion SESWM0005 1 $62.00
Motion Trx Onyx Seat 16-19" Width SESZG0005 1 $555.00
Concepts
Trx Onyx Seat 20-22" Width SESZG0010 1 $599.00
Nighthawk 2" Standard Foam With Cover SESNM2000 1 $82.00
3" Standard Foam With Cover SESNM2010 1 $47.00
Page: 74 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Seat Cushion Nighthawk Aero Space Cushion, 18x16x3 SESNM9060 1 $208.00
Afg Cushion 16x16, 16x18, 18x16, SESNM1010 1 $299.00
18x18
Bi-Sunmate Cushion & Base SESNM8070 1 $392.00
Cumfy Plus Cushion With Cover SESNM4000 1 $273.00
Gel Suspension Cushion SESNM9045 1 $257.00
16x16,18x16,18x18
Gel Suspension Cushion 20x16, 20x18 SESNM9050 1 $216.00
Med Foam 1" Thru 4" With Cover SESNM0010 1 $221.00
Superior Cumfy Cushion & Base SESNM8000 1 $474.00
Superior Cushion With Cover SESNM2050 1 $372.00
Upcharge For Custom Sized Or SESNM0000 1 $42.00
Oversized Cushions
Orthofab Cushion With Contour Add Ons SESOF1005 1 $279.00
15-18" Width & 15-20" Depth
Cushion With Contour Add Ons Non SESOF1010 1 $331.00
Standard Sizes & Options
Cushion With Visco Foam Insert & SESOF1025 1 $317.00
Contour
Add
Ons
14-20" Width & 15-20" Depth

Cushion With Visco Foam Insert & SESOF1030 1 $386.00
Contour
Add
Ons
Non Standard Sizes & Options

Otto Bock Aerial Cushion 15"x16" to 20"x18" SE0000691 1 $480.00
All Sizes SESOB704L 1 $383.00
Aquos Cushion 15"x18" to 20"x18" SE0000690 1 $359.00
Comfort Custom Sizes SESOB8045 1 $699.00
Seat Finished With Spray SESOB7100 1 $1,710.00
Coating,Cover,Sewing Pattern
Seat-Itemized Cushion (Unfinished) SESOB7105 1 $1,253.00
Page: 75 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Seat Cushion Otto Bock Sizes 16x18,17x16,17x17,18 X16 SESOB6020 1 $434.00
Sizes 17x18,18x17,18x18,19 X16 SESOB6025 1 $434.00
Sizes 19x18,20x16,20x18 SESOB6030 1 $446.00
Standard Sizes SESOB8040 1 $541.00
Standard Sizes Smaller Than 16x17 SESOB6015 1 $422.00
Terra Cushion 15"x16" to 20"x18" SE0000689 1 $328.00
Permobil Corpus Ergo Air SE0001267 1 $325.00
Ergo Seat - All Sizes SES1P0005 1 $351.00
M2 ATI Cushion (Bariatric Sizes) SE0001705 1 $621.00
M2 ATI Cushion (Custom Sizes) SE0001706 1 $635.00
M2 ATI Cushion (Paediatric Sizes) SE0001704 1 $528.00
M2 ATI Cushion (Standard Sizes) SE0001703 1 $542.00
M2 ATI Cushion w/ Glidewear SE0001709 1 $638.00
(Bariatric Sizes)
(Custom Sizes)
(Paediatric Sizes)
(Standard Sizes)
M2 Cushion (Bariatric Sizes) SE0001697 1 $469.00
M2 Cushion (Custom Sizes) SE0001698 1 $483.00
M2 Cushion (Paediatric Sizes) SE0001696 1 $380.00
M2 Cushion (Standard Sizes) SE0001695 1 $404.00
M2 Cushion w/ Glidewear (Bariatric SE0001701 1 $483.00
Sizes)
M2 Cushion w/ Glidewear (Custom SE0001702 1 $497.00
Sizes)
M2 Cushion w/ Glidewear (Paediatric SE0001700 1 $414.00
Page: 76 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Seat Cushion Permobil Sizes)
M2 Cushion w/ Glidewear (Standard SE0001699 1 $424.00
Sizes)
Physipro Brio Seat Cushion Non Std. 21" and SE0001805 1 $341.00
less
Brio Seat Cushion Std. Sizes 14" x 14", SE0001804 1 $289.00
16" x 16", 16 x 18", 18" x 16", 18" x
18", 20" x 20'
C3S Cushion - All Sizes SE0001119 1 $235.00
Contour Insert (Bariatric) - All Sizes SE0001611 1 $759.00
Contour Insert - All Sizes SE0001610 1 $714.00
LXA Cushion - All Sizes SE0001070 1 $319.00
Physiair (Bariatric) - All Sizes SE0001613 1 $690.00
Physiair - All Sizes SE0001612 1 $638.00
Siliko (Bariatric) - All Sizes SE0001615 1 $759.00
Siliko - All Sizes SE0001614 1 $552.00
Ultra Cushion - All Sizes SE0001120 1 $254.00
Ultra Cushion with Gel - All Sizes SE0001121 1 $435.00
Zero Pressure Cushion - All Sizes SE0001122 1 $258.00
Zero Pressure Cushion with Gel - All SE0001123 1 $424.00
Sizes
Positech STOPUS (oversize) anti-slip SE0001445 1 $750.00
Innovation Inc. waterproof seat cushion multidensity
foam (all sizes)
STOPUS anti-slip seat waterproof SE0001444 1 $650.00
cushion multidensity foam (all sizes)
Power Plus Relax AirFlow Single & Dual Valve SE0001669 1 $587.00
Mobility Cushion (All Sizes)
Relax Comfy SESWM0030 1 $538.00
Relax Firm SESWM0040 1 $676.00
Page: 77 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Seat Cushion Power Plus Relax Soft SESWM0050 1 $414.00
Mobility
Precision Rehab Base Cushion Seat Sewn Cover SESWB0010 1 $1,476.00
Manufacturing Waterproof
Foam,
Includes
Labour For Digitizing Or Plastering

Base Cushion Seat Vacuum Formed SESWB0005 1 $1,241.00
Cover,
Includes
Labour
For Digitizing Or Plastering

Base Cushion Seat With All SESWB0015 1 $1,793.00
Modifications,
Includes
Labour For Digitizing Or Plastering

Comfort -Fit 12x12 to 20x20 SE0000754 1 $184.00
Contoured-Fit (Moderate Positioning SE0000757 1 $567.00
Air
Option)
12x12 to 20x20
Gel
Option)
12x12 to 20x20
Visco-Foam)
12X12 20X20
Contoured-Fit Aggressive Positioning SE0000760 1 $567.00
Air Option 12x12 to 20x20
Contoured-Fit Agressive Positioning SE0000759 1 $446.00
Gel
Option
12x12 to 20x20
Contoured-Fit Agressive Positioning SE0000758 1 $446.00
Visco-Foam
12x12 to 20x20
Precision-Fit Cushion Upcharge, Extra SESWB0024 1 $264.00
Seat Depth 20"-24"
Precision-Fit Cushion Upcharge, Extra SESWB0022 1 $264.00
Seat Width 20"-24"
Page: 78 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Seat Cushion Precision Rehab Precision-Fit Cushion, Subtle, SESWB0020 1 $931.00
Manufacturing Moderate
Or
Aggressive
Positioning. Includes Shape

Adjustments,
Inner
Cover,
Outer
Cover And Cushion Rigidizer.

Pride Mobility Contoured Seat Cushion - All Sizes SESK20005 1 $269.00
Products
Synergy Simplicity All Sizes SESX10080 1 $103.00
Synergy
Solution
Cushion
SESX10015 1 $275.00
Standard Sizes
Synergy Solution Cushion Custom SESX10020 1 $310.00
Sizes
Synergy
Solution
SG
Cushion
SESX10100 1 $185.00
Sizes 14" X 14" - 20" X 18"
Synergy
Solution
SG
Cushion
SESX10105 1 $220.00
Sizes 20" X 20" - 24" X 24"
Synergy
Spectrum
Cushion
SESX10025 1 $379.00
Viscoelastic Insert,Standard Sizes
Synergy Spectrum Cushion Twin Cell SESX10040 1 $413.00
Insert,Custom Sizes
Synergy Spectrum Cushion Twin Cell SESX10035 1 $379.00
Insert,Standard Sizes
Synergy Spectrum Cushion SESX10030 1 $413.00
Viscoelastic Insert,Custom Sizes
Synergy Tru Comfort/ Tru Comfort 2 SESX10095 1 $344.00
Cushion Sizes 22" X 16" - 22" X 24"
Synergy Tru Comfort/ Tu Comfort 2 SESX10090 1 $275.00
Cushion
Sizes 16" X 14" - 20" X 24"

