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File: 81, IEN: 104840
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YES
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File: 81, IEN: 104840
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400 E
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File: 81, IEN: 104840
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ACTIVE
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R80 C
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900 K
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File: 81, IEN: 104840
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ACTIVE
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R20 A
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200 I
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File: 81, IEN: 104840
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File: 81, IEN: 104840
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File: 81, IEN: 104840
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MULTI-AXIAL KNEE/SHIN SYSTEM
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File: 81, IEN: 104840
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R20 A
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200 I
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File: 81, IEN: 104840
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200 I
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MECH HIP EXTENSION ASSIST
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File: 81, IEN: 104840
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200 I
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File: 81, IEN: 104840
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ACTIVE
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R20 C
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200 I
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File: 81, IEN: 104840
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ACTIVE
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R20 A
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200 I
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ABOVE KNEE MANUAL LOCK
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File: 81, IEN: 104840
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ACTIVE
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R20 A
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200 I
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HEAT LAMP WITHOUT STAND
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File: 81, IEN: 104840
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ACTIVE
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R80 C
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900 K
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ENDO BK ULTRA-LIGHT MATERIAL
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File: 81, IEN: 104840
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ACTIVE
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R20 C
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200 I
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ENDO AK ULTRA-LIGHT MATERIAL
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File: 81, IEN: 104840
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ACTIVE
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R20 A
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200 I
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ENDO HIP ULTRA-LIGHT MATERIA
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File: 81, IEN: 104840
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ACTIVE
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R20 D
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200 I
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BELOW KNEE FLEX COVER SYSTEM
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File: 81, IEN: 104840
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ACTIVE
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R20 C
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200 I
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ABOVE KNEE FLEX COVER SYSTEM
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File: 81, IEN: 104840
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ACTIVE
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R20 A
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200 I
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HIP FLEXIBLE COVER SYSTEM
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File: 81, IEN: 104840
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ACTIVE
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R20 D
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200 I
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FOOT EXTERNAL KEEL SACH FOOT
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File: 81, IEN: 104840
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ACTIVE
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200 I
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FLEXIBLE KEEL FOOT
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File: 81, IEN: 104840
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ACTIVE
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R20 D
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200 I
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FOOT SINGLE AXIS ANKLE/FOOT
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File: 81, IEN: 104840
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ACTIVE
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R20 D
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200 I
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ENERGY STORING FOOT
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File: 81, IEN: 104840
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ACTIVE
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R20 D
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200 I
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HEAT LAMP WITH STAND
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File: 81, IEN: 104840
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ACTIVE
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R80 C
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900 K
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FT PROSTH MULTIAXIAL ANKL/FT
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File: 81, IEN: 104840
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ACTIVE
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R20 D
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200 I
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ALL LE PROSTH/DYNAMIC RES FT
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File: 81, IEN: 104840
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ACTIVE
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R20 D
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200 I
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FLEX FOOT SYSTEM
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File: 81, IEN: 104840
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R20 D
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200 I
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File: 81, IEN: 104840
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200 I
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EXOSKELETAL AXIAL ROTATION U
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File: 81, IEN: 104840
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200 I
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File: 81, IEN: 104840
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ACTIVE
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R20 D
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MULTI-AXIAL ROTATION UNIT
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File: 81, IEN: 104840
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ACTIVE
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R20 A
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200 I
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PAR HAND ROBIN-AIDS THUM REM
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File: 81, IEN: 104840
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ACTIVE
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R30
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300 D
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1
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HAND ROBIN-AIDS LITTLE/RING
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File: 81, IEN: 104840
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ACTIVE
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R30
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300 D
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1
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ELECTRIC HEAT PAD STANDARD
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File: 81, IEN: 104840
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ACTIVE
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R80 C
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900 K
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PART HAND ROBIN-AIDS NO FING
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File: 81, IEN: 104840
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ACTIVE
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R30
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300 D
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1
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WRST MLD SCK FLX HNG TRI PAD
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File: 81, IEN: 104840
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ACTIVE
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R30
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300 A
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1
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WRST MOLD SOCK W/EXP INTERFA
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File: 81, IEN: 104840
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ACTIVE
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R30
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300 A
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1
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ELB MOLD SOCK FLEX HINGE PAD
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File: 81, IEN: 104840
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ACTIVE
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R30
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300 A
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1
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ELBOW MOLD SOCK SUSPENSION T
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File: 81, IEN: 104840
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ACTIVE
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R30
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300 A
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1
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ELBOW MOLD DOUB SPLT SOC STE
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File: 81, IEN: 104840
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ACTIVE
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R30
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300 A
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1
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ELBOW STUMP ACTIVATED LOCK H
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File: 81, IEN: 104840
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ACTIVE
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R30
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300 A
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1
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ELBOW MOLD OUTSID LOCK HINGE
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File: 81, IEN: 104840
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ACTIVE
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R30
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300 D
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1
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ELBOW MOLDED W/ EXPAND INTER
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File: 81, IEN: 104840
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ACTIVE
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R30
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300 D
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1
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ELBOW INTER LOC ELBOW FORARM
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File: 81, IEN: 104840
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ACTIVE
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R30
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300 B
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1
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ELECTRIC HEAT PAD MOIST
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File: 81, IEN: 104840
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\n
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ACTIVE
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R80 C
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900 K
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SHLDER DISART INT LOCK ELBOW
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File: 81, IEN: 104840
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ACTIVE
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R30
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300 D
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1
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SHOULDER PASSIVE RESTOR COMP
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File: 81, IEN: 104840
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ACTIVE
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R30
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300 D
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1
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SHOULDER PASSIVE RESTOR CAP
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File: 81, IEN: 104840
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ACTIVE
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R30
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300 D
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1
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THORACIC INTERN LOCK ELBOW
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File: 81, IEN: 104840
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ACTIVE
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R30
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300 D
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1
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THORACIC PASSIVE RESTOR COMP
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File: 81, IEN: 104840
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ACTIVE
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R30
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300 D
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1
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THORACIC PASSIVE RESTOR CAP
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File: 81, IEN: 104840
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ACTIVE
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R30
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300 D
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1
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POSTOP DSG CAST CHG WRST/ELB
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File: 81, IEN: 104840
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ACTIVE
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R30
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300 D
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POSTOP DSG CAST CHG ELB DIS/
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File: 81, IEN: 104840
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ACTIVE
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R30
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300 D
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POSTOP DSG CAST CHG SHLDER/T
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File: 81, IEN: 104840
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ACTIVE
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R30
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300 D
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1
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POSTOP EA CAST CHG & REALIGN
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File: 81, IEN: 104840
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\n
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ACTIVE
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R30
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300 D
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1
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HYDROCOLLATOR UNIT
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File: 81, IEN: 104840
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\n
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ACTIVE
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R80 C
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900 K
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POSTOP APPLICAT RIGID DSG ON
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File: 81, IEN: 104840
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ACTIVE
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R30
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300 D
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1
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BELOW ELBOW PROSTH TISS SHAP
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File: 81, IEN: 104840
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\n
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ACTIVE
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R30
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300 A
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1
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ELB DISART PROSTH TISS SHAP
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File: 81, IEN: 104840
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ACTIVE
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R30
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300 D
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1
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ABOVE ELBOW PROSTH TISS SHAP
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File: 81, IEN: 104840
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ACTIVE
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R30
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300 B
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1
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SHLDR DISAR PROSTH TISS SHAP
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File: 81, IEN: 104840
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ACTIVE
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R30
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300 D
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1
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SCAP THORAC PROSTH TISS SHAP
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File: 81, IEN: 104840
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ACTIVE
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R30
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300 D
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1
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WRIST/ELBOW BOWDEN CABLE MOL
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File: 81, IEN: 104840
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ACTIVE
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R30
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300 A
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1
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WRIST/ELBOW BOWDEN CBL DIR F
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File: 81, IEN: 104840
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ACTIVE
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R30
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300 A
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1
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ELBOW FAIR LEAD CABLE MOLDED
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File: 81, IEN: 104840
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ACTIVE
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R30
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300 B
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1
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ELBOW FAIR LEAD CABLE DIR FO
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File: 81, IEN: 104840
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ACTIVE
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R30
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300 B
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1
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PARAFFIN BATH UNIT PORTABLE
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File: 81, IEN: 104840
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R80 C
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900 K
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SHDR FAIR LEAD CABLE MOLDED
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File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", "
1
\n"], ["L6590", "
SHDR FAIR LEAD CABLE DIRECT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", "
1
\n"], ["L6600", "
POLYCENTRIC HINGE PAIR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L6605", "
SINGLE PIVOT HINGE PAIR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L6610", "
FLEXIBLE METAL HINGE PAIR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L6615", "
DISCONNECT LOCKING WRIST UNI
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L6616", "
DISCONNECT INSERT LOCKING WR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L6620", "
FLEXION-FRICTION WRIST UNIT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L6623", "
SPRING-ASS ROT WRST W/ LATCH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L6625", "
ROTATION WRST W/ CABLE LOCK
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["E0236", "
PUMP FOR WATER CIRCULATING P
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["L6628", "
QUICK DISCONN HOOK ADAPTER O
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L6629", "
LAMINATION COLLAR W/ COUPLIN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L6630", "
STAINLESS STEEL ANY WRIST
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L6632", "
LATEX SUSPENSION SLEEVE EACH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L6635", "
LIFT ASSIST FOR ELBOW
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L6637", "
NUDGE CONTROL ELBOW LOCK
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L6640", "
SHOULDER ABDUCTION JOINT PAI
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L6641", "
EXCURSION AMPLIFIER PULLEY T
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L6642", "
EXCURSION AMPLIFIER LEVER TY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L6645", "
SHOULDER FLEXION-ABDUCTION J
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["E0237", "
HEAT/COLD PAD WITH PUMP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["L6650", "
SHOULDER UNIVERSAL JOINT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L6655", "
STANDARD CONTROL CABLE EXTRA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L6660", "
HEAVY DUTY CONTROL CABLE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L6665", "
TEFLON OR EQUAL CABLE LINING
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L6670", "
HOOK TO HAND CABLE ADAPTER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L6672", "
HARNESS CHEST/SHLDER SADDLE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L6675", "
HARNESS FIGURE OF 8 SING CON
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L6676", "
HARNESS FIGURE OF 8 DUAL CON
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L6680", "
TEST SOCK WRIST DISART/BEL E
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L6682", "
TEST SOCK ELBW DISART/ABOVE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["E0238", "
HEAT PAD NON-ELECTRIC MOIST
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["L6684", "
TEST SOCKET SHLDR DISART/THO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L6686", "
SUCTION SOCKET
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L6687", "
FRAME TYP SOCKET BEL ELBOW/W
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L6688", "
FRAME TYP SOCK ABOVE ELB/DIS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 B
\n", "
\n
\n\n
\n", ""], ["L6689", "
FRAME TYP SOCKET SHOULDER DI
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L6690", "
FRAME TYP SOCK INTERSCAP-THO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L6691", "
REMOVABLE INSERT EACH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L6692", "
SILICONE GEL INSERT OR EQUAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L6700", "
TERMINAL DEVICE MODEL #3
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L6705", "
TERMINAL DEVICE MODEL #5
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["A4495", "
THIGH LENGTH SURG STOCKING
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
400 E
\n", "
\n
\n\n
\n", ""], ["E0239", "
HYDROCOLLATOR UNIT PORTABLE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["L6710", "
TERMINAL DEVICE MODEL #5X
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L6715", "
TERMINAL DEVICE MODEL #5XA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L6720", "
TERMINAL DEVICE MODEL #6
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L6725", "
TERMINAL DEVICE MODEL #7
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L6730", "
TERMINAL DEVICE MODEL #7LO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L6735", "
TERMINAL DEVICE MODEL #8
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L6740", "
TERMINAL DEVICE MODEL #8X
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L6745", "
TERMINAL DEVICE MODEL #88X
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L6750", "
TERMINAL DEVICE MODEL #10P
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L6755", "
TERMINAL DEVICE MODEL #10X
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["E0241", "
BATH TUB WALL RAIL
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
900 I
\n", "
\n
\n\n
\n", ""], ["L6765", "
TERMINAL DEVICE MODEL #12P
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L6770", "
TERMINAL DEVICE MODEL #99X
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L6775", "
TERMINAL DEVICE MODEL#555
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L6780", "
TERMINAL DEVICE MODEL #SS555
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L6790", "
HOOKS-ACCU HOOK OR EQUAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L6795", "
HOOKS-2 LOAD OR EQUAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L6800", "
HOOKS-APRL VC OR EQUAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L6805", "
MODIFIER WRIST FLEXION UNIT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L6806", "
TRS GRIP VC OR EQUAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L6809", "
TRS SUPER SPORT PASSIVE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["E0242", "
BATH TUB RAIL FLOOR
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
900 I
\n", "
\n
\n\n
\n", ""], ["L6810", "
PINCHER TOOL OTTO BOCK OR EQ
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L6825", "
HANDS DORRANCE VO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L6830", "
HAND APRL VC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L6835", "
HAND SIERRA VO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L6840", "
HAND BECKER IMPERIAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L6845", "
HAND BECKER LOCK GRIP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L6850", "
TERM DVC-HAND BECKER PLYLITE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L6855", "
HAND ROBIN-AIDS VO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L6860", "
HAND ROBIN-AIDS VO SOFT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L6865", "
HAND PASSIVE HAND
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L6875", "
HAND BOCK VC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L6880", "
HAND BOCK VO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L6890", "
PRODUCTION GLOVE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 C
\n", "
\n
\n\n
\n", ""], ["L6895", "
CUSTOM GLOVE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 C
\n", "
\n
\n\n
\n", ""], ["L6900", "
HAND RESTORAT THUMB/1 FINGER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L6905", "
HAND RESTORATION MULTIPLE FI
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L6910", "
HAND RESTORATION NO FINGERS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L6915", "
HAND RESTORATION REPLACMNT G
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L6920", "
WRIST DISARTICUL SWITCH CTRL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 F
\n", "
\n
\n\n
\n", "
1
\n"], ["L6925", "
WRIST DISART MYOELECTRONIC C
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 F
\n", "
\n
\n\n
\n", "
1
\n"], ["E0244", "
TOILET SEAT RAISED
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
900 I
\n", "
\n
\n\n
\n", ""], ["L6930", "
BELOW ELBOW SWITCH CONTROL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 F
\n", "
\n
\n\n
\n", "
1
\n"], ["L6935", "
BELOW ELBOW MYOELECTRONIC CT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 F
\n", "
\n
\n\n
\n", "
1
\n"], ["L6940", "
ELBOW DISARTICULATION SWITCH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 F
\n", "
\n
\n\n
\n", "
1
\n"], ["L6945", "
ELBOW DISART MYOELECTRONIC C
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 F
\n", "
\n
\n\n
\n", "
1
\n"], ["L6950", "
ABOVE ELBOW SWITCH CONTROL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 F
\n", "
\n
\n\n
\n", "
1
\n"], ["L6955", "
ABOVE ELBOW MYOELECTRONIC CT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 F
\n", "
\n
\n\n
\n", "
1
\n"], ["L6960", "
SHLDR DISARTIC SWITCH CONTRO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 F
\n", "
\n
\n\n
\n", "
1
\n"], ["L6965", "
SHLDR DISARTIC MYOELECTRONIC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 F
\n", "
\n
\n\n
\n", "
1
\n"], ["L6970", "
INTERSCAPULAR-THOR SWITCH CT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 F
\n", "
\n
\n\n
\n", "
1
\n"], ["L6975", "
INTERSCAP-THOR MYOELECTRONIC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 F
\n", "
\n
\n\n
\n", "
1
\n"], ["E0245", "
TUB STOOL OR BENCH
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
900 I
\n", "
\n
\n\n
\n", ""], ["L7010", "
HAND OTTO BACK STEEPER/EQ SW
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L7015", "
HAND SYS TEKNIK VILLAGE SWIT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L7020", "
ELECTRONIC GREIFER SWITCH CT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L7025", "
ELECTRON HAND MYOELECTRONIC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L7030", "
HAND SYS TEKNIK VILL MYOELEC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L7035", "
ELECTRON GREIFER MYOELECTRO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L7040", "
PREHENSILE ACTUATOR HOSMER S
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L7045", "
ELECTRON HOOK CHILD MICHIGAN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L7160", "
ELBOW BOSTON/EQ SWITCH CTRL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R30
\n", "
300 F
\n", "
\n
\n\n
\n", ""], ["L7165", "
ELBOW BOSTON/EQ MYOELECTRON
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R30
\n", "
300 F
\n", "
\n
\n\n
\n", ""], ["E0246", "
TRANSFER TUB RAIL ATTACHMENT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
900 I
\n", "
\n
\n\n
\n", ""], ["L7170", "
ELECTRONIC ELBOW HOSMER SWIT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L7180", "
ELECTRONIC ELBOW UTAH MYOELE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L7185", "
ELECTRON ELBOW ADOLESCENT SW
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L7186", "
ELECTRON ELBOW CHILD SWITCH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L7190", "
ELBOW ADOLESCENT MYOELECTRON
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L7191", "
ELBOW CHILD MYOELECTRONIC CT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L7260", "
ELECTRON WRIST ROTATOR OTTO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L7261", "
ELECTRON WRIST ROTATOR UTAH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L7266", "
SERVO CONTROL STEEPER OR EQU
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L7272", "
ANALOGUE CONTROL UNB OR EQUA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["E0249", "
PAD WATER CIRCULATING HEAT U
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["L7274", "
PROPORTIONAL CTL 12 VOLT UTA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L5999", "
LOWER EXTREMITY PROSTH, NOS
\n", "", "", "", "", "", "", "
YES
\n", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 D
\n", "
200 F
\n", "
\n
\n\n
\n", ""], ["L7362", "
BATTERY CHRGR SIX VOLT OTTO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L7364", "
TWELVE VOLT BATTERY UTAH/EQU
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L7366", "
BATTERY CHRGR 12 VOLT UTAH/E
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L7500", "
PROSTHETIC DVC REPAIR HOURLY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 D
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L7510", "
PROSTHETIC DEVICE REPAIR REP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 D
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L8000", "
MASTECTOMY BRA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
700 C
\n", "
\n
\n\n
\n", ""], ["L8010", "
MASTECTOMY SLEEVE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
700 C
\n", "
\n
\n\n
\n", ""], ["E0250", "
HOSP BED FIXED HT W/ MATTRES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 C
\n", "
\n
\n\n
\n", ""], ["L8020", "
MASTECTOMY FORM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
700 C
\n", "
\n
\n\n
\n", ""], ["L8030", "
BREAST PROSTHESIS SILICONE/E
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
700 C
\n", "
\n
\n\n
\n", ""], ["L8100", "
ELAS SUPRT STOCK BK MED WGT
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
400 E
\n", "
\n
\n\n
\n", ""], ["L8110", "
ELASTIC SUPP STOCKING BK HVY
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
400 E
\n", "
\n
\n\n
\n", ""], ["L8120", "
ELASTIC SUPP STOCKNG BK SURG
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
400 E
\n", "
\n
\n\n
\n", ""], ["L8130", "
ELASTIC SUPP STOCKING AK MED
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
400 E
\n", "
\n
\n\n
\n", ""], ["L8140", "
ELASTIC SUPP STOCKING AK HVY
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
400 E
\n", "
\n
\n\n
\n", ""], ["L8150", "
ELASTIC SUPP STOCKNG AK SURG
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
400 E
\n", "
\n
\n\n
\n", ""], ["L8160", "
SUPP STOCKING FULL LGTH MED
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
400 E
\n", "
\n
\n\n
\n", ""], ["L8170", "
SUPP STOCKING FULL LGTH HVY
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
400 E
\n", "
\n
\n\n
\n", ""], ["E0251", "
HOSP BED FIXD HT W/O MATTRES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 C
\n", "
\n
\n\n
\n", ""], ["L8180", "
SUPP STOCKING HEAVY SURG WEI
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
400 E
\n", "
\n
\n\n
\n", ""], ["L8190", "
ELAS STOCKING LEOTARDS MED W
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
400 E
\n", "
\n
\n\n
\n", ""], ["L8200", "
ELAS STOCKING LEOTARDS SURG
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
400 E
\n", "
\n
\n\n
\n", ""], ["L8210", "
ELASTIC STOCKING CUSTOM MADE
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
400 E
\n", "
\n
\n\n
\n", ""], ["L8220", "
ELASTIC STOCKING LYMPHEDEMA
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
400 E
\n", "
\n
\n\n
\n", ""], ["L8230", "
ELASTICSTOCKING GARTER BELT
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
400 G
\n", "
\n
\n\n
\n", ""], ["L8300", "
TRUSS SINGLE W/ STANDARD PAD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 G
\n", "
\n
\n\n
\n", ""], ["L8310", "
TRUSS DOUBLE W/ STANDARD PAD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 G
\n", "
\n
\n\n
\n", ""], ["L8320", "
TRUSS ADDITION TO STD PAD WA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 G
\n", "
\n
\n\n
\n", ""], ["L8330", "
TRUSS ADD TO STD PAD SCROTAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 G
\n", "
\n
\n\n
\n", ""], ["A4500", "
BELOW KNEE SURGICAL STOCKING
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
400 E
\n", "
\n
\n\n
\n", ""], ["E0255", "
HOSPITAL BED VAR HT W/ MATTR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 C
\n", "
\n
\n\n
\n", ""], ["L8400", "
SHEATH, BELOW KNEE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
999 A
\n", "
\n
\n\n
\n", ""], ["L8410", "
SHEATH, ABOVE KNEE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
999 A
\n", "
\n
\n\n
\n", ""], ["L8415", "
SHEATH UPPER LIMB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
999 A
\n", "
\n
\n\n
\n", ""], ["L8420", "
SOCK, PROSTHETIC, BK
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
999 A
\n", "
\n
\n\n
\n", ""], ["L8430", "
SOCK, PROSTHETIC, AK
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
999 A
\n", "
\n
\n\n
\n", ""], ["L8435", "
SOCK, PROSTHETIC, UE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
999 A
\n", "
\n
\n\n
\n", ""], ["L8440", "
SHRINKER BELOW KNEE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
999 A
\n", "
\n
\n\n
\n", ""], ["L7499", "
UPPER EXTREMITY PROSTH, NOS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L8470", "
STUMP SOCK SINGLE BELOW KNEE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
999 A
\n", "
\n
\n\n
\n", ""], ["E0256", "
HOSPITAL BED VAR HT W/O MATT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 C
\n", "
\n
\n\n
\n", ""], ["L8480", "
STUMP SOCK SINGLE ABOVE KNEE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
999 A
\n", "
\n
\n\n
\n", ""], ["L8485", "
STUMP SOCK FITTING UPPR LIMB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
999 A
\n", "
\n
\n\n
\n", ""], ["L8614", "
COCHLEAR DEVICE/SYSTEM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
960 A
\n", "
\n
\n\n
\n", ""], ["V2020", "
VISION SVCS FRAMES PURCHASES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2025", "
EYEGLASSES DELUX FRAMES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2100", "
LENS SPHER SINGLE PLANO 4.00
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2101", "
SINGLE VISN SPHERE 4.12-7.00
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2102", "
SINGL VISN SPHERE 7.12-20.00
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2103", "
SPHEROCYLINDR 4.00D/12-2.00D
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["E0260", "
HOSP BED SEMI-ELECTR W/ MATT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 D
\n", "
\n
\n\n
\n", ""], ["V2104", "
SPHEROCYLINDR 4.00D/2.12-4D
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2105", "
SPHEROCYLINDER 4.00D/4.25-6D
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2106", "
SPHEROCYLINDER 4.00D/>6.00D
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2107", "
SPHEROCYLINDER 4.25D/12-2D
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2108", "
SPHEROCYLINDER 4.25D/2.12-4D
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2109", "
SPHEROCYLINDER 4.25D/4.25-6D
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2110", "
SPHEROCYLINDER 4.25D/OVER 6D
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2111", "
SPHEROCYLINDR 7.25D/.25-2.25
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2112", "
SPHEROCYLINDR 7.25D/2.25-4D
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2113", "
SPHEROCYLINDR 7.25D/4.25-6D
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["E0261", "
HOSP BED SEMI-ELECTR W/O MAT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 D
\n", "
\n
\n\n
\n", ""], ["V2114", "
SPHEROCYLINDER OVER 12.00D
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2115", "
LENS LENTICULAR BIFOCAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2116", "
NONASPHERIC LENS BIFOCAL
\n", "", "", "
V2199
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2117", "
ASPHERIC LENS BIFOCAL
\n", "", "", "
V2199
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2200", "
LENS SPHER BIFOC PLANO 4.00D
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2201", "
LENS SPHERE BIFOCAL 4.12-7.0
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2202", "
LENS SPHERE BIFOCAL 7.12-20.
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2203", "
LENS SPHCYL BIFOCAL 4.00D/.1
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["E0265", "
HOSP BED TOTAL ELECTR W/ MAT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 D
\n", "
\n
\n\n
\n", ""], ["V2204", "
LENS SPHCY BIFOCAL 4.00D/2.1
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2205", "
LENS SPHCY BIFOCAL 4.00D/4.2
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2206", "
LENS SPHCY BIFOCAL 4.00D/OVE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2207", "
LENS SPHCY BIFOCAL 4.25-7D/.
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2208", "
LENS SPHCY BIFOCAL 4.25-7/2.
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2209", "
LENS SPHCY BIFOCAL 4.25-7/4.
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2210", "
LENS SPHCY BIFOCAL 4.25-7/OV
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2211", "
LENS SPHCY BIFO 7.25-12/.25-
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2212", "
LENS SPHCYL BIFO 7.25-12/2.2
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2213", "
LENS SPHCYL BIFO 7.25-12/4.2
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["E0266", "
HOSP BED TOTAL ELEC W/O MATT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 D
\n", "
\n
\n\n
\n", ""], ["V2214", "
LENS SPHCYL BIFOCAL OVER 12.
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2215", "
LENS LENTICULAR BIFOCAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2216", "
LENS LENTICULAR NONASPHERIC
\n", "", "", "
V2299
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2217", "
LENS LENTICULAR ASPHERIC BIF
\n", "", "", "
V2299
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2218", "
LENS ANISEIKONIC BIFOCAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2219", "
LENS BIFOCAL SEG WIDTH OVER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2220", "
LENS BIFOCAL ADD OVER 3.25D
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2299", "
LENS BIFOCAL SPECIALITY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2300", "
LENS SPHERE TRIFOCAL 4.00D
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2301", "
LENS SPHERE TRIFOCAL 4.12-7.
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["E0270", "
HOSPITAL BED INSTITUTIONAL T
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 D
\n", "
\n
\n\n
\n", ""], ["V2302", "
LENS SPHERE TRIFOCAL 7.12-20
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2303", "
LENS SPHCY TRIFOCAL 4.0/.12-
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2304", "
LENS SPHCY TRIFOCAL 4.0/2.25
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2305", "
LENS SPHCY TRIFOCAL 4.0/4.25
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2306", "
LENS SPHCYL TRIFOCAL 4.00/>6
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2307", "
LENS SPHCY TRIFOCAL 4.25-7/.