Tru Comfort 2 non standard sizes, SE0001050 1 $413.00
including air mesh cover
Tru Comfort 2 standard sizes, SE0001049 1 $344.00
including air mesh cover
Page: 79 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Seat Cushion Quickie 2", 3" Or 4" Cushion With Cover SESQU0355 1 $105.00
BREEZY RELAX2 COMFORT CUSHION SE0000118 1 $1,722.00
Contour Seat - Tilt Fx SESQU0400 1 $338.00
JAY X2 with cover SE0001155 1 $580.00
Ride Designs Ride Custom AccuSoft Cushion SE0001606 1 $1,806.00
Ride Custom Cushion 2 SE0001358 1 $1,456.00
Ride Custom Cushion: Standard SESR40005 1 $1,474.00
(12-20"), Extra Wide (21-22"), Custom
Sizes.
Ride Forward Cushion - All Sizes SESR41020 1 $407.00
Ride Java SE0001223 1 $524.00
Roho Adaptor 9x13x1" (Maximum 5) SESRO1105 5 $180.00
Airlite Cushion With Built In Cover All SESRO9005 1 $388.00
Sizes
Contour Select Cushion Custom Sizes SESRO9025 1 $663.00
Contour Select Cushion Standard SESRO9020 1 $620.00
Sizes
Custom (Made To Order) Cushion SESRO030L 2 $663.00
W/Cover
Enhancer, Custom Sizes,Dual SESRO8010 1 $625.00
Valve,Cover
Enhancer, Standard Adult & Paediatric SESRO8005 1 $561.00
Sizes, Dual Valve, With Cover
Harmony Cushion With Cover-Sizes SESRO9050 1 $430.00
14x16, 20x18
High-Profile - LTC Cushion, Including SESRO3015 1 $632.00
Cover
High-Profile, All Standard Adult & SESRO3005 1 $561.00
Paediatric Sizes Including Cover
High-Profile, Custom Sizes Including SESRO3010 1 $625.00
Cover
Page: 80 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Seat Cushion Roho Hybrid Elite/Hybrid Elite LTC Cushion, SESRO9503 1 $681.00
Dual Valve, With Cover Sizes
14x14 ,20x20
Hybrid Elite/Hybrid Elite LTC Cushion, SESRO9504 1 $693.00
Dual Valve, With Cover, Sizes 22x18,
24x20
Hybrid Elite/Hybrid Elite LTC Cushion, SESRO9501 1 $640.00
Single Valve With Cover, Sizes 14x14 ,
20x20
Hybride Elite/Hybrid Elite LTC SESRO9502 1 $652.00
Cushion, Single Valve With Cover,
Sizes 22x18, 24x20
Low-Profile, All Standard Adult & SESRO3105 1 $561.00
Pediatric Sizes Including Cover
Low-Profile, Custom Sizes Including SESRO3110 1 $625.00
Cover
Low-Profile, LTC Cushion, Including SESRO3115 1 $632.00
Cover
Mid-Profile, All Standard Adult & SESRO2005 1 $568.00
Paediatric Sizes Including Cover
Mid-Profile, Custom Sizes Including SESRO2010 1 $637.00
Cover
Mini-Max Cushion, Standard Sizes SESRO4005 1 $513.00
(Does Not Include Cover)
Nexus Spirit Cushion With Cover, SESRO6010 1 $505.00
Standard Sizes
Nexus Spirit Cushion, Custom Sizes, SESRO6015 1 $525.00
With Cover
Quatro Select LTC Cushion, Including SESRO7055 1 $687.00
Cover
Quatro Select Low Or High Profile SESRO7040 1 $663.00
Cushion, Custom Sizes With Cover
Quatro Select, Low Or High Profile SESRO7035 1 $620.00
Page: 81 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Seat Cushion Roho Cushion With Cover, Standard Sizes
Solus Medical EquaGel Pro Flex I SE0001113 1 $199.00
Manufacturing
EquaGel Pro Flex II SE0001114 1 $468.00
Inc
EquaGel Pro Flex II Hybrid SE0001115 1 $344.00
EquaGel Pro Flex III Hybrid SE0001116 1 $392.00
EquaGel Pro Flex Ultra SE0001117 1 $668.00
Star Cushion Custom Sizes Over 22" In Two SESTJ0110 1 $618.00
Products Inc. Directions Width And Depth
Custom Sizes Over 22" One Direction SESTJ0105 1 $555.00
Width Or Depth
Galaxy Cushion - All Sizes SESTJ3005 1 $647.00
Mid Contour Cushion 3" Cells With SESTJ0015 1 $428.00
Cover
Short Contour Cushion 2" Cells With SESTJ0010 1 $428.00
Cover
Standard Contour Cushion 4" Cells SESTJ0005 1 $428.00
With Cover
Star Cushion Custom Cell Height SESTJ0115 1 $647.00
Cushion Standard Sizes
Star GUARD Galaxy Cushion SE0001566 1 $927.00
Star GUARD Stabil-Air 2", 3" & 4" SE0001562 1 $1,031.00
Cushion All Sizes
Star GUARD Stabil-Air 5" Cushion All SE0001563 1 $1,057.00
Sizes
Star GUARD Standard Air 2", 3" & 4" SE0001560 1 $880.00
Cushion Custom Sizes (up to 21" x
21")
Star GUARD Standard Air 2", 3" & 4" SE0001559 1 $817.00
Cushion Standard Sizes
Star GUARD Standard Air 5" Cushion SE0001561 1 $906.00
All Sizes
Page: 82 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Seat Cushion Star Cushion Star GUARD StarLock 2", 3" & 4" SE0001564 1 $992.00
Products Inc. Cushion All Sizes
Star GUARD StarLock 5" Cushion All SE0001565 1 $1,031.00
Sizes
Star MAX Immerse Standard Air 5" SE0001550 1 $772.00
Cushion Custom Sizes (up to 21" x
21")
Star MAX Immerse Standard Air SE0001549 1 $707.00
5¿ Cushion Standard Sizes
Star Stabil-Air 2" & 4" Cushion SE0001552 1 $792.00
Custom Sizes (up to 21" x 21")
Star Stabil-Air 2" & 4¿ Cushion SE0001551 1 $727.00
Standard Sizes
Star Stabil-Air 3" Cushion Custom SE0001554 1 $841.00
Sizes (up to 21" x 21")
Star Stabil-Air 3¿ Cushion Standard SE0001553 1 $776.00
Sizes
Star Stabil-Air 5" Cushion Custom SE0001556 1 $964.00
Star Stabil-Air 5¿ Cushion Standard SE0001555 1 $900.00
Sizes
Star Standard Air 2" & 4" Cushion SE0001546 1 $620.00
Custom Sizes (up to 21" x 21")
Star Standard Air 2" & 4" Cushion SE0001545 1 $555.00
Standard Sizes
Star Standard Air 3" Cushion Custom SE0001548 1 $667.00
Star Standard Air 3¿ Cushion Standard SE0001547 1 $602.00
Sizes
Star StarLock 5" Cushion Custom Sizes SE0001558 1 $795.00
(up to 21" x 21")
Star StarLock 5" Cushion Standard SE0001557 1 $731.00
Page: 83 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Seat Cushion Star Cushion Sizes
Products Inc.
Star StarLock All Sizes 12x12 Through SESTJ2005 1 $656.00
22x22
Stealth Products Essence Basic (sizes greater than 20" X SE0001482 1 $376.00
20")
Essence Basic (sizes up to 20" X 20") SE0001481 1 $335.00
Essence Low Contour (sizes greater SE0001484 1 $414.00
than 20" x 20")
Essence Low Contour (sizes up to 20" SE0001483 1 $369.00
x 20")
Essence Medium Contour (sizes SE0001486 1 $493.00
greater than 20" x 20")
Essence Medium Contour (sizes up to SE0001485 1 $438.00
20" X 20")
Essence Plus (sizes greater than to 20" SE0001488 1 $562.00
X 20")
Essence Plus (sizes up to 20" X 20") SE0001487 1 $500.00
Stealth Glacial SP (16" to 19" wide) SE0001620 1 $269.00
Stealth Glacial SP (20" to 24" wide) SE0001621 1 $366.00
Stealth Glacial SP (up to 15" wide) SE0001619 1 $183.00
Stealth Premiere P (16" to 20" wide) SE0001622 1 $404.00
Stealth Premiere P (greater than 20" SE0001623 1 $504.00
wide)
Stealth Simplicity G (sizes greater than SE0001523 1 $255.00
20"x20")
Stealth Simplicity G (sizes up to SE0001522 1 $214.00
20"x20")
Stealth Solution SPP (sizes greater SE0001527 1 $445.00
than 20"x20")
Stealth Solution SPP (sizes up to SE0001526 1 $400.00
20"x20")
Page: 84 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Seat Cushion Stealth Products Stealth Spectrum Foam SPP (sizes SE0001529 1 $435.00
greater than 20"x20")
Stealth Spectrum Foam SPP (sizes up SE0001528 1 $400.00
to 20"x20")
Stealth Spectrum Gel SPP (sizes SE0001531 1 $449.00
Stealth Spectrum Gel SPP (sizes up to SE0001530 1 $400.00
20"x20")
Stealth Tru Comfort 2 SPP (sizes SE0001525 1 $397.00
Stealth Tru Comfort 2 SPP (sizes up to SE0001524 1 $355.00
20"x20")
Stealth Zen SP Cushion (sizes 10" - SE0001651 1 $314.00
15")
20")
24")
Sunrise Medical JAY Fusion Cryo (16" - 21" wide) SE0001685 1 $749.00
JAY Fusion Cryo (22" wide) SE0001686 1 $783.00
JAY Syncra Cushion (Jay Flow Fluid w/ SE0001676 1 $690.00
Cryo Technology, all sizes)
JAY Syncra Cushion (w/ ROHO Dry SE0001677 1 $725.00
Flotation Air Bladder, all sizes)
JAY Syncra Cushion (w/ Visco Foam, SE0001675 1 $656.00
all sizes)
Seat Cushion -Sellaskin SESM90005 1 $135.00
16x16,16x18,18x16,18x18
Sedeo Pro-comfort Cushion 16"w to SE0000667 1 $345.00
18"w (fits 16" w to 20" deep)
Sedeo Pro-comfort Cushion 20"w and SE0000668 1 $380.00
22"w (fits 16" to 20" deep)
Page: 85 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Seat Cushion Sunrise Medical Sedeo Pro-contour Cushion 16"w and SE0000669 1 $414.00
18"w (fits 16"w to 20" deep)
Sedeo Pro-contour Cushion 20"w and SE0000698 1 $449.00
22"w (fits 16" to 2-" deep)
Sedeo Pro-stability Cushion 20"w and SE0000671 1 $449.00
22"w (fits 16" to 20" deep)
Sedeo Pro-stability cushion 16" w and SE0000670 1 $414.00
18"w (fits 16"to 20" deep)
Spex Flex Cushion High Contour Large SE0001641 1 $1,445.00
(16"x18" - 20"x20")
Spex Flex Cushion High Contour SE0001639 1 $1,364.00
Regular (12"x14" - 15"x18")
Spex Flex Cushion High Contour SE0001640 1 $1,445.00
Regular (16"x16")
Spex Flex Cushion Standard Contour SE0001638 1 $1,521.00
Large (16"x18" - 20"x20")
Regular (12"x14" - 15"x18")
Regular (16"x16")
Spex High-Contour sizes from 16"x16" SE0001497 1 $735.00
to 17"x18"
to 18"x20"
Spex High-Contour sizes from 18"x18" SE0001502 1 $1,094.00
to 20"x21"
to 20"x22"
Spex High-Contour sizes up to SE0001496 1 $711.00
14"x16"
Spex Super High-Contour sizes from SE0001501 1 $963.00
16"x16" to 17"x18"
Page: 86 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Seat Cushion Sunrise Medical Spex Super High-Contour sizes up to SE0001500 1 $932.00
14"x16"
Support Seat Cushion SESM90020 1 $259.00
Supracor Bariatric Cushion (Classic) Clb 20-24" SESRR0016 1 $652.00
Bariatric Cushion (Classic) Clb 25-28" SESRR0017 1 $750.00
Bariatric Cushion (Classic) Clb 29-31" SESRR0018 1 $897.00
Bariatric Cushion (Classic) Clb 32-35" SESRR0019 1 $1,044.00
Classic Cushion 14x16-20x20 SESRR0010 1 $470.00
Classic Sling Bottom Cushion SESRR0015 1 $489.00
14x16-20x20
Contoured Cushion 14x16-20x20 SESRR0020 1 $574.00
Contoured Cushion, Standard Sizes SESRR0060 1 $549.00
Contoured Sling Bottom Cushion SESRR0025 1 $568.00
14x16-20x20
Corbee Cushion 10x10-14x14 SESRR0100 1 $296.00
Corbee Sling 10x10-14x14 SESRR0110 1 $320.00
Paediatric Contoured Cushion, SESRR0065 1 $405.00
Custom Sizes
Slimline Cushion 16x16-20x18 SESRR0030 1 $380.00
Slimline Sling Bottom Cushion SESRR0035 1 $405.00
16x16-20x18
The Comfort Curve Cushion, Stretch Air Or Fusion SES7C0050 1 $116.00
Company Cover, All Sizes
Curve Cushion, Stretch Air Or Fusion SES7C0055 1 $211.00
Cover, Custom Sizes
Custom Embrace Anti Thrust Cushion SE0000127 1 $591.00
Custom
Embrace
Anti
Thrust
Cushion
SE0000130 1 $701.00
Hook and Loop non skid bottom
Custom Embrace Zero Elevation SE0000128 1 $591.00
Cushion
Page: 87 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Seat Cushion The Comfort Custom Embrace Zero Elevation SE0000129 1 $701.00
Company Cushion
Hook and Loop non skid bottom

Embrace
Anti-Thrust
Cushion
SE0000113 1 $369.00
Hook and loop non-skid bottom
Embrace Zero Elevation Cushion SE0000125 1 $369.00
Embrace
Zero
Elevation
Cushion
SE0000126 1 $438.00
Hook and Loop non-skid bottom
Hyalite Cushion, Condura Knit Or SES7C0030 1 $345.00
Stretch
Air
Cover, All Sizes

Hyalite Cushion, Condura Knit Or SES7C0035 1 $618.00
Stretch
Air
Cover, Custom Sizes

Maxx Cushion, Round Or Flat Bottom, SES7C0020 1 $443.00
Fusion
Or Stretch Air Cover, All Sizes

Maxx Cushion, Round Or Flat Bottom, SES7C0025 1 $782.00
Fusion
Or Stretch Air Cover, Custom Sizes

Ridge Cushion, Stretch Air Or Fusion SES7C0040 1 $420.00
Cover, All Sizes
Ridge Cushion, Stretch Air Or Fusion SES7C0045 1 $771.00
Cover, Custom Sizes
Toronto Tops Seat Cushion (10" & 12" Width) SESTP0005 1 $212.00
Orthopedic Ltd.
Trulife Gelcell Contour Cushion, All Sizes SESCZ0080 1 $286.00
Relax Duogel Contour Cushion, All SESCZ0040 1 $201.00
Sizes
Relax Easy Cushion All Sizes SESCZ0070 1 $201.00
Relax Gelcell, All Sizes SESCZ0045 1 $275.00
Relax Trio Cushion, All Sizes SESCZ0035 1 $91.00
Page: 88 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Seat Cushion Varilite Medical Evolution Bariatric Cushion Standard SESVP0408 1 $616.00
Products Or
Psv,
All
Sizes,
Includes Cover And Pressure Setting

Valve
Evolution Cushion Standard Or Psv, All SESVP0406 1 $580.00
Sizes,
Includes Cover And Pressure Setting

Valve
Evolution Wave Bariatric Cushion SESVP0402 1 $705.00
Includes,
Cover And Positioning Base

Evolution
Wave,
All
Sizes,
Includes
SESVP0401 1 $604.00
Cover And Positioning Base
Junior Cushion SE0001146 1 $562.00
Meridian Bariatric Cushion, All Sizes, SESVP0605 1 $652.00
Includes Cover
Meridian Cushion, All Sizes, Includes SESVP0600 1 $543.00
Cover
Meridian Wave Bariatric Cushion, All SESVP0615 1 $741.00
Sizes, Includes Cover
Meridian Wave Cushion, All Sizes, SESVP0610 1 $636.00
Includes Cover
Proform Nx Cushion, Single, Dual, All SESVP0351 1 $575.00
Sizes
Includes Cover
Reflex Cushion, All Sizes, Includes SESVP6020 1 $342.00
Cover
Solo Cushion, Standard Or Psv, All SESVP0200 1 $418.00
Sizes, Includes Cover
Stratus Cushion, All Sizes, Includes SESVP0410 1 $318.00
Cover
Zoid Cushion, All Sizes, Includes Cover SESVP0500 1 $479.00
Vicair Academy Adjuster SESV10020 1 $543.00
Page: 89 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Seat Cushion Vicair Academy Junior Adjuster SESV10010 1 $467.00
Academy Vector SESV10025 1 $584.00
Upcharge For Custom Sizes SESV11005 1 $69.00
Vicair Active: Sizes 12X12 - 18X18 SE0001102 1 $500.00
Vicair Active: Sizes 18X20 - 20X20 SE0001103 1 $549.00
Vision Epic Cushion: custom sizes (up to SE0000673 1 $418.00
Wheelchair 19x19)
Seating Systems
Epic Cushion: standard sizes: 16x16 SE0000672 1 $373.00
Inc.
1/2 to 18x18
Epic Drop Seat: Custom Sizes (up to SE0000675 1 $544.00
19x19)
Epic Drop Seat: standard sizes: 16x16 SE0000674 1 $485.00
1/2 to 18x18
Epic Plus Cushion Standard Sizes SE0000676 1 $418.00
16x20 to 20x18
Epic Plus Cushion: Bariatric Custom SE0000677 1 $502.00
sizes, 20x20 to 24x24
Epic Plus Drop Seat: Bariatric Custom SE0000679 1 $674.00
sizes, 20x20 to 24x24
Epic Plus Drop Seat: Standard Sizes SE0000678 1 $545.00
16x20 to 20x18
Upcharge for custom Cushions SESVC4510 1 $169.00
20"X20 - 24"X24"
Upcharge for custom Cushions Up To SESVC4500 1 $116.00
20" X 19", Inclusive
Upcharge for custom Drop-Seat up to SESVC4520 1 $132.00
20"X19", Inclusive
Upcharge for custom Drop-Seats SESVC4530 1 $186.00
20"X20 - 24"X24"
V3 Cushion Bariatric Custom Sizes (up SE0001456 1 $929.00
to 24")
Page: 90 of 135
Ministry of Health
Seating
Allowed Price
Qty.
Seat Cushion Vision V3 Cushion Custom Sizes (up to 20 x SE0001455 1 $840.00
Wheelchair 19)
Seating Systems
V3 Cushion Standard Sizes SE0001454 1 $683.00
Inc.
V3 Gel Cushion Bariatric Custom Sizes SE0001459 1 $999.00
(up to 24")
V3 Gel Cushion Custom Sizes (up to SE0001458 1 $904.00
20 x 19)
V3 Gel Cushion Standard Sizes SE0001457 1 $735.00
VIVE -Deep Leg Trough -Drop Seat; SESVC4180 1 $858.00
Standard Sizes 16x16 1/2 to 20x18
VIVE -Deep Leg Trough Cushion; SESVC4170 1 $658.00
VIVE -Drop Seat; Standard Sizes 16x16 SESVC4160 1 $819.00
1/2 to 20x18
VIVE Cushion; Standard Sizes 16x16 SESVC4150 1 $627.00
1/2 to 20x18
Very Soft Drop-Seat; Standard Sizes SESVC4030 1 $752.00
16x16 1/2 to 20x18
VerySOFT -Deep Leg Trough Cushion; SESVC4100 1 $585.00
VerySOFT Cushion, Standard Sizes SESVC4000 1 $590.00
16x16 1/2 to 20x18
VerySOFT- Deep Leg Trough -Drop SESVC4120 1 $793.00
Seat; Standard Sizes 16x16 1/2 to
20x18
Page: 91 of 135
Ministry of Health
Seating
OPTIONS:
Allowed Price
Qty.
Arm Support Hardware Approved ADP Non Standard Modular Mounting SEAND0025 2 $138.00
Manufacturers Hardware
Only Required For Positioning (Maximum

2)
Custom Swivel Armrest Hardware (Maximum SEICF301L 2 $60.00
Fabricated 2)
Arm Support Options Approved ADP Add Modular Pressure Relief To SEAND0030 2 $65.00
Manufacturers Armrest
-
Only Specialty Foam/Gel (Maximum 2)

Custom Rigid Side Panel For Custom Arm SEMCF601L 2 $52.00
Fabricated Support
(Maximum 2)
Side Panel Pad For Custom Arm SEMCF602L 2 $35.00
Support
(Maximum 2)
Arm Support(s) Approved ADP Extra Wide &/Or Extended Length For SEAND0010 2 $91.00
Manufacturers Modular
Arm
Supports
-
Only Includes Mounting Hardware

(Maximum 2)
Modular Arm Support - Includes SEAND0005 2 $237.00
Mounting Hardware (Maximum 2)
Modular
Hand
Support
-
Flat/Cone
-
SEAND0015 2 $65.00
Includes Mounting Hardware
(Maximum 2)
Custom Complex Arm Support, Multi SEACF102L 2 $216.00
Fabricated Component,
Includes Hardware (Maximum 2)

Fixed Arm Support, One Piece, SEACF101L 2 $129.00
Full
Sling
Arm
Support,
SEACF104L 2 $259.00
Heavy Duty Solid Padded Armrest SEACF103L 2 $65.00
Page: 92 of 135
Ministry of Health
Seating
OPTIONS:
Allowed Price
Qty.
Arm Support(s) Custom Support,
Fabricated Replaces
Padded
W/C
Armpad,

Back Cover Custom Removable Cover For Back With SEMCF103L 2 $198.00
Fabricated Laterals
Removable Cover For SEMCF102L 2 $155.00
Contoured/Custom Contoured Back
Removable Cover For Flat Back SEMCF101L 2 $104.00
Removable Cover For Sculptured Or SEMCF104L 2 $233.00
Molded Back
Back Hardware Approved ADP Complex Specialized Mounting SEBND0010 2 $345.00
-
Including
Only Hardware For Custom Molded

Modular Systems
Custom Simple Back Interface Mounts Back To SEICF160L 1 $168.00
Fabricated Wheelchair Frame
Back Support Options Approved ADP Additional Pressure Relief - Gel/Air SEBND0020 6 $116.00
Manufacturers Inserts/Pads
Etc.
Only (Maximum 6)
Custom Modifications And Sizing - SEBND0015 6 $47.00
Including
Custom
Sizes,
Additional Postural Support - Lumbar

Pad,
Foam
Pads
Etc.
(Maximum 6)
Custom Back Channeling - Upgrade For Slots SEMCF201L 1 $129.00
Fabricated For Lateral Adjustments
Back Plaster Molding/Vacuum Form, SEUCF003L 1 $138.00
for Custom Fabricated Device Only
Back Reinforcement - Heavy Duty SEMCF202L 1 $86.00
Upgrade
Modify Or Refurbish Existing Custom SEMCF200L 1 $194.00
Page: 93 of 135
Ministry of Health
Seating
OPTIONS:
Allowed Price
Qty.
Back Support Options Custom Fabricated
Back,
Fabricated Includes Parts, Hardware & Labour

Foot/Leg Support Hardware Approved ADP Complex Specialized Mounting SEFND0030 2 $86.00
Only
Custom Mount Footrest To Seating System SEICF501L 2 $104.00
Fabricated
Foot/Leg Support Options Approved ADP Extra Padding For Specific Pressure SEFND0035 2 $43.00
Manufacturers Relief - (Maximum 2)
Only
Custom Footrest
Discrepancy
Upcharge
-
SEMCF801L 1 $69.00
Fabricated Accommodates Differences Between
Left & Right Leg
Footrest Extension, Not Padded SE0000322 2 $65.00
(Maximum 2)
Footrest Padding (Maximum2) SEMCF803L 2 $52.00
Footrest Reinforcement Upcharge - SEMCF802L 2 $121.00
Heavy
Duty
Upgrade To Reinforce Footrest

Foot/Leg Support(s) Approved ADP 1 Piece Foot Board - Includes SEFND0015 1 $95.00
Manufacturers Mounting
Only Hardware & Padding

Amputee
Board/Stump
Support
-
SEFND0005 1 $246.00
Includes Mounting Hardware &
Padding
Calf Panel - Includes Mounting SEFND0010 2 $43.00
Hardware & Padding
Foot Box - Includes Mounting SEFND0020 2 $207.00
Hardware
&
Padding
-
Foot Box May Be 1 Piece Or 2 Piece

(Each Foot)
Page: 94 of 135
Ministry of Health
Seating
OPTIONS:
Allowed Price
Qty.
Foot/Leg Support(s) Custom Calf Support, Padded And Removable SEFCF107L 2 $168.00
Fabricated
Complex Foot Rest (One Or Two SEFCF102L 1 $380.00
Piece),
Includes Parts, Hardware, And Labour

Footpocket, Not Padded ( Maximum SEFCF106L 2 $173.00
2)
One Piece Double Footbox, Not SEFCF103L 1 $256.00
Padded
One
Piece
Fixed
Footrest,
SEFCF101L 1 $129.00
Not Padded
Headrest/Neckrest Hardware Approved ADP Bracket To Mount Headrest To SEHND0020 1 $86.00
Manufacturers Seating
System/Back
Only Support Or Wheelchair

Complex Specialized Mounting SEHND0015 1 $259.00
Hardware
Non Standard Mounting Hardware SEHND0010 1 $138.00
Not
Included
In
Base
Device
-
Removable, Allows Multi Axis

Adjustments
Standard Mounting Hardware Not SEHND0005 1 $121.00
Included
In
Base
Device
-
Removable, Allows Height, Anterior &

Posterior Adjustments
Custom Complex Headrest Hardware, Allows SEICF007L 1 $134.00
Fabricated For
Removability
& Height And Forward Adjustment

Multi-Axis Headrest Hardware, Allows SEICF008L 1 $225.00
For
Removability
And Multi Adjustments

Simple Headrest Hardware, Allows For SEICF006L 1 $60.00
Removability
& Height Adjustment
Page: 95 of 135
Ministry of Health
Seating
OPTIONS:
Allowed Price
Qty.
Headrest/Neckrest Hardware Custom Wheelchair Mounting Bracket For SEICF009L 1 $190.00
Fabricated Headrest Hardware
Headrest/Neckrest Options Custom Complex Extension Pad, Mounted SEMCF006L 2 $259.00
Fabricated (Maximum 2)
Removable Cover For Complex SEMCF002L 2 $155.00
Headrests,
Use
For
Complex
Headrest & Headrest/Neckrest

Combinations
Removable Headrest/Neckrest Cover, SEMCF001L 2 $104.00
Any
Fabric,
Use
For Flat/Contoured Headrest &

Neckrest
Simple Extension Pad, Mounted SEMCF005L 2 $173.00
(Maximum 2)
Quickie RELAX HEADREST PAD SE0000119 1 $235.00
Lateral Support Hardware Custom Fixed Lateral Hardware, Non- SEICF201L 2 $52.00
Fabricated Adjustable (Maximum 2)
Hinged
Swingaway
Lateral
Hardware,
SEICF202L 2 $173.00
Height& Width Adjustable (Maximum
2)
Removable
Lateral
Hardware,
SEICF203L 2 $86.00
Height & Width Adjustable (Maximum
2)
Lateral Support Options Custom Extra Padding (Maximum 2) SEMCF651L 2 $52.00
Fabricated
Lateral Support(s) Approved ADP Complex Shape Lateral Supports, Each SELND0015 4 $166.00
Manufacturers -
Only Includes Padding & Mounting

Hardware (Maximum 4)
Fixed
Lateral
Supports,
Each
-
SELND0005 4 $104.00
Includes Padding & Mounting
Page: 96 of 135
Ministry of Health
Seating
OPTIONS:
Allowed Price
Qty.
Lateral Support(s) Approved ADP Shoulder Wings, Each - Includes SELND0020 2 $47.00
Manufacturers Padding
&
Mounting
Hardware
Only (Maximum 2)
Swingaway
Lateral
Supports,
Each
SELND0010 4 $155.00
Custom Complex Shaped Thoracolumbar SELCF102L 2 $151.00
Fabricated Supports,
Non
Adjustable,
Includes Cover (Maximum 2)

Shoulder Wings, Non Adjustable, SELCF103L 2 $82.00
Includes Cover
Thoracolumbar Supports, Rigid & Non SELCF101L 2 $69.00
Adjustable,
Includes Cover (Maximum 2)

Pommel Hardware Custom Hardware For Fixed Pommel SEICF401L 1 $73.00
Fabricated
Hardware For Flip-Down Pommel SEICF403L 1 $259.00
Hardware For Removable Pommel SEICF402L 1 $151.00
Pommel/Adductors Approved ADP Pommel, Flip Down, All Components SESND1043 1 $259.00
Manufacturers Including Hardware
Only
Custom Custom Pommel Without Hardware SEMCF701L 1 $138.00
Fabricated
Fixed Padded Adductor Includes SEMCF702L 2 $104.00
Cover
(Maximum 2)
Removable Padded Adductor Includes SEMCF703L 2 $164.00
Cover
(Maximum 2)
Positioning Belts Approved ADP Any 2 Point Strap For Positioning Only SERND0030 6 $56.00
Manufacturers -
Any
Closure
-
Only Includes Padding & Mounting

Hardware
-Chest,
Hip,
Page: 97 of 135
Ministry of Health
Seating
OPTIONS:
Allowed Price
Qty.
Positioning Belts Approved ADP Thigh, Calf, Ankle, Foot (Maximum 6)
Manufacturers
Any 4 Point Strap For Positioning Only SERND0020 2 $129.00
Only
-
Any
Closure
-