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2308", "
LENS SPHC TRIFOCAL 4.25-7/2.
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2309", "
LENS SPHC TRIFOCAL 4.25-7/4.
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2310", "
LENS SPHC TRIFOCAL 4.25-7/>6
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2311", "
LENS SPHC TRIFO 7.25-12/.25-
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["E0271", "
MATTRESS INNERSPRING
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 E
\n", "
\n
\n\n
\n", ""], ["V2312", "
LENS SPHC TRIFO 7.25-12/2.25
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2313", "
LENS SPHC TRIFO 7.25-12/4.25
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2314", "
LENS SPHCYL TRIFOCAL OVER 12
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2315", "
LENS LENTICULAR TRIFOCAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2316", "
LENS LENTICULAR NONASPHERIC
\n", "", "", "
V2399
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2317", "
LENS LENTICULAR ASPHERIC TRI
\n", "", "", "
V2399
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2318", "
LENS ANISEIKONIC TRIFOCAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2319", "
LENS TRIFOCAL SEG WIDTH > 28
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2320", "
LENS TRIFOCAL ADD OVER 3.25D
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2399", "
LENS TRIFOCAL SPECIALITY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["E0272", "
MATTRESS FOAM RUBBER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 E
\n", "
\n
\n\n
\n", ""], ["V2410", "
LENS VARIAB ASPHERICITY SING
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2430", "
LENS VARIABLE ASPHERICITY BI
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2499", "
VARIABLE ASPHERICITY LENS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2500", "
CONTACT LENS PMMA SPHERICAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
600 D
\n", "
\n
\n\n
\n", ""], ["V2501", "
CNTCT LENS PMMA-TORIC/PRISM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
600 D
\n", "
\n
\n\n
\n", ""], ["V2502", "
CONTACT LENS PMMA BIFOCAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
600 D
\n", "
\n
\n\n
\n", ""], ["V2503", "
CNTCT LENS PMMA COLOR VISION
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
600 D
\n", "
\n
\n\n
\n", ""], ["V2510", "
CNTCT GAS PERMEABLE SPHERICL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
600 D
\n", "
\n
\n\n
\n", ""], ["V2511", "
CNTCT TORIC PRISM BALLAST
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
600 D
\n", "
\n
\n\n
\n", ""], ["V2512", "
CNTCT LENS GAS PERMBL BIFOCL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
600 D
\n", "
\n
\n\n
\n", ""], ["E0273", "
BED BOARD
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 G
\n", "
\n
\n\n
\n", ""], ["V2513", "
CONTACT LENS EXTENDED WEAR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
600 D
\n", "
\n
\n\n
\n", ""], ["V2520", "
CONTACT LENS HYDROPHILIC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
600 D
\n", "
\n
\n\n
\n", ""], ["V2521", "
CNTCT LENS HYDROPHILIC TORIC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
600 D
\n", "
\n
\n\n
\n", ""], ["V2522", "
CNTCT LENS HYDROPHIL BIFOCL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
600 D
\n", "
\n
\n\n
\n", ""], ["V2523", "
CNTCT LENS HYDROPHIL EXTEND
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
600 D
\n", "
\n
\n\n
\n", ""], ["V2530", "
CONTACT LENS GAS IMPERMEABLE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
600 D
\n", "
\n
\n\n
\n", ""], ["V2599", "
CONTACT LENS/ES OTHER TYPE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
600 D
\n", "
\n
\n\n
\n", ""], ["V2600", "
HAND HELD LOW VISION AIDS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["V2610", "
SINGLE LENS SPECTACLE MOUNT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["V2615", "
TELESCOP/OTHR COMPOUND LENS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["A4510", "
FULL LENGTH SURG STOCKING
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
400 E
\n", "
\n
\n\n
\n", ""], ["E0274", "
OVER-BED TABLE
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 G
\n", "
\n
\n\n
\n", ""], ["V2623", "
PLASTIC EYE PROSTH CUSTOM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
700 A
\n", "
\n
\n\n
\n", ""], ["V2624", "
POLISHING ARTIFICAL EYE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
700 A
\n", "
\n
\n\n
\n", ""], ["V2625", "
ENLARGEMNT OF EYE PROSTHESIS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
700 A
\n", "
\n
\n\n
\n", ""], ["V2626", "
REDUCTION OF EYE PROSTHESIS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
700 A
\n", "
\n
\n\n
\n", ""], ["V2627", "
SCLERAL COVER SHELL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
700 A
\n", "
\n
\n\n
\n", ""], ["V2628", "
FABRICATION & FITTING
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
700 C
\n", "
\n
\n\n
\n", ""], ["V2629", "
PROSTHETIC EYE OTHER TYPE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
700 A
\n", "
\n
\n\n
\n", ""], ["V2700", "
BALANCE LENS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2710", "
GLASS/PLASTIC SLAB OFF PRISM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2715", "
PRISM LENS/ES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["E0275", "
BED PAN STANDARD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
999 A
\n", "
\n
\n\n
\n", ""], ["V2718", "
FRESNELL PRISM PRESS-ON LENS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2730", "
SPECIAL BASE CURVE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2740", "
ROSE TINT PLASTIC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2741", "
NON-ROSE TINT PLASTIC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2742", "
ROSE TINT GLASS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2743", "
NON-ROSE TINT GLASS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2744", "
TINT PHOTOCHROMATIC LENS/ES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2750", "
ANTI-REFLECTIVE COATING
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2755", "
UV LENS/ES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2760", "
SCRATCH RESISTANT COATING
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["E0276", "
BED PAN FRACTURE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
999 A
\n", "
\n
\n\n
\n", ""], ["V2770", "
OCCLUDER LENS/ES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2780", "
OVERSIZE LENS/ES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
600 1
\n", "
\n
\n\n
\n", ""], ["V5014", "
HEARING AID REPAIR/MODIFYING
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 C
\n", "", "
\n
\n\n
\n", ""], ["V5030", "
BODY-WORN HEARING AID AIR
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 C
\n", "
600 B
\n", "
\n
\n\n
\n", ""], ["V5040", "
BODY-WORN HEARING AID BONE
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 C
\n", "
600 B
\n", "
\n
\n\n
\n", ""], ["V5050", "
HEARING AID MONAURAL IN EAR
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 C
\n", "
600 B
\n", "
\n
\n\n
\n", ""], ["V5060", "
BEHIND EAR HEARING AID
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 C
\n", "
600 B
\n", "
\n
\n\n
\n", ""], ["V5070", "
GLASSES AIR CONDUCTION
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 C
\n", "
600 B
\n", "
\n
\n\n
\n", ""], ["V5080", "
GLASSES BONE CONDUCTION
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 C
\n", "
600 B
\n", "
\n
\n\n
\n", ""], ["V5090", "
H/A DISPENSING FEE UNILATERAL
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 C
\n", "", "
\n
\n\n
\n", ""], ["E0277", "
POWERED PRESS-REDUCING AIR MAT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 F
\n", "
\n
\n\n
\n", ""], ["V5100", "
BODY-WORN BILAT HEARING AID
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 C
\n", "
600 B
\n", "
\n
\n\n
\n", ""], ["V5110", "
H/A DISPENSING FEE BILATERAL
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 C
\n", "", "
\n
\n\n
\n", ""], ["V5120", "
BODY-WORN BINAUR HEARING AID
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 C
\n", "
600 B
\n", "
\n
\n\n
\n", ""], ["V5130", "
IN EAR BINAURAL HEARING AID
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 C
\n", "
600 B
\n", "
\n
\n\n
\n", ""], ["V5140", "
BEHIND EAR BINAUR HEARING AI
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 C
\n", "
600 B
\n", "
\n
\n\n
\n", ""], ["V5150", "
GLASSES BINAURAL HEARING AID
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 C
\n", "
600 B
\n", "
\n
\n\n
\n", ""], ["V5160", "
DISPENSING FEE BINAURAL
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 C
\n", "", "
\n
\n\n
\n", ""], ["V5170", "
WITHIN EAR CROS HEARING AID
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 C
\n", "
600 B
\n", "
\n
\n\n
\n", ""], ["V5180", "
BEHIND EAR CROS HEARING AID
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 C
\n", "
600 B
\n", "
\n
\n\n
\n", ""], ["V5190", "
GLASSES CROS HEARING AID
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 C
\n", "
600 B
\n", "
\n
\n\n
\n", ""], ["E0280", "
BED CRADLE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 G
\n", "
\n
\n\n
\n", ""], ["V5200", "
CROS HEARING AID DISPENS FEE
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 C
\n", "", "
\n
\n\n
\n", ""], ["V5210", "
IN EAR BICROS HEARING AID
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 C
\n", "
600 B
\n", "
\n
\n\n
\n", ""], ["V5220", "
BEHIND EAR BICROS HEARING AI
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 C
\n", "
600 B
\n", "
\n
\n\n
\n", ""], ["V5230", "
GLASSES BICROS HEARING AID
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 C
\n", "
600 B
\n", "
\n
\n\n
\n", ""], ["V5240", "
DISPENSING FEE BICROS
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 C
\n", "", "
\n
\n\n
\n", ""], ["L8490", "
AIR SEAL SUCTION RETEN SYSTM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
999 A
\n", "
\n
\n\n
\n", ""], ["V2199", "
LENS SINGLE VISION NOT OTH C
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["L3964", "
SEO MOBILE ARM SUP ATT TO WC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L3610", "
TRANS SHOE CALIPER PLATE NEW
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "", "
\n
\n\n
\n", ""], ["E0290", "
HOSP BED FX HT W/O RAILS W/M
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 C
\n", "
\n
\n\n
\n", ""], ["L2184", "
LIMITED MOTION KNEE JOINT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L2350", "
PROSTHETIC TYPE SOCKET MOLDE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 A
\n", "
\n
\n\n
\n", ""], ["A5500", "
DIAB SHOE FOR DENSITY INSERT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 A
\n", "
500 B
\n", "
\n
\n\n
\n", ""], ["A5501", "
DIABETIC CUSTOM MOLDED SHOE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 A
\n", "
500 C
\n", "
\n
\n\n
\n", ""], ["A5502", "
DIABETIC SHOE DENSITY INSERT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R50 A
\n", "
500 E
\n", "
\n
\n\n
\n", ""], ["A5503", "
DIABETIC SHOE W/ROLLER/ROCKR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 A
\n", "
500 D
\n", "
\n
\n\n
\n", ""], ["A5504", "
DIABETIC SHOE WITH WEDGE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 A
\n", "
500 D
\n", "
\n
\n\n
\n", ""], ["A5505", "
DIAB SHOE W/METATARSAL BAR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 A
\n", "
500 D
\n", "
\n
\n\n
\n", ""], ["A5506", "
DIABETIC SHOE W/OFF SET HEEL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 A
\n", "
500 D
\n", "
\n
\n\n
\n", ""], ["A5507", "
MODIFICATION DIABETIC SHOE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "
500 F
\n", "
\n
\n\n
\n", ""], ["E0291", "
HOSP BED FX HT W/O RAIL W/O
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 C
\n", "
\n
\n\n
\n", ""], ["K0175", "
DISPOSABLE CORRUGATED TUBING
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["K0176", "
NON DISPOS CORRUGATED TUBING
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["K0177", "
WATER COLLEC DEV W NEBULIZER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R91 C
\n", "
800 D
\n", "
\n
\n\n
\n", ""], ["K0178", "
DISPOSBL FILTER W COMPRESSOR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["K0179", "
NON-DISPOS FILTER W/COMPRESS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["K0180", "
AEROSOL MASK WITH NEBULIZER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R91 C
\n", "
800 D
\n", "
\n
\n\n
\n", ""], ["K0183", "
NASAL APPLICATION WITH CPAP
\n", "", "", "
A7034
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R91 C
\n", "
800 D
\n", "
\n
\n\n
\n", ""], ["K0184", "
NASAL SINGLE PIECE
\n", "", "", "
A7032
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R91 C
\n", "
800 D
\n", "
\n
\n\n
\n", ""], ["K0185", "
HEADGEAR WITH CPAP DEVICE
\n", "", "", "
A7035
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R91 C
\n", "
800 D
\n", "
\n
\n\n
\n", ""], ["K0186", "
CHIN STRAP WITH CPAP DEVICE
\n", "", "", "
A7036
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R91 C
\n", "
800 D
\n", "
\n
\n\n
\n", ""], ["E0292", "
HOSP BED VAR HT W/O RAIL W/O
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 C
\n", "
\n
\n\n
\n", ""], ["K0187", "
TUBING WITH CPAP DEVICE
\n", "", "", "
A7037
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["K0188", "
FILTER DISPOSABLE WITH CPAP
\n", "", "", "
A7038
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["K0190", "
DISPOSABLE CANISTER W/PUMP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["K0191", "
NON-DISPOSBL CANISTER W/PUMP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R91 C
\n", "
800 D
\n", "
\n
\n\n
\n", ""], ["K0192", "
TUBING USED W/ SUCTION PUMP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["K0193", "
AIRWAY PRESSURE DEV/W HMDFER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R91 C
\n", "
800 D
\n", "
\n
\n\n
\n", ""], ["K0194", "
ASSIST DEVICE W/HUMIDIFIER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R91 C
\n", "
800 D
\n", "
\n
\n\n
\n", ""], ["K0267", "
BATTERY GLUCOSE MONITOR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0268", "
HUMIDIFIER WITH CPAP DEVICE
\n", "", "", "
E0561
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R91 C
\n", "
800 D
\n", "
\n
\n\n
\n", ""], ["K0269", "
AEROSOL COMPRESSOR CPAP DEV
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0293", "
HOSP BED VAR HT W/O RAIL W/
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 C
\n", "
\n
\n\n
\n", ""], ["K0271", "
DRAINABLE POUCH W/ FACEPLATE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0272", "
DRAINABLE POUCH W/O FACEPL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0273", "
URINARY POUCH W/FACEPLATE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0274", "
URINARY POUCH W/O FACEPLATE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0275", "
OSTOMY FACEPLATE REUSUABLE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0276", "
OSTOMY FACEPLAT CUSTOM REUSE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0277", "
SKIN BARRIER SOLID 4X4 EQUIV
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0278", "
SKIN BARRIER WITH FLANGE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0279", "
SKIN BARRIER EXTENDED WEAR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0280", "
EXTENSION DRAINAGE TUBING
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["E0294", "
HOSP BED SEMI-ELECT W/ MATTR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 D
\n", "
\n
\n\n
\n", ""], ["K0281", "
LUBRICANT CATHETER INSERTION
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0284", "
EXTERNAL INFUSION PUMP REUSE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["L3890", "
TORSION MECHANISM WRIST/ELBO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
\n", ""], ["L3224", "
WOMAN'S SHOE OXFORD BRACE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 A
\n", "
500 B
\n", "
\n
\n\n
\n", ""], ["L3225", "
MAN'S SHOE OXFORD BRACE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 A
\n", "
500 B
\n", "
\n
\n\n
\n", ""], ["E1699", "
DIALYSIS EQUIPMENT UNSPECIFI
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R70
\n", "
920 A
\n", "
\n
\n\n
\n", ""], ["V5299", "
HEARING SERVICE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "
\n
\n\n
\n", "
R90
\n", "
600 E
\n", "
\n
\n\n
\n", ""], ["D2999", "
DENTAL UNSPEC RESTORATIVE PR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
700 B
\n", "
\n
\n\n
\n", ""], ["A4913", "
DIALYSIS SUPP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
920 B
\n", "
\n
\n\n
\n", ""], ["A4556", "
ELECTRODES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["E0295", "
HOSP BED SEMI-ELECT W/O MATT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 D
\n", "
\n
\n\n
\n", ""], ["E0296", "
HOSP BED TOTAL ELECT W/ MATT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 D
\n", "
\n
\n\n
\n", ""], ["E0297", "
HOSP BED TOTAL ELECT W/O MAT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 D
\n", "
\n
\n\n
\n", ""], ["E0305", "
RAILS BED SIDE HALF LENGTH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 G
\n", "
\n
\n\n
\n", ""], ["E0310", "
RAILS BED SIDE FULL LENGTH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 G
\n", "
\n
\n\n
\n", ""], ["E0315", "
BED ACCESSORY BRD/TBL/SUPPRT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 G
\n", "
\n
\n\n
\n", ""], ["E0424", "
STATIONARY COMPRESSED GAS 02
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R91 E
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["E0425", "
GAS SYSTEM STATIONARY COMPRE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R91 C
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["E0430", "
OXYGEN SYSTEM GAS PORTABLE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R91 C
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["E0431", "
PORTABLE GASEOUS 02
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R91 C
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["A4557", "
LEAD WIRES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["E0434", "
PORTABLE LIQUID 02
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R91 G
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["E0435", "
OXYGEN SYSTEM LIQUID PORTABL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R91 G
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["E0439", "
STATIONARY LIQUID 02
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R91 G
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["E0440", "
OXYGEN SYSTEM LIQUID STATION
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R91 G
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["E0441", "
OXYGEN CONTENTS GASEOUS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R91 E
\n", "", "
\n
\n\n
\n", ""], ["E0442", "
OXYGEN CONTENTS, LIQ
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R91 F
\n", "", "
\n
\n\n
\n", ""], ["E0443", "
PORT 02 CONTENTS GASEOUS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R91 E
\n", "", "
\n
\n\n
\n", ""], ["E0444", "
PORT 02 CONTENTS LIQUID
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R91 F
\n", "", "
\n
\n\n
\n", ""], ["E0450", "
VOLUME VENT STATIONARY/PORTA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R91 B
\n", "
800 F
\n", "
\n
\n\n
\n", ""], ["E0452", "
INTERMIT ASSIS DEVICE W CPAP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R91 C
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["A4558", "
CONDUCTIVE PASTE OR GEL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["E0453", "
VENTILATOR 12 HRS/LESS PER D
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R91 B
\n", "
800 F
\n", "
\n
\n\n
\n", ""], ["E0455", "
OXYGEN TENT EXCL CROUP/PED T
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R91 C
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["E0457", "
CHEST SHELL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R91 C
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["E0459", "
CHEST WRAP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R91 C
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["E0460", "
NEG PRESS VENT PORTABL/STATN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R91 B
\n", "
800 F
\n", "
\n
\n\n
\n", ""], ["E0462", "
ROCKING BED W/ OR W/O SIDE R
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 D
\n", "
\n
\n\n
\n", ""], ["E0480", "
PERCUSSOR ELECT/PNEUM HOME M
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0500", "
IPPB ALL TYPES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0550", "
HUMIDIF EXTENS SUPPLE W IPPB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R91 C
\n", "
800 D
\n", "
\n
\n\n
\n", ""], ["E0555", "
HUMIDIFIER FOR USE W/ REGULA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R91 C
\n", "
800 D
\n", "
\n
\n\n
\n", ""], ["A4565", "
SLINGS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
999 A
\n", "
\n
\n\n
\n", ""], ["E0565", "
COMPRESSOR AIR POWER SOURCE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R91 C
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["E0570", "
NEBULIZER WITH COMPRESSOR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R91 C
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["E0575", "
NEBULIZER ULTRASONIC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R91 C
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["E0580", "
NEBULIZER FOR USE W/ REGULAT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R91 C
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["E0585", "
NEBULIZER W/ COMPRESSOR & HE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R91 C
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["E0600", "
SUCTION MACHINE RESPIRATORY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R91 C
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["E0601", "
CONT AIRWAY PRESSURE DEVICE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R91 C
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["E0605", "
VAPORIZER ROOM TYPE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R91 C
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["E0607", "
BLOOD GLUCOSE MONITOR HOME
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["A4570", "
SPLINT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["E0609", "
BLOOD GLUC MON W/SPECIAL FEA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0621", "
PATIENT LIFT SLING OR SEAT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 A
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["E0625", "
PATIENT LIFT BATHROOM OR TOI
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 A
\n", "
900 B
\n", "
\n
\n\n
\n", ""], ["E0627", "
SEAT LIFT INCORP LIFT-CHAIR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0628", "
SEAT LIFT FOR PT FURN-ELECTR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0629", "
SEAT LIFT FOR PT FURN-NON-EL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0630", "
PATIENT LIFT HYDRAULIC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 A
\n", "
900 B
\n", "
\n
\n\n
\n", ""], ["E0635", "
PATIENT LIFT ELECTRIC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 A
\n", "
900 B
\n", "
\n
\n\n
\n", ""], ["E0650", "
PNEUMA COMPRESOR NON-SEGMENT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0651", "
PNEUM COMPRESSOR SEGMENTAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["A4572", "
RIB BELT
\n", "", "", "
L0210
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 G
\n", "
\n
\n\n
\n", ""], ["E0652", "
PNEUM COMPRES W/CAL PRESSURE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0655", "
PNEUMATIC APPLIANCE HALF ARM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["E0660", "
PNEUMATIC APPLIANCE FULL LEG
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["E0665", "
PNEUMATIC APPLIANCE FULL ARM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["E0666", "
PNEUMATIC APPLIANCE HALF LEG
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["E0667", "
SEG PNEUMATIC APPL FULL LEG
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["E0668", "
SEG PNEUMATIC APPL FULL ARM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["E0669", "
SEG PNEUMATIC APPLI HALF LEG
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["#SHIP", "
SHIPPING CHARGES
\n", "", "", "", "", "", "", "", "", "", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90 A
\n", "", "
\n
\n\n
\n", ""], ["E0700", "
SAFETY EQUIPMENT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
999 A
\n", "
\n
\n\n
\n", ""], ["A4265", "
PARAFFIN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4611", "
HEAVY DUTY BATTERY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 B
\n", "
\n
\n\n
\n", ""], ["E0720", "
TENS TWO LEAD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0730", "
TENS FOUR LEAD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0731", "
CONDUCTIVE GARMENT FOR TENS/
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 J
\n", "
\n
\n\n
\n", ""], ["E0776", "
IV POLE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0115", "
CRUTCH, UNDERARM INCLUDES CR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 A
\n", "
\n
\n\n
\n", ""], ["E0120", "
CRUTCH UNDERARM INCLUDES CRU
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 A
\n", "
\n
\n\n
\n", ""], ["E0781", "
EXTERNAL AMBULATORY INFUS PU
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0140", "
WALKER W TRUNK SUPPORT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
900 A
\n", "
\n
\n\n
\n", ""], ["E0150", "
UNDERARM PAD, CRUTCH, REPLAC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
999 A
\n", "
\n
\n\n
\n", ""], ["E0151", "
HANDGRIP,CANE, CRUTCH, OR WA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
999 A
\n", "
\n
\n\n
\n", ""], ["E0152", "
TIP, CANE, CRUTCH, WALKER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
999 A
\n", "
\n
\n\n
\n", ""], ["E0170", "
COMMODE CHAIR, STATIONARY WI
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 I
\n", "
\n
\n\n
\n", ""], ["E0183", "
FLOTATION PAD FOR WHEELCHAIR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
100 F
\n", "
\n
\n\n
\n", ""], ["E0190", "
POSITIONING CUSHION
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0195", "
REPLACEMENT PAD FOR USE WITH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
999 A
\n", "
\n
\n\n
\n", ""], ["E0202", "
PHOTOTHERAPY LIGHT W/ PHOTOM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0220", "
HOT WATER BOTTLE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["E0840", "
TRACT FRAME ATTACH HEADBOARD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 G
\n", "
\n
\n\n
\n", ""], ["E0230", "
ICE CAP OR COLLAR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["E0240", "
BATH/SHOWER CHAIR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
900 I
\n", "
\n
\n\n
\n", ""], ["E0252", "
HOSPITAL BED, FIXED HEIGHT,
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 C
\n", "
\n
\n\n
\n", ""], ["E0300", "
MATTRESS, REPLACEMENT FOR ME
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 E
\n", "
\n
\n\n
\n", ""], ["E0320", "
BEDPAN, INCLUDES FRACTURE AN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R80 C
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["E0325", "
URINAL MALE JUG-TYPE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["E0330", "
URINAL, MALE, DAY/NIGHT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["E0352", "
DISPOSABLE PACK W/BOWEL SYST
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["E0400", "
OXYGEN CONTENTS, GASEOUS, PE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R91 C
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["E0405", "
OXYGEN CONTENTS, GASEOUS, PE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R91 C
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["E0850", "
TRACTION STAND FREE STANDING
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0410", "
OXYGEN CONTENTS, LIQUID, PER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R91 C
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["E0415", "
OXYGEN CONTENTS, LIQUID, PER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R91 C
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["E0416", "
OXYGEN REFILL FOR PORTABLE G
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R91 C
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["E0420", "
OXYGEN CYLINDER, DEMURRAGE O
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
800 A
\n", "
\n
\n\n
\n", ""], ["E0445", "
OXIMETER MSR BLD O2 LVL NO-INV
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
800 A
\n", "
\n
\n\n
\n", ""], ["E0451", "
VOLUME VENTILATOR; PORTABLE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R91 B
\n", "
800 F
\n", "
\n
\n\n
\n", ""], ["E0458", "
NEGATIVE PRESSURE PUMP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0505", "
IPPB MACHINES WITH MANUAL VA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0510", "
IPPB MACHINES WITH AUTOMATIC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0515", "
IPPB MACHINES WITH AUTOMATIC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0860", "
TRACT EQUIP CERVICAL TRACT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0608", "
APNEA MONITOR
\n", "", "", "
E0618
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0610", "
PACEMAKER MONITR AUDIBLE/VIS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0620", "
SEAT LIFT CHAIR, MOTORIZED T
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0671", "
PRESSURE PNEUM APPL FULL LEG
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["E0672", "
PRESSURE PNEUM APPL FULL ARM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["E0710", "
RESTRAINTS ANY TYPE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
999 A
\n", "
\n
\n\n
\n", ""], ["E0870", "
TRACT FRAME ATTACH FOOTBOARD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 G
\n", "
\n
\n\n
\n", ""], ["E0784", "
EXT AMB INFUSN PUMP INSULIN
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0925", "
CONTINUOUS PASSIVE MOTION DE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0935", "
EXERCISE DEVICE PASSIVE MOTI
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0956", "
W/C LATERAL TRUNK/HIP SUPPORT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E0880", "
TRAC STAND FREE STAND EXTREM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 G
\n", "
\n
\n\n
\n", ""], ["E1010", "
ADD POWER LEG ELEVATION
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E1020", "
RESID LIMB SUPP SYS FOR W/C
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E1030", "
W/C VENT TRAY GIMBALED
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E1035", "
GERIATRIC CHAIR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E1036", "
POSITIONING CHAIR (SUBMIT BR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E1040", "
ROLLABOUT CHAIR, WITH FIXED
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["E1067", "
PROPORTIONAL CONTROL DEVICE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E1068", "
BATTERY, EACH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
999 A
\n", "
\n
\n\n
\n", ""], ["E1080", "
MOTORIZED WHEELCHAIR, WITH M
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 A
\n", "
\n
\n\n
\n", ""], ["A4612", "
BATTERY CABLES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "", "
\n
\n\n
\n", ""], ["E0890", "
TRACTION FRAME ATTACH PELVIC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 G
\n", "
\n
\n\n
\n", ""], ["E1081", "
MOTORIZED WHEELCHAIR, WITH M
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 A
\n", "
\n
\n\n
\n", ""], ["E1082", "
MOTORIZED WHEELCHAIR, WITH M
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 A
\n", "
\n
\n\n
\n", ""], ["E1091", "
WHEELCHAIR YOUTH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", "
1
\n"], ["E1120", "
SEMI-RECLINING WHEELCHAIR, D
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["E1299", "
SPECIAL WHEELCHAIR SEAT WIDT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["E1350", "
OXYGEN REPAIR OR SERVICE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "", "
\n
\n\n
\n", ""], ["E1351", "
CANNULA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["E1352", "
TUBING, UNSPECIFIED LENGTH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["E1354", "
MOUTH PIECE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["E1356", "
BREATHING CIRCUITS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["E0900", "
TRAC STAND FREE STAND PELVIC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 G
\n", "
\n
\n\n
\n", ""], ["E1360", "
REPLACEMENT, SUPPLY OR ACCES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R80 C
\n", "
800 D
\n", "
\n
\n\n
\n", ""], ["E1370", "
COMPRESSED AIR CYLINDER PER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
800 D
\n", "
\n
\n\n
\n", ""], ["E1372", "
IMMERSION EXTERNAL HEATER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R91 C
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["E1373", "
TRACHEOTOMY MASK OR COLLAR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R80 C
\n", "
800 D
\n", "
\n
\n\n
\n", ""], ["E1374", "
VARIABLE CONCENTRATION MASK
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R80 C
\n", "
800 D
\n", "
\n
\n\n
\n", ""], ["E1376", "
OXYGEN CONCENTRATOR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
800 B
\n", "
\n
\n\n
\n", ""], ["E1388", "
OXYGEN CONCENTRATOR, EQUIVAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
800 B
\n", "
\n
\n\n
\n", ""], ["E1389", "
OXYGEN CONCENTRATOR, EQUIVAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
800 B
\n", "
\n
\n\n
\n", ""], ["E1390", "
OXYGEN CONCENTRATOR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R91 A
\n", "
800 B
\n", "
\n
\n\n
\n", ""], ["E1393", "
OXYGEN CONCENTRATOR, EQUIVAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
800 B
\n", "
\n
\n\n
\n", ""], ["E0910", "
TRAPEZE BAR ATTACHED TO BED
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 G
\n", "
\n
\n\n
\n", ""], ["E1394", "
OXYGEN CONCENTRATOR, EQUIVAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
800 B
\n", "
\n
\n\n
\n", ""], ["E1396", "
OXYGEN CONCENTRATOR, EQUIVAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
800 B
\n", "
\n
\n\n
\n", ""], ["E1397", "
OXYGEN CONCENTRATOR, HIGH HU
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
800 B
\n", "
\n
\n\n
\n", ""], ["E1500", "
CENTRIFUGE DIALYSIS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R70
\n", "
920 A
\n", "
\n
\n\n
\n", ""], ["E1530", "
REPLACEMENT AIR BUBBLE DETEC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R70
\n", "
920 A
\n", "
\n
\n\n
\n", ""], ["E1550", "
BATH CONDUCTIVITY METER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R70
\n", "
920 A
\n", "
\n
\n\n
\n", ""], ["E1570", "
ADJUSTABLE CHAIR FOR ESRD PT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R70
\n", "
920 A
\n", "
\n
\n\n
\n", ""], ["E1594", "
CYCLER DIALYSIS MACHINE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R70
\n", "
920 A
\n", "
\n
\n\n
\n", ""], ["E1600", "
DELIV/INSTALL EQUIP FOR DIAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R70
\n", "
920 B
\n", "
\n
\n\n
\n", ""], ["E1610", "
REVERSE OSMOSIS WATER PURIFI
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R70
\n", "
920 A
\n", "
\n
\n\n
\n", ""], ["E0920", "
FRACTURE FRAME ATTACHED TO B
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 G
\n", "
\n
\n\n
\n", ""], ["E1615", "
DEIONIZER WATER PURIFICATION
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R70
\n", "
920 A
\n", "
\n
\n\n
\n", ""], ["E1701", "
REPL CUSHIONS FOR JAW MOTION
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["E1800", "
DYNAMIC ADJUST ELBOW EX/FL DEV
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["E1805", "
DYNAMIC ADJ WRIST E/F DEVICE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["E1810", "
DYNAMIC ADJ KNEE E/F DEVICE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["E1815", "
ADJUST ANKLE EXT/FLEX DEVICE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["E1820", "
SOFT INTERFACE MATERIAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["E1825", "
DYNAMIC ADJ FINGER E/F DEV
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["E1830", "
DYNAMIC ADJ TOE E/F DEV
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["E0930", "
FRACTURE FRAME FREE STANDING
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 G
\n", "
\n
\n\n
\n", ""], ["E0940", "
TRAPEZE BAR FREE STANDING
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 G
\n", "
\n
\n\n
\n", ""], ["K0111", "
EXTERNAL DRUG INFUSION PUMP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["K0118", "
TENS SUPPLIES - ONE MONTH SU
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0126", "
REPLACE MULTI-PODUS SPLINT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["K0127", "
REPLACE ANKLE CONTRAC SPLINT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 A
\n", "
\n
\n\n
\n", ""], ["K0128", "
REPLACE FOOT DROP SPLINT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 A
\n", "
\n
\n\n
\n", ""], ["K0129", "
ANKLE CONTRACTURE SPLINT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 A
\n", "
\n
\n\n
\n", ""], ["K0130", "
FOOT DROP SPLINT RECUMBENT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 A
\n", "
\n
\n\n
\n", ""], ["K0134", "
INTERMITTENT URINARY CATHETE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["E0941", "
GRAVITY ASSISTED TRACTION DE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 G
\n", "
\n
\n\n
\n", ""], ["K0137", "
SKIN BARRIER LIQUID PER OZ
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0138", "
SKIN BARRIER PASTE PER OZ
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0139", "
SKIN BARRIER POWDER PER OZ
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0152", "
PASTE/POWDRS/GRANULS/BEADS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0162", "
PROGRESSIVE LENS, EACH LENS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
600 D
\n", "
\n
\n\n
\n", ""], ["K0165", "
TRACHEOSTOMY CARE KIT FOR ES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["E0942", "
CERVICAL HEAD HARNESS/HALTER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 G
\n", "
\n
\n\n
\n", ""], ["K0168", "
DISPOSABLE NEBULIZER SET
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
900 K
\n", "
\n
\n\n
\n", ""], ["K0169", "
DISPOSABLE NEBULIZER SMALL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
900 K
\n", "
\n
\n\n
\n", ""], ["K0170", "
NON DISPOSABLE NEBULIZER SET
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["K0171", "
FILTERED NEBULIZER SET
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["K0172", "
DISPOSABLE NEBULIZER UNFILL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
900 K
\n", "
\n
\n\n
\n", ""], ["K0174", "
RESERVOIR BOTTLE W NEBULIZER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["K0181", "
DOME & MOUTHPIECE W/ NEBULIZ
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R91 C
\n", "
800 D
\n", "
\n
\n\n
\n", ""], ["K0182", "
WATER DISTILLED W/ NEBULIZER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R91 C
\n", "
800 D
\n", "
\n
\n\n
\n", ""], ["K0189", "
FILTER NON-DISPOSABLE W/CPAP
\n", "", "", "
A7039
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R91 C
\n", "
800 D
\n", "
\n
\n\n
\n", ""], ["K0195", "
ELEVATING WHLCHAIR LEG RESTS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E0943", "
CERVICAL PILLOW
\n", "", "", "
DL191
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
999 A
\n", "
\n
\n\n
\n", ""], ["E0944", "
PELVIC BELT/HARNESS/BOOT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 G
\n", "
\n
\n\n
\n", ""], ["K0270", "
ULTRASONIC GENERATOR W NEBUL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["K0285", "
REPAIR PROSTHESIS PER 15 MIN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R20 D
\n", "
200 G
\n", "
\n
\n\n
\n", ""], ["K0400", "
SKIN SUPPORT ATTACHMENT EACH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4613", "
BATTERY CHARGER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "", "
\n
\n\n
\n", ""], ["E0945", "
BELT/HARNESS EXTREMITY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 G
\n", "
\n
\n\n
\n", ""], ["K0401", "
DIABETIC DELUXE SHOE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R50 C
\n", "
500 B
\n", "
\n
\n\n
\n", ""], ["K0408", "
URINARY CATH LEG STRAP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0410", "
MALE EXT CATH W/ADH COATING
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["L1885", "
KO, SINGLE/DBLE
\n", "", "", "
L1831
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 F
\n", "
\n
\n\n
\n", ""], ["L2035", "
KAFO PLASTIC PEDIATRIC SIZE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2100", "
ANKLE-FOOT-ORTHOSIS (AFO), F
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 A
\n", "
\n
\n\n
\n", ""], ["L2110", "
AFO, FRACTURE ORTHOSES, TIBI
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 A
\n", "
\n
\n\n
\n", ""], ["E0946", "
FRACTURE FRAME DUAL W CROSS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 G
\n", "
\n
\n\n
\n", ""], ["L2120", "
AFO, FRACTURE ORTHOSES, TIBI
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 A
\n", "
\n
\n\n
\n", ""], ["L2130", "
AFO FRACTURE ORTHOSES, TIBIA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 A
\n", "
\n
\n\n
\n", ""], ["L2140", "
KNEE-ANKLE-FOOT ORTHOSES (KA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2150", "
KAFO, FRACTURE ORTHOSES, FEM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2160", "
HIP-ANKLE-FOOT ORTHOSES (HAF
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L2186", "
ADJ MOTION KNEE JNT LERMAN T
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L2188", "
QUADRILATERAL BRIM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2190", "
WAIST BELT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2192", "
PELVIC BAND & BELT THIGH FLA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2200", "
LIMITED ANKLE MOTION EA JNT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["E0947", "
FRACTURE FRAME ATTACHMNTS PE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 G
\n", "
\n
\n\n
\n", ""], ["L2210", "
DORSIFLEXION ASSIST EACH JOI
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L2220", "
DORSI & PLANTAR FLEX ASS/RES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L2475", "
ADDITION TO KNEE JOINT, BAIL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "", "
\n
\n\n
\n", ""], ["L2495", "
ADDITIONS TO LOWER EXTREMITY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R20 B
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L2850", "
FEMORAL LGTH SOCK FX OR EQUA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "", "
\n
\n\n
\n", ""], ["L2860", "
TORSION MECHANISM KNEE/ANKLE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "", "
\n
\n\n
\n", ""], ["L3160", "
SHOE STYLED POSITIONING DEV
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["E0948", "
FRACTURE FRAME ATTACHMNTS CE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 G
\n", "
\n
\n\n
\n", ""], ["L3200", "
ORTHOPEDIC FOOTWEAR - L3200-
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "", "
\n
\n\n
\n", ""], ["L3201", "
OXFORD W SUPINAT/PRONAT INF
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 C
\n", "
500 D
\n", "
\n
\n\n
\n", ""], ["L3202", "
OXFORD W/ SUPINAT/PRONATOR C
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 C
\n", "
500 D
\n", "
\n
\n\n
\n", ""], ["L3203", "
OXFORD W/ SUPINATOR/PRONATOR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 C
\n", "
500 D
\n", "
\n
\n\n
\n", ""], ["L3204", "
HIGHTOP W/ SUPP/PRONATOR INF
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 C
\n", "
500 D
\n", "
\n
\n\n
\n", ""], ["L3206", "
HIGHTOP W/ SUPP/PRONATOR CHI
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 C
\n", "
500 D
\n", "
\n
\n\n
\n", ""], ["L3207", "
HIGHTOP W/ SUPP/PRONATOR JUN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 C
\n", "
500 D
\n", "
\n
\n\n
\n", ""], ["L3680", "
UPPER LIMB - ELBOW - L3700-L
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["E0950", "
TRAY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["L4220", "
REPLACEMENT PART FOR ORTHOTI
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "", "
\n
\n\n
\n", ""], ["L5110", "
BELOW KNEE, WOOD SOCKET, JOI
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R20 A
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L5550", "
PREPARATORY, ABOVE KNEE-KNEE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R20 A
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L5617", "
AK/BK SELF-ALIGNING UNIT EA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 D
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L5703", "
ALL LOWER EXTREMITY PROSTHES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R20 B
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L5708", "
ALL LOWER EXTREMITY PROSTHES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R20 B
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L5709", "
ALL LOWER EXTREMITY PROSTHES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R20 B
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L5930", "
HIGH ACTIVITY KNEE FRAME
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 A
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L6760", "
TERMINAL DEVICE,
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L6870", "
HAND CHILD MITT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["E0951", "
LOOP HEEL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["L7050", "
BELOW ELBOW, EXTERNAL POWER,
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R30
\n", "
300 F
\n", "
\n
\n\n
\n", ""], ["L7100", "
ELBOW DISARTICULATION, EXTER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R30
\n", "
300 F
\n", "
\n
\n\n
\n", ""], ["L7520", "
REPAIR PROSTHESIS PER 15 MIN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 D
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L8460", "
SHRINKER ABOVE KNEE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
999 A
\n", "
\n
\n\n
\n", ""], ["L8465", "
SHRINKER UPPER LIMB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
999 A
\n", "
\n
\n\n
\n", ""], ["L8499", "
UNLISTED MISC PROSTHETIC SER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R20 D
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L8500", "
ARTIFICIAL LARYNX
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
999 A
\n", "
\n
\n\n
\n", ""], ["L8501", "
TRACHEOSTOMY SPEAKING VALVE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["E0952", "
LOOP TOE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E0953", "
PNEUMATIC TIRE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E0954", "
WHEELCHAIR SEMI-PNEUMATIC CA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["A4615", "
CANNULA NASAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["E0959", "
AMPUTEE ADAPTER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E0961", "
WHEELCHAIR BRAKE EXTENSION
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E0962", "
WHEELCHAIR 1 INCH CUSHION
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
100 E
\n", "
\n
\n\n
\n", ""], ["E0963", "
WHEELCHAIR 2 INCH CUSHION
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
100 E
\n", "
\n
\n\n
\n", ""], ["E0964", "
WHEELCHAIR 3 INCH CUSHION
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
100 E
\n", "
\n
\n\n
\n", ""], ["E0965", "
WHEELCHAIR 4 INCH CUSHION
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
100 E
\n", "
\n
\n\n
\n", ""], ["E0966", "
WHEELCHAIR HEAD REST EXTENSI
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E0967", "
WHEELCHAIR HAND RIMS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E0968", "
WHEELCHAIR COMMODE SEAT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
900 I
\n", "
\n
\n\n
\n", ""], ["E0969", "
WHEELCHAIR NARROWING DEVICE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["V1000", "
EYE, ARTIFICIAL, REGULAR GLA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
700 A
\n", "
\n
\n\n
\n", ""], ["V1005", "
EYE, ARTIFICIAL, REGULAR PLA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
700 A
\n", "
\n
\n\n
\n", ""], ["V1010", "
EYE, ARTIFICIAL, CUSTOM MADE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
700 A
\n", "
\n
\n\n
\n", ""], ["V1035", "
CATARACT SPECTACLES, USUALLY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V1065", "
TRIFOCAL GLASSES, UNILATERAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V1070", "
TRIFOCAL GLASSES, BILATERAL,
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["A4616", "
TUBING (OXYGEN) PER FOOT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["E0970", "
WHEELCHAIR NO. 2 FOOTPLATES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["V1130", "
CATARACT LENSES, SPECTACLES,
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
600 1
\n", "
\n
\n\n
\n", ""], ["V1205", "
CATARACT LENSES, SPECTACLES,
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
600 1
\n", "
\n
\n\n
\n", ""], ["V1340", "
BALANCE LENSES, BALANCE WEIG
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
600 1
\n", "
\n
\n\n
\n", ""], ["V1355", "
READING GLASSES, POST CATARA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V1440", "
CATARACT LENS, SPECTACLES, U
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
600 1
\n", "
\n
\n\n
\n", ""], ["V1540", "
BIFOCAL LENSES, BILATERAL, W
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
600 1
\n", "
\n
\n\n
\n", ""], ["V1545", "
BIFOCAL LENSES, UNILATERAL,
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
600 1
\n", "
\n
\n\n
\n", ""], ["V1550", "
BIFOCAL LENSES, BILATERAL, W
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
600 1
\n", "
\n
\n\n
\n", ""], ["V1560", "
TRIFOCAL LENSES, BILATERAL,
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
600 1
\n", "
\n
\n\n
\n", ""], ["V1599", "
EYE PROSTHESIS, MISCELLANEOU
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 B
\n", "
700 A
\n", "
\n
\n\n
\n", ""], ["E0971", "
WHEELCHAIR ANTI-TIPPING DEVI
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["V2030", "
FRAMES, REPAIR OR PART REPLA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 B
\n", "", "
\n
\n\n
\n", ""], ["V2531", "
CONTACT LENS GAS PERMEABLE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
600 D
\n", "
\n
\n\n
\n", ""], ["V2621", "
PROSTHETIC, EYE PLASTIC, STO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
700 A
\n", "
\n
\n\n
\n", ""], ["V2622", "
PROSTHETIC, EYE, GLASS, CUST
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
700 A
\n", "
\n
\n\n
\n", ""], ["V2799", "
MISCELLANEOUS VISION SERVICE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "
\n
\n\n
\n", "
R60 B
\n", "", "
\n
\n\n
\n", ""], ["E0972", "
TRANSFER BOARD OR DEVICE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["V5335", "
REPAIR/MODIFICATION OF ORAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "", "
\n
\n\n
\n", ""], ["V5336", "
REPAIR COMMUNICATION DEVICE
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "", "
\n
\n\n
\n", ""], ["D2499", "
UNSPECIFIED RESTORATIVE (FIL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
700 C
\n", "
\n
\n\n
\n", ""], ["A9010", "
ROUTINE EYEGLASSES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["E0973", "
WHEELCHAIR ADJ HEIGHT ARMS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["UNKNOWN", "
UNKNOWN HCPCS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R99 Z
\n", "
999 Z
\n", "
\n
\n\n
\n", ""], ["K0438", "
OSTOMY POUCH LIQ DEODORANT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0439", "
OSTOMY POUCH SOLID DEODORANT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0440", "
NASAL PROSTHESIS
\n", "", "", "", "", "", "", "
YES
\n", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
700 B
\n", "
\n
\n\n
\n", ""], ["K0441", "
MIDFACIAL PROSTHESIS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
700 B
\n", "
\n
\n\n
\n", ""], ["K0442", "
ORBITAL PROSTHESIS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
700 A
\n", "
\n
\n\n
\n", ""], ["K0443", "
UPPER FACIAL PROSTHESIS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
700 B
\n", "
\n
\n\n
\n", ""], ["K0444", "
HEMI-FACIAL PROSTHESIS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
700 B
\n", "
\n
\n\n
\n", ""], ["K0445", "
AURICULAR PROSTHESIS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
700 C
\n", "
\n
\n\n
\n", ""], ["K0446", "
PARTIAL FACIAL PROSTHESIS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
700 B
\n", "
\n
\n\n
\n", ""], ["E0974", "
WHEELCHAIR GRADE-AID
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["K0447", "
NASAL SEPTAL PROSTHESIS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
700 B
\n", "
\n
\n\n
\n", ""], ["K0448", "
UNSPEC MAXILLOFACIAL PROSTH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
700 B
\n", "
\n
\n\n
\n", ""], ["K0449", "
REPAIR MAXILLOFACIAL PROSTH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
700 B
\n", "
\n
\n\n
\n", ""], ["K0450", "
LIQ ADHES FOR FACIAL PROSTH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0451", "
ADHESIVE REMOVER WIPES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0452", "
WHEELCHAIR BEARINGS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["L1740", "
LEGG PERTHES ORTHOSIS, POST
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L2039", "
KAFO,PLSTIC,MEDLAT ROTAT CON
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["A4254", "
BATTERY FOR GLUCOSE MONITOR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4255", "
GLUCOSE MONITOR PLATFORMS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
999 A
\n", "
\n
\n\n
\n", ""], ["E0975", "
WHEELCHAIR REINFORCED SEAT U
\n", "", "", "
E0981
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["L2335", "
ANTERIOR SWING BAND
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["A4364", "
ADHESIVE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4365", "
ADHESIVE REMOVER WIPES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4366", "
OSTOMY BAG, REUSEABLE OR DRA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4368", "
OSTOMY FILTER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4369", "
OSTOMY SKIN BARRIER, LIQUID
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4370", "
OSTOMY SKIN BARRIER,PASTE,
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4380", "
OSTOMY POUCH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4390", "
OSTOMY POUCH,DRAINABLE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4402", "
LUBRICANT PER OUNCE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["E0979", "
WHEELCHAIR REINFORCED BACK U
\n", "", "", "
E0982
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["A4404", "
OSTOMY RING EACH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4410", "
OST SKN BAR W/O CONV>4X4IN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4420", "
OSTOMY SUPPLIES NECESSARY FO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4430", "
URETEROSTOMY SET
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4440", "
NOT OTHERWISE CLASSIFIED URE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4450", "
TAPE NON-WTRPROOF-18 SQ IN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4453", "
MICROPOROUS TAPE, ALL SIZES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4454", "
TAPE ALL TYPES ALL SIZES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4455", "
ADHESIVE REMOVER PER OUNCE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4595", "
TENS SUPPL 2 LEAD PER MONTH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0977", "
WHEELCHAIR WEDGE CUSHION
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
100 E
\n", "
\n
\n\n
\n", ""], ["A4610", "
MED SUPPLIES FOR USE IN DME
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4619", "
FACE TENT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["A4621", "
TRACHEOTOMY MASK OR COLLAR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4622", "
TRACHEOSTOMY OR LARNGECTOMY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4623", "
TRACHEOSTOMY INNER CANNULA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4624", "
TRACHEAL SUCTION TUBE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4625", "
TRACH CARE KIT FOR NEW TRACH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4626", "
TRACHEOSTOMY CLEANING BRUSH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["L2430", "
KNEE JNT RATCHET LOCK EA JNT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["A4627", "
SPACER BAG/RESERVOIR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["E0978", "
WHEELCHAIR BELT W/AIRPLANE B
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["A4628", "
OROPHARYNGEAL SUCTION CATH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4629", "
TRACHEOSTOMY CARE KIT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4660", "
SPHYGMOMANOMETER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["A4663", "
BLOOD PRESSURE CUFF
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
900 K
\n", "
\n
\n\n
\n", ""], ["A4670", "
AUTO BLOOD PRESSURE MONITOR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["A4680", "
ACTIVATED CARBON FILTERS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4690", "
DIALYZERS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4710", "
SALINE SOLUTION FOR DIALYSIS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
920 B
\n", "
\n
\n\n
\n", ""], ["A4712", "
WATER STERILE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
920 B
\n", "
\n
\n\n
\n", ""], ["A4714", "
TREATED WATER FOR DIALYSIS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
920 B
\n", "
\n
\n\n
\n", ""], ["E0979", "
WHEELCHAIR BELT WITH VELCRO
\n", "", "", "
E0978
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["A4720", "
DIALYSATE ADMINISTRATION SET
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
920 B
\n", "
\n
\n\n
\n", ""], ["A5051", "
POUCH CLSD W BARR ATTACHED
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A5052", "
CLSD OSTOMY POUCH W/O BARR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A5053", "
CLSD OSTOMY POUCH FACEPLATE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A5054", "
CLSD OSTOMY POUCH W/FLANGE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A5055", "
STOMA CAP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A5061", "
POUCH DRAINABLE W BARRIER AT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A5062", "
DRNBLE OSTOMY POUCH W/O BARR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A5063", "
DRAIN OSTOMY POUCH W/FLANGE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A5064", "
DRAIN OSTOMY POUCH W/FCEPLTE
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4617", "
MOUTH PIECE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["E0980", "
WHEELCHAIR SAFETY VEST
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["A5065", "
DRAIN OSTOMY POUCH ON FCPLTE
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A5071", "
URINARY POUCH W/BARRIER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A5072", "
URINARY POUCH W/O BARRIER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A5073", "
URINARY POUCH ON BARR W/FLNG
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A5074", "
URINARY POUCH W/FACEPLATE
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A5075", "
URINARY POUCH ON FACEPLATE
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A5081", "
CONTINENT STOMA PLUG
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A5082", "
CONTINENT STOMA CATHETER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A5093", "
OSTOMY ACCESSORY CONVEX INSE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A5102", "
BEDSIDE DRAIN BTL W/WO TUBE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["E0990", "
WHELLCHAIR ELEVATING LEG RES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["A5105", "
URINARY SUSPENSORY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A5112", "
URINARY LEG BAG
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A5113", "
LATEX LEG STRAP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A5114", "
FOAM/FABRIC LEG STRAP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A5119", "
SKIN BARRIER WIPES BOX PR 50
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A5121", "
SOLID SKIN BARRIER 6X6
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A5122", "
SOLID SKIN BARRIER 8X8
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A5123", "
SKIN BARRIER WITH FLANGE
\n", "", "", "
A4373
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A5126", "
ADHESIVE DISC/FOAM PAD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A5131", "
APPLIANCE CLEANER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["E0991", "
WHEELCHAIR UPHOLSTRY SEAT
\n", "", "", "
E0981
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["A5149", "
INCONTINENCE/OSTOMY SUPPLY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["L2670", "
THORAC CONT PARASPINAL UPRIG
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["A9020", "
ROUTINE CONTACT LENSES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
600 D
\n", "
\n
\n\n
\n", ""], ["L2755", "
LOWER EXTORTHOSIS HYBIRD LAM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "", "
\n
\n\n
\n", ""], ["A9040", "
HEARING AIDS
\n", "", "", "
V5298
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 C
\n", "
600 B
\n", "
\n
\n\n
\n", ""], ["A9070", "
ORTHOPEDIC SHOES
\n", "", "", "
L3219
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R50 A
\n", "
500 F
\n", "
\n
\n\n
\n", ""], ["E0159", "
BRAKE FOR WHEELED WALKER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 A
\n", "
\n
\n\n
\n", ""], ["E0217", "
WATER CIRC HEAT PAD W PUMP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0218", "
WATER CIRC COLD PAD W PUMP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0326", "
URINAL FEMALE JUG-TYPE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["E0992", "
WHEELCHAIR SOLID SEAT INSERT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E0370", "
AIR PRESSURE ELEVATOR FOR HEEL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["E0461", "
VOL VEN BKUP RATE NON-INV
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["E0673", "
PRESSURE PNEUM APPL HALF LEG
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["E1005", "
POWER SEAT RECLINE POWER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E1371", "
FACE TENT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["E1391", "
OXY CONCENTRATOR,DUAL DEL PORT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R91 A
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["E1392", "
OXYGEN CONCENTRATOR, EQUIVAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
800 B
\n", "
\n
\n\n
\n", ""], ["E1395", "
OXYGEN CONCENTRATOR, EQUIVAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
800 B
\n", "
\n
\n\n
\n", ""], ["E1520", "
HEPARIN INFUSION PUMP FOR DI
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R70
\n", "
920 A
\n", "
\n
\n\n
\n", ""], ["E1540", "
PRESSURE ALARM FOR DIALYSIS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R70
\n", "
920 A
\n", "
\n
\n\n
\n", ""], ["E0993", "
WHEELCHAIR BACK UPHOLSTERY
\n", "", "", "
E0982
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E1560", "
BLOOD LEAK DETECTOR FOR DIAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R70
\n", "
920 A
\n", "
\n
\n\n
\n", ""], ["E1590", "
HEMODIALYSIS MACHINE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R70
\n", "
920 A
\n", "
\n
\n\n
\n", ""], ["E1592", "
AUTO INTERM PERITONEAL DIALY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R70
\n", "
920 A
\n", "
\n
\n\n
\n", ""], ["E1620", "
BLOOD PUMP FOR DIALYSIS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R70
\n", "
920 A
\n", "
\n
\n\n
\n", ""], ["E1625", "
WATER SOFTENING SYSTEM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R70
\n", "
920 A
\n", "
\n
\n\n
\n", ""], ["E1630", "
RECIPROCATING PERITONEAL DIA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R70
\n", "
920 A
\n", "
\n
\n\n
\n", ""], ["E1635", "
COMPACT TRAVEL HEMODIALYZER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R70
\n", "
920 A
\n", "
\n
\n\n
\n", ""], ["E1636", "
SORBENT CARTRIDGES FOR DIALY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R70
\n", "
920 B
\n", "
\n
\n\n
\n", ""], ["E1640", "
REPLACEMENT COMPONENTS FOR D
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R70
\n", "
920 B
\n", "
\n
\n\n
\n", ""], ["E1700", "
JAW MOTION REHAB SYSTEM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0994", "
WHEELCHAIR ARM REST
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E1702", "
REPL MEASR SCALES JAW MOTION
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["L3956", "
ADD JOINT UPPER EXT ORTHOSIS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L4390", "
REPLACE MULTI-PODUS SPLINT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["K0173", "
DISPOSABLE NEBULIZER PREFILL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
900 K
\n", "
\n
\n\n
\n", ""], ["L4392", "
REPLACE REPLACEMENT STATIC AFO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "", "
\n
\n\n
\n", ""], ["L4394", "
REPLACE FOOT DROP SPLINT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "", "
\n
\n\n
\n", ""], ["L4396", "
STATIC AFO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 A
\n", "
\n
\n\n
\n", ""], ["L4398", "
FOOT DROP SPLINT RECUMBENT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 A
\n", "
\n
\n\n
\n", ""], ["K0413", "
NONPOWER ADJ AIRMATT OVERLAY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 F
\n", "
\n
\n\n
\n", ""], ["K0414", "
POWERED AIR MATTRESS OVERLAY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 F
\n", "
\n
\n\n
\n", ""], ["E0995", "
WHEELCHAIR CALF REST
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["L5814", "
ENDO KNEE-SHIN HYDRAL SWG PH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 A
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L5845", "
KNEE-SHIN SYS STANCE FLEXION
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 A
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L5846", "
KNEE-SHIN SYS MICROPROCESSOR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 A
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L5985", "
LWR EXT DYNAMIC PROSTH PYLON
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 A
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L5987", "
SHANK FT W VERT LOAD PYLON
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 D
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L6807", "
TERM DEVICE GRIP1/2 OR EQUAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 E
\n", "
\n
\n\n
\n", ""], ["L7360", "
SIX VOLT BAT OTTO BOCK/EQ EA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L7900", "
VACUUM ERECTION SYSTEM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["L8417", "
PROS SHEATH/SOCK W GEL CUSHN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
999 A
\n", "
\n
\n\n
\n", ""], ["K0428", "
OSTOMY FACEPLT/SILICONE RING
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["E0996", "
WHEELCHAIR TIRE SOLID
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["K0429", "
SKIN BARRIER SOLID EXT WEAR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0430", "
SKIN BARRIER W FLANG EX WEAR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0431", "
CLOSED POUCH W ST WEAR BAR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0432", "
DRAINABLE PCH W EX WEAR BAR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0433", "
DRAINABLE PCH W ST WEAR BAR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0434", "
DRAINABLE PCH EX WEAR CONVEX
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["BA100", "
READING MACHINE
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "
YES
\n", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["E0371", "
NONPOWERED MATTRESS OVERLAY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 F
\n", "
\n
\n\n
\n", ""], ["E0372", "
POWER AIR MATTRESS OVERLAY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 F
\n", "
\n
\n\n
\n", ""], ["E0373", "
NONPOWERED PRESSURE MATTRESS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 F
\n", "
\n
\n\n
\n", ""], ["E0997", "
WHEELCHAIR CASTER W/ A FORK
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E0855", "