Hardware
-
Pelvic "Y" Strap, "H" Leg Strap

(Maximum 2)
Chest Harness For Positioning Only - SERND0001 1 $121.00
Any
Closure
-

Hardware
Non Standard Chest Or Shoulder SERND0035 1 $397.00
Harness
Required
For
Positioning Support Only

Shoulder Straps For Positioning Only - SERND0010 2 $52.00
Any
Closure
-

Custom Custom Chest Support, Includes SERCF103L 1 $129.00
Fabricated Attachments
Custom Positioning Belt, Includes SERCF105L 12 $47.00
Attachments.
Specify Upper &/Or Lower Extremity

&/Or
Chest
(Maximum 12)
Custom Shoulder Harness, Includes SERCF104L 1 $181.00
Padding & Attachments
Pelvic "Y" Belt Or Groin Strap, SERCF101L 1 $52.00
Includes Attachments
Positioning Belts Options Custom Complex Control Pads (Maximum 4) SEMCF503L 4 $142.00
Fabricated
Positioning Control Pads (Maximum SEMCF502L 12 $47.00
12)
Page: 98 of 135
Ministry of Health
Seating
OPTIONS:
Allowed Price
Qty.
Positioning Belts Options Custom Positioning Support Pads (Maximum SEMCF501L 12 $47.00
Fabricated 12)
SE - Custom Modifications Approved ADP Custom Modifications Required To SEMCF990L 1
Manufacturers Adp
Listed
Wheelchair
To
Only Facilitate Installation Of Custom

Fabricated
Positioning
Devices (Seating). Authorizer Must

Provide
Clinical
Rational
To Support Request. Clinic Must

Provide
A
Breakdown
Of The Cost Of Parts And Labour (Not

To Exceed $40.00/Hour).
Custom Modifications To An Adp SEMND2005 1
Listed
Modular
Seating
Device
& No Adp Code With Assigned

Funding
Is
Available
-
Authorizer Must Provide Clinical

Rationale
To
Support
Request - Vendor Must Provide

Breakdown
Of
Cost
Of
Parts
& Labour (Not To Exceed

$40.00/Hour)
Transfer Existing Adp Approved SEMND1005 1 $69.00
Modular
Seating
System
Into New Or Modified Adp Approved

Wheelchair
-
Labour Only, When No Parts Required

Custom Transfer Existing Adp Approved SEUCF200L 1 $69.00
Fabricated Custom
Seating
System
Into A New Or Modified Adp

Approved
Wheelchair.
Labour Only, No Parts Required.

Seat Cushion Cover(s) Approved ADP Extra Cover Bariatric Sizes SESND1060 2 $134.00
Manufacturers
Extra Cover Non Standard Sizes SESND1055 2 $99.00
Page: 99 of 135
Ministry of Health
Seating
OPTIONS:
Allowed Price
Qty.
Seat Cushion Cover(s) Only Extra Cover Standard Sizes SESND1050 2 $65.00
Custom Removable Cover For Flat Seat, For SEMCF105L 2 $108.00
Fabricated Incontinence
(Maximum 2)
Removable Cover For Sculptured Or SEMCF107L 2 $216.00
Molded
Seat,
For Incontinence (Maximum 2)

Removable Cover For Wedged Or SEMCF106L 2 $155.00
Contoured
Seat,
For Incontinence (Maximum 2)

Seat Hardware Approved ADP Complex Specialized Mounting SESND1010 1 $259.00
-
Including
Only Hardware For Custom Molded

Modular Systems
Custom Complex Interface Mounts Seat & SEICF170L 1 $302.00
Fabricated Back To Wheelchair Frame
Hardware To Mount Positioning SEICF190L 1 $86.00
Device
Into
Paediatric Stroller
Hardware To Mount Seat & Back Into SEICF180L 1 $492.00
Dynamic Tilt Wheelchair
Seat Rigidizer - Flat Rigid Insert SEICF192L 1 $52.00
Securing Hardware That Mounts SEICF191L 8 $22.00
Hardware
To
Mobility
Device
(Maximum 8)
Simple Seat Interface Mounts Seat To SEICF150L 2 $168.00
Wheelchair Frame
Strap Interface (2) Mounts Seat To SEICF140L 2 $86.00
Wheelchair
Seat Options Approved ADP Additional Pressure Relief - Specialty SESND1045 1 $358.00
Manufacturers Foam, Air, Gel
Page: 100 of 135

Ministry of Health
Seating
OPTIONS:
Allowed Price
Qty.
Seat Options Only Custom Modifications And Sizing - SESND1040 6 $69.00
Including
Custom
Sizes,
Static Adductors & Pommels, Wedges

&
Anti-Thrust
Devices, Leg Length Discrepancy

Allowance (Maximum 6).
Drop Base And Hooks (4) SESND1020 1 $216.00
Roho Bolster SESND1035 1 $155.00
Solid Seat Insert SESND1015 1 $69.00
Subasis Bar, Complete, Including SESND1041 1 $173.00
Hardware
Custom 2"
Convolute
Foam
Cut
To
Size
SEMCF403L 2 $35.00
Fabricated (Maximum 2)
2"
Polyfoam
Cut
To
Size
SEMCF406L 2 $26.00
(Maximum 2)
3"
Convolute
Foam
Cut
To
Size
SEMCF404L 2 $39.00
(Maximum 2)
3"
Polyfoam
Cut
To
Size
SEMCF407L 2 $30.00
(Maximum 2)
4"
Convolute
Foam
Cut
To
Size
SEMCF405L 2 $43.00
(Maximum 2)
Add Waterproof Skin On Complex SEMCF210L 2 $86.00
Indirect Molded Seat
Complex Pelvic Stabilizers, Each SEMCF206L 2 $194.00
(Maximum 2)
Contoured Cushion With Troughing SEMCF209L 1 $328.00
Secured
In
Front
Of
A
Roho
Cushion, Not Including Roho Cushion,

Includes Cover
Heavy Duty Upgrade To Reinforce SEMCF207L 1 $65.00
Seat
Page: 101 of 135

Ministry of Health
Seating
OPTIONS:
Allowed Price
Qty.
Seat Options Custom Modify Or Refurbish Existing Custom SEMCF212L 1 $194.00
Fabricated Fabricated
Seat,
Includes Parts, Hardware & Labour

Pelvic Stabilizer (Maximum 2) SEMCF204L 2 $185.00
Polymer
Supplement
Pad
SEMCF402L 2 $129.00
(Maximum 2)
Seat Plaster Molding/Vacuum Form, SEUCF005L 1 $138.00
for Custom Fabricated Device Only
Simple Cushion Secured In Front Of A SEMCF208L 1 $173.00
Roho
Cushion,
Not Including Roho Cushion, Includes

Cover
Single Complex Pelvic Stabilizer For SEMCF205L 1 $259.00
Seat Or Back
Upgrade To Provide Extra Pressure SEMCF203L 2 $129.00
Relief,
Gel/Foam/Air/Liquid Etc. (Maximum

2)
Viscoelastic Foam Or Pudgee 1" SEMCF401L 2 $52.00
Thick/1
Square
Foot
(Maximum 2)
Tray Approved ADP Full Tray For Positioning Support Only SETND0005 1 $164.00
Manufacturers -
Standard
Only Adult & Paediatric Sizes, Includes

Mounting Hardware
Full Tray Non Standard Size For SETND0010 1 $280.00
Positioning
Support
Only
-
Adult & Paediatric Sizes, Includes

Mounting Hardware
Half Tray For Positioning Support Only SETND0020 2 $272.00
-
Non
Standard
Page: 102 of 135

Ministry of Health
Seating
OPTIONS:
Allowed Price
Qty.
Tray Approved ADP Mounting Hardware
Manufacturers
Half Tray For Positioning Support Only SETND0015 2 $203.00
Only
-
Standard

Mounting Hardware
Custom Customized Lexan Tray, Includes SETCF103L 1 $362.00
Fabricated Mounting Hardware
Kydex Tray, Includes Mounting SETCF104L 1 $311.00
Hardware
Plastic Tray, Includes Mounting SETCF101L 1 $302.00
Hardware
Wood/Arborite Tray, Includes SETCF102L 1 $220.00
Mounting Hardware
Tray Options Approved ADP Add Modular Elbow Or Hip Blocks To SETND0030 4 $56.00
Manufacturers Any
Modular
Tray
-
Only (Maximum 4)
Add Padding To Any Tray SETND0035 2 $65.00
Custom Clear Tray Cover, Removable SEMCF301L 1 $69.00
Fabricated
Elbow Block Padding Including Cover SEMCF306L 2 $52.00
(Maximum 2)
Elbow Blocks (Maximum 2) SEMCF305L 2 $73.00
Large/Full Tray Pad (Maximum 2) SEMCF304L 2 $125.00
Small Tray Pad (Maximum 2) SEMCF303L 2 $69.00
Page: 103 of 135

Ministry of Health
Wheelchairs (Manual)
Allowed Price
Qty.
Adult High Performance Rigid Invacare A-4 WMA4IN015 1 $3,098.00
Manual Wheelchair
Crossfire T6/Ti WMA4IN110 1 $3,098.00
Wheelchair type offers
lightweight rigid frame and Crossfire T7a WMA4IN130 1 $3,098.00
optimal maneuverability. Terminator WMA4IN105 1 $3,098.00
Suitable for the very active user
Ki Mobility Ethos Adult High Performance WM0001809 1 $3,098.00
who requires postural support
Rigid Manual Wheelchair
and altered wheel placement for
mobility. ADP price includes Rogue WM0001043 1 $3,098.00
frame (sizes up to 18"wide x Tsunami WMA4KI015 1 $3,098.00
18"deep), standard upholstery,
swing away detachable footrests, LEVO AG LEVO compact-easy LCEV with WM0000471 1 $3,098.00
height adjustable armrests, rear battery powered stand-up
anti-tippers, 2 point seat belt any feature
closure, brake extensions, front Motion Apex WM0001305 1 $3,098.00
casters, wheels. See Manual Composites
Wheelchair Options Chart for Veloce WM0001029 1 $3,098.00
other basic components funded Pantera AB Panthera S2 WM0000972 1 $3,098.00
by ADP.
Panthera U2 WM0000973 1 $3,098.00
Product Design Elevation WM0001203 1 $3,098.00
Group
Quickie Quickie Gp/Gpv WMA4QU005 1 $3,098.00
Quickie Gt WMA4QU030 1 $3,098.00
Quickie Q7, Q7R, Q7RS WMA4QU040 1 $3,098.00
Quickie QRi WM0000991 1 $3,098.00
Rgk Wheelchairs Hi-Lite WMA4RZ005 1 $3,098.00
Maxima WM0000696 1 $3,098.00
Sunrise Medical Quickie 5R WM0001272 1 $3,098.00
TiLite Tilite Aero T WM0001252 1 $3,098.00
Tilite Aero Z WMA4TZ010 1 $3,098.00
Tilite Yr/Tr,Yra/Tra,Trc,Zra/Zr WMA4TZ005 1 $3,098.00
iCON Icon A1 WM0000945 1 $3,098.00
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Ministry of Health
Allowed Price
Qty.
Adult Lightweight Performance Future Mobility Galaxy Lite WMA3FM010 1 $2,290.00
Manual Wheelchair
Northern Lite WMA3FM005 1 $2,290.00
Wheelchair type offers maximum
adjustments and options. Invacare Compass Xe (Allegro) WMA3IN030 1 $2,290.00
Suitable for the very active user Mvp WMA3IN060 1 $2,290.00
who requires altered wheel
Myon Active WMA3IN065 1 $2,290.00
placement for optimal postural
support and mobility. ADP price Myon HC WM0001299 1 $2,290.00
includes frame (sizes up to Prospin X4 WMA3IN035 1 $2,290.00
18"wide x 18"deep), standard
upholstery, swing away Xtra WMA3IN005 1 $2,290.00
detachable footrests, height Ki Mobility Catalyst 5, 5ti WMA3KI010 1 $2,290.00
adjustable armrests, rear anti-
tippers, 2 point seat belt any Catalyst 5vx WMA3KI015 1 $2,290.00
closure, brake extensions, front Maple Leaf EZ Ride WMA3WM005 1 $2,290.00
casters, wheels. See Manual Wheelchair
Wheelchair Options Chart for
Motion Helio A6 WM0001489 1 $2,290.00
other basic components funded
Composites
by ADP. Helio A7 WM0001020 1 $2,290.00
Helio C2 WM0000964 1 $2,290.00
Helio XC2 WM0001260 1 $2,290.00
Orthofab Prima WMA3OF010 1 $2,290.00
Physipro XL-5/XL-5 ci WM0001132 1 $2,290.00
Power Plus Glyder WM0001061 1 $2,290.00
Mobility
Pride Mobility Litestream Xf WMA3X1010 1 $2,290.00
Products
Product Design Eclipse 600 WMA3MV005 1 $2,290.00
Group
Quickie Quickie 2 (VIP 2) WMA3QU005 1 $2,290.00
Quickie 2 Hp WMA3QU010 1 $2,290.00
Quickie 2 Lite WMA3QU020 1 $2,290.00
Quickie Gtx WMA3QU040 1 $2,290.00
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Ministry of Health
Allowed Price
Qty.
Adult Lightweight Performance Quickie Quickie Lxi WMA3QU405 1 $2,290.00
Manual Wheelchair
Quickie M6 WMA3QU420 1 $2,290.00
adjustments and options. Quickie QXi WM0000562 1 $2,290.00
Suitable for the very active user
who requires altered wheel Quickie Revolution WMA3QU410 1 $2,290.00
placement for optimal postural Quickie Xenon WM0001156 1 $2,290.00
support and mobility. ADP price
includes frame (sizes up to Rgk Wheelchairs Maxima WMA3RZ005 1 $2,290.00
Sunrise Medical Legend 2 Exigo/Exigo WMA3M9015 1 $2,290.00
upholstery, swing away
detachable footrests, height Xenon 2 Fixed Front WM0001595 1 $2,290.00
tippers, 2 point seat belt any Xenon 2 Hybrid WM0001594 1 $2,290.00
closure, brake extensions, front
Xenon 2 Swing Away WM0001592 1 $2,290.00
casters, wheels. See Manual
Wheelchair Options Chart for TiLite TiLite AERO X WM0001169 1 $2,290.00
by ADP. Tilite X, Sx, Tx WMA3TZ005 1 $2,290.00
Adult Lightweight Standard Broda Ikon 40 WM0001722 1 $1,449.00