CERVICAL TRACTION EQUIPMENT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["K0501", "
AEROSOL COMPRESSOR FOR SVN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["K0530", "
NEBULIZER NOT USED W/OXYGEN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["L0999", "
ADD TO SPINAL ORTHOSIS, NOS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "", "
\n
\n\n
\n", ""], ["L1843", "
KO SINGLE UPRIGHT PREFAB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 F
\n", "
\n
\n\n
\n", ""], ["L5826", "
PEDIATRIC KNEE JOINT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 A
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L8039", "
BREAST PROSTHESIS, NOS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["L8239", "
ELASTIC SUPPORT, NOS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
400 E
\n", "
\n
\n\n
\n", ""], ["BA101", "
COMPUTER SOFTWARE
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 M
\n", "
\n
\n\n
\n", ""], ["BA102", "
COMPUTER HARDWARE
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 M
\n", "
\n
\n\n
\n", ""], ["E0998", "
WHEELCHAIR CASTER W/O A FORK
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["BA103", "
ARKENSTONE OPEN BOOK
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA104", "
BRAILLE AND SPEAK
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA105", "
TYPE AND SPEAK
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA106", "
PRINTER, COMPUTER
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 M
\n", "
\n
\n\n
\n", ""], ["BA107", "
CCTV
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA108", "
ELECTRIC IRON GUIDE
\n", "", "
YES
\n", "
BA208
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA109", "
NEEDLES AND THREADERS
\n", "", "
YES
\n", "
BA208
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA110", "
RAZOR, ALL TYPES
\n", "", "
YES
\n", "
BA208
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA111", "
SOCK SORTER
\n", "", "
YES
\n", "
BA208
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA112", "
SOCK TUCKER
\n", "", "
YES
\n", "
BA208
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["L5050", "
ANK SYMES MOLD SCKT SACH FT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 D
\n", "
200 E
\n", "
\n
\n\n
\n", "
1
\n"], ["E0999", "
WHEELCHR PNEUMATIC TIRE W/WH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["BA113", "
LEVEL, AUDIBLE
\n", "", "
YES
\n", "
BA209
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA114", "
SQUARE, FRAMING
\n", "", "
YES
\n", "
BA209
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA115", "
RULER, BRAILLE
\n", "", "
YES
\n", "
BA209
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA116", "
BLADE, SAW
\n", "", "
YES
\n", "
BA209
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA117", "
TAPE MEASURE
\n", "", "
YES
\n", "
BA209
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA118", "
CASSETTE/PLAYER RECORDER
\n", "", "
YES
\n", "
BA204
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA119", "
CHECK REGISTER
\n", "", "
YES
\n", "
BA203
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA120", "
LABELER AND TAPE
\n", "", "
YES
\n", "
BA203
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA121", "
LAP DESK
\n", "", "
YES
\n", "
BA203
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA122", "
LOC DOTS
\n", "", "
YES
\n", "
BA203
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["E1000", "
WHEELCHAIR TIRE PNEUMATIC CA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["BA123", "
TAPE, MAGNETIC
\n", "", "
YES
\n", "
BA203
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA124", "
MAT, METAL TRAINING
\n", "", "
YES
\n", "
BA203
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA125", "
MICROPHONE
\n", "", "
YES
\n", "
BA202
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA126", "
HEADPHONE, MINI STEREO
\n", "", "
YES
\n", "
BA204
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA127", "
PHONE OVERLAY
\n", "", "
YES
\n", "
BA207
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA128", "
SLATE AND STYLUS
\n", "", "
YES
\n", "
BA203
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA129", "
SWITCH, FOOT PEDAL
\n", "", "
YES
\n", "
BA203
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA130", "
TELEPHONE
\n", "", "
YES
\n", "
BA207
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA131", "
TYPEWRITER
\n", "", "
YES
\n", "
BA203
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA132", "
VOXCOM
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["E1001", "
WHEELCHAIR WHEEL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["BA133", "
GUIDE, WRITING
\n", "", "
YES
\n", "
BA203
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA134", "
CARDS
\n", "", "
YES
\n", "
BA206
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA135", "
CARD SHUFFLER
\n", "", "
YES
\n", "
BA206
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA136", "
CHIPS, POKER
\n", "", "
YES
\n", "
BA206
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA137", "
GAMES
\n", "", "
YES
\n", "
BA206
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA138", "
QUICK TYE
\n", "", "
YES
\n", "
BA206
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA139", "
BEVERAGE MAKER
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA140", "
HOLDER, BREAD
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA141", "
CUTLERY, BUILT UP HANDLE
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA142", "
CAN OPENER
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["E1031", "
ROLLABOUT CHAIR WITH CASTERS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "
\n
\n\n
\n", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["BA143", "
COOK BOOK
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA144", "
CROCK POT
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA145", "
BOARD, CUTTING
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA146", "
FOOD BUMPER
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA147", "
PLATE, INNER LIP NON SKID
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA148", "
KNIFE MAGNA
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA149", "
LEVEL, LIQUID INDICATOR
\n", "", "
YES
\n", "
BA209
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA150", "
POT, LOCK LID
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA151", "
MEASURING CUPS
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA152", "
MEASURING SPOONS
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["E1050", "
W/C RECLINING FXD ARMS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["BA153", "
HOLDER, MILK CARTON
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA154", "
OVEN MITT
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA155", "
GUIDE, SLICING
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA156", "
SPATULA AND FOOD TURNER
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA157", "
SPLATTER SCREEN
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA158", "
EYE DROP GUIDE
\n", "", "
YES
\n", "
BA205
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA159", "
PILL BOX
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA160", "
PILL CRUSHER
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA161", "
PILL SPLITTER
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA162", "
CANE, BLIND
\n", "", "
YES
\n", "
BA210
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["E1060", "
WHEELCHAIR DETACHABLE ARMS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["BA163", "
TIP, CANE
\n", "", "
YES
\n", "
BA210
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA164", "
COMPASS
\n", "", "
YES
\n", "
BA210
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA165", "
MOWAT SENSOR
\n", "", "
YES
\n", "
BA210
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA166", "
POLARON NAVIGATION DEVICE
\n", "", "
YES
\n", "
BA210
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA167", "
ULTRASONIC WALKMATE
\n", "", "
YES
\n", "
BA210
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA168", "
ALPHABET, TRAINER
\n", "", "
YES
\n", "
BA203
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA169", "
ALPHABET EMBOSSER
\n", "", "
YES
\n", "
BA203
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA170", "
BILLFOLD AND WALLET ORGANIZER
\n", "", "
YES
\n", "
BA206
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA171", "
BOOK, LARGE PRINT/BRAILLE
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA172", "
BRAILLE BOOK SERIES
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
600 C
\n", "
\n
\n\n
\n", ""], ["E1065", "
WHEELCHAIR POWER ATTACHMENT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["BA173", "
BRAILLER AND CASE
\n", "", "
YES
\n", "
BA203
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA174", "
BRAILLE ERASER
\n", "", "
YES
\n", "
BA203
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA175", "
BRAILLE PAPER
\n", "", "
YES
\n", "
BA203
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA176", "
CALCULATOR
\n", "", "
YES
\n", "
BA202
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA177", "
CASSETTE
\n", "", "
YES
\n", "
BA204
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA178", "
CATARACT READER
\n", "", "
YES
\n", "
BA205
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA179", "
CLIP ONS
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA180", "
TAPE, REFLECTIVE
\n", "", "
YES
\n", "
BA203
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA181", "
OCCLUDERS
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA182", "
SOLAR SHIELDS
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["E1066", "
WHEELCHAIR BATTERY CHARGER
\n", "", "", "
E2367
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["BA183", "
EYEWEAR, SUN
\n", "", "
YES
\n", "
BA205
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA184", "
CLOCK
\n", "", "
YES
\n", "
BA200
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA185", "
WATCH, ALL TYPES
\n", "", "
YES
\n", "
BA200
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA186", "
BULB
\n", "", "
YES
\n", "
BA201
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA187", "
LAMP, DESK
\n", "", "
YES
\n", "
BA201
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA188", "
READING STAND
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["#SHIP", "
SHIPPING CHARGES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90 A
\n", "", "
\n
\n\n
\n", ""], ["DL101", "
DRESSING STICK
\n", "", "
YES
\n", "
DL186
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL102", "
LACE LOCK FOR SHOES
\n", "", "
YES
\n", "
DL186
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL103", "
REACHER (ALL TYPES)
\n", "", "
YES
\n", "
DL186
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E1069", "
WHEELCHAIR DEEP CYCLE BATTER
\n", "", "", "
E2366
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["DL104", "
SHOE HORN, ALL TYPES
\n", "", "
YES
\n", "
DL186
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL105", "
SHOE LACES (ALL TYPES)
\n", "", "
YES
\n", "
DL186
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL106", "
SOCK & STOCKING AID
\n", "", "
YES
\n", "
DL186
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL107", "
TROUSER PULL
\n", "", "
YES
\n", "
DL186
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL108", "
ZIPPER PULL
\n", "", "
YES
\n", "
DL186
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL109", "
FEEDER, BALL BEARING
\n", "", "
YES
\n", "
DL190
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL110", "
FEEDER, SPLINT, DORSAL
\n", "", "
YES
\n", "
DL190
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL111", "
FEEDER, ELECTRIC SELF
\n", "", "
YES
\n", "
DL190
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL112", "
FEEDER, FRICTION
\n", "", "
YES
\n", "
DL190
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL113", "
FORK
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E1070", "
WHEELCHAIR DETACHABLE FOOT R
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["DL114", "
KNIFE
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL115", "
FEEDER, SUSPENSION, OFFSET
\n", "", "
YES
\n", "
DL190
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL116", "
HOLDER, SANDWICH
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL117", "
SPOON
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL118", "
SPORK
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL119", "
UTENSIL HOLDER
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL120", "
BLANKET SUPPORT ADJUSTABLE
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL121", "
BED PULL-UP
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL122", "
HOLDER, BOOK
\n", "", "
YES
\n", "
DL191
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL123", "
OPENER, CAR DOOR
\n", "", "
YES
\n", "
DL191
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["A4620", "
VARIABLE CONCENTRATION MASK
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["E1084", "
HEMI-WHEELCHAIR DETACHABLE A
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["DL124", "
TURNER, DOOR KNOB
\n", "", "
YES
\n", "
DL191
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL125", "
MAT, DYCEM
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL126", "
MITT, HOLDING
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL127", "
HOLDER, INSULIN
\n", "", "
YES
\n", "
DL191
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL128", "
KEY HOLDER/TURNER
\n", "", "
YES
\n", "
DL191
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL129", "
KNEE SPREADER
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL130", "
HINGES, OFFSET DOOR
\n", "", "
YES
\n", "
DL191
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL131", "
PALM GUARD
\n", "", "
YES
\n", "
DL191
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL132", "
PILLOW (ALL TYPES)
\n", "", "
YES
\n", "
DL191
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL133", "
HOLDER, PHONE
\n", "", "
YES
\n", "
DL191
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E1083", "
HEMI-WHEELCHAIR FIXED ARMS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["DL134", "
READING DESK
\n", "", "
YES
\n", "
DL192
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL135", "
SCISSORS, SPRING ACTION
\n", "", "
YES
\n", "
DL191
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL136", "
TAP TURNER
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["HISAS", "
HISA S/C
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
940 A
\n", "
\n
\n\n
\n", ""], ["HISAN", "
HISA NSC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
940 B
\n", "
\n
\n\n
\n", ""], ["DL137", "
OPENER, BOX TOP
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL138", "
OPENER, CAN
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL139", "
OPENER, JAR
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL140", "
HOLDER, PAN
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL141", "
PARING BOARD
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E1085", "
HEMI-WHEELCHAIR FIXED ARMS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["DL142", "
OPENER, PLASTIC BAG
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL143", "
TAB GRABBER
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL144", "
HEADPOINTER
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL145", "
MOUTHSTICK, CLAMP-ON
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL146", "
MOUTHSTICK, STRAIGHT WAND
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL147", "
MOUTHSTICK, VACUUM WAND
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL148", "
GROOMING EXTENDER,
\n", "", "
YES
\n", "
DL187
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL149", "
BRUSH, BATH
\n", "", "
YES
\n", "
DL187
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL150", "
MITTS, BATH
\n", "", "
YES
\n", "
DL187
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL151", "
SPONGES, BATH
\n", "", "
YES
\n", "
DL187
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E1086", "
HEMI-WHEELCHAIR DETACHABLE A
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["DL152", "
BOWEL STIMULATOR
\n", "", "
YES
\n", "
DL189
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL153", "
BASIN, SHAMPOO
\n", "", "
YES
\n", "
DL187
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL154", "
HAIRBRUSH
\n", "", "
YES
\n", "
DL186
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL155", "
MIRROR, INSPECTION
\n", "", "
YES
\n", "
DL186
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL156", "
CLIPPER/FILE, NAIL
\n", "", "
YES
\n", "
DL187
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL157", "
HOLDER, RAZOR
\n", "", "
YES
\n", "
DL187
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL158", "
DISPENSER, SHAVING CREAM
\n", "", "
YES
\n", "
DL187
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL159", "
BRUSH, SUCTION
\n", "", "
YES
\n", "
DL187
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL160", "
BRUSH, DENTURE SUCTION
\n", "", "
YES
\n", "
DL187
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL161", "
SUPPOSITORY INSERTER
\n", "", "
YES
\n", "
DL189
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E1087", "
HGH STRGHT LT WT W/C FXED ARM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 C
\n", "
\n
\n\n
\n", ""], ["DL162", "
TOILET AID
\n", "", "
YES
\n", "
DL189
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL163", "
CUP, (ALL TYPES)
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL164", "
FOOD GUARD
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL165", "
HOLDER, GLASS
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL166", "
DISH SCOOP
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL167", "
BOWL SCOOP
\n", "", "
YES
\n", "
DL188
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL168", "
STRAW (ALL TYPES)
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL169", "
HOLDER, WHEELCHAIR CUP
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL170", "
GRIPPER, FOAM
\n", "", "
YES
\n", "
DL192
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL171", "
HOLDER, PENCIL
\n", "", "
YES
\n", "
DL192
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E1088", "
HIGH STRENGTH LT WT WC DET ARM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 C
\n", "
\n
\n\n
\n", ""], ["DL172", "
ORTHOSIS, WANCHIK TYPE
\n", "", "
YES
\n", "
DL192
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL173", "
PEN, WEIGHTED
\n", "", "
YES
\n", "
DL192
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL174", "
BOARD, WRITING W/CLAMPS
\n", "", "
YES
\n", "
DL192
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["ECU01", "
ENVIRONMENTAL CONTROL UNIT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 B
\n", "
900 H
\n", "
\n
\n\n
\n", "
1
\n"], ["DL175", "
GLOVES, WHEELCHAIR
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "
\n
\n\n
\n", "", "
100 D
\n", "
\n
\n\n
\n", ""], ["DL100", "
BUTTON HOOK
\n", "", "
YES
\n", "
DL186
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E1340", "
DELIVERY OF DME
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "
\n
\n\n
\n", "
R90 A
\n", "", "
\n
\n\n
\n", ""], ["VA100", "
DME PICK-UP/DELIVERY
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "
R80 D
\n", "", "
\n
\n\n
\n", ""], ["VA101", "
HAIR PIECE/WIG
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
700 C
\n", "
\n
\n\n
\n", ""], ["BA189", "
RADIO
\n", "", "", "
BA200
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
600 C
\n", "
\n
\n\n
\n", ""], ["E1089", "
HGH STRNTH LT WT W/C SWG AWAY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 C
\n", "
\n
\n\n
\n", ""], ["VA102", "
AIR CONDITIONER
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "
YES
\n", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL176", "
GRIPPER, ICE
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
900 A
\n", "
\n
\n\n
\n", ""], ["DL177", "
COVER WHEELCHAIR/SCOOTER
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
100 D
\n", "
\n
\n\n
\n", ""], ["VA103", "
LIFT, SCOOTER
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 B
\n", "
100 G
\n", "
\n
\n\n
\n", "
1
\n"], ["VA104", "
LIFT, PORCH
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["VA105", "
LIFT, WHEELCHAIR (VAN)
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 C
\n", "
100 H
\n", "
\n
\n\n
\n", ""], ["VA106", "
RAMP, PORTABLE
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL178", "
GEL PACK (COLD)
\n", "", "
YES
\n", "
VA145
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["VA107", "
LIFELINE MEDIC ALERT
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["VA108", "
STAIR LIFT/GLIDE
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E1090", "
H STR LT WT DT ARM DSK SWG AWY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 C
\n", "
\n
\n\n
\n", ""], ["VA109", "
CARRIER, WHEELCHAIR
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 B
\n", "
100 G
\n", "
\n
\n\n
\n", ""], ["DL179", "
AIR PURIFIER
\n", "", "
YES
\n", "
VA146
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["BA190", "
EYE PATCH
\n", "", "", "
BA205
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
600 C
\n", "
\n
\n\n
\n", ""], ["VA111", "
CONSERVER, OXYGEN
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R91 C
\n", "
800 D
\n", "
\n
\n\n
\n", ""], ["VA112", "
HITCH, TRAILER
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 C
\n", "
100 H
\n", "
\n
\n\n
\n", "
1
\n"], ["VA113", "
COMPUTER SOFTWARE (NEURO)
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 M
\n", "
\n
\n\n
\n", ""], ["VA114", "
COMPUTER HARDWARE (NEURO)
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 M
\n", "
\n
\n\n
\n", ""], ["DL180", "
PUTTY, EXERCISE/THERAPY
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["DL181", "
CARRYING CASE
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
900 K
\n", "
\n
\n\n
\n", ""], ["E1092", "
WHEELCHAIR WIDE W/ LEG RESTS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["VA115", "
WHEEL-O-VATOR
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["BA191", "
GUIDE DOG SERVICE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 A
\n", "", "
\n
\n\n
\n", ""], ["A4614", "
PEAK FLOW METER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R91 C
\n", "
800 D
\n", "
\n
\n\n
\n", ""], ["L8015", "
BREAST PROSTHESIS GARMENT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R90
\n", "
700 C
\n", "
\n
\n\n
\n", ""], ["L8035", "
CUSTOM BREAST PROSTHESIS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R90
\n", "
700 C
\n", "
\n
\n\n
\n", ""], ["L8195", "
COMPRESSION STOCKING
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
400 E
\n", "
\n
\n\n
\n", ""], ["K0456", "
HOSPITAL BED, HEAVY DUTY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 D
\n", "
\n
\n\n
\n", ""], ["K0457", "
EXTRA WIDE COMMODE CHAIR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 I
\n", "
\n
\n\n
\n", ""], ["K0458", "
HEAVY DUTY WALKER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 A
\n", "
\n
\n\n
\n", ""], ["K0459", "
HD WHEELED WALKER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 A
\n", "
\n
\n\n
\n", ""], ["E1093", "
WHEELCHAIR WIDE W/ FOOT REST
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["K0460", "
POWER ADD-ON JOYSTK
\n", "", "", "
E0983
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["K0461", "
POWER ADD-ON TILLER
\n", "", "", "
E0984
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["L1690", "
COMBO,BILAT/L-S/HIP-FEMUR ORTH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L1847", "
KO,DBL UPRIGHT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 F
\n", "
\n
\n\n
\n", ""], ["L3675", "
SO, VEST TYPE ABDUCTION
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 G
\n", "
\n
\n\n
\n", ""], ["L5968", "
ANKLE, MULTIAXIAL SHOCK SYSTEM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R20 D
\n", "
200 F
\n", "
\n
\n\n
\n", ""], ["L5975", "
SINGLE AXIS ANKLE&FLX KEEL FT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R20 D
\n", "
200 F
\n", "
\n
\n\n
\n", ""], ["L5988", "
TORSIONAL FORCE REDUCING PYLON
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R20 D
\n", "
200 F
\n", "
\n
\n\n
\n", ""], ["L6693", "
EXTERNAL LOCKING ELBOW
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R30
\n", "
300 B
\n", "
\n
\n\n
\n", ""], ["VA110", "
BATTERY, HEARING AID, EACH
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "
R90
\n", "
910 A
\n", "", ""], ["A4630", "
REPL BAT T.E.N.S. OWN BY PT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 B
\n", "
\n
\n\n
\n", ""], ["E1100", "
W/C S-RECL FXD ARM LEG RES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["VA116", "
CHARGER, BATTERY, ASST DEVICE
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 B
\n", "
\n
\n\n
\n", ""], ["VA117", "
ASSIST DEV-ACCESSORY-NEUROSENS
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R90
\n", "
600 F
\n", "
\n
\n\n
\n", ""], ["VA118", "
HEARING AID, ACCESSORY
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "
R90
\n", "
600 F
\n", "
\n
\n\n
\n", ""], ["VA119", "
BATTERY, ASST DEV/ACC
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 B
\n", "
\n
\n\n
\n", ""], ["SI100", "
H&N BRAIN CATHETER
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["SI101", "
H&N BRAIN ELECTRODES
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["SI102", "
H&N BRAIN PULSE GENERATOR
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["SI103", "
H&N BRAIN RECEIVER
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["SI104", "
H&N BRAIN RESERVOIR
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["SI105", "
H&N BRAIN SHUNT
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["E1110", "
WHEELCHAIR SEMI-RECL DETACH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["SI106", "
H&N EAR AURICULAR PROSTHESIS
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["SI107", "
H&N EAR COCHLEAR DEVICE
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["L8613", "
H&N EAR OSSICLE IMPLANTS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["V2630", "
ANTERIOR INTRAOCULAR LENS
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["V2632", "
POSTERIOR INTRAOCULAR LENS
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["L8612", "
H&N EYE AQUEOUS SHUNT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["SI112", "
H&N EYE VITREOUS INVITREAL SYS
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["L8610", "
H&N EYE OCULAR IMPLANT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["SI114", "
H&N EYE CONJUNCTIVA STENT
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["SI115", "
H&N FACIAL
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["E1130", "
W/C STAND DET ARM FT REST
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 C
\n", "
\n
\n\n
\n", ""], ["SI128", "
H&N SPEECH AID
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["D5924", "
H&N CRANIAL PLATE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R90
\n", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["SI130", "
H&N TEMPOROMANDIBULAR JOINT
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["SI200", "
ABDOMEN ACCESS PORT
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["SI201", "
ABDOMEN BLADDER SPHINCTER
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["SI202", "
ABD CATHETER INTRAPERITONEAL
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["SI203", "
ABD CATHETER BILE DUCT
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["SI204", "
ABD CATHETER PERCUTANEOUS
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["SI205", "
ABD CATHETER SPINAL CORD
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["SI206", "
ABD CATHETER SUPRAPUBIC
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["E1140", "
WHEELCHAIR STANDARD DETACH A
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 C
\n", "
\n
\n\n
\n", ""], ["SI207", "
ABD CATHETER VENOUS
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["SI208", "
ABD HERNIA MESH
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["E0782", "
INFUSION PUMP,IMPLANTABLE
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["SI210", "
ABD IVC FILTER UMBRELLA
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["SI211", "
ABD JEJUNOSTOMY TUBE
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["SI212", "
PENILE IMPLANT, ABD
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["SI213", "
ABD PESSARY
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["SI214", "
ABD SHUNT
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "", "
1
\n"], ["SI215", "
DIALYSIS SHUNT ABD
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["SI216", "
ABD STENT BILE DUCT
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["E1150", "
WHEELCHAIR STANDARD W/ LEG R
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 C
\n", "
\n
\n\n
\n", ""], ["SI217", "
ABD STENT INDWELLING-URETER
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["SI218", "
ABD STENT PANCREATIC DUCT
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["SI219", "
ABD STENT URETERAL
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["SI220", "
ABD STENT URETHRAL
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["SI221", "
TESTICULAR IMPLANT
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["SI222", "
VENOUS ACCESS SYS
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["SI300", "
UE SHOULDER TOTAL JOINT
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 C
\n", "
\n
\n\n
\n", "
1
\n"], ["SI301", "
UE HUMERAL HEAD PROXIMAL
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 C
\n", "
\n
\n\n
\n", "
1
\n"], ["SI302", "
UE HUMERAL HEAD DISTAL
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 C
\n", "
\n
\n\n
\n", "
1
\n"], ["SI303", "
UE ELBOW TOTAL IMPLANT
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 C
\n", "
\n
\n\n
\n", "
1
\n"], ["E1160", "
WHEELCHAIR FIXED ARMS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 C
\n", "
\n
\n\n
\n", ""], ["SI304", "
UE ELBOW REPLACEMENT IMPLANT
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 C
\n", "
\n
\n\n
\n", "
1
\n"], ["SI305", "
UE RADIUS
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 C
\n", "
\n
\n\n
\n", "
1
\n"], ["SI306", "
UE WRIST CARPAL IMPLANTS
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 C
\n", "
\n
\n\n
\n", "
1
\n"], ["L8630", "
UE HAND METACARPOPHALANGEAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["SI400", "
LE HIP ACETABULAR ORIF SCREWS
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["SI401", "
LE FEMORAL NECK ORIF NAILING
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["SI402", "
LE FEMUR ORIF IM RODDING
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "", "
1
\n"], ["SI403", "
LE HIP PARTIAL REPLACEMENT
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["SI404", "
LE TOTAL HIP REPLACEMENT
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["SI405", "
LE KNEE PATELLA
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["E1170", "
W/C AMP FXD ARM LEG REST
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["SI406", "
LE TOTAL KNEE REPLACEMENT
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["SI407", "
LE ANKLE
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["L8641", "
LE FOOT METATARSAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["L8642", "
LE FOOT HALLUX
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["L8658", "
LE FOOT INTERPHALANGEAL JOINT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["L8600", "
BREAST IMPLANT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["SI501", "
HEART PACEMAKER, PERMANENT
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["SI502", "
HEART, DEFIBRILLATOR (AICD)
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["SI503", "
HEART PACEMAKER LEADS
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["SI504", "
HEART PACEMAKER PADS
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["E1171", "
WHEELCHAIR AMPUTEE W/O LEG R
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["SI505", "
HEART PULSE GENERATOR
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["SI506", "
HEART VALVE, AORTIC
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["SI507", "
HEART VALVE, MITRAL
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["SI508", "
HEART VALVE, TRICUSPID
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["SI509", "
HEART VALVE, PULMONARY
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["SI510", "
HEART VENTRICULAR ASSIST DEV
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["SI511", "
HEART SINGLE VENTRICLE
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["SI512", "
HEART BIVENTRICULAR
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["SI513", "
INFUSION PUMP INTRA-ARTERIAL
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["E0783", "
INFUSION PUMP IMPLANTABLE
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["E1172", "
WHEELCHAIR AMPUTEE DETACH AR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["SI515", "
NEUROSTIMULATOR ELECTRODES
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "", "
1
\n"], ["SI516", "
NEUROSTIMULATOR PULSE GENERAT
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["SI517", "
NEUROSTIMULATOR RECEIVER
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["SI518", "
SPINAL CORD PULSE GENERATOR
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["SI519", "
SPINAL CORD RECEIVER
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["SI520", "
SPINAL CORD RESERVOIR
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["SI521", "
(SCI) HARRINGTON RODS
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["SI522", "
(SCI) METAL CAGE
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["D5925", "
FACIAL AUGMENTATION
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R90
\n", "
700 B
\n", "
\n
\n\n
\n", "
1
\n"], ["D5934", "
FACE MANDIBLE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R90
\n", "
700 C
\n", "
\n
\n\n
\n", "
1
\n"], ["E1180", "
WHEELCHAIR AMPUTEE W/ FOOT R
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["SI118", "
FACE, MANDIBULAR BODY
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["SI119", "
FACE, NASAL
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["SI120", "
FACE, NASAL SEPTUM
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["SI121", "
FACE, ORBITAL
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["SI122", "
OBTURATOR, INTERIM
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["D5932", "
OBTURATOR, DEFINITIVE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R90
\n", "
700 A
\n", "
\n
\n\n
\n", "
1
\n"], ["SI124", "
PALATE AUGMENTATION
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["D5955", "
PALATE LIFT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R90
\n", "
700 C
\n", "
\n
\n\n
\n", "
1
\n"], ["SI523", "
STENT, CORONARY
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["SI524", "
STENT, ESOPHAGUS
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["A4631", "
WHEELCHAIR BATTERY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
100 D
\n", "
\n
\n\n
\n", ""], ["E1190", "
WHEELCHAIR AMPUTEE W/ LEG RE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["SI525", "
STENT, LACRIMAL DUCT
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["L8670", "
VASCULAR GRAFTS, THORACIC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["SI199", "
HEAD & NECK, UNKNOWN
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["SI299", "
ABDOMEN, UNKNOWN
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["SI399", "
UPPER EXTREMITY, UNKNOWN
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 C
\n", "
\n
\n\n
\n", "
1
\n"], ["SI499", "
LOWER EXTREMITY, UNKNOWN
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["SI599", "
THORACIC, UNKNOWN
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["VA120", "
RT VISIT (HOME O2)
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R91 D
\n", "", "
\n
\n\n
\n", ""], ["A4280", "
ADHESIVE SKIN SUPPORT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4371", "
OSTOMY SKIN BARRIER,POWDER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["E1195", "
WHEELCHAIR AMPUTEE HEAVY DUT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["E0240", "
OSTOMY SKIN BARRIER,SOLID
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4373", "
OSTOMY SKIN BARRIER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4374", "
OSTOMY SKIN BARRIER
\n", "", "", "
A4373
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4375", "
OSTOMY POUCH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4376", "
OSTOMY POUCH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4377", "
OSTOMY POUCH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4378", "
OSTOMY POUCH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4379", "
OSTOMY POUCH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4381", "
OSTOMY POUCH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4382", "
OSTOMY POUCH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["E1200", "
WHEELCHAIR AMPUTEE FIXED ARM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["A4383", "
OSTOMY POUCH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4384", "
OSTOMY FACEPLATE EQUIVALENT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4385", "
OSTOMY SKIN BARRIER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4386", "
OSTOMY SKIN BARRIER
\n", "", "", "
A4409
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4387", "
OSTOMY POUCH, CLOSED
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4388", "
OSTOMY POUCH-DRAIN-SEE DESC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4389", "
OSTOMY POUCH-DRAIN-SEE DESC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4391", "
OSTOMY POUCH-URINARY-SEE DESC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4392", "
OSTOMY POUCH-URINARY-SEE DESC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4393", "
OSTOMY POUCH-URINARY-SEE DESC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["E1210", "
W/C MOTORFXD ARM LEG REST
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 A
\n", "
\n
\n\n
\n", ""], ["A4394", "
OSTOMY DEODORANT-LIQUID
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4395", "
OSTOMY DEODORANT-SOLID
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A5508", "
DELUXE FEATURE DIABETIC SHOE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R50 C
\n", "
500 F
\n", "
\n
\n\n
\n", ""], ["A7000", "
CANISTER, DISPOSABLE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["A7001", "
CANISTER, NON-DISPOSABLE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["A7002", "
TUBING
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["A7003", "
ADMIN SET-NEBULIZER-DISPOSABLE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["A7004", "
NEBULIZER, PNEUMATIC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["A7005", "
ADMIN SET-NEBULIZER-NON DISPOS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["A7006", "
ADMIN SET-NEBULIZER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["E1211", "
WHEELCHAIR MOTORIZED W/ DET
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 A
\n", "
\n
\n\n
\n", ""], ["A7007", "
NEBULIZER-LG VOLUME-UNFILLED
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["A7008", "
NEBULIZER-LG VOLUME-PREFILLED
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["A7009", "
RESERVOIR BOTTLE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["A7010", "
CORRUGATED TUBING
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["A7011", "
CORRUGATED TUBING N-D
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["A7012", "
WATER COLLECTION DEVICE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["A7013", "
FILTER, DISPOSABLE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["A7014", "
FILTER, NON-DISPOSABLE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["A7015", "
AEROSOL MASK
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["A7016", "
DOME & MOUTHPIECE, NEBULIZER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["E1212", "
WHEELCHAIR MOTORIZED W FULL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 A
\n", "
\n
\n\n
\n", ""], ["A7017", "
NEBULIZER, NOT USED W OXYGEN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["A9901", "
DME DELIVERY,SET-UP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 D
\n", "", "
\n
\n\n
\n", ""], ["E0144", "
WALKER W/ POSTERIOR SEAT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 A
\n", "
\n
\n\n
\n", ""], ["E0602", "
MANUAL BREAST PUMP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0616", "
CARDIAC EVENT RECORDER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R90
\n", "
960 E
\n", "
\n
\n\n
\n", ""], ["E0779", "
INFUSION PUMP>8 HOURS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0780", "
INFUSION PUMP<8 HOURS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["L3807", "
WHFO, W/O JOINTS, PF
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
\n", ""], ["S8095", "
WIG
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R90
\n", "
700 C
\n", "
\n
\n\n
\n", ""], ["S8096", "
PEAK FLOW METER, PORTABLE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["E1213", "
WHEELCHAIR MOTORIZED W/ DET
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 A
\n", "
\n
\n\n
\n", ""], ["S8260", "
ORAL ORTHOTIC FOR SLEEP APNEA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["VA121", "
SCALE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R90
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["VA122", "
THERMOMETER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["DL182", "
TOOTHBRUSH-ELECTRIC
\n", "", "", "
DL187
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["BA192", "
MAGNET
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
600 C
\n", "
\n
\n\n
\n", ""], ["VA123", "
BIPAP MACHINE
\n", "", "", "
E0470
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "
R91 C
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["VA124", "
VEST, COOLING
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R90
\n", "
999 A
\n", "
\n
\n\n
\n", ""], ["DL183", "
LEG LIFTER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["L8619", "
COCHLEAR-EXTERNAL DEVICE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", ""], ["A4258", "
LANCET DEVICE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["E1220", "
W/C SPECIAL SIZE/CONSTRC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["E0747", "
BONE STIMULATOR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0748", "
BONE STIMULATOR-SPINAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0749", "
BONE STIMULATOR-SURGICAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", ""], ["A4300", "
IMPLANTABLE ACCESS CATHETER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", ""], ["A4324", "
MALE EXTERNAL CATHETER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4325", "
MALE EXTERNAL CATHETER STRIP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4331", "
EXTENSION DRAINAGE TUBING
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4332", "
LUBRICANT, INDIVIDUAL PACKET
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4333", "
URINARY CATHETER ANCHORING
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4334", "
URINARY CATHETER ANCHOR LEG
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["E1221", "
WHEELCHAIR SPEC SIZE W FOOT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["A4348", "
MALE EXTERNAL CATHETER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4396", "
OSTOMY BELT WITH HERNIA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4464", "
JOINT SUPPORTIVE DEVICE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4481", "
TRACHEOSTOMA FILTER, ANY TYPE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4561", "
PESSARY, RUBBER, ANY TYPE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4562", "
PESSARY, NON RUBBER, ANY TYPE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4608", "
TRANSTRACHEAL OXYGEN CATHETER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4740", "
SHUNT ACCESSORY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", ""], ["B4084", "
GASTROSTOMY/JEJUNOSTOMY TUBING
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", ""], ["B4085", "
GASTRONOMY TUBE, SILICONE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", ""], ["E1222", "
WHEELCHAIR SPEC SIZE W/ LEG
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["C1000", "
PERCLOSCLOSR PROSTARARTVAS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["C1006", "
ARRAY POST CHAMB IOL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["C1007", "
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\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C1008", "
UROLUME-IMPLT URETHRAL STN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C1027", "
MAGIC X/SHORT RADIUS 14MM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1029", "
CRE GUIDED BALLOON DIL CATH,
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C1030", "
CTHTR:MRSHAL,BLU MAX UTR DMD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C1034", "
SURPASS, LONG30 SURPASS-CATH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1036", "
R PORT/RESERVOIR IMPL DEV
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C1037", "
VAXCELCHRONIC DIALYSIS CATH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["A4361", "
OSTOMY FACE PLATE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4635", "
UNDERARM CRUTCH PAD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
900 A
\n", "
\n
\n\n
\n", ""], ["E1223", "
WHEELCHAIR SPEC SIZE W FOOT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["C1039", "
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\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["C1040", "
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\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C1042", "
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\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C1060", "
ACS MULTI-LINK TRISTAR STENT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1063", "
ENDOTAK ENDURANCE EZ,RX LEAD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1067", "
MEGALINK BILIARY STENT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C1068", "
PULSAR DDD PMKR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1069", "
DISCOVERY DR, PMKR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1071", "
PULSAR MAX, PULSAR SR PMKR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1072", "
GUIDANT:BLLN DIL CATH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["E1224", "
WHEELCHAIR SPEC SIZE W/ LEG
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["C1075", "
LEAD, PACEMAKER, SELUTE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1076", "
VENTAK MINI SC DEFIB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1077", "
VENTAK VR,PRIZM VR, SC DEFIB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1078", "
VENTAK:PRIZM,AV III DR DEFIB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1101", "
MEDTRONIC AVE ZUMA GUIDECATH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C1102", "
GENERATOR, PULSE, NEUROSTIM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1103", "
DEFIBRILLATOR, IMPLANTABLE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1105", "
PACEMAKER, DUAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1106", "
NEUROSTIMULATOR, EZ PATIENT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1109", "
ANCHOR, IMPLANTABLE,
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["E1225", "
WHEELCHAIR SPEC SZ SEMI-RECL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["C1111", "
STENT GRAFT, ANEURX AORTO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1112", "
STENT GRAFT SYSTEM, ANEURX
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1113", "
STENT GRAFT, TALENT ENDO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1114", "
STENT GRAFT, TALENT SPRING
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1115", "
LEAD, PACEMAKER, 5038S,
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1116", "
LEAD, PACE, CAPSURE SP NOVUS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1118", "
PACEMAKER, SIGMA 300 DR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1119", "
LEAD, DEFIB, SPRINT 6932
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1120", "
LEAD, DEFIB, SPRINT 6942,
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1121", "
DEFIB, IMPLANT, GEM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["E1226", "
WHEELCHAIR SPEC SZ FULL-RECL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["C1123", "
DEFIBRIB, IMPLANT, GEM II VR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1124", "
LEAD, NEUROSTIM, KIT,
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1125", "
KAPPA 400SR,TOPAZ II SR PMKR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1126", "
PACEMAKER, DUAL, KAPPA 700
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1127", "
PACEMAKER, SINGLE, KAPPA 700
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1128", "
PACEMAKER, DUAL, RUBY II D
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1129", "
PACEMAKER, KAPPA 700 VDD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1130", "
PACEMAKER, DUAL,LEGACY II D
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1131", "
PACEMAKER, DUAL,SIGMA 200 DR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1132", "
PACEMAKER, SINGLE,LEGACY II SR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["E1227", "
WHEELCHAIR SPEC SZ SPEC HT A
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["C1133", "
PACEMAKER, SINGLE,SIGMA 300 SR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1134", "
PACEMAKER, DUAL, SIGMA 300
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1135", "
ENTITY DR 5326L/R, DC, PMKR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1136", "
PACEMAKER, DUAL, RATE-RESP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1137", "
SEPTAL DEFECT IMPLANT SYS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1143", "
PACEMAKER,DUAL, ADDVENT 2060BL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1144", "
PACEMAKER, SINGLE,RATE-RESP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1145", "
VASCULAR CLOSURE DEVICE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1146", "
ENDOTRACHEAL TUBE, VETT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["C1147", "
LEAD, PACEMAKER, AV PLUS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["E1228", "
WHEELCHAIR SPEC SZ SPEC HT B
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["C1148", "
DEFIB, SINGLE,CONTOUR MD V-175
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1149", "
PACEMAKER,DUAL,ENTITY DC 5226R
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1151", "
LEAD, PACEMAKER,PASSIVE PLUS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1153", "
PACEMAKER, SINGLE,REGENCY SC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1154", "
LEAD, DEFIB,SPL SP01,
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1155", "
REPLIFORM TIS/REGENER MATRIX,
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1156", "
PACEMAKER, SINGLE, AFFINITY SR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1157", "
PACEMAKER, DUAL CHAMBER,
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1158", "
LEAD, DEFIBRILLATOR, TVL SV01
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1159", "
LEAD, TVL RV02, TVL06, TVL07
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["E1230", "
POWER OPERATED VEHICLE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "
\n
\n\n
\n", "
R10 A
\n", "
100 A1
\n", "
\n
\n\n
\n", ""], ["C1160", "
LEAD, TVL-ADX 1559/65
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1161", "
LEAD, PACEMAKER, TENDRIL DX
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1162", "
PACEMAKER, DUAL-CHAMBER,
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1163", "
LEAD, PACEMAKER, TENDRIL SDX
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1173", "
STENT, CORONARY, S540
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1180", "
VIGOR SR, SC, PMKR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1181", "
MERIDIAN SSI, SC, PMKR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1182", "
PULSAR SSI, SC, PMKR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1183", "
JADE IIS, SIGMA 300S, SC, PM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1184", "
SIGMA 200S, SC, PMKR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["E1240", "
WHCHR LITWT DET ARM LEG REST
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["C1302", "
LEAD, DEFIBRILLATOR, TVL SQ01
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1303", "
CAPSURE FIX 6940/4068-110
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1305", "
APLIGRAF, PER 44 SQUARE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1306", "
LEAD, NEUROSTIMULATOR,
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1311", "
PACEMAKER, TRILOGY DR+/DAO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1312", "
STENT, MAGIC WALLSTENT MINI
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1313", "
STENT, MAGIC WALLSTENT MEDIUM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1314", "
STENT,WALLSTENT LONG CORONARY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1315", "
PACEMAKER, VIGOR DR,
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1316", "
PACEMAKER, MERIDIAN DDD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["E1250", "
WHEELCHAIR LIGHTWT FIXED ARM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["C1317", "
PACEMAKER, DISCOVERY SR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1318", "
PACEMAKER, MERIDIAN SR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1319", "
STENT, ENTERAL,
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1320", "
STENT, ILIAC,
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1328", "
EXTERNAL TRANSMITTER,
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1333", "
BILIARY STENT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C1334", "
STENT, PALMAZ-SCHATZ CROWN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1335", "
MESH, HERNIA, PROLENE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C1336", "
CONSTANT FLOW IMP PUMP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1337", "
ISOMED 8472-20/35/60
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["E1260", "
WHEELCHAIR LIGHTWT FOOT REST
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["C1351", "
LEAD, PACEMAKER, CAPSUREFIX,
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1352", "
DEFIBRILLATOR,IMPLANTABLE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1353", "
NEUROSTIMULATOR, IMPLANTABLE,
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1354", "
PACEMAKER,KAPPA 400 DR,
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1355", "
PACEMAKER, KAPPA 600 DR,
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1356", "
DEFIBRILLATOR, PROFILE MD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1357", "
DEFIBRILLATOR, ANGSTROM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1358", "
PACEMAKER,AFFINITY DC 5230R
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1359", "
PACEMAKER, PULSAR DR,
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1361", "
RECORDER, CARDIAC EVENT,
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["A4636", "
HANDGRIP FOR CANE ETC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
900 A
\n", "
\n
\n\n
\n", ""], ["E1270", "
WHEELCHAIR LIGHTWEIGHT LEG R
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["C1362", "
STENT, RX HERCULINK
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C1363", "
GEM DR, DC, DEFIB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1364", "
PHOTON DR V-230HV3 DC DEFIB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1368", "
ON-Q PAIN MGT SYS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1369", "
ANS RENEW STIM SYS RECVR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1371", "
SYMP NITINOL TRANSHEP BIL SY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C1372", "
CORDIS NITINOL BIL STENT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C1375", "
STENT, CORONARY, NIR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1376", "
ANS RENEW STIM SYS LEAD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["C1377", "
SPECIFY 3988 NEURO LEAD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["E1280", "
W/C H-DUTY DET ARM LEG RES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["C1378", "
INTERSTIM TX 3080/3886 LEAD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["C1379", "
PISCES-QUAD 3887 LEAD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["C1420", "
STAPLETAC2 BONEW/DERMIS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["C1421", "
STAPLETAC2 BONE WO DERMIS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["C1450", "
ORTHOSPHERE ARTHROPLASTY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["C1451", "
ORTHOSPHERE ARTHROPLASTY KIT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["C1500", "
ATHERECTOMY SYS, PERIPHERAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1810", "
D114S DILATATION CATH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1811", "
SUGICAL DYNAMICS ANCHORS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["C1812", "
OBL ANCHORS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["E1285", "
WHEELCHAIR HEAVY DUTY FIXED
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["C1850", "
REPLIFORM 14/21 SQ CM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["C1851", "
REPLIFORM 24/28 SQ CM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["C1852", "
TRANSCYTE, PER 247 SQ CM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["C1853", "
SUSPEND, PER 8/14 SQ CM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["C1854", "
SUSPEND, PER 24/28 SQ CM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["C1855", "
SUSPEND, PER 36 SQ CM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["C1856", "
SUSPEND, PER 48 SQ CM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["C1857", "
SUSPEND TUTOPLAST 84 SQ CM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["C1858", "
DURADERM, PER 8/14 SQ CM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["C1859", "
DURADERM, PER 21/24/28 SQ CM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["E1290", "
WHEELCHAIR HVY DUTY DETACH A
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["C1860", "
DURADERM, PER 48 SQ CM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["C1861", "
DURADERM ACELLULAR PER 36SQ
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["C1862", "
DURADERM, PER 72 SQ CM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["C1863", "
DURADERM, PER 84 SQ CM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["C1864", "
SPERMATEX, PER 13.44 SQ CM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["C1865", "
FASLATA, PER 8/14 SQ CM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["C1866", "
FASLATA, PER 24/28 SQ CM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["C1867", "
FASLATA, PER 36/48 SQ CM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["C1868", "
FASLATA, PER 96 SQ CM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["C1869", "
GORE THYROPLASTY DEVICE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["E1295", "
WHEELCHAIR HEAVY DUTY FIXED
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["C1870", "
DERMMATRIX, PER 16 SQ CM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["C1871", "
DERMMATRIX, 32 OR 64 SQ CM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["C1872", "
DERMAGRAFT, PER 37.5 SQ CM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["C1873", "
BARD 3DMAX MESH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["C1929", "
MAVERICK PTCA CATH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1930", "
COYOTE DIL CATH, 20/30/40MM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1931", "
TALON DIL CATH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1932", "
SCIMED REMEDY DIL CATH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1933", "
OPTI-PLAST XL/CENTURION CATH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1934", "
ULTRAVERSE 3.5F BAL DIL CATH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["E1296", "
WHEELCHAIR SPECIAL SEAT HEIG
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["C1935", "
WORKHORSE PTA BAL CATH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1936", "
UROMAX ULTRA BAL DIL CATH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1937", "
SYNERGY/EXPLORER CATH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1938", "
UROFORCE BAL DIL CATH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1939", "
RAPTUR, NINJA PTCA DIL CATH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1940", "
POWERFLEX,OPTA 5/LP BAL CATH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1941", "
JUPITER PTA DIL CATH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1942", "
CORDIS MAXI LD PTA BAL CATH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1943", "
RXCROSSSAIL OTW OPENSAIL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1944", "
RAPID EXCHANGE BIL DIL CATH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["E1297", "
WHEELCHAIR SPECIAL SEAT DEPT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["C1945", "
SAVVY PTA DIL CATH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1946", "
R1S RAPID DIL CATH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1947", "
GAZELLE BAL DIL CATH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C2597", "
CLINICATH 16/18 SGL/DBL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C2598", "
CLINICATH 18/20/24G--SINGLE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C2599", "
CLINICATH 16/18 DOUBLE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C2601", "
BARD DL URETERAL CATH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C2609", "
FLEXIMA BIL DRAINAGE CATH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C2700", "
MYCROPHYLAX PLUS SC DEFIB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C2701", "
PHYLAX XM SC DEFIB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["E1298", "
WHEELCHAIR SPEC SEAT DEPTH/W
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["C2702", "
VENTAK PRIZM 2 VR DEFIB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C2703", "
VENTAK PRIZM VR HE DEFIB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C2704", "
VENTAK MINI IV+ DEFIB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C2801", "
DEFENDER IV DR 612 DC DEFIB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C2802", "
PHYLAX AV
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C2803", "
VENTAK PRIZM DR HE DEFIB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C2804", "
VENTAK PRIZM 2 DR DEFIB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C2805", "
JEWEL AF 7250 DEFIB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C2806", "
GEM VR 7227 DEFIB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C2807", "
CONTAK CD 1823
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["E1300", "
WHIRLPOOL PORTABLE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["C2808", "
CONTAK TR 1241
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C3001", "
KAINOX SL/RV DEFIB LEAD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C3002", "
EASYTRAK DEFIB LEAD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C3003", "
ENDOTAK SQ ARAY XP LEAD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C3004", "
INTERVENE DEFIB LEAD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C3400", "
SILTEX SPECTRUM,CONTOUR PROF
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C3401", "
SALINE-FILLED SPECTRUM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C3500", "
ALPHA I INF PRO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C3510", "
AMS 800 URINARY PROS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C3800", "
SYNCHROMED EL INFUSION PUMP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["E1353", "
OXYGEN REGULATOR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R91 C
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["C3801", "
ARROW/MICROJECT PCA SYS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C3851", "
ELASTIC UV IOLAA-4203T/TF/TL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["C4000", "
OPUS G 4621, 4624 SC PMKR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C4001", "
OPUS S 4121/4124 SC PMKR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C4002", "
TALENT 113 SC PMKR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C4003", "
KAIROS SR SC PMKR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C4004", "
ACTROS SR, ACTROSSR-B SC PMK
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C4005", "
PHILOS SR/SR-B SC PMKR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C4006", "
PULSAR MAX II SR PMKR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C4007", "
MARATHON SR PMKR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["A4637", "
REPL TIP CANE/CRUTCH/WALKER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
900 A
\n", "
\n
\n\n
\n", ""], ["E1355", "
OXYGEN STAND/RACK
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R91 C
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["C4008", "
DISCOVERY II SSI PMKR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C4009", "
DISCOVERY II SR PMKR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C4300", "
INTEGRITY AFX DR 5342 PMKR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C4301", "
INTEGRITY AFX DR 5346 PMKR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C4302", "
AFFINITY VDR 5430 PMKR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C4303", "
BRIO 112 DC PMKR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C4304", "
BRIO212,TALENT213/223DCPMKR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
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INACTIVE
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960 E
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\n
\n\n
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1
\n"], ["C4305", "
BRIO 222 DC PMKR
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File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
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1
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BRIO 220 DC PMKR
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File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
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\n
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1
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KAIROS DR DC PMKR
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File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
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\n
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1
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OXYGEN SUPPL NEBULIZER PORTA
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File: 81, IEN: 104840
\n", "
\n
\n\n
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INACTIVE
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R91 C
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800 A
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\n
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INOS2, INOS2+ DC PMKR
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File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
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\n
\n\n
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1
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ACTROS DR,D,DR-A,SLR DC PMKR
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File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
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\n\n
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1
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ACTROS DR-B DC PMKR