Manual Wheelchair
Drive Medical Viper Plus GT WM0000317 1 $1,449.00
Wheelchair type most suitable Design &
for user who is independently Manufacturing
mobile and requires some
adjustments to accommodate Future Mobility Stellato WMA2FM005 1 $1,449.00
postural and mobility Stellato II WM0001188 1 $1,449.00
requirements. ADP price
includes frame (sizes up to Invacare 9000 SL WMA2IN030 1 $1,449.00
18"wide x 18"deep), standard 9000 Topaz WMA2IN055 1 $1,449.00
9000 Xt WMA2IN025 1 $1,449.00
detachable footrests, height
adjustable armrests, rear anti- Myon Manual Wheelchair WMA2IN060 1 $1,449.00
tippers, 2 point seat belt any
Patriot WMA2IN050 1 $1,449.00
casters, wheels. See Manual Ki Mobility Catalyst 4, 4c WMA2KI010 1 $1,449.00
Maple Leaf NRG+ WMA2WM005 1 $1,449.00
Wheelchair
by ADP. NRG+ Gold WM0001134 1 $1,449.00
Page: 106 of 135

Ministry of Health
Allowed Price
Qty.
Adult Lightweight Standard Maple Leaf Swift WMA2WM010 1 $1,449.00
Manual Wheelchair Wheelchair
Wheelchair type most suitable Motion Move WM0001196 1 $1,449.00
for user who is independently Composites
mobile and requires some
adjustments to accommodate Orthofab Ch+ WMA2OF005 1 $1,449.00
postural and mobility Power Plus Magic Plus WM0001062 1 $1,449.00
requirements. ADP price Mobility
includes frame (sizes up to Voyager Plus WM0001063 1 $1,449.00
18"wide x 18"deep), standard Pride Mobility Litestream Xf Ltd WMA2X1010 1 $1,449.00
upholstery, swing away Products
Stylus 400 WMA2X1005 1 $1,449.00
adjustable armrests, rear anti- Quickie Breezy 600 WMA2QU001 1 $1,449.00
Breezy RubiX2 WM0000567 1 $1,449.00
casters, wheels. See Manual Breezy Ultra 4 WMA2QU010 1 $1,449.00
Quickie Lx WMA2QU105 1 $1,449.00
by ADP. Quickie Qx WM0001310 1 $1,449.00
Adult Manual Dynamic Tilt Advanced Mobility Ams Itilt2 WMA5AO020 1 $2,110.00
Wheelchair Systems Corp
Tilt Recline/ I Tilt WMA5AO015 1 $2,110.00
Wheelchair type offers manual
dynamic tilt required by the user Broda Comfort Tilt 587V3 WMA5B-025 1 $2,110.00
who can not maintain an upright Elite 785 WMA5B-020 1 $2,110.00
posture through the use of
Models 48 WMA5B-005 1 $2,110.00
seating components alone. ADP
price includes dynamic tilt frame Models 85 WMA5B-010 1 $2,110.00
(sizes up to 18" wide x 18"deep), Synthesis Tilt Recliner WM0001668 1 $2,110.00
standard upholstery, swing away
detachable footrests, height Future Mobility Capella (20), Capella 45 WM0000559 1 $2,110.00
adjustable armrests, rear anti- Orion 500 WMA5FM010 1 $2,110.00
tippers, brake extensions, 2 point
seat belt any closure, front Orion III WM0001195 1 $2,110.00
casters, wheels. See Manual Orion Ii WMA5FM005 1 $2,110.00
Invacare Concept 45 WMA5IN020 1 $2,110.00
by ADP. Freedom NXT WM0001366 1 $2,110.00
Htr WMA5IN025 1 $2,110.00
Page: 107 of 135

Ministry of Health
Allowed Price
Qty.
Adult Manual Dynamic Tilt Invacare Solara 2g WMA5IN035 1 $2,110.00
Wheelchair
Solara 3g WMA5IN040 1 $2,110.00
dynamic tilt required by the user Ki Mobility Focus CR WM0001160 1 $2,110.00
who can not maintain an upright Liberty FT WM0001569 1 $2,110.00
Lpa Medical Inc Comp-Position WMA5LQ010 1 $2,110.00
price includes dynamic tilt frame Dyn-Ergo WMA5LQ020 1 $2,110.00
(sizes up to 18" wide x 18"deep), Evolution WMA5LQ015 1 $2,110.00
detachable footrests, height Optimum Posturo-Pedic WMA5LQ005 1 $2,110.00
adjustable armrests, rear anti- Maple Leaf Lowrider WM0001080 1 $2,110.00
tippers, brake extensions, 2 point Wheelchair
seat belt any closure, front MLT 700 A/B WMA5WM015 1 $2,110.00
casters, wheels. See Manual MLTR 500/600 WMA5WM010 1 $2,110.00
Supertilt Oval Frame (maximum WM0001111 1 $2,110.00
tilt 45 deg)
by ADP.
Supertilt Square Frame WM0001166 1 $2,110.00
(maximum tilt 35 deg)
Orthofab Tango WMA5OF005 1 $2,110.00
Physipro Neox Tilt-in-Space and Neox HD WM0001255 1 $2,110.00
Power Plus Extreme WM0001041 1 $2,110.00
Mobility
NV Tilt WM0001076 1 $2,110.00
Supertilt Plus WM0001040 1 $2,110.00
Product Design Bentley, Bentley LT WMA5MV005 1 $2,110.00
Group
Fuze T20 WMA5MV025 1 $2,110.00
Fuze T50 WMA5MV020 1 $2,110.00
Stellar Impact WM0001603 1 $2,110.00
Stellar LEAP WM0001532 1 $2,110.00
Stellar, Stellar GL, Stellar GLT, WMA5MV010 1 $2,110.00
Stellar HD
Quickie Breezy Relax2 WM0000454 1 $2,110.00
Page: 108 of 135

Ministry of Health
Allowed Price
Qty.
Adult Manual Dynamic Tilt Quickie Quickie Iris WMA5QU015 1 $2,110.00
Wheelchair
Wheelchair type offers manual Quickie SR-45 WM0000474 1 $2,110.00
dynamic tilt required by the user
who can not maintain an upright
Quickie Ts WMA5QU005 1 $2,110.00
price includes dynamic tilt frame Tilt Fx WMA5QU020 1 $2,110.00
(sizes up to 18" wide x 18"deep),
standard upholstery, swing away Seating Matters Phoenix WM0000974 1 $2,110.00
detachable footrests, height Limited
Sorrento WM0000975 1 $2,110.00
seat belt any closure, front
casters, wheels. See Manual Sunrise Medical Emineo WMA5M9010 1 $2,110.00
other basic components funded Ibis WMA5M9005 1 $2,110.00
by ADP.
Adult Standard Manual Drive Medical Airgo WMA1GM005 1 $1,228.00
Wheelchair
Wheelchair type most suitable
for user who is not consistently
independently mobile and Everest & Jennings Traveler WMA1EJ005 1 $1,228.00
requires minimal adjustments to
accommodate postural and
mobility requirements. ADP price
includes frame (sizes up to Invacare 900 WMA1IN015 1 $1,228.00
Tracer WMA1IN005 1 $1,228.00
Quickie Easy Care 2000 & 4000 WMA1QU015 1 $1,228.00
by ADP.
Paediatric High Performance Hoggi Supra WM0000462 1 $3,354.00
Page: 109 of 135

Ministry of Health
Allowed Price
Qty.
Rigid Manual Wheelchair Invacare Crossfire T6a WMK4IN130 1 $3,354.00
Wheelchair type offers Ki Mobility Little Wave Clik WM0001298 1 $3,354.00
lightweight rigid frame and
optimal maneuverability. Rogue WM0001044 1 $3,354.00
Suitable for the very active user Tsunami WMK4KI005 1 $3,354.00
who requires postural support
LEVO AG LEVO compact-easy LCEV with WM0000472 1 $3,354.00
and altered wheel placement for
battery operated Stand-up
mobility. ADP price includes
feature
frame (sizes up to 16"wide x
16"deep), standard upholstery, Motion Veloce 2018 WM0001598 1 $3,354.00
swing away detachable footrests, Composites
height adjustable armrests, rear Pantera AB Bambino WM0000976 1 $3,354.00
anti-tippers, 2 point seat belt any
closure, brake extensions, front Quickie Quickie Gp WMK4QU010 1 $3,354.00
casters, wheels. See Manual Quickie Gt WMK4QU030 1 $3,354.00
other basic components funded Quickie Q7, Q7R, Q7RS WMK4QU035 1 $3,354.00
by ADP. Quickie QRi WM0000992 1 $3,354.00
Quickie Ti WMK4QU025 1 $3,354.00
Zippie WMK4QU005 1 $3,354.00
Zippie Zone WMK4QU040 1 $3,354.00
Rgk Wheelchairs Hi-Lite WMK4RZ005 1 $3,354.00
Maxima WM0000697 1 $3,354.00
TiLite TiLite Twist WM0001187 1 $3,354.00
Tilite Aero Z WMK4TZ010 1 $3,354.00
Tilite Yr/Tr,Yra/Tra,Trc,Zra/Zr WMK4TZ005 1 $3,354.00
iCON Icon A1 WM0000946 1 $3,354.00
Paediatric Lightweight Invacare Compass Xe (Allegro) WMK3IN020 1 $2,310.00
Performance Manual Wheelchair
Mvp Junior WMK3IN030 1 $2,310.00
adjustments and options. Myon Jr Manual Wheelchair WMK3IN040 1 $2,310.00
Suitable for the active user who Prospin X4 WMK3IN035 1 $2,310.00
requires altered wheel
placement for optimal postural Ki Mobility Catalyst 5 WM0001313 1 $2,310.00
Page: 110 of 135

Ministry of Health
Allowed Price
Qty.
support and mobility. ADP price Ki Mobility Catalyst Spark WM0000695 1 $2,310.00
includes frame (sizes up to
Motion Helio Kids WM0000563 1 $2,310.00
Composites
detachable footrests, height Quickie Quickie 2 (VIP 2) WMK3QU010 1 $2,310.00
adjustable armrests, rear anti- Quickie 2 Hp WMK3QU015 1 $2,310.00
closure, brake extensions, front Quickie 2 Lite WMK3QU020 1 $2,310.00
casters, wheels. See Manual Quickie Gtx WMK3QU040 1 $2,310.00
Quickie Lxi WMK3QU030 1 $2,310.00
by ADP. Quickie Xenon WM0001157 1 $2,310.00
Zippie 2 WMK3QU005 1 $2,310.00
Zippie Gs WMK3QU035 1 $2,310.00
Rgk Wheelchairs Maxima WMK3RZ005 1 $2,310.00
Sunrise Medical Zippie X'Cape WM0001239 1 $2,310.00
TiLite TILite AERO X WM0001170 1 $2,310.00
Tilite X, Sx, Tx WMK3TZ005 1 $2,310.00
Paediatric Lightweight Standard Invacare 9000 Jymni WMK2IN010 1 $1,596.00
Manual Wheelchair
for user who requires some Pride Mobility Litestream Xf WMK2X1010 1 $1,596.00
adjustments to accommodate Products
postural and mobility
requirements. ADP price
includes frame (sizes up to
16"wide x 16"deep), standard Quickie Quickie Lx WMK2QU020 1 $1,596.00
adjustable armrests, rear anti- Quickie Qx WM0001311 1 $1,596.00
Wheelchair Options Chart for Sunrise Medical Legend 2 Exigo/Exigo WMK2M9020 1 $1,596.00
by ADP.
Page: 111 of 135