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File: 81, IEN: 104840
\n", "", "
INACTIVE
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960 E
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1
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PHILOS DR/DR-B/SLR DC PMKR
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File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
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1
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PULSAR MAX II DR PMKR
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File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
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1
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MARATHON DR PMKR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
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\n
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1
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MOMENTUM DR PMKR
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File: 81, IEN: 104840
\n", "", "
INACTIVE
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960 E
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1
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SELECTION AFM PMKR
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File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
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1
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DISCOVERY II DR
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File: 81, IEN: 104840
\n", "", "
INACTIVE
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960 E
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1
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DISCOVERY II DDD
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File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
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\n
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1
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OXYGEN CONCENTRATOR TO 244 C
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File: 81, IEN: 104840
\n", "
\n
\n\n
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INACTIVE
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R91 A
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800 B
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\n
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SYNOX,POLYROX,ELOX,RETROX
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File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
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1
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AESCULA LV PMKR LEAD
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File: 81, IEN: 104840
\n", "", "
INACTIVE
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960 E
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\n
\n\n
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1
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TENDRIL SDX, 1488K PMKR LEAD
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File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
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\n
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1
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OSCOR/FLEXION PMKR LEAD
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File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
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\n
\n\n
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1
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CRYSTALLINEACTFIX,CAPSUREFIX
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File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
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\n
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1
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CAPSURE EPI PMKR LEAD
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File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
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\n
\n\n
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1
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FLEXTEND PMKR LEAD
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File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
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\n
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1
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FINELINEII/EZ, THINLINEII/EZ
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File: 81, IEN: 104840
\n", "", "
INACTIVE
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960 E
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1
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BX VELOCITY W/HEPACOAT
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File: 81, IEN: 104840
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INACTIVE
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960 B
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\n\n
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1
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MEMOTHERM STENT
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File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
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1
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OXYGEN CONCENTRATOR TO 488 C
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File: 81, IEN: 104840
\n", "
\n
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INACTIVE
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R91 A
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800 B
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\n
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MEMOTHERM BIL STENT, LARGE
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File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
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\n
\n\n
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1
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MEMOTHERM BIL STENT, X-LARGE
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File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
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\n
\n\n
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1
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PALMAZCORINTHIAN IQ BIL STNT
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File: 81, IEN: 104840
\n", "", "
INACTIVE
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960 B
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\n
\n\n
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1
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PALMAZCORINTHIAN IQ TRANS/BI
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File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
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1
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PALMAZTRANS BIL STENTSYS-MED
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File: 81, IEN: 104840
\n", "", "
INACTIVE
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960 B
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\n
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1
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PALMAZTRANS XL BIL ST-40MM
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File: 81, IEN: 104840
\n", "", "
INACTIVE
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960 B
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\n
\n\n
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1
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PALMAZTRANS XL BIL ST-50MM
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File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
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\n\n
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1
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VISTAFLEX BILIARY STENT
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File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
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\n
\n\n
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1
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RAPID EXCHANGE BIL STENT SYS
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File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
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\n
\n\n
\n", "
1
\n"], ["C5011", "
INTRASTENT, INTRASTENT LP
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File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
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\n
\n\n
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1
\n"], ["E1379", "
OXYGEN CONCENTRATOR TO 732 C
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File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R91 A
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800 B
\n", "
\n
\n\n
\n", ""], ["C5012", "
INTRASTENT DOUBLESTRUT LD
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File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
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\n
\n\n
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1
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INTRASTENT DOUBLESTRUT, XS
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File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
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\n
\n\n
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1
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AVE BRIDGE STENTSYS10/17/28
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File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
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\n
\n\n
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1
\n"], ["C5015", "
AVE/X3 BRIDGE SYS, 40-100
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File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
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\n
\n\n
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1
\n"], ["C5016", "
BILIARY STENT SINGLE USE COV
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File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
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\n
\n\n
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1
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WALLSTENTRP-BIL-20/40/60/68
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
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\n
\n\n
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1
\n"], ["C5018", "
WALLSTENTRP BIL--80/94MM
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File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
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\n
\n\n
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1
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FLEXIMA BIL STENT SYS
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File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
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\n
\n\n
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1
\n"], ["C5020", "
SMART NITINOL STENT--20MM
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File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
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\n
\n\n
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1
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SMART NITINOL STENT--40/60MM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
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\n
\n\n
\n", "
1
\n"], ["E1380", "
OXYGEN CONCENTRATOR TO 976 C
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R91 A
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800 B
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\n
\n\n
\n", ""], ["C5022", "
SMART NITINOL STENT--80MM
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File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
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\n
\n\n
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1
\n"], ["C5023", "
BX VELOCITY STENT--8/13MM
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File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
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\n
\n\n
\n", "
1
\n"], ["C5024", "
BX VELOCITY STENT
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File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C5025", "
BX VELOCITY STENT--23MM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C5026", "
BX VELOCITY STENT--28/33MM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C5027", "
BX VELOCITY W/HEP--8/13MM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C5028", "
BX VELOCITY W/HEP--18MM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
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\n
\n\n
\n", "
1
\n"], ["C5029", "
BX VELOCITY W/HEP--23MM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C5030", "
STENT, CORONARY, S660 9/12MM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C5031", "
STENT, CORONARY, S660 15/18
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["E1381", "
OXYGEN CONCENTRAT TO 1220 CU
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R91 A
\n", "
800 B
\n", "
\n
\n\n
\n", ""], ["C5032", "
STENT,CORONARY, S660 24/30
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
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NIROYAL STNT SYS, 9MM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C5034", "
NIROYAL STENT SYS, 12/15MM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C5035", "
NIROYAL STENT SYS, 18MM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C5036", "
NIROYAL STENT SYS, 25MM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C5037", "
NIROYAL STENT SYS, 31MM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C5038", "
BX VELOCITY STNT W/RAPTOR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C5039", "
INTRACOIL PERIP STENT--40MM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C5040", "
INTRACOIL PERIPH STENT--60MM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C5041", "
BESTENT OVER-THE-WIRE24/30MM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["E1382", "
OXYGEN CONCENTRAT TO 1464 CU
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R91 A
\n", "
800 B
\n", "
\n
\n\n
\n", ""], ["C5042", "
BESTENT OVER-THE-WIRE 18MM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C5043", "
BESTENT OVER-THE-WIRE 15MM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C5044", "
BESTENT OVER-THE-WIRE 9/12MM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C5045", "
MULTILINK TETRA COR STENT SY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C5046", "
RADIUS 20MM COR STENT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C5047", "
NIROYAL ELITE COR STENT SYS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C5048", "
GR II CORONARY STENT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C5130", "
WILSON-COOK Z-STENT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C5131", "
BARD COLORECTAL STENT--60MM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C5132", "
BARD COLORECTAL STENT--80MM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["E1383", "
OXYGEN CONCENTRAT TO 1708 CU
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R91 A
\n", "
800 B
\n", "
\n
\n\n
\n", ""], ["C5133", "
BARD COLORECTAL STENT-100MM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C5134", "
WALLSTENT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C5279", "
CONTOUR/PERCUFLEX STENT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C5280", "
INLAY DBL URETERAL STENT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C5281", "
WALLGRAFT TRACH SYS 70MM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["C5282", "
WALLGRAFT TRACH SYS 20/30/50
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["C5283", "
WALLSTENT/RP TIPS--80MM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["C5284", "
WALLSTENT TRACHULTRAFLEX
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["C5600", "
CLOSURE DEV, VASOSEAL ES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["C5601", "
VASOSEAL 1000
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["E1384", "
OXYGEN CONCENTRAT TO 1952 CU
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R91 A
\n", "
800 B
\n", "
\n
\n\n
\n", ""], ["C6001", "
COMPOSIX MESH 8/18 IN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C6002", "
COMPOSIX MESH 32 IN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C6003", "
COMPOSIX MESH 48 IN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C6004", "
COMPOSIX MESH 80 IN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C6005", "
COMPOSIX MESH 140 IN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C6006", "
COMPOSIX MESH 144 IN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C6012", "
PELVICOL COLLAGEN 8/14 SQ CM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C6013", "
PELVICOL COLLAGEN 21/24/28
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C6014", "
PELVICOL COLLAGEN 40 SQ CM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C6015", "
PELVICOL COLLAGEN 48 SQ CM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["A4640", "
ALTERNATING PRESSURE PAD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
900 F
\n", "
\n
\n\n
\n", ""], ["E1385", "
OXYGEN CONCENTRATOR > 1952 C
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R91 A
\n", "
800 B
\n", "
\n
\n\n
\n", ""], ["C6016", "
PELVICOL COLLAGEN 96 SQ CM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C6017", "
GORE-TEX DUALMESH 75/96 SQCM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C6018", "
GORE TEX MESH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C6019", "
GORE-TEX DUALMESH 285 SQCM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C6020", "
GORE-TEX DUALMESH 432SQCM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C6021", "
GORE-TEX DUALMESH 600 SQCM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C6022", "
GORE-TEX DUALMESH 884 SQCM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C6023", "
GORE-TEXPLUS 1MM,75/96 SQCM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C6024", "
GORE-TEXPLUS 1MM, 150 SQ CM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C6025", "
GORE-TEXPLUS 1MM, 285 SQ CM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["E1399", "
DURABLE MEDICAL EQUIPMENT MI
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "
\n
\n\n
\n", "
R90
\n", "
999 A
\n", "
\n
\n\n
\n", ""], ["C6026", "
GORE-TEXPLUS 1MM, 432 SQCM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C6027", "
GORE-TEXPLUS 1MM, 600 SQCM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C6028", "
GORE-TEXPLUS 1MM,884 SQ CM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C6029", "
GORE-TEXPLUS 2MM, 150 SQ CM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C6030", "
GORE-TEXPLUS 2MM, 285 SQ CM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C6031", "
GORE-TEXPLUS 2MM, 432 SQ CM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C6032", "
GORE-TEXPLUS 2MM, 600 SQ CM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C6033", "
GORE-TEXPLUS 2MM,884 SQ CM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C6034", "
BARD EPTFE: 150 SQ CM-2MM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C6035", "
BARD EPTFE150SQCM-1MM,75-2MM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["E1400", "
OXYGEN CONCENTRATOR < 2 LITE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R91 A
\n", "
800 B
\n", "
\n
\n\n
\n", ""], ["C6036", "
BARD EPTFE: 50/75SQCM-1,2MM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C6037", "
BARD EPFTE: 300SQ CM-1MM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C6038", "
BARD EPTFE: 600SQ CM-1MM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C6039", "
BARD EPTFE: 884 CM--1MM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C6040", "
BARD EPTFE: 600SQ CM-2MM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C6041", "
BARD EPTFE: 884SQ CM-2MM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C6053", "
SURGISIS SOFT GRAFT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C6054", "
SURGISIS ENCHANCED GRAFT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C6055", "
SURGISIS ENHANCED TISSUE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C6056", "
SURGISIS SOFT TISSUE GRAFT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["E1401", "
OXYGEN CONCENTRATOR 2-3 LITE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R91 A
\n", "
800 B
\n", "
\n
\n\n
\n", ""], ["C6057", "
SURGISIS HERNIA GRAFT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C6058", "
PLUG CATHETER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["C6200", "
EXXCEL SFT EPTFE VAS GRAFT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["C6201", "
IMPRA VENAFLO-10/20CM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["C6202", "
IMPRA VENAFLO-30/40CM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["C6203", "
IMPRA VENAFLO-50CM/VT45
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["C6204", "
IMPRA VENAFLO-STEPPED
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["C6205", "
IMPRA CARBOFLO-10CM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["C6206", "
IMPRA CARBOFLO-20CM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["C6207", "
IMPRA CARBOFLO-30/34/40CM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["E1402", "
OXYGEN CONCENTRATOR 3-4 LITE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R91 A
\n", "
800 B
\n", "
\n
\n\n
\n", ""], ["C6208", "
IMPRA CARBOFLO-40/50CM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["C6209", "
IMPRA CARBOFLO-CTRFLEX
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["C6210", "
EXXCEL EPTFE VAS GRAFT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["C6300", "
ENDOVASCULAR GRAFT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["C8501", "
PACEMAKER, VIGOR SSI
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C8504", "
CLOSURE DEVICE, VASOSEAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["C8505", "
INFUSION PUMP, SYNCHROMED
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C8506", "
LEAD, PACEMAKER 4057M,
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C8507", "
LEAD, DEFIBRILLATOR, 6721L,
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C8508", "
LEAD, DEFIBRILLATOR, CAPSURE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["E1403", "
OXYGEN CONCENTRATOR 4-5 LITE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R91 A
\n", "
800 B
\n", "
\n
\n\n
\n", ""], ["C8509", "
LEAD, DEFIBRILLATOR, TRANSVENE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["C8510", "
LEAD, DEFIBRILLATOR, DP-3238
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["C8511", "
LEAD, DEFIBRILLATOR, ENDOTAK
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["C8512", "
LEAD, NEUROSTIMU MODEL 3987,
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["C8513", "
LEAD, NEUROSTIMULPISCES--QUAD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["C8514", "
PROSTHESIS, PENILE, DURA II
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", ""], ["C8516", "
PROSTHESIS, PENILE, MENTOR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", ""], ["C8518", "
PACEMAKER, VIGOR DDD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["C8519", "
PACEMAKER, VISTA DDD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["C8520", "
PACEMAKER, LEGACY II S
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["E1404", "
OXYGEN CONCENTRATOR > 5 LITE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R91 A
\n", "
800 B
\n", "
\n
\n\n
\n", ""], ["C8521", "
MEDTRONIC MATTRIX RCVR/TRMR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["C8522", "
STENT, PALMAZ BALLOON
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", ""], ["C8523", "
STENT,WALLSTENT TRANSHEPATIC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", ""], ["C8524", "
WALLSTENT ESOP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", ""], ["C8525", "
WALLSTENT ESOPH--DOUBLE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", ""], ["C8528", "
MS CLASSIQUE BL DIL CATH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["C8530", "
GEL-FILLED/SMOOTH MAMMARY PR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["C8531", "
WILSON-COOK ESOPH Z-STENT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", ""], ["C8532", "
STENT, ESOPHAGEAL, ULTRAFLEX
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", ""], ["C8533", "
CATHETER, SYNCHROMED VASCULAR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", ""], ["E1405", "
O2/WATER VAPOR ENRICH W/HEAT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R91 C
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["C8534", "
AMS MALLEABLE 650
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", ""], ["C8535", "
BILIARY EXPENDABLE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", ""], ["C8536", "
ESOPH Z METAL STENT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", ""], ["C8539", "
QUANTUM DIL BALLOON
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["C8540", "
FLEX-EZ BAL DILATOR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["C8541", "
CARSON/PASSPRT DIL CATH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["C8542", "
URETHRAMAX DIL CATH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", ""], ["C8724", "
OCTAD NEURO LEAD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["C8725", "
SYMMIX NEURO LEAD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["C8748", "
ENDOTAK SQ PATCH DEFIB LEAD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["E1406", "
O2/WATER VAPOR ENRICH W/O HE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R91 C
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["C8749", "
ENDOTAK SQ ARRAY DEFIB LEAD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["C8750", "
UNITY VDDR DC PMKR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["C8775", "
2188 COR PMKR LEAD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["C8776", "
INNOMEDICA PMKR LEAD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["C8777", "
UNIPASS PMKR LEAD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["C8800", "
LG PALMAZ BIL STENT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", ""], ["C8801", "
GIANTURCO BIL Z STENT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", ""], ["C8802", "
OASIS STENT INTRO SYS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", ""], ["C8830", "
GIANTURCO-ROUBIN COR SNT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["K0001", "
STANDARD WHEELCHAIR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 C
\n", "
\n
\n\n
\n", ""], ["D5935", "
MANDIBULAR RESECTION PROSTH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R90
\n", "
700 C
\n", "
\n
\n\n
\n", ""], ["D5936", "
OBTURATOR/PROSTHESIS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R90
\n", "
700 A
\n", "
\n
\n\n
\n", ""], ["D5953", "
SPEECH AID PROSTHESIS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["D5958", "
PALATAL LIFT PROSTHESIS, INT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R90
\n", "
700 C
\n", "
\n
\n\n
\n", "
1
\n"], ["D5959", "
PALATAL LIFT PROSTHESIS, MOD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R90
\n", "
700 C
\n", "
\n
\n\n
\n", "
1
\n"], ["E0148", "
WALKER, HEAVY DUTY, W/O WHEEL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 A
\n", "
\n
\n\n
\n", ""], ["E0149", "
WALKER, HEAVY DUTY, WHEELED
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 A
\n", "
\n
\n\n
\n", ""], ["E0168", "
COMMODE CHAIR, EXTRA WIDE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 I
\n", "
\n
\n\n
\n", ""], ["E0298", "
HOSPITAL BED, HEAVY DUTY,E/W
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 A
\n", "
\n
\n\n
\n", ""], ["A9300", "
EXERCISE EQUIPMENT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["K0002", "
STD HEMI (LOW SEAT) W/C
\n", "", "", "
E1084
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["E0571", "
AEROSOL COMP, BATTERY PWD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R91 C
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["E0572", "
AEROSOL COMP, ADJ PRESS, LT D
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R91 C
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["E0574", "
ULTRASONIC GENERATOR, SM VOL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R91 C
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["E0756", "
IMPLANTABLE NEUROSTIMULATOR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["E0757", "
IMPLANTABLE NEUROSTIMULATOR RA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 C
\n", "
\n
\n\n
\n", ""], ["E0758", "
RADIOFREQUENCY TRANSMITTER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0765", "
NERVE STIMULATOR, WITH BATTE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0786", "
IMPLANTABLE PROGRAMMABLE INFUS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", ""], ["E0830", "
AMBULATORY TRACTION DEVICE ATT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E1900", "
SYNTHESIZED SPEECH AUGMENTAT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 M
\n", "
\n
\n\n
\n", ""], ["K0003", "
LIGHTWEIGHT WHEELCHAIR
\n", "", "", "
E1240
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["K0538", "
NEGATIVE PRESSURE WOUND THERA
\n", "", "", "
E2402
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["K0540", "
CANISTER SET FOR NEGATIVE PRES
\n", "", "", "
A6551
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["K0541", "
SPEECH DIGITIZED, PRE-RECORDED
\n", "", "", "
E2500
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 M
\n", "
\n
\n\n
\n", ""], ["K0542", "
SPEECH DIGIT PRE-RECORDED 8MIN
\n", "", "", "
E2502
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 M
\n", "
\n
\n\n
\n", ""], ["K0543", "
SPEECH SYNTHESIZED FORMULATION
\n", "", "", "
E2508
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 M
\n", "
\n
\n\n
\n", ""], ["K0544", "
SPEECH SYNTHESIZED MULTIPLE
\n", "", "", "
E2510
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 M
\n", "
\n
\n\n
\n", ""], ["K0545", "
SPEECH GENERATING SOFTWARE
\n", "", "", "
E2511
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 M
\n", "
\n
\n\n
\n", ""], ["K0546", "
ACCESSORY SPEECH GENERATING
\n", "", "", "
E2512
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 M
\n", "
\n
\n\n
\n", ""], ["K0547", "
ACCESSORY SPEECH NOT OTHERWISE
\n", "", "", "
E2599
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 M
\n", "
\n
\n\n
\n", ""], ["L3760", "
ELBOW ORTHOSIS, ADJUSTABLE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["K0004", "
HIGH STRENGTH LTWT WHLCHR
\n", "", "", "
E1088
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["L3923", "
HAND FINGER ORTHOSIS WITHOUT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
\n", ""], ["L8040", "
NASAL PROSTHESIS, NON-PHYSIC
\n", "", "", "", "", "", "", "
YES
\n", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
700 B
\n", "
\n
\n\n
\n", ""], ["L8041", "
MIDFACIAL PROSTHESIS, NON-PH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
700 B
\n", "
\n
\n\n
\n", ""], ["L8042", "
ORBITAL PROSTHESIS, NON-PHYSIC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
700 B
\n", "
\n
\n\n
\n", ""], ["L8043", "
UPPER FACIAL PROSTHESIS, NON
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
700 B
\n", "
\n
\n\n
\n", ""], ["L8044", "
HEMI-FACIAL PROSTHESIS, NON-
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
700 B
\n", "
\n
\n\n
\n", ""], ["L8045", "
AURICULAR PROSTHESIS, NON-PHYS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
700 B
\n", "
\n
\n\n
\n", ""], ["L8046", "
PARTIAL FACIAL PROSTHESIS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
700 B
\n", "
\n
\n\n
\n", ""], ["L8047", "
NASAL SEPTAL PROSTHESIS, NON
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
700 B
\n", "
\n
\n\n
\n", ""], ["L8048", "
UNSPECIFIED MAXILLOFACIAL PROS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
700 B
\n", "", ""], ["K0005", "
ULTRALIGHTWEIGHT WHEELCHAIR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["L8049", "
REP/MODIF OF MAXILLOFACIAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
700 B
\n", "
\n
\n\n
\n", ""], ["L8699", "
PROSTHETIC IMPLANT, NOT OTHER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", ""], ["S8105", "
OXIMETER FOR MEASURING BLOOD
\n", "", "", "
E0445
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "
R91 D
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["S8200", "
CHEST COMPRESSION VEST
\n", "", "", "
E0483
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["S8205", "
CHECT COMPRESSION SYSTEM
\n", "", "", "
E0483
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["S8400", "
INCONTINENCE PANTS, EACH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["S8402", "
DIAPERS, EACH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["S8405", "
INCONTINENCE LINERS, EACH
\n", "", "", "
A4535
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4301", "
IMPLANTABLE ACCESS TOTAL SYSTE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", ""], ["A4460", "
ELASTIC BANDAGE, PER ROLL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
400 D
\n", "
\n
\n\n
\n", ""], ["K0006", "
HEAVY DUTY WHEELCHAIR
\n", "", "", "
E1290
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["D6020", "
ENDOSTEAL IMPLANT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 F
\n", "
\n
\n\n
\n", "
1
\n"], ["D6040", "
EPOSTEAL IMPLANT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 F
\n", "
\n
\n\n
\n", "
1
\n"], ["D6056", "
PREFABRICATED ABUTMENT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 F
\n", "
\n
\n\n
\n", "
1
\n"], ["D6057", "
CUSTOM ABUTMENT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 F
\n", "
\n
\n\n
\n", "
1
\n"], ["K0007", "
EXTRA HEAVY DUTY WHEELCHAIR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["C1948", "
ORACLE MEGASONICS CATH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["DI100", "
FIXTURE, CYL, NON-COATED
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 F
\n", "
\n
\n\n
\n", "
1
\n"], ["K0008", "
CSTM MANUAL WHEELCHAIR/BASE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["DI101", "
FIXTURE, CYL, HA COATED
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 F
\n", "
\n
\n\n
\n", "
1
\n"], ["DI102", "
FIXTURE, CYL, TPS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 F
\n", "
\n
\n\n
\n", "
1
\n"], ["DI103", "
FIXTURE, SCREW, NON-COATED
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 F
\n", "
\n
\n\n
\n", "
1
\n"], ["DI104", "
FIXTURE, SCREW, HA COATED
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 F
\n", "
\n
\n\n
\n", "
1
\n"], ["DI105", "
FIXTURE, SCREW, TPS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 F
\n", "
\n
\n\n
\n", "
1
\n"], ["DI106", "
HEALING ABUTMENT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 F
\n", "
\n
\n\n
\n", "
1
\n"], ["DI107", "
COVER SCREW
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 F
\n", "
\n
\n\n
\n", "
1
\n"], ["DI108", "
DRILL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 F
\n", "
\n
\n\n
\n", "
1
\n"], ["DI109", "
TRANSMANDIBULAR IMPLANT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 F
\n", "
\n
\n\n
\n", "
1
\n"], ["DI110", "
STAPLE IMPLANT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 F
\n", "
\n
\n\n
\n", "
1
\n"], ["K0009", "
OTHER MANUAL WHEELCHAIR/BASE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["DI111", "
TMI RINGS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 F
\n", "
\n
\n\n
\n", "
1
\n"], ["DI112", "
TMI BAR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 F
\n", "
\n
\n\n
\n", "
1
\n"], ["DI113", "
STAPLE IMPLANT BAR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 F
\n", "
\n
\n\n
\n", "
1
\n"], ["D6095", "
REPAIR IMPLANT ABUTMENT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 F
\n", "
\n
\n\n
\n", "
1
\n"], ["D6199", "
UNSPECIFIED IMPLANT PROCEDURE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 F
\n", "
\n
\n\n
\n", "
1
\n"], ["A7018", "
WATER DISTILLED W/ NEBULIZER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["A4360", "
ADULT INCONTINENCE GARMENT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4706", "
BICARBONATE CONC SOL PER GAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
920 B
\n", "
\n
\n\n
\n", ""], ["A4707", "
BICARBONATE CONC POW PER PAC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
920 B
\n", "
\n
\n\n
\n", ""], ["A4708", "
ACETATE CONCENTRATE SOLUTION
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
920 B
\n", "
\n
\n\n
\n", ""], ["K0010", "
STD WT FRAME POWER W/C
\n", "", "", "
E1213
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 A
\n", "
\n
\n\n
\n", ""], ["A4709", "
ACID CONCENTRATE, SOLUTION
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
920 B
\n", "
\n
\n\n
\n", ""], ["A4719", "
Y SET TUBING FOR PERITONEAL D
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
920 B
\n", "
\n
\n\n
\n", ""], ["A4721", "
DIALYSATE SOLUTION
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
920 B
\n", "
\n
\n\n
\n", ""], ["A4722", "
DIALYSATE SOLUTION, ANY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
920 B
\n", "
\n
\n\n
\n", ""], ["C1756", "
CATHETER, PACING
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["C1757", "
CATH, THROMBECTOMY/EMBOLECT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["A4723", "
DIALYS SOL FLD VOL > 2999CC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
920 B
\n", "
\n
\n\n
\n", ""], ["A4724", "
DIALYS SOL FLD VOL > 3999CC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
920 B
\n", "
\n
\n\n
\n", ""], ["C1758", "
CATHETER, URETERAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", ""], ["A4725", "
DIALYS SOL FLD VOL > 4999CC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
920 B
\n", "
\n
\n\n
\n", ""], ["K0011", "
STND WT PWR WHLCHR W CONTROL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 A
\n", "
\n
\n\n
\n", ""], ["C2621", "
PMKR, OTHER THAN SING/DUAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["A4726", "
DIALYS SOL FLD VOL > 5999CC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
920 B
\n", "
\n
\n\n
\n", ""], ["C2622", "
PROSTHESIS, PENILE, NON-INF
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", ""], ["A4766", "
DIALYSATE CONC SOL ADD 10 ML
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
920 B
\n", "
\n
\n\n
\n", ""], ["C2625", "
STENT, NON-COR, TEM W/DEL SY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", ""], ["A4911", "
DRAIN BAG/BOTTLE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
920 B
\n", "
\n
\n\n
\n", ""], ["C2626", "
INFUSION PUMP, NON-PROG,TEMP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", ""], ["B9000", "
ENTER INFUSION PUMP W/O ALRM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["K0012", "
LTWT PORTBL POWER WHLCHR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 A
\n", "
\n
\n\n
\n", ""], ["A4928", "
SURGICAL MASK
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
920 B
\n", "
\n
\n\n
\n", ""], ["C2627", "
CATH, SUPRAPUBIC/CYSTOSCOPIC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", ""], ["A4929", "
TOURNIQUET FOR DIALYSIS, EA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
920 B
\n", "
\n
\n\n
\n", ""], ["C2628", "
CATHETER, OCCLUSION
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", ""], ["A5509", "
DIRECT HEAT FORM SHOE INSERT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R50 A
\n", "
500 F
\n", "
\n
\n\n
\n", ""], ["C9201", "
DERMAGRAFT, PER 37.5 SQ CM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", ""], ["C1763", "
CONNECTIVE TISSUE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", ""], ["A5510", "
COMPRESSION FORM SHOE INSERT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
500 E
\n", "
\n
\n\n
\n", ""], ["A5511", "
CUSTOM FAB MOLDED SHOE INSER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
500 E
\n", "
\n
\n\n
\n", ""], ["A6000", "
WOUND WARMING WOUND COVER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0013", "
CUSTOM POWER WHLCHR BASE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 A
\n", "
\n
\n\n
\n", ""], ["C1759", "
CATH, INTRA ECHOCARDIOGRAPHY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["A7505", "
HMES OR TRACH VALVE HOUSING
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["C1760", "
CLOSURE DEV, VASC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["E0169", "
SEATLIFT INCORP COMMODECHAIR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 I
\n", "
\n
\n\n
\n", ""], ["A7506", "
HMES/TRACHVALVE ADHESIVEDISK
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["E0221", "
INFRARED HEATING PAD SYSTEM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["C1762", "
CONN TISS, HUMAN(INC FASCIA)
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", ""], ["B4086", "
GASTROSTOMY/JEJUNOSTOMY TUBE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", ""], ["E0231", "
WOUND WARMING DEVICE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["C1713", "
ANCHOR/SCREW BN/BN,TIS/BN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", ""], ["K0014", "
OTHER POWER WHLCHR BASE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 A
\n", "
\n
\n\n
\n", ""], ["C1714", "
CATH, TRANS ATHERECTOMY, DIR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", ""], ["E0232", "
WARMING CARD FOR NWT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["C1764", "
EVENT RECORDER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["C1721", "
AICD, DUAL CHAMBER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["E0316", "
BED SAFETY ENCLOSURE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
900 G
\n", "
\n
\n\n
\n", ""], ["C1722", "
AICD, SINGLE CHAMBER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["E0481", "
INTRPULMNRY PERCUSS VENT SYS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
900 K
\n", "
\n
\n\n
\n", ""], ["C1724", "
CATH, TRANS ATHEREC,ROTATION
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", ""], ["E0482", "
COUGH STIMULATING DEVICE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0603", "
ELECTRIC BREAST PUMP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
900 K
\n", "
\n
\n\n
\n", ""], ["K0015", "
DETACH NON-ADJUS HGHT ARMRST
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["C1725", "
CATH, TRANSLUMIN NON-LASER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["C1767", "
GENERATOR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", ""], ["E0604", "
HOSP GRADE ELEC BREAST PUMP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
900 K
\n", "
\n
\n\n
\n", ""], ["C1726", "
CATH, BAL DIL, NON-VASCULAR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["E0752", "
NEUROSTIMULATOR ELECTRODE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", ""], ["E0754", "
PULSEGENERATOR PT PROGRAMMER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
900 K
\n", "
\n
\n\n
\n", ""], ["C1727", "
CATH, BAL TIS DIS, NON-VAS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["C1768", "
GRAFT, VASCULAR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", ""], ["E0759", "
REPLACE RDFRQUNCY TRANSMITTR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "", "
\n
\n\n
\n", ""], ["C1728", "
CATH, BRACHYTX SEED ADM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["K0016", "
DETACH ADJUST ARMRST CMPLETE
\n", "", "", "
E0973
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["C1769", "
GUIDE WIRE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["C1729", "
CATH, DRAINAGE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", ""], ["C1750", "
CATH, HEMODIALYSIS,LONG-TERM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 C
\n", "
\n
\n\n
\n", ""], ["C1751", "
CATH, INF, PER/CENT/MIDLINE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", ""], ["E1637", "
HEMOSTATS FOR DIALYSIS, EACH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
920 A
\n", "
\n
\n\n
\n", ""], ["C1772", "
INFUSION PUMP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", ""], ["C1752", "
CATH,HEMODIALYSIS,SHORT-TERM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 C
\n", "
\n
\n\n
\n", ""], ["E1638", "
PERI DIALYSIS HEATING PAD
\n", "", "", "
E0210
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
920 A
\n", "
\n
\n\n
\n", ""], ["C1753", "
CATH, INTRAVAS ULTRASOUND
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", ""], ["E1639", "
DIALYSIS SCALE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
920 A
\n", "
\n
\n\n
\n", ""], ["K0017", "
DETACH ADJUST ARMREST BASE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["C1776", "
JOINT DEVICE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", ""], ["C1754", "
CATHETER, INTRADISCAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", ""], ["C1755", "
CATHETER, INTRASPINAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", ""], ["E1801", "
SPS ELBOW DEVICE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["C1777", "
LEAD, AICD, ENDO SINGLE COIL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["C1785", "
PMKR, DUAL, RATE-RESP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["E1806", "
SPS WRIST DEVICE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["C1778", "
LEAD, NEUROSTIMULATOR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["C1786", "
PMKR, SINGLE, RATE-RESP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["E1811", "
SPS KNEE DEVICE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["K0018", "
DETACH ADJUST ARMRST UPPER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["C1787", "
PATIENT PROGR, NEUROSTIM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["C1779", "
LEAD, PMKR, TRANSVENOUS VDD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["E1816", "
SPS ANKLE DEVICE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["C1788", "
PORT, INDWELLING, IMP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["C1780", "
LENS, INTRAOCULAR (NEW TECH)
\n", "", "", "
V2630
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", ""], ["E1818", "
SPS FOREARM DEVICE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["C1789", "
PROSTHESIS, BREAST, IMP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["C1781", "
MESH (IMPLANTABLE)
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", ""], ["E1821", "
REPLACEMENT INTERFACE SPSD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["C1813", "
PROSTHESIS, PENILE, INFLATAB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", ""], ["K0019", "
ARM PAD EACH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["C1784", "
OCULAR DEV, INTRAOP, DET RET
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", ""], ["E1840", "
ADJ SHOULDER EXT/FLEX DEVICE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["C1815", "
PROS, URINARY SPH, IMP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", ""], ["E1902", "
COMMUNICATION BOARD, NON-ELECT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
900 K
\n", "
\n
\n\n
\n", ""], ["C1816", "
RECEIVER/TRANSMITTER, NEURO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", ""], ["C2620", "
PMKR, SINGLE, NON RATE-RESP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["E2000", "
GASTRIC SUCTION PUMP, HOME
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["C2619", "
PMKR, DUAL, NON RATE-RESP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["C1817", "
SEPTAL DEFECT IMPLANT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", ""], ["E2100", "
BLOOD GLUCOSE MONITOR W VOICE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["K0020", "
FIXED ADJUST ARMREST PAIR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["C2617", "
STENT, NON-CORONARY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["E2101", "
BLOOD GLUCOSE MONITOR W LANCE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["C1874", "
STENT, COATED/COV W/DEL SYS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["C1899", "
LEAD, PMKR/AICD COMBINATION
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["K0549", "
HOSP BED HVY DTY XTRA WIDE
\n", "", "", "
E0301
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 D
\n", "
\n
\n\n
\n", ""], ["C1875", "
STENT, COATED/COV W/O DEL SY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["K0550", "
HOSP BED XTRA HVY DTY X WIDE
\n", "", "", "
E0302
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 D
\n", "
\n
\n\n
\n", ""], ["C1876", "
STENT, NON-COA/NON-COV W/DEL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["C1898", "
LEAD, PMKR, OTHER THAN TRANS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["C1897", "
LEAD, NEUROSTIM TEST KIT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", ""], ["K0021", "
ANTI-TIPPING DEVICE EACH
\n", "", "", "
E0971
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["C1877", "
STENT, NON-COAT/COV W/O DEL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["K0551", "
RESIDUAL LIMB SUPPORT SYSTEM
\n", "", "", "
E1020
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["C1878", "
MATRL FOR VOCAL CORD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", ""], ["C1896", "
LEAD, AICD, NON SING/DUAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["C1895", "
LEAD, AICD, ENDO DUAL COIL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["C1879", "
TISSUE MARKER, IMPLANTABLE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["L0321", "
TLSO, ANTERIOR-POSTERIOR CON
\n", "", "", "
L0468
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["C1891", "
INFUSION PUMP,NON-PROG, PERM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", ""], ["C1880", "
VENA CAVA FILTER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "", ""], ["L0331", "
TLSO ANT-POST-LAT CNTRL PRFB
\n", "", "", "
L0450
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["B9002", "
ENTERAL INFUSION PUMP W/ ALA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["K0022", "
REINFORCED BACK UPHOLSTERY
\n", "", "", "
E0982
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["C1883", "
ADAPT/EXT, PACING/NEURO LEAD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["C1881", "
DIALYSIS ACCESS SYSTEM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 C
\n", "
\n
\n\n
\n", ""], ["L0391", "
TLSO ANT-POST-LAT-ROT CNTRL
\n", "", "", "
L0470
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L0561", "
PREFAB LSO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L5331", "
HIP DISARTICULATION, CANADIAN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 D
\n", "
200 G
\n", "
\n
\n\n
\n", "
1
\n"], ["L0986", "
SPINAL ORTH ABDM PNL PREFAB
\n", "", "", "
L0999
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "
R40
\n", "", "
\n
\n\n
\n", ""], ["C1882", "
AICD, OTHER THAN SING/DUAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["L5341", "
HEMIPELVECTOMY CANADIAN SACH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 D
\n", "
200 G
\n", "
\n
\n\n
\n", "
1
\n"], ["L1005", "
TENSION BASED SCOLIOSIS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L5671", "
BK/AK LOCKING MECHANISM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 A
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["K0023", "
PLANR BACK INSRT FOAM W/STRP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["L2768", "
ORTHOTIC SIDE BAR DISCON
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "", "
\n
\n\n
\n", ""], ["L5847", "
MICROPROCESSOR CNTRL FEATURE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R20 A
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L3677", "
SHOULDER ORTHOSIS, HARD PLAS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["S8180", "
TRACHEOSTOMY SHOW PROTECTOR
\n", "", "", "
A7523
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["L5989", "
PYLON W ELCTRNC FORCE SENSOR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R20 A
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L5301", "
BELOW KNEE, MOLDED SOCK
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 C
\n", "
200 F
\n", "
\n
\n\n
\n", "
1
\n"], ["L5990", "
USER ADJUSTABLE HEEL HEIGHT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R20 D
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L5311", "
KNEE DISARTICULATION
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 C
\n", "
200 G
\n", "
\n
\n\n
\n", "
1
\n"], ["L6881", "
AUTOGRASP FEATURE UL TERM DV
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["S8181", "
TRACHEOSTOMY TUBE HOLDER
\n", "", "", "
A7526
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0024", "
PLNR BACK INSRT FOAM W/HRDWR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["L5321", "
ABOVE KNEE, MOLDED SOC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 A
\n", "
200 H
\n", "
\n
\n\n
\n", "
1
\n"], ["L6882", "
MICROPROCESSOR CONTROL UPLMB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R30
\n", "
300 D
\n", "
\n
\n\n
\n", ""], ["L8001", "
BREAST PROSTHESIS BRA & FORM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
700 C
\n", "
\n
\n\n
\n", ""], ["S8182", "
HUMIDIFIER NON-SERVO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
800 A
\n", "
\n
\n\n
\n", ""], ["L8002", "
BRST PRSTH BRA & BILAT FORM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
700 C
\n", "
\n
\n\n
\n", ""], ["S8450", "
SPLINT, DIGIT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
400 D
\n", "
\n
\n\n
\n", ""], ["S8183", "
HUMIDIFIER DUAL SERVO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
800 A
\n", "
\n
\n\n
\n", ""], ["S8452", "
SPLINT, ELBOW
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
400 D
\n", "
\n
\n\n
\n", ""], ["L8505", "
ARTIFICIAL LARYNX, ACCESSORY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R90
\n", "", "
\n
\n\n
\n", ""], ["S8185", "
FLUTTER DEVICE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["K0025", "
HOOK-ON HEADREST EXTENSION
\n", "", "", "
E0966
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["S8186", "
SWIVEL ADAPTOR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["L8507", "
TRACH-ESOPH VOICE PROS PT IN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["V5242", "
HEARING AID, MONAURAL, CIC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 C
\n", "
600 B
\n", "
\n
\n\n
\n", ""], ["S8190", "
ELECTRONIC SPIROMETER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
800 A
\n", "
\n
\n\n
\n", ""], ["L8509", "
TRACH-ESOPH VOICE PROS MD IN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["V5243", "
HEARING AID, MONAURAL, ITC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 C
\n", "
600 B
\n", "
\n
\n\n
\n", ""], ["S8403", "
ADULT-SIZE PULL-UP BRIEF
\n", "", "", "
A4528
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["L8510", "
VOICE AMPLIFIER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R90
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["V5244", "
HEARING AID, PROG, MON, CIC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 C
\n", "
600 B
\n", "
\n
\n\n
\n", ""], ["S8420", "
CUSTOM GRADIENT SLEEV/GLOV
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0026", "
BACK UPHOLST LGTWT WHLCHR
\n", "", "", "
E0982
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["S0500", "
DISPOSABLE CONTACT LENS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
600 D
\n", "
\n
\n\n
\n", ""], ["V5245", "
HEARING AID, PROG, MON, ITC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 C
\n", "
600 B
\n", "
\n
\n\n
\n", ""], ["S0504", "
SINGLE VISION PRESCR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["S0506", "
BIFOCAL VISION PRESCR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V5246", "
HEARING AID, PROG, MON, ITE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 C
\n", "
600 B
\n", "
\n
\n\n
\n", ""], ["S8421", "
READY GRADIENT SLEEV/GLOV
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["S0508", "
TRIFOCAL VISION PRESCR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V5247", "
HEARING AID, PROG, MON, BTE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 C
\n", "
600 B
\n", "
\n
\n\n
\n", ""], ["S8422", "
CUSTOM GRAD SLEEVE MED
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["S0510", "
NON-PRESCRIPTION LENS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["K0027", "
BACK UPHOLST OTHER WHLCHR
\n", "", "", "
E0982
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["S0512", "
DAILY CONT LENS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
600 D
\n", "
\n
\n\n
\n", ""], ["V5248", "
HEARING AID, BINAURAL, CIC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 C
\n", "
600 B
\n", "
\n
\n\n
\n", ""], ["S0514", "
COLOR CONTACT LENS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
600 D
\n", "
\n
\n\n
\n", ""], ["S8423", "
CUSTOM GRAD SLEEVE HEAVY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["S0516", "
SAFETY EYEGLASS FRAMES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 B
\n", "", "
\n
\n\n
\n", ""], ["V5249", "
HEARING AID, BINAURAL, ITC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 C
\n", "
600 B
\n", "
\n
\n\n
\n", ""], ["S0518", "
SUNGLASSES FRAMES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 B
\n", "", "
\n
\n\n
\n", ""], ["S8424", "
READY GRADIENT SLEEVE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["V5250", "
HEARING AID, PROG, BIN, CIC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 C
\n", "
600 B
\n", "
\n
\n\n
\n", ""], ["S0580", "
POLYCARBONATE LENS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 B
\n", "", "
\n
\n\n
\n", ""], ["K0028", "
FULLY RECLINING BACK
\n", "", "", "
E1226
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["V5251", "
HEARING AID, PROG, BIN, ITC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 C
\n", "
600 B
\n", "
\n
\n\n
\n", ""], ["S0581", "
NONSTANDARD LENS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 B
\n", "", "
\n
\n\n
\n", ""], ["V5252", "
HEARING AID, PROG, BIN, ITE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 C
\n", "
600 B
\n", "
\n
\n\n
\n", ""], ["S8100", "
SPACER WITHOUT MASK
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["S8425", "
CUSTOM GRAD GLOVE MED
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["V5253", "
HEARING AID, PROG, BIN, BTE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 C
\n", "
600 B
\n", "
\n
\n\n
\n", ""], ["S8101", "
SPACER WITH MASK
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["V5254", "
HEARING AID, DIGIT, MON, CIC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 C
\n", "
600 B
\n", "
\n
\n\n
\n", ""], ["S8426", "
CUSTOM GRAD GLOVE HEAVY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["V5255", "
HEARING AID, DIGIT, MON, ITC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 C
\n", "
600 B
\n", "
\n
\n\n
\n", ""], ["K0029", "
REINFORCED SEAT UPHOLSTERY
\n", "", "", "
E0981
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["S8427", "
READY GRADIENT GLOVE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["V5256", "
HEARING AID, DIGIT, MON, ITE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 C
\n", "
600 B
\n", "
\n
\n\n
\n", ""], ["S8428", "
READY GRADIENT GAUNTLET
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["V5257", "
HEARING AID, DIGIT, MON, BTE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 C
\n", "
600 B
\n", "
\n
\n\n
\n", ""], ["V5258", "
HEARING AID, DIGIT, BIN, CIC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 C
\n", "
600 B
\n", "
\n
\n\n
\n", ""], ["S8429", "
GRADIENT PRESSURE WRAP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["V5259", "
HEARING AID, DIGIT, BIN, ITC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 C
\n", "
600 B
\n", "
\n
\n\n
\n", ""], ["V5260", "
HEARING AID, DIGIT, BIN, ITE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 C
\n", "
600 B
\n", "
\n
\n\n
\n", ""], ["V5261", "
HEARING AID, DIGIT, BIN, BTE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 C
\n", "
600 B
\n", "
\n
\n\n
\n", ""], ["V5262", "
HEARING AID, DISP, MONAURAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 C
\n", "
600 B
\n", "
\n
\n\n
\n", ""], ["K0030", "
SOLID PLNR SEAT SNGL DNSFOAM
\n", "", "", "
E0992
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["V5263", "
HEARING AID, DISP, BINAURAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 C
\n", "
600 B
\n", "
\n
\n\n
\n", ""], ["V5264", "
EAR MOLD/INSERT NOT DISP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
600 E
\n", "
\n
\n\n
\n", ""], ["V5265", "
EAR MOLD/INSERT, DISP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
600 E
\n", "
\n
\n\n
\n", ""], ["V5266", "
BATTERY FOR HEARING DEVICE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 C
\n", "", "
\n
\n\n
\n", ""], ["V5267", "
HEARING AID SUPPLY/ACCESSORY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 C
\n", "", "
\n
\n\n
\n", ""], ["V5268", "
ALD, TELEPHONE AMPLIFIER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 D
\n", "
600 F
\n", "
\n
\n\n
\n", ""], ["V5269", "
ALD, ALERTING DEVICE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 D
\n", "
600 F
\n", "
\n
\n\n
\n", ""], ["V5270", "
ALD, TV AMPLIFIER, ANY TYPE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 D
\n", "
600 F
\n", "
\n
\n\n
\n", ""], ["V5271", "
ALD, TV CAPTION DECODER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 D
\n", "
600 F
\n", "
\n
\n\n
\n", ""], ["V5272", "
ALD, TDD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 D
\n", "
600 F
\n", "
\n
\n\n
\n", ""], ["K0031", "
SAFETY BELT/PELVIC STRAP
\n", "", "", "
E0978
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["V5273", "
ASSISTIVE LISTENING DEVICE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 D
\n", "
600 F
\n", "
\n
\n\n
\n", ""], ["V5274", "
ASSISTIVE LEARNING DEVICE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 D
\n", "
600 F
\n", "
\n
\n\n
\n", ""], ["V5275", "
EAR IMPRESSION, EACH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
600 E
\n", "
\n
\n\n
\n", ""], ["S8451", "
SPLINT WRIST OR ANKLE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
400 D
\n", "
\n
\n\n
\n", ""], ["DI114", "
FIXTURE, SURFACE PREPARED
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 F
\n", "
\n
\n\n
\n", ""], ["DI115", "
FIXTURE ANALOG
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 F
\n", "
\n
\n\n
\n", ""], ["DI116", "
ABUTMENT ANALOG
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 F
\n", "
\n
\n\n
\n", ""], ["DI117", "
IMPRESSION COPING, PIN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 F
\n", "
\n
\n\n
\n", ""], ["DI118", "
LABORATORY SCREW
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 F
\n", "
\n
\n\n
\n", ""], ["DI119", "
FIXTURE SCREW
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 F
\n", "
\n
\n\n
\n", ""], ["B9004", "
PARENTERAL INFUS PUMP PORTAB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["K0032", "
SEAT UPHOLS LGTWT WHLCHR
\n", "", "", "
E0981
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["DI120", "
ABUTMENT SCREW
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 F
\n", "
\n
\n\n
\n", ""], ["DI121", "
OVERDENTURE ABUTMENT, HOUSING
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 F
\n", "
\n
\n\n
\n", ""], ["VA125", "
SOCKS, DIABETIC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4462", "
ABDOMINAL DRESSING BINDER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
400 G
\n", "
\n
\n\n
\n", ""], ["A4465", "
NONELASTIC BINDER EXTREMITY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
400 D
\n", "
\n
\n\n
\n", ""], ["E0785", "
IMPLANT INTRASPINAL CATHETER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", ""], ["E0791", "
PARENTRAL INFUSION PUMP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["VA126", "
SERVICE DOG
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["C1887", "
CATHETER GUIDING
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", ""], ["DL184", "
COVERS/CUSHIONS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
100 F
\n", "
\n
\n\n
\n", ""], ["K0033", "
SEAT UPHOLSTERY OTHER WHLCHR
\n", "", "", "
E0981
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["DL185", "
COVERS/MATTRESSES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
900 F
\n", "
\n
\n\n
\n", ""], ["DL186", "
DRESSING AIDS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL187", "
GROOMING ACCESSORIES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL188", "
KITCHEN PRODUCTS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL189", "
PERSONAL CARE/HYGIENE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL190", "
FEEDER & ACCESSORIES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL191", "
ADL UTILITY PRODUCTS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
900 K
\n", "
\n
\n\n
\n", ""], ["DL192", "
WRITING ASSISTING DEVICES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
900 K
\n", "
\n
\n\n
\n", ""], ["SI408", "
LE INTERSTEM IMPLANT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", ""], ["SI409", "
LE HIP SCREW,ANCOR,PLT,ROD,ETC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["K0034", "
HEEL LOOP EACH
\n", "", "", "
E0951
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["SI410", "
LE PARTIAL HIP STEM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["SI411", "
LE PARTIAL HIP CUP/SHELL-ACETA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["SI412", "
LE TOT HIP INSERT/LINEAR ACETA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["SI413", "
LE TOT HIP HEAD-FEMORAL MODU
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["SI414", "
LE TOT HIP SCRW,ANCR,ROD,ETC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["SI415", "
LE PARTIAL HIP COMPONENT-OTHER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["SI416", "
LE PARTIAL KNEE COMPONENT-FEMO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["SI417", "
LE PARTIAL KNEE BASE-TIBIAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["SI418", "
LE PARTIAL KNEE PATELLA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["SI419", "
LE PARTIAL KNEE COMP/OTHR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["K0035", "
HEEL LOOP WITH ANKLE STRAP
\n", "", "", "
E0951
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["SI131", "
HN SCREW,ANCOR,PLT,ROD,ETC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["SI223", "
ABD IMPLANT SCREW, ANCHOR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["SI307", "
UE SCREW,ANCOR,PLT,ROD,PIN,ETC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 C
\n", "
\n
\n\n
\n", "
1
\n"], ["SI526", "
THOR SCREW,ANCOR,PLT,ROD,ETC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["SI527", "
GRAFT/MESH/CAGE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["SI528", "
GRAFT/ABDOMINAL/HERNIA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["VA127", "
WALKER ACCESSORIES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
900 A
\n", "
\n
\n\n
\n", ""], ["VA128", "
SCOOTER ACCESSORIES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
100 I
\n", "
\n
\n\n
\n", ""], ["VA129", "
EDEMA GLOVES(I.E.ISOTONER)
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["VA130", "
DOOR OPENER ELECTRIC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
900 K
\n", "
\n
\n\n
\n", ""], ["K0036", "
TOE LOOP EACH
\n", "", "", "
E0952
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["VA131", "
PROTECTOR, HIP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["VA132", "
BATTERIES ALL OTHER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 B
\n", "
\n
\n\n
\n", ""], ["VA133", "
CB RADIO/CELL FOR VAN MOD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 C
\n", "
100 H
\n", "
\n
\n\n
\n", ""], ["VA134", "
VAN AIR CONDITIONER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 C
\n", "
100 H
\n", "
\n
\n\n
\n", ""], ["VA135", "
PWR DOOR OPENER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 C
\n", "
100 H
\n", "
\n
\n\n