Ministry of Health
Allowed Price
Qty.
Paediatric Manual Dynamic Tilt Convaid Safari Tilt WMK5CO040 1 $2,804.00
Wheelchair
Future Mobility Super Chair For Kids WMK5FM010 1 $2,804.00
dynamic tilt required by the user Hoggi Bingo/Bingo Evolution WMK5K2010 1 $2,804.00
who can not maintain an upright Swingbo Plus WM0000461 1 $2,804.00
Invacare Freedom NXT WM0001367 1 $2,804.00
price includes dynamic tilt frame Orbit/Tiger WMK5IN010 1 $2,804.00
(sizes up to 16" wide x 16"deep), Spree 3g WMK5IN030 1 $2,804.00
detachable footrests, height Spree Gt WMK5IN025 1 $2,804.00
adjustable armrests, rear anti- Spree Xt WMK5IN020 1 $2,804.00
seat belt any closure, front Ki Mobility Focus CR WM0001161 1 $2,804.00
casters, wheels. See Manual Liberty FT WM0001579 1 $2,804.00
Little Wave Flip XP WM0001342 1 $2,804.00
by ADP. Kid Kart Kid Kart Xpress WMK5KT020 1 $2,804.00
Kid-Tlc WMK5KT010 1 $2,804.00
Otto Bock Kimba Spring & Kimba Spring WMK5OB010 1 $2,804.00
Plus
Physipro NEOX Junior WM0001312 1 $2,804.00
Spiral WM0001600 1 $2,804.00
Product Design Fuze T20 WMK5MV025 1 $2,804.00
Group
Fuze T50 WMK5MV020 1 $2,804.00
Quickie Quickie SR-45 WM0000473 1 $2,804.00
Zippie Iris (Folding & Non WMK5QU010 1 $2,804.00
Folding)
Zippie Ts WMK5QU005 1 $2,804.00
THOMASHILFEN Easy S WM0000326 1 $2,804.00
Thevo Twist WM0000325 1 $2,804.00
Paediatric Specific Specialty Alvema Series 100/Pix1 WMK6AL005 1 $1,303.00
Stroller
Convaid Cruiser Cx WMK6CO005 1 $1,303.00
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Ministry of Health
Allowed Price
Qty.
ADP price includes stroller frame Convaid Ez Rider WMK6CO050 1 $1,303.00
and upholstery, foot support,
Metro WMK6CO030 1 $1,303.00
seat and back supports,
headrest, chest and pelvic Rodeo Tilt WMK6CO060 1 $1,303.00
positioning straps (harness), Trekker WM0001374 1 $1,303.00
abductor, and wheels. See
Manual Wheelchair Options Maclaren Buggy WMK6AM005 1 $1,303.00
Chart for additional basic Ormesa New Bug WM0001271 1 $1,303.00
components funded by ADP.
Otto Bock Kimba Kruze WM0001302 1 $1,303.00
Kimba Neo WM0001100 1 $1,303.00
Quickie Zippie Voyage WM0001083 1 $1,303.00
Synetik ErgoCare Corzo X Country WM0001599 1 $1,303.00
Piper WM0001601 1 $1,303.00
THOMASHILFEN Swifty Stroller - Paediatric WM0000318 1 $1,303.00
specific specialty stroller type 6
Thevo Swifty Stroller WM0000316 1 $1,303.00
Page: 113 of 135

Ministry of Health
OPTIONS:
Allowed Price
Qty.
Amputee Axle Plates (pair) WAMT 1 $89.00
Caster Pin Locks (pair) WAMS 1 $135.00
Clothing Guards WAMV 1 $99.00
Elevating Legrests (pair) WAMK 1 $318.00
Grade Aids (pair) WAMR 1 $91.00
Heavy Duty Cross Braces & WAMC 1 $536.00

Upholstery
This item is not compatible for
individuals with weight greater
than 250 lbs. (please see heavy
duty model codes). Devices
approved and listed by the
Program are suitable and
warranted against normal use to
the weight capacity of the device
being provided. Where an
applicant has a basic functional
mobility status and/or medical
condition where additional
structural integrity is required,
funding may be available for
heavy duty cross braces and
upholstery. Please select this
option only when this criteria is
met.
Hub-Eez Easy Push Wheel WAMM 1 $564.00
MW - Adjustable Tension Back WAME 1 $189.00

Upholstery over 18" Frame
Width
MW - Adjustable Tension Back WAMD 1 $110.00

Upholstery up to 18" Frame
Page: 114 of 135

Ministry of Health
OPTIONS:
Allowed Price
Qty.
Width
MW - Angle Adjustable WAMJ 1 $102.00

Footplates (pair)
MW - Custom Modifications MWCM 1
MW - Heavy Duty Model, Client WAMF 1 $575.00

Weight Exceeds 250 Lbs
Heavy duty model required,
client weight exceeds 250lbs.
Authorizer must document client
weight. Selected device must
meet weight requirements.
MW - Heavy Duty Model, Client WAMG 1 $781.00
MW - Heavy Duty Model, Client WAMH 1 $874.00
MW - Oxygen Tank Holder WAMX 1 $154.00
MW - Seat Depth Required is WAMB 1 $209.00

Greater Than 18"
MW - Seat Width Required is WAMA 1 $314.00

Greater Than 18"
Page: 115 of 135

Ministry of Health
OPTIONS:
Allowed Price
Qty.
MW - Ventilator Tray WAMY 1 $335.00
One Arm/Lever Drive WAML 1 $824.00
Plastic Coated Handrims WAMO 1 $106.00
Power Add-On Device Dolomite Alber E.Motion WPS1DO005 1 $4,831.00

Device is added onto a manual
wheelchair to assist the user
meet their long term basic and Invacare Twion WM0001376 1 $4,831.00
essential mobility requirements.
User must be able to operate the
manual wheelchair
independently. This code may be Magicwheels Magicwheels WPS1WS005 1 $4,831.00
used only when it is not
anticipated that the user will
require the use of a power Max Mobility Smart Drive WM0001081 1 $4,831.00
wheelchair to meet their long
term basic and essential mobility
requirements. ADP funding
assistance is not provided for a Quickie Quickie Xtender WPS1QU005 1 $4,831.00
power add on device and a
power wheelchair.
Projected Handrims (pair) WAMQ 1 $176.00
Quick Release Axles (pair) WAMU 1 $87.00
Recliner Option WAMI 1 $415.00
Spoke Protectors (pair) WAMP 1 $91.00
Standard Manual Wheelchair WANA 1 $945.00

Frame with Manual Dynamic Tilt
*
Standard manual wheelchair
with manual dynamic tilt. Frame
offers ongoing adjustability and
facilitates independent mobility.
Page: 116 of 135

Ministry of Health
OPTIONS:
Allowed Price
Qty.
Authorizer must provide clinical
rationale to support the request.
clinical requirements.
Stroller Handles/Paediatric WAMW 1 $116.00
Titanium Frame * WAMZ 1 $1,181.00

Titanium/Composite Frame *.
Uni-Lateral Wheel Lock WAMN 1 $117.00
Page: 117 of 135

Ministry of Health
Wheelchairs (Power)
Allowed Price
Qty.
Adult Power Base Type 1 Invacare Nutron Series R51lxp WPA1IN065 1 $4,392.00
Wheelchair type most suitable Pronto M51 WPA1IN075 1 $4,392.00
for use on hard, flat surfaces.
Primarily for user who requires KYMCO K-ACTIV WP0001448 1 $4,392.00
minimal adjustments to support (Canadian
independent mobility. ADP price Mobility Corp.)
includes seat and back frame Power Plus Mp1 WPA1WN005 1 $4,392.00
(sizes up to 18" wide x 18"deep), Mobility
standard joystick control, swing
away detachable footrests, Pride Mobility J6 Jazzy WP0000564 1 $4,392.00
height adjustable armrests, 2 Products
Jazzy Elite ES Portable WP0001224 1 $4,392.00
point seat belt any closure, front
casters, wheels. See Power Jazzy Select 6 WPA1X1230 1 $4,392.00
Shoprider/ Shoprider P424l WPA1S7015 1 $4,392.00
Pihsiang
by ADP. Shoprider P424m WPA1S7010 1 $4,392.00
Adult Power Base Type 2 Invacare 3g Ranger X Storm Series WPA2IN040 1 $5,812.00
Wheelchair type suitable for use
on most surfaces. Primarily for Motion Rovi X3 5.0 mph WP0001539 1 $5,812.00
user who requires postural Concepts
support, modifications to
electronics, and other specific
options to support independent Permobil M1 WP0001577 1 $5,812.00
mobility. ADP price includes seat
and back frame (sizes up to 18"
Power Plus Mp2 WPA2WN005 1 $5,812.00
wide x 18"deep), standard
Mobility
joystick control, swing away
adjustable armrests, 2 point seat Pride Mobility Quantum Q4 WP0001541 1 $5,812.00
belt any closure, front casters, Products
and wheels. See Power
other basic components funded Sunrise Medical Quickie 400 M WP0001649 1 $5,812.00
by ADP.
Adult Power Base Type 3 AMYLIOR Alltrack HD3 WP0001766 1 $6,125.00
Wheelchair type suitable for use Alltrack M3 WP0001767 1 $6,125.00
on most surfaces. Primarily for
Alltrack M3 (HD) WP0001768 1 $6,125.00
Page: 118 of 135

Ministry of Health
Wheelchairs (Power)
Allowed Price
Qty.
the user who requires ongoing AMYLIOR Alltrack R3 WP0001769 1 $6,125.00
changes in postural support,
Alltrack R3 (HD) WP0001770 1 $6,125.00
modifications to electronics, and
other specific options to support Future Mobility Orion Explorer Magellan WPA3FM005 1 $6,125.00
independent mobility. ADP price Orion Explorer Viking WPA3FM010 1 $6,125.00
includes base, 2 point seat belt
any closure and standard joystick Invacare Action Torque Storm WPA3IN015 1 $6,125.00
control. See Power Wheelchair Arrow Storm Rwd WPA3IN020 1 $6,125.00
Options Chart for other basic
Fdx WPA3IN080 1 $6,125.00
Invacare TDX SP2 HD Adult Power WP0001773 1 $6,125.00
Base Type 3 Heavy Duty Wheel
Chair
Pronto M91 WPA3IN050 1 $6,125.00
Pronto M94 WPA3IN052 1 $6,125.00
TDXSP2 WP0001447 1 $6,125.00
Tdx Sp/Sr WPA3IN070 1 $6,125.00
Tdx-Sc WPA3IN075 1 $6,125.00
LEVO AG LEVO C3 WP0001140 1 $6,125.00
Motion Rovi X3 5.0 (Modular Maxx), 5.8 or WP0001287 1 $6,125.00
Concepts 6.2 mph, Rovi A3 R-Net Adult
Power Base, 5.8 or 6.2 mph
Permobil C300 WPA31P010 1 $6,125.00
C350 WPA31P030 1 $6,125.00
C400 WPA31P015 1 $6,125.00
C500 WPA31P020 1 $6,125.00
Chairman Hd3 WPA31P025 1 $6,125.00
F3 Corpus (Adult) WP0001258 1 $6,125.00
F5 / F5 VS Corpus (Adult) WP0001256 1 $6,125.00
M3 Corpus WP0001401 1 $6,125.00
M300 WP0000455 1 $6,125.00
Page: 119 of 135

Ministry of Health
Wheelchairs (Power)
Allowed Price
Qty.
Permobil M300 Corpus HD R-Net WP0001165 1 $6,125.00
M5 Corpus WP0001449 1 $6,125.00
Street WPA31P005 1 $6,125.00
Power Plus Mp5 WPA3WM005 1 $6,125.00
Mobility
Pride Mobility Q6 Edge HD WP0001058 1 $6,125.00
Products
Quantum 1450 WP0001021 1 $6,125.00
Quantum 4Front WP0001441 1 $6,125.00
Quantum 6000z WPA3X1245 1 $6,125.00
Quantum 610 WPA3X1225 1 $6,125.00
Quantum Edge 3 WP0001575 1 $6,125.00
Quantum Q6 Edge 2.0 (Adult) WP0001254 1 $6,125.00
Quantum Q6 Edge 3 Stretto WP0001806 1 $6,125.00
Quantum Q6 Edge Adult WP0000108 1 $6,125.00
Quantum Q6 Edge Z (Adult) WP0001269 1 $6,125.00
Quantum Rival WP0000968 1 $6,125.00
Quickie Quickie 500 M WP0001630 1 $6,125.00
Quickie 700 M, 710, 715, 720 WP0000686 1 $6,125.00
Quickie P-222 WPA3QU240 1 $6,125.00
Quickie Pulse 6 WP0000637 1 $6,125.00
Quickie S-646 (S-626) WPA3QU230 1 $6,125.00
Quickie X2 WPA3QU290 1 $6,125.00
Quickie XCEL & Quickie XCEL 2 WPA3QU300 1 $6,125.00
Quickie Xperience & Quickie WPA3QU280 1 $6,125.00
Xperience 2
Quickie Xplore & Quickie Xplore 2 WPA3QU270 1 $6,125.00
Ranger Express WP0001023 1 $6,125.00
Wheelchairs
Page: 120 of 135

Ministry of Health
Wheelchairs (Power)
Allowed Price
Qty.
Sunrise Medical Alex Power Wheelchair WPA3M9005 1 $6,125.00
PUMA 40 WP0000647 1 $6,125.00
SAMM WP0001233 1 $6,125.00
Paediatric Power Base Type 1 Invacare Nutron Series R51lxp WPK1IN015 1 $4,678.00
for use on hard, flat surfaces.
Primarily for user who requires
minimal adjustments to support
independent mobility. ADP price
includes seat and back frame
(sizes up to 16" wide x 16"deep),
standard joystick control, swing
away detachable footrests,
height adjustable armrests, 2
point seat belt any closure, front
casters, wheels. See Power
by ADP.
Paediatric Power Base Type 2 Invacare Tiger WPK2IN015 1 $5,507.00
user who requires postural
support, modifications to
electronics, and other specific Motion Rovi X3 5.0 mph WP0001540 1 $5,507.00
options to support independent Concepts
mobility. ADP price includes seat
and back frame (sizes up to 16"
wide x 16"deep), standard
adjustable armrests, 2 point seat Permobil M1 WP0001578 1 $5,507.00
belt any closure, front casters,
wheels. See Power Wheelchair
Page: 121 of 135

Ministry of Health
Wheelchairs (Power)
Allowed Price
Qty.
Paediatric Power Base Type 3 AMYLIOR Alltrack PM3 WP0001771 1 $5,902.00
Wheelchair type suitable for use Alltrack PR3 WP0001772 1 $5,902.00
the user who requires ongoing Invacare Arrow Storm WPK3IN010 1 $5,902.00
changes in postural support, Fdx WPK3IN080 1 $5,902.00
modifications to electronics, and
Storm Torque WPK3IN015 1 $5,902.00
other specific options to support
independent mobility. ADP price Tdx Sp/Sr WPK3IN070 1 $5,902.00
includes base, 2 point seat belt Tdx Spree WPK3IN075 1 $5,902.00
any closure, and standard
joystick control. See Power LEVO AG LEVO C3 WP0001141 1 $5,902.00
Wheelchair Options Chart for Motion Rovi X3 5.8 or 6.2 mph WP0001443 1 $5,902.00
other basic components funded Concepts
by ADP.
Permobil C300 Corpus Junior / K300 WPK31P010 1 $5,902.00
C400 Corpus Junior WPK31P015 1 $5,902.00
F3 Corpus (Paediatric) WP0001259 1 $5,902.00
F5 / F5 VS Corpus (Paediatric) WP0001257 1 $5,902.00
M3 Corpus WP0001402 1 $5,902.00
M300 WP0000987 1 $5,902.00
M5 Corpus WP0001450 1 $5,902.00
Pride Mobility Q6 Edge HD WP0001059 1 $5,902.00
Products
Quantum 4Front WP0001442 1 $5,902.00
Quantum 610 WPK3X1225 1 $5,902.00
Quantum Edge 3 WP0001576 1 $5,902.00
Quantum Q6 Edge 2.0 (Paediatric) WP0001253 1 $5,902.00
Quantum Q6 Edge 3 Stretto WP0001807 1 $5,902.00
Quantum Q6 Edge Paediatric Power WP0000109 1 $5,902.00
Base Type 3 Wheelchair
Quantum Q6 Edge Z (Paediatric) WP0001270 1 $5,902.00
Quantum Rival WP0000969 1 $5,902.00
Quickie Quickie P-222 WPK3QU020 1 $5,902.00
Page: 122 of 135

Ministry of Health
Wheelchairs (Power)
Allowed Price
Qty.
Paediatric Power Base Type 3 Quickie Quickie Pulse 6 with SPOT Tilt WP0000638 1 $5,902.00
on most surfaces. Primarily for Quickie QM-710, 715, 720 WP0000687 1 $5,902.00
the user who requires ongoing
changes in postural support, Quickie Xperience & Zippie WPK3QU080 1 $5,902.00
modifications to electronics, and Xperience 2
other specific options to support
independent mobility. ADP price Quickie Xplore & Zippie Xplore 2 WPK3QU070 1 $5,902.00
includes base, 2 point seat belt
Sunrise Medical Alex Power Wheelchair WPK3M9005 1 $5,902.00
any closure, and standard
joystick control. See Power
SAMM WP0001234 1 $5,902.00
Zippie ZM-310 WP0001261 1 $5,902.00
by ADP.
Paediatric Power Base with Invacare Tdx Spree WPK4IN075 1 $5,611.00
Manual Dynamic Tilt
dynamic tilt required by the user
who can not maintain a
functional posture through the
use of seating components
alone. ADP price includes
dynamic tilt frame (sizes up to
Tiger WPK4IN005 1 $5,611.00
16" wide x 16"deep), standard
adjustable armrests, 2 point seat
belt any closure, front casters,
wheels. See Power Wheelchair
Power Scooter AMIGO AMIGO RD310000 - 3 WHEEL WP0000333 1 $2,395.00
Device is suitable for the user MOBILITY SCOOTER
who requires power mobility to INTERNATIONAL
meet their long term basic and Activelite Easy Travel -3 Wh. WS16A0005 1 $2,395.00
essential mobility requirements, Mobility
and does not require specific
Advanced Quingo Classic WS15V0005 1 $2,395.00
Page: 123 of 135

Ministry of Health
Wheelchairs (Power)
Allowed Price
Qty.
postural support now or in the Vehicle
future. ADP price includes base, Concepts
tiller and seat. ADP funding for
Fortress 1700fs -3 Wh. WS1FS0015 1 $2,395.00
positioning devices (seating) is
not available for scooters. See 1700fs -4 Wh. WS1FS0020 1 $2,395.00
Power Wheelchair Options Chart Winner -3 Wh. WS1FS0070 1 $2,395.00
when heavy duty models are
required. Winner -4 Wh. WS1FS0075 1 $2,395.00
Invacare COLIBRI 4 -Wheel 18AH WP0001285 1 $2,395.00
Comet Pro 4 Wheel Scooter WP0000121 1 $2,395.00
Comet Ultra Scooter WP0000546 1 $2,395.00
Leo Scooter 3 Wheel WP0001019 1 $2,395.00
Leo Scooter 4 Wheel WS1IN0085 1 $2,395.00
Pegasus Metro 3-Wheel Scooter WP0000122 1 $2,395.00
Pegasus Metro 4-Wheel Scooter WP0000123 1 $2,395.00
Pegasus Pro 3 Wheel Scooter WP0001399 1 $2,395.00
Pegasus Pro 4 Wheel Scooter WP0001400 1 $2,395.00
KYMCO Midi XL WP0001232 1 $2,395.00
(Canadian
Mobility Corp.) Mini LS WP0001284 1 $2,395.00
Power Plus Mp3 -3 Wh. WS1WN0005 1 $2,395.00

Mobility
Mp4 -4 Wh. WS1WN0010 1 $2,395.00
Pride Mobility Celebrity LR WP0000965 1 $2,395.00
Products
Go Go LX 4 Wheel WP0001142 1 $2,395.00
Go Go Sport - 4 Wheel WP0001075 1 $2,395.00
Jazzy Zero Turn WP0001567 1 $2,395.00
Maxima -3 Wh. WS1X10060 1 $2,395.00
Maxima -4 Wh. WS1X10065 1 $2,395.00
Pursuit Scooter (Model SC713CA) WP0001262 1 $2,395.00
Revo 2.0 (3 & 4 wheel) WP0001573 1 $2,395.00
Page: 124 of 135

Ministry of Health
Wheelchairs (Power)
Allowed Price
Qty.
Pride Mobility Victory 10 (3 wheel Twin) WS1X10110 1 $2,395.00
Products
Victory 10 DX WP0000688 1 $2,395.00
Victory 10.2 (3 & 4 wheel) WS1X10115 1 $2,395.00
Victory LX WP0001273 1 $2,395.00
Victory Twin DX WP0000699 1 $2,395.00
Shoprider/ Chameleon Gkb - 3 Wh WS1S7005 1 $2,395.00
Pihsiang
Chameleon Gkb - 4 Wh WS1S7010 1 $2,395.00
Cobra 778el -3 Wh. WS1S70020 1 $2,395.00
Cobra 778el -4 Wh. WS1S70025 1 $2,395.00
Landcruiser 889-3wh. WS1S70035 1 $2,395.00
Landcruiser 889xls 4wh. WS1S70036 1 $2,395.00
Sovereign 888 -4 Wh. WS1S70032 1 $2,395.00
Trailblazer 889sel 4wh. WS1S70045 1 $2,395.00
Voyager 778s -3 Wh. WS1S70037 1 $2,395.00
Voyager 888sel -4 Wh. WS1S70040 1 $2,395.00
Yelle & Safari/Ltd-3 Wh. WS1YE0020 1 $2,395.00
Associates Ltd.
Solo Ltd-4 Wh. WS1YE0007 1 $2,395.00
Solo/Ltd-3 Wh. WS1YE0005 1 $2,395.00
Solo/Xt550-4 Wh. WS1YE0010 1 $2,395.00
ZHE JIANY Boomer Buggy (3 or 4 Wheel) WP0000561 1 $2,395.00
BISWIFT
ENTERPRISE
Page: 125 of 135

Ministry of Health
Wheelchairs (Power)
OPTIONS:
Allowed Price
Qty.
Auto Correction System* WEPQ 1 $1,181.00
Specialized electronics for power
wheelchairs - Offers increased
driving control through specific
auto-correction system; for
client with limited trunk and/or
upper extremity control.
Manual Elevating Legrests (pair) WEPK 1 $308.00
Manual Recline Option WEPI 1 $590.00
Midline Control WE3D 1 $268.00
Multi-function Control Box Amysystems Multi-Function Control Box, For SEC4P5005 1 $1,766.00
Use
On
Systems With Multiple Functions

Including
Tilt
And
Power
Legs, Tilt, Recline And Power Legs

Etc.
Invacare Multi-Function Control Box For Use SECIN5005 1 $1,588.00
On
Systems With Multiple Functions.

Including
Tilt
And Power Legs, Tilt, Recline And

Power Legs Etc.
Motion Trx Helix / 600 Series Multi- SECZG5005 1 $1,570.00
Concepts Function
Control
Box
(Thmc)
For Use On Systems With Multiple

Functions,
Including Tilt And Power Legs, Tilt,

Recline,
Power
Legs,
Etc. Includes Reduced Drive With
Page: 126 of 135

Ministry of Health
Wheelchairs (Power)
OPTIONS:
Allowed Price
Qty.
Multi-function Control Box Elevate.
Permobil Multi-Function Control Box - For SEC1P1005 1 $1,847.00
Use
On
Systems
With Multiple Functions Including,

Tilt
And
Power Legs, Tilt, Recline And Power

Legs, Etc.
Pride Mobility Multi-Function Control Box - SECX15005 1 $514.00
Products Advanced Acutator Module (Aam)
Quickie Multi-Function Control Box For Use SECQU4005 1 $2,403.00
On
Systems
With
Multiple
Functions, Including Tilt And Power

Legrest,
Tilt,
Recline,
Power Legrests Etc.

Sunrise Medical multi-function control box - for use WP0000654 1 $403.00
on systems with multiple functions
including tilt and power legs, tilt
and power legs, etc
One Piece 90/90 Front Riggings WEPL 1 $168.00
PW - Adjustable Tension Back WEPE 1 $189.00

Upholstery over 18" Frame
Width
PW - Adjustable Tension Back WEPD 1 $110.00

Upholstery up to 18" Frame
Width
PW - Angle Adjustable WEPJ 1 $92.00

Footplates (pair)
PW - Custom Modifications PWCM 1
PW - Heavy Duty Model, Client WEPF 1 $438.00

Page: 127 of 135

Ministry of Health
Wheelchairs (Power)
OPTIONS:
Allowed Price
Qty.
PW - Heavy Duty Model, Client WEPG 1 $525.00
PW - Heavy Duty Model, Client WEPH 1 $771.00
PW - Oxygen Tank WEPX 1 $106.00
PW - Seat Depth Required is WEPB 1 $230.00

Greater Than 18"
PW - Seat Width Required is WEPA 1 $339.00

Greater Than 18"
PW - Ventilator Tray WEPY 1 $1,331.00
Power Elevating Footrests Amysystems Power Elevating & Articulating SEF4P0005 1 $2,250.00
Legrests or Center mount foot
platform
Motion Power Elevating At5544 Legrest SEFZG0010 1 $2,214.00
Concepts Package
For
Invacare
And Quickie Bases. Includes

Legrests And Actuators.
Page: 128 of 135

Ministry of Health
Wheelchairs (Power)
OPTIONS:
Allowed Price
Qty.
Power Elevating Footrests Motion Power Elevating Legrests For SEFZG0005 1 $2,214.00
Concepts Invacare,
Quantum,
And
Quickie Bases. Includes Legrests

And Actuators.
Permobil Power Elevating Articulating Leg SEF1P0005 1 $2,274.00
Rests
Pride Mobility Articulating Foot Platform SEFX13010 1 $2,411.00
Products
Power Elevating Articulating Leg SEFX13005 1 $2,193.00
Rests
Quickie Power Elevating/Articulating Leg SEFQU0005 1 $2,250.00
Rests
Sunrise Medical Power elevating and articulating WP0000653 1 $2,415.00
legrests
Tarsys (Invacare) Power Elevating Legrests SEFTY0005 1 $2,368.00
Power Recline Only Amysystems Power Recline With Integrated SEC4P0045 1 $6,436.00
Shear Reduction (Isr)
Invacare Formula CG 12" 20" Recline Only SECIN1010 1 $8,009.00
Formula CG 21" - 24" Recline Only SECIN1015 1 $8,660.00
Motion Bariatric POWER RECLINE SYSTEM SECZG1010 1 $8,223.00
Concepts WITH ESR FOR INVACARE, QUICKIE,
AND QUANTUM BASES.
Modular CG Recline WP0001296 1 $7,245.00
Ultra Low POWER RECLINE ONLY SECZG0015 1 $7,502.00
WITH POWER SLIDING BACK (PSB)
FOR INVACARE, QUANTUM, AND
QUICKIE BASES.
Ultra Low POWER RECLINE SYSTEM SECZG0010 1 $7,019.00
WITH EXTENDED SHEAR
REDUCTION (ESR) FOR INVACARE,
QUANTUM, AND QUICKIE BASES.
Page: 129 of 135

Ministry of Health
Wheelchairs (Power)
OPTIONS:
Allowed Price
Qty.
Power Recline Only Permobil Corpus Power Positioning System SEC1P0010 1 $6,001.00
With Power Recline Only
Pride Mobility Quantum TRU-Balance 3 WP0001163 1 $5,434.00
Products Redesigned Power Recline
Tru-Balance 2 Power Recline SECX12055 1 $5,434.00
Quickie Recline with Power Shear WP0001149 1 $6,563.00
Reduction
Sunrise Medical QLASS power recline WP0000995 1 $6,842.00
Sedeo Pro Recline (130° Powered WP0001633 1 $6,521.00
Semi-Recline)
Sedeo Pro Recline (150° Powered WP0001632 1 $7,004.00
Recline w/ Shear Reduction)
Sedeo Pro recline WP0000652 1 $6,842.00
Power Tilt Only Amysystems Bariatric CG Power Tilt SEC4P0060 1 $6,436.00
Cg Power Tilt SEC4P0040 1 $5,228.00
Invacare Formula CG 12" - 20" Tilt Only SECIN1000 1 $5,390.00
Formula CG 21" - 24" Tilt Only SECIN1005 1 $6,040.00
LEVO AG C3 Power Tilt Only WP0001151 1 $5,095.00
Motion Bariatric POWER TILT ONLY FOR SECZG1005 1 $6,436.00
Concepts INVACARE, QUANTUM, AND
QUICKIE BASES.
Modular DG Tilt WP0001295 1 $5,232.00
Single Pivot Power Tilt Only For SECZG2005 1 $4,528.00
Invacare, Quantum, and Quickie
Bases
Ultra Low CG POWER TILT ONLY SECZG0005 1 $5,233.00
FOR INVACARE, QUANTUM, AND
QUICKIE BASES.
Permobil Corpus Hd Power Positioning SEC1P0105 1 $9,173.00
Page: 130 of 135

Ministry of Health
Wheelchairs (Power)
OPTIONS:
Allowed Price
Qty.
Power Tilt Only Permobil System
With
30
Deg.
Power Tilt Only

Corpus Power Positioning System SEC1P0005 1 $5,309.00
With 45 Deg. Power Tilt Only
Ps Power Positioning System With SEC1P0205 1 $4,504.00
45 Deg. Power Tilt Only
Pride Mobility Quantum TRU-Balance 3 Power WP0001162 1 $5,211.00
Products Positioning
Tru-Balance 2 Power Tilt SECX12050 1 $4,826.00
Tru-Balance Bariatric Power Tilt WP0001022 1 $5,630.00
Quickie Power C.G. Tilt For Quickie G-424 & SECQU1005 1 $4,684.00
S-525
Power C.G. Tilt For Quickie P-222se SECQU1015 1 $4,726.00
Power C.G. Tilt For Quickie Rhythm SECQU3005 1 $4,745.00
Power C.G. Tilt For Quickie S-626 SECQU1010 1 $4,684.00
SPOT TILT WP0000639 1 $3,466.00
Spot Tilt II WP0001148 1 $5,332.00
Sunrise Medical QLASS centre of gravity power tilt WP0000993 1 $5,232.00
Sedeo Pro Tilt WP0001631 1 $7,004.00
Sedeo Pro centre of gravity power WP0000650 1 $5,233.00
tilt
Power Tilt and Recline Amysystems Bariatric CG Power Tilt and Power SEC4P0070 1 $10,460.00
Recline With Integrated Shear
Reduction (Isr)
Cg Power Tilt & Power Recline With SEC4P0050 1 $9,253.00
Integrated
Shear
Reduction (Isr)
Invacare Formula CG 16" 20" Tilt And SECIN1020 1 $8,654.00
Recline
Page: 131 of 135

Ministry of Health
Wheelchairs (Power)
OPTIONS:
Allowed Price
Qty.
Power Tilt and Recline Invacare Formula CG 21" - 24" Tilt And SECIN1025 1 $9,605.00
Recline
Motion Bariatric POWER TILT AND POWER SECZG1015 1 $9,293.00
Concepts RECLINE WITH ESR FOR INVACARE,
QUICKIE, AND QUANTUM BASES.
Modular CG Tilt and Recline WP0001297 1 $8,855.00
Single Pivot POWER TILT AND SECZG2010 1 $7,647.00
POWER RECLINE FOR INVACARE,
QUANTUM, AND QUICKIE BASES.
POWER RECLINE WITH ESR FOR
INVACARE, QUANTUM, AND
QUICKIE BASES.
POWER RECLINE WITH PSB FOR
QUICKIE BASES.
Ultra Low CG POWER TILT AND SECZG0020 1 $8,806.00
POWER RECLINE WITH ESR FOR
QUICKIE BASES.
Ultra Low CG POWER TILT AND SECZG0025 1 $9,289.00
POWER RECLINE WITH PSB FOR
QUICKIE BASES.
Ultra Low POWER TILT AND POWER SECZG0018 1 $8,352.00
RECLINE FOR INVACARE, QUICKIE,
AND QUANTUM BASES.
Permobil Corpus Power Positioning System SEC1P0015 1 $8,851.00
With
45
Deg.
Power
Tilt
And Power Recline

Pride Mobility Quantum TRU-Balance 3 Power Tilt WP0001164 1 $9,056.00
Page: 132 of 135

Ministry of Health
Wheelchairs (Power)
OPTIONS:
Allowed Price
Qty.
Power Tilt and Recline Products & Redesigned Recline
Tru-Balance 2 Power Tilt And SECX12060 1 $9,056.00
Recline
Quickie Smart Seat Tilt & Recline System SECQU2005 1 $9,257.00
Tilt & Recline with Power Shear WP0001150 1 $9,440.00
Reduction
Sunrise Medical QLASS centre of gravity power tilt WP0000994 1 $9,096.00
and recline
Quickie Sedeo Ergo Seating System WP0001341 1 $10,022.25
Sedeo Pro Tilt & Recline (130° WP0001635 1 $10,686.00
Powered Semi-Recline)
Sedeo Pro Tilt & Recline (150° WP0001634 1 $10,868.00
Powered Recline w/ Shear
Reduction)
Sedeo Pro centre of gravity power WP0000651 1 $9,096.00
tilt plus recline
Seat Package 1 for Power Bases WEPN 1 $663.00
Seat package 1 for power bases
(includes frame, sling upholstery,
armrests, footrests.)
Seat Package 2 for Power Bases WEPO 1 $682.00
Seat package 2 for power bases
(includes deluxe seat and back,
armrests, footrests.) No
positioning devices (seating)
allowed with this code.
Specialty Controls 1 Non WEX1 1 $1,103.00
Standard Joystick*
Specialty controls 1 - Simple
Non-Standard Joystick (includes
mounting hardware, upgraded
Page: 133 of 135

Ministry of Health
Wheelchairs (Power)
OPTIONS:
Allowed Price
Qty.
electronics & labour). Authorizer
support the request. Selected
device must meet clinical
requirements.
Specialty Controls 2 Chin/Rim WEX2 1 $2,363.00
Control*
Specialty controls 2 - Complex
Non-Standard Joystick (includes
upgraded electronics, mounting
hardware, display, joystick
modifications & labour). For
chin/rim control etc. Authorizer
support the request. Selected
device must meet clinical
requirements.
Specialty Controls 3 Simple WEX3 1 $5,276.00
Touch*
Specialty controls 3 - Simple
Touch (includes mounting
hardware, upgraded electronics,
display, cables, 4 switches &
labour). For
footplate/headrest/tray switches
etc. Authorizer must provide
clinical rationale to support the
request. Selected device must
meet clinical requirements.
Specialty Controls 4 Proximity WEX4 1 $5,906.00
Control*
Specialty controls 4 - Proximity
Control (includes mounting
hardware, upgraded electronics,
Page: 134 of 135

Ministry of Health
Wheelchairs (Power)
OPTIONS:
Allowed Price
Qty.
display, cables, 4 switches &
labour). Authorizer must provide
Specialty Controls 5 Breath WEX5 1 $2,363.00
Control*
Specialty Controls 5 - Breath
Control - Sip'N'Puff (includes
mounting hardware, upgraded
electronics, display, cables &
labour). Authorizer must provide
Specialty Controls 6 Scanners* WEX6 1 $3,938.00
Specialty Controls 6 - Scanners
(includes mounting hardware,
upgraded electronics, display,
cables, scanner & labour).
Swingaway Mounting Bracket WEPM 1 $232.00
Page: 135 of 135

Mobility Devices Product Manual Effective Date - November 02, 2020

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Mobility Devices Product Manual Effective Date - November 02, 2020

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Printed Date: Nov 2, 2020 Page: 1 of 135

Mobility Devices Effective From: November 02, 2020

Mobility Devices Effective From: November 02, 2020

Mobility Devices Effective From: November 02, 2020

Mobility Devices Effective From: November 02, 2020

Mobility Devices Effective From: November 02, 2020

Mobility Devices Effective From: November 02, 2020

Mobility Devices Effective From: November 02, 2020

Mobility Devices Effective From: November 02, 2020

Mobility Devices Effective From: November 02, 2020

Mobility Devices Effective From: November 02, 2020

Mobility Devices Effective From: November 02, 2020

Mobility Devices Effective From: November 02, 2020

Systems (Aes) & Adjustment Brackets.

Mount Hardware & Rotating Hold

14" Wide Or Less.

Mobility Devices Effective From: November 02, 2020

Amysystems Contour Back Support For Heavy Duty SEB4P0020 1 $825.00

Without Mounting Hardware

Without Cover And Mounting

Mobility Devices Effective From: November 02, 2020

Fabricated Vinyl Cover, Without Mounting

Vinyl Cover, Without Mounting

Without Mounting Hardware

Mobility Devices Effective From: November 02, 2020

Mobility Devices Effective From: November 02, 2020

Mobility Devices Effective From: November 02, 2020

Mobility Devices Effective From: November 02, 2020

Mobility Devices Effective From: November 02, 2020

& Vacuum/Moisture Proof

& Cover Pattern.

Mobility Devices Effective From: November 02, 2020

Hardware, Cover, Lumbar Supports &

Hardware, Cover, Lumbar Supports &

For 0 Or 8 Degree Backposts

Cover & Lumbar Supports (14""-19"")

& Lumbar Supports (12"/13")

Mobility Devices Effective From: November 02, 2020

Cover & Lumbar Supports (20"")

With Headrest Mounting Kit

& Lumbar Supports (14"/16"/17"/18")

Various Back Heights

Mobility Devices Effective From: November 02, 2020

Various Back Heights

Various Back Heights

Mobility Devices Effective From: November 02, 2020

Mobility Devices Effective From: November 02, 2020

Mobility Devices Effective From: November 02, 2020

Wheelchairs, Height Adjustable 18-26"

Mobility Devices Effective From: November 02, 2020

Mobility Devices Effective From: November 02, 2020

Mobility Devices Effective From: November 02, 2020

For Digitizing Or Plastering

Wide Or Extra Tall, 20" - 24"

Mobility Devices Effective From: November 02, 2020

Positioning. Includes Hinged Or Fixed

Recline Back Greater Than 20" Wide

Mobility Devices Effective From: November 02, 2020

(One Piece Back & Seat- 2 Sections,2

Mobility Devices Effective From: November 02, 2020