\n", ""], ["VA136", "
RAISED ROOF
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 C
\n", "
100 H
\n", "
\n
\n\n
\n", ""], ["VA137", "
RAISED DOORS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 C
\n", "
100 H
\n", "
\n
\n\n
\n", ""], ["VA138", "
DROP FLOOR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 C
\n", "
100 H
\n", "
\n
\n\n
\n", ""], ["VA139", "
W/C TIE DOWNS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 C
\n", "
100 H
\n", "
\n
\n\n
\n", ""], ["VA140", "
BACK UP BATTERY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 C
\n", "
100 H
\n", "
\n
\n\n
\n", ""], ["K0037", "
HIGH MOUNT FLIP-UP FOOTREST
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["VA141", "
MINI-VAN CONVERSION
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 C
\n", "
100 H
\n", "
\n
\n\n
\n", ""], ["VA142", "
GAS TANK CONVERSION
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 C
\n", "
100 H
\n", "
\n
\n\n
\n", ""], ["VA143", "
TOGGLE SWITCHES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 C
\n", "
100 H
\n", "
\n
\n\n
\n", ""], ["VA144", "
REMOTE ENTRY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 C
\n", "
100 H
\n", "
\n
\n\n
\n", ""], ["VA145", "
GEL PACK (COLD)
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["VA146", "
AIR PURIFIER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["BA200", "
CLOCKS/WATCHES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA201", "
MAGNIFIERS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA202", "
TALKING PRODUCTS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA203", "
WRITING EQP GUIDES/ACCESS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["K0038", "
LEG STRAP EACH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["BA204", "
CASSETTE PLAYERS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA205", "
SIGHT ENHANCERS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA206", "
RECREATIONAL ITEMS BL AIDS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA207", "
COMMUNICATION DEVICES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA208", "
BLIND GROOMING AIDS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA209", "
HAND TOOLS BL AIDS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["BA210", "
MOBILITY AIDS BL AIDS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 A
\n", "
600 C
\n", "
\n
\n\n
\n", ""], ["B9998", "
ENTERAL SUPPLIES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["B9999", "
PARENTERAL SUPPLIES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4405", "
OST SKN BARR NON-PEC PASTE-O
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0039", "
LEG STRAP H STYLE EACH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["K0594", "
OST POUCH URIN/BARR FAUCET
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0595", "
OST POUCH URIN/BARR FLNGE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4406", "
OST SKN BARR PECTIN PASTE-OZ
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0596", "
OST POUCH URIN/BARR LOCK
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0597", "
OST POUCH URIN/BARR LOCK TAP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4407", "
OST SKN BARR W/CONV 4X4 IN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["L0450", "
TLSO FLEX TRK UP/PRFAB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["A4408", "
OST SKN BARR W/CONV > 4X4 IN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["L0452", "
TLSO FLEX TRK UP/CSTM FA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L0454", "
TLSO FLEX TRK SC JUNC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["K0040", "
ADJUSTABLE ANGLE FOOTPLATE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["A4409", "
OST SKN BARR W/O CONV 4X4 IN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["L0456", "
TLSO FLEX TRK SC SCAP SPN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L0458", "
TLSO TRIPLAN 2 SHELL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["A4413", "
OST POUCH DRNABL BARR FLNG/FLT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["L0460", "
TLSO TRIPLN 2 SHELL ANT-STER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["A4414", "
OST SKN BARR W/O CONVX 4X4 IN/
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["L0462", "
TLSO TRIPLN 3 SHELL ANT-STER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["A4415", "
OST SKN BARR W/O CONVX >4X4 IN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["L0464", "
TLSO TRIPLN 4 SHELL ANT-STER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L0466", "
TLSO SAGIT POST FRME&ANT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["K0041", "
LARGE SIZE FOOTPLATE EACH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["A4422", "
OST ABSO MATL TCKN LQD STO O
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["L0468", "
TLSO SAGIT-CORONAL FRME
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L0470", "
TLSO TRIPLN FRME&APRN STRAP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["A4452", "
TAPE WTRPROOF PER 18 SQU IN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4521", "
ADL-SZD INCON PROD DIAP SM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["L0472", "
TLSO TRIPLN HYPREXT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["A4522", "
ADL-SZ INCON PROD DIAP MED
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4523", "
ADL-SZ INCON PROD DIAPER LG
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["L0474", "
TLSO TRIPLN FRM&APR MX STRAPS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["A4524", "
ADL-SZ INCON DIAP XTRA LG
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["B9006", "
PARENTERAL INFUS PUMP STATIO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["K0042", "
STANDARD SIZE FOOTPLATE EACH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["L0476", "
TLSO SAGIT CORNL CNTL PRFAB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L0478", "
TLSO SAGIT CORNL CNTL CSTM FAB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["A4525", "
ADL-SZ INCON PROD BRF SM SZ
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4526", "
ADL-SZ INCON PRO BRF MED SZ
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["L0480", "
TLSO TRIPLN 1 PC NO INTFCE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L0482", "
TLSO TRIPLN 1 PC W INTFCE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["A4527", "
ADL-SZ INCON PROD BRF LG SZ
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["L0484", "
TLSO TRIPLN 2 PC NO INTFCE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["A4528", "
ADL-SZ INCON PROD BRF XTR-LG
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["L0486", "
TLSO TRIPLN 2 PC W INTERFCE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["K0043", "
FTRST LOWER EXTENSION TUBE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["L0488", "
TLSO TRIPLN 1 PC W INTERFCE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["A4535", "
DISP LINR/SHLD INCONT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["L0490", "
TLSO SAGIT CORNL REINF PRFAB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L1652", "
HIP ORTHO BIL THI CUFF
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L1836", "
KN ORTH RGD W NO JT W INTFC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["A4536", "
PROTVE UNDERWEAR WASH ANY SZ
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["L1901", "
ANK ORTH ELAST PREFAB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L3651", "
SHLDR ORTH 1 SHL ELAS PREFB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L3652", "
SHLDR ORTH DBL ELAST PRFAB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["K0044", "
FTRST UPPER HANGER BRACKET
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["L3701", "
ELB ORTH ELAST PREFAB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L3762", "
ELB ORTH RIGD W/O JNT W/INTFC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L3909", "
WRST ORTH ELAST PREFAB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
\n", ""], ["L3911", "
WRST HND FNGR ORTH ELAS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
\n", ""], ["L4386", "
NON-PNEUMT WALK SPLNT PRFAB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L5781", "
ADD LW LIMB MGMT SYS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R20 A
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["A4537", "
UNDR PAD REUS/WASH ANY SZ
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["L5782", "
ADD LW LIMB MGMT HVY DUT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R20 A
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L5848", "
ADD ENDOSK KNEE-SHIN HYDRAU
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R20 A
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["A4632", "
RPL BATTERY EX INF PUMP TYP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 B
\n", "
\n
\n\n
\n", ""], ["K0045", "
FOOTREST COMPLETE ASSEMBLY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["A4633", "
RPLT BULB/LAMP UV LGT TX SYS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A4634", "
RPLT BULB TX LGT BOX TABOP MDL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A6412", "
EYE PATCH OCCLUSIVE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["L5995", "
ADD LE HEVY DUTY FEATU
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R20 A
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L6025", "
TRNSCARPL/MC/PT HND DISARTC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R30
\n", "
300 A
\n", "
\n
\n\n
\n", ""], ["L6638", "
UE ADD PROS LOCK W/M PW ELBOW
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R30
\n", "
300 B
\n", "
\n
\n\n
\n", ""], ["L6646", "
UE ADD SHDLR JNT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R30
\n", "
300 B
\n", "
\n
\n\n
\n", ""], ["L6647", "
UE ADD SHDLR LOCK MECH/BDY PWR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R30
\n", "
300 B
\n", "
\n
\n\n
\n", ""], ["L6648", "
UE ADD SHDLR LOCK MECH/EXT PWR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R30
\n", "
300 B
\n", "
\n
\n\n
\n", ""], ["L7367", "
LITH ION BATTRY REPLMT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
300 D
\n", "
\n
\n\n
\n", ""], ["K0046", "
ELEVAT LEGRST LOW EXTENSION
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["L7368", "
LITH ION BATTRY CHGR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
300 D
\n", "
\n
\n\n
\n", ""], ["A6421", "
PAD BANDAGE NO-ELAST>/=3&<5 IN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
400 D
\n", "
\n
\n\n
\n", ""], ["S1040", "
CRANL REMLD ORTH RIGD CSTM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
400 D
\n", "
\n
\n\n
\n", ""], ["A6422", "
COFRM BANDAGE NO-STRL>/=3&<5IN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
400 D
\n", "
\n
\n\n
\n", ""], ["V5095", "
SEMI-IMPL MID EAR HEARING
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", ""], ["V5298", "
HEARING AID NOC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R60 C
\n", "
600 B
\n", "
\n
\n\n
\n", ""], ["A6424", "
COFRM BANDAGE NO-STRL>/=5IN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
400 D
\n", "
\n
\n\n
\n", ""], ["A6426", "
COFRM BANDGE STRL>/=3&<5IN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
400 D
\n", "
\n
\n\n
\n", ""], ["A6428", "
COFRM BANDGE STRL >/=5IN-ROLL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
400 D
\n", "
\n
\n\n
\n", ""], ["A6430", "
LT COMP BANDGE>/=3&<5IN-ROLL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
400 D
\n", "
\n
\n\n
\n", ""], ["K0047", "
ELEVAT LEGRST UP HANGR BRACK
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["A6432", "
LT COMPRS BANDGE >/= 5 IN-ROLL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
400 D
\n", "
\n
\n\n
\n", ""], ["A6434", "
MOD COMP BANDGE>/=3/<5IN-ROLL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
400 D
\n", "
\n
\n\n
\n", ""], ["A6436", "
HI COMP BANDGE>/=3&<5IN-ROLL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
400 D
\n", "
\n
\n\n
\n", ""], ["A6438", "
SLF-ADHR BANDAGE>/=3&<5IN-ROL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
400 D
\n", "
\n
\n\n
\n", ""], ["A7025", "
HI FRQ CHST WALL OSCI VEST REP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A7026", "
HI FREQ CHST WAL OSCI HOSE REP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A7030", "
FUL FCE MSK POS ARWY PRS DEV
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["A7031", "
FCE MSK INTFCE REP FULL MSK
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["A7032", "
RPLT CUSHN NASL APPLIC DEV
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["A7033", "
RPL PILLWS NASL APPLIC DEV PR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["K0048", "
ELEVATE LEGREST COMPLETE
\n", "", "", "
E0990
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["A7034", "
NASL INTFCE POS ARWY PRSS DEV
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["A7035", "
HDGR USED W/POS ARWY PRSS DEV
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["A7036", "
CHNSTP USE W/POS ARWY PRSS DEV
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["A7037", "
TUBING USD W/POS ARWY PRSS DEV
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["A7038", "
FLTR DISP W/POS ARWY PRSS DEV
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["A7039", "
FLTR NO DISP POS ARWY PRSS DEV
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["A7044", "
ORL INTFCE W/POS ARWY PRSS DEV
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["C1783", "
OCULR IMP AQUEOUS DRN ASS DEV
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", ""], ["C1888", "
CATH ABLATION NON-CARD ENDOVAS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", ""], ["C1900", "
LEAD LT VENTCLR CORO VENU SY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["K0049", "
CALF PAD EACH
\n", "", "", "
E0995
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["C2614", "
PROBE PERCUT LUMBAR DISCECTOMY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", ""], ["E0117", "
CRTCH UNDARM ART SPRNG ASS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
900 A
\n", "
\n
\n\n
\n", ""], ["E0203", "
THERAPEUTIC LGHTBOX
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0454", "
PRS VEN PRS CTRL SUPP&FLW TRIG
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["E0483", "
HI FREQ CHST WAL AIRPULS GEN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["E0484", "
OSCILLAT POS EXPIRTRY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["E0618", "
APNEA MONTR W/O RECORD FEAT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0619", "
APNEA MONITOR W/RECORD FEATURE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0636", "
MULTPOS PT SUPPT SYS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 A
\n", "
900 B
\n", "
\n
\n\n
\n", ""], ["E0701", "
HELMET FCE GRD&SFT INTFCE PRFA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
999 A
\n", "
\n
\n\n
\n", ""], ["K0050", "
RATCHET ASSEMBLY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E1015", "
SHCK ABSORB MAN WHEELCHR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E1016", "
SHCK ABSORB PWR WHEELCHAIR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E1017", "
HVD SHCK ABSORB MAN WHLCHR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E1018", "
HVD SHCK ABSORB PWR WHLCHR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E1038", "
TRANSPORT CHAIR ADULT SIZE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 C
\n", "
\n
\n\n
\n", ""], ["E1161", "
ADLT SZ MAN WHCHR INC TILT SPA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 B
\n", "
\n
\n\n
\n", ""], ["E1802", "
ADJ FORARM PRO/SUP DEV
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["K0556", "
ADD LE BK/AK W/LOCK MECH
\n", "", "", "
L5673
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R20 A
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["K0557", "
ADD LE BK/AK NOT W/LOCK MEC
\n", "", "", "
L5679
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R20 A
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["K0558", "
ADD LE INS CON/TRM AMP INI
\n", "", "", "
L5681
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R20 A
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["K0051", "
CAM RELESE ASSEM FTRST/LGRST
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["K0559", "
ADD LE INS NOT CONG/TRMA AM
\n", "", "", "
L5683
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R20 A
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["K0581", "
OST POUCH CLO W/BARR W/FLTR EA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0582", "
OST POUCH CL W,BAR BLT-IN CON
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0583", "
OST POUCH CLOS W/O BARR W/FLTR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0584", "
OST POUCH CLOS BARR FLNGE FLTR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0585", "
OST POUCH CLOS BARR LOCK FLNGE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0586", "
OST POUCH CL BAR LCK FLG FLTR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0587", "
OST POUCH DRNBLE W/BAR FLTR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0588", "
OST POUCH DRNBL BARR FLGE FLTR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0589", "
OST POUCH DRNBLE BAR LOCK FLGE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["D5913", "
NASAL PROSTHESIS
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
700 B
\n", "
\n
\n\n
\n", ""], ["K0052", "
SWINGAWAY DETACH FOOTREST
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["K0590", "
OST POUCH DRN BAR LCK FLG FLTR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0591", "
OST POUCH URN W/EX WR BAR TP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0592", "
OST POUCH URN BAR BLT-IN CONV
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0593", "
OST POUCH URN EX WR BLT-IN CNV
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["E0691", "
UL LT TX SYS PANL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["K0531", "
HEATED HUMIDIFIER CPAP/BIPAP
\n", "", "", "
E0562
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "
R91 C
\n", "
800 D
\n", "
\n
\n\n
\n", ""], ["G0290", "
STENT, DRUG ELUTING W/DEL SYS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["G0291", "
STENT, DRUG ELUTING W/O DEL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["TM100", "
TELEMED HOME COMPUTER/EQUIPMT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 N
\n", "
\n
\n\n
\n", ""], ["K0053", "
ELEVATE FOOTREST ARTICULATE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["TM102", "
TELEMED HOME EQUIPMENT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 N
\n", "
\n
\n\n
\n", ""], ["TM104", "
TELEMED AUDIO/VIDEO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 N
\n", "
\n
\n\n
\n", ""], ["TM105", "
TELEMED WOUND CARE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 N
\n", "
\n
\n\n
\n", ""], ["TM101", "
TELEMED VIDEO MONITOR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 N
\n", "
\n
\n\n
\n", ""], ["TM103", "
TELEMED MESSAGE/MONITORING
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 N
\n", "
\n
\n\n
\n", ""], ["DI122", "
PROTECTION CAP/ANALOG
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 F
\n", "
\n
\n\n
\n", ""], ["DI123", "
GUIDE PIN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 F
\n", "
\n
\n\n
\n", ""], ["SI420", "
LE PARTIAL KNEE SCRW,ANCR,ETC.
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["SI421", "
LE PARTIAL HIP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["K0054", "
SEAT WDTH 10-12/15/17/20 WC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["SI422", "
LE PARTIAL HIP CUP/SHELL ACETA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["SI423", "
LE PARTIAL HIP INS/LIN-ACETA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["SI424", "
LE PARTIAL HIP HEAD-FEMOR-MODU
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["SI425", "
LE ANKLE SCREW,ANCOR,PLT,ETC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["SI426", "
LE FOOT SCREW,ANCOR,PLT,ETC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["SI427", "
UE HAND SCREW,ANCOR,PLT,ETC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104713
\n", "", "
INACTIVE
\n", "", "", "", "
960 C
\n", "
\n
\n\n
\n", ""], ["SI428", "
UE ARM SCREW,ANCOR,PLT,ETC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 C
\n", "
\n
\n\n
\n", ""], ["SI429", "
UE WRIST SCREW,ANCOR,PLT,ETC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 C
\n", "
\n
\n\n
\n", ""], ["SI430", "
UE BACK SCREW,ANCOR,PLT,ROD,ET
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 C
\n", "
\n
\n\n
\n", ""], ["SI431", "
UE COIL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 C
\n", "
\n
\n\n
\n", ""], ["K0055", "
SEAT DPTH 15/17/18 LTWT WC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["SI432", "
LE COIL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["SI433", "
LE UNUSABLE PRODUCT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["SI434", "
LE BEAD KIT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 D
\n", "
\n
\n\n
\n", "
1
\n"], ["SI435", "
THORACIC COIL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["SI436", "
THORACIC AORTIC ENTENDER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", ""], ["VA147", "
HUMIDIFIER (ROOM)
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["VA148", "
DE-HUMIDIFIER (ROOM)
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R90
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["VA149", "
COLD WEATHER MASK
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["VA150", "
COLOSTOMY SUPPLIES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["VA151", "
ILEOSTOMY SUPPLIES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0056", "
SEAT HT <17 OR <=21 LTWT WC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["VA152", "
PEDOMETERS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
900 K
\n", "
\n
\n\n
\n", ""], ["VA153", "
IBOT SPECIALIZED POWER WC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 A
\n", "
\n
\n\n
\n", ""], ["VA154", "
POWER ASS CHAIR IGLIDE/PWR HUB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["VA155", "
PROS/ORTH SUPPLIES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A9999", "
DME SUPPLY OR ACCESSORY,NOS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["E0745", "
NEUROMUSCLAR STIMULATOR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
900 K
\n", "
\n
\n\n
\n", ""], ["A6550", "
NEG PRES WOUND THER DRSG SET
\n", "", "", "
A6550
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A6551", "
NEG PRESS WOUND THER CANISTER
\n", "", "", "
A6551
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A7046", "
REPL WATER CHAMBER PAP DEV
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["A7520", "
TRACH/LARYN TUBE NON CUFFED
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0057", "
SEAT WDTH 19/20 HVY DTY WC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["A7521", "
TRACH/LARYN TUBE CUFFED
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A7522", "
TRACH/LARYN TUBE STAINLESS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A7523", "
TRACHEOSTOMY SHOWER PROTECT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A7524", "
TRACHEOSTOMA STENT/STUD/BTTN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A7525", "
TRACHEOSTOMY MASK
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A7526", "
TRACHEOSTOMY TUBE COLLAR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["A9280", "
ALERT OR ALARM DEVICE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["B4083", "
ENTERAL STOMACH TUBE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", ""], ["E0118", "
CRUTCH SUBSTITUTE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R90
\n", "
900 A
\n", "
\n
\n\n
\n", ""], ["E0247", "
TRANSFER BENCH W/WO COMMODE OP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R90
\n", "
900 I
\n", "
\n
\n\n
\n", ""], ["K0058", "
SEAT DPTH 17/18 POWER WC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E0248", "
HD TRANS BENCH W/WO COMMODE OP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R90
\n", "
900 I
\n", "
\n
\n\n
\n", ""], ["E0301", "
HOSP BED HVY DTY 350-600 LBS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 D
\n", "
\n
\n\n
\n", ""], ["E0302", "
HOSP BED XTRA HD > 600 LBS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 D
\n", "
\n
\n\n
\n", ""], ["E0303", "
HOSP BED HVY DUTY XTRA WIDE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 D
\n", "
\n
\n\n
\n", ""], ["E0304", "
HOSP BED XTRA HVY DTY X WIDE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 D
\n", "
\n
\n\n
\n", ""], ["E0470", "
BIPAP MACHINE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R91 C
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["E0471", "
BIPAP MACHINE W B/U NONINV INT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R91 C
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["E0472", "
BIPAP MACHINE W B/U FTR INVAS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R91 C
\n", "
800 A
\n", "
\n
\n\n
\n", ""], ["E0561", "
HUMIDIFIER NONHEATED W PAP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["E0562", "
HUMIDIFIER HEATED USED W PAP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
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PLASTIC COATED HANDRIM EACH
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File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E0637", "
SIT-STAND W SEATLIFT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0638", "
STANDING FRAME SYS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0675", "
PNEUMATIC COMPRESSION DEVICE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0955", "
W/C CUSHIONED HEADREST
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E0957", "
W/C MEDIAL THIGH SUPPORT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E0960", "
W/C SHOULDER HARNESS/STRAPS
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File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E0981", "
W/C SEAT UPHOLSTRY,RPLSMT ONLY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E0982", "
W/C BACK UPHOLSTRY,RPLSMT ONLY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E0983", "
W/C MANUAL ADD PWR JOYSTICK
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E0984", "
W/C MANUAL ADD PWR TILLER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["K0060", "
STEEL HANDRIM EACH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E0985", "
W/C SEAT LIFT MECHANISM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E0986", "
W/C MAN PUSH-RIM POWER ASSIST
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E1002", "
POWER SEAT TILT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E1003", "
POWER SEAT RECLINE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E1004", "
POWER SEAT RECLINE MECHANICAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E1006", "
POWER SEAT COMBO W/O SHEAR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E1007", "
POWER SEAT COMBO W/SHEAR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E1008", "
POWER SEAT COMBO W/POWER SHEAR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E1009", "
ADD MECH LEG ELEVATION
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E1019", "
HEAVY DUTY FEATURE POWER SEAT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["K0061", "
ALUMINUM HANDRIM EACH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E1021", "
EXTRA HD FEATURE POWER SEAT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E1028", "
W/C MANUAL SWINGAWAY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E1029", "
W/C VENT TRAY FIXED
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["K0602", "
INF PMP RPLMT BAT SLV OXIDE 3V
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 B
\n", "
\n
\n\n
\n", ""], ["E2201", "
MAN W/C ACC SEAT WIDTH>=20<24\"
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["K0603", "
INF PMP RPLMT BATT ALKAL 1.5V
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 B
\n", "
\n
\n\n
\n", ""], ["K0604", "
INF PMP REPLMT BATT LITH 3.6V
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 B
\n", "
\n
\n\n
\n", ""], ["K0605", "
INF PMP REPLMT BATT LITH 4.5V
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 B
\n", "
\n
\n\n
\n", ""], ["E2202", "
MAN W/C ACC SEAT WIDTH 24-27\"
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["K0618", "
TLSO 2 PIECE RIGID SHELL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["A4362", "
SOLID SKIN BARRIER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["D5914", "
AURICULAR PROSTHESIS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
700 B
\n", "
\n
\n\n
\n", ""], ["K0062", "
HANDRIM 8-10 VERT/OBLIQ PROJ
\n", "", "", "
E0967
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E2203", "
MAN W/C ACC FRAME DEPTH <22\"
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["K0619", "
TLSO 3 PIECE RIGID SHELL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L0112", "
CRANIAL CERVICAL ORTHOSIS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["E2204", "
MAN W/C ACC FRAME DEPTH 22-25\"
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["L0861", "
HALO REPL LINER/INTERFACE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["E2300", "
PWR W/C ACC PWR SEAT ELEV SYS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["L1831", "
KO POS LOCKING JOINT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 F
\n", "
\n
\n\n
\n", ""], ["E2301", "
PWR W/C ACC POWER STANDING
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E2310", "
ELECT CONN BTWN CONTROL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["L1907", "
AFO SUPRAMALLEOLAR CUSTOM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 A
\n", "
\n
\n\n
\n", ""], ["K0063", "
HNDRM 12-16 VERT/OBLIQ PROJ
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E0967
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["L1951", "
AFO SPIRAL PREFABRICATED
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 A
\n", "
\n
\n\n
\n", ""], ["L1971", "
AFO W/ANKLE JOINT, PREFAB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 A
\n", "
\n
\n\n
\n", ""], ["E2311", "
ELEC CONN BETWEEN 2 SYS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["L3031", "
FOOT LAMIN/PREPREG COMPOSITE
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File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["E2320", "
HAND CHIN CONTROL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["L3917", "
PREFAB MATACARPL FX ORTHOSIS
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File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
\n", ""], ["L5673", "
AD LE BK/AK SOC IN W LOCK MECH
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File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R20 D
\n", "
200 I
\n", "
\n
\n\n
\n", "
1
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HAND INTERFACE JOYSTICK
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["L5679", "
AD LE BK/AK SOC IN WO LOCK MEC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R20 D
\n", "
200 I
\n", "
\n
\n\n
\n", "
1
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INTL CUST CONG/LATYP INSERT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R20 D
\n", "
200 I
\n", "
\n
\n\n
\n", "
1
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ZERO PRESSURE TUBE FLAT FREE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E2322", "
MULTI MECHANICAL SWITCHES
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File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E2323", "
SPECIAL JOYSTICK HANDLE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E2324", "
CHIN CUP INTERFACE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["L5683", "
AD LE EXT INTL CUST SOCK INSRT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R20 D
\n", "
200 I
\n", "
\n
\n\n
\n", "
1
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SIP AND PUFF INTERFACE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["L8511", "
INDWELLING TRACH INSERT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", ""], ["L8513", "
TRACH PROS CLEANING DEVICE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["L8631", "
MCP JOINT REPL 2 PC OR MORE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", ""], ["L8659", "
INTERPHALANGEAL JOINT REPL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", ""], ["E2326", "
BREATH TUBE KIT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["K0065", "
SPOKE PROTECTORS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["S2213", "
IMPLANT GASTRIC STIM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", ""], ["E2327", "
HEAD,CTRL INTERFACE MECHANISM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["S2230", "
IMPLANT SEMI-IMP HEAR DEVICE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", ""], ["S2235", "
IMPLANT AUDITORY BRAIN IMP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", ""], ["S8120", "
O2 CONTENTS GAS CUBIC FT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R91 E
\n", "", "
\n
\n\n
\n", ""], ["S8121", "
O2 CONTENTS LIQUID LB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R91 F
\n", "", "
\n
\n\n
\n", ""], ["S8460", "
CAMISOLE POST-MAST
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["E2328", "
HEAD/EXTREMITY CTRL INTERFACE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["V2121", "
LENTICULAR LENS, SINGLE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2221", "
LENTICULAR LENS, BIFOCAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["K0066", "
SOLID TIRE ANY SIZE EACH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E2330", "
HEAD CONTROL PROXIMITY SWITCH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["V2321", "
LENTICULAR LENS, TRIFOCAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2745", "
TINT, ANY COLOR/SOLID/GRADE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 B
\n", "
600 1
\n", "
\n
\n\n
\n", ""], ["V2761", "
MIRROR COATING
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 B
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["V2762", "
POLARIZATION, ANY LENS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 B
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["V2782", "
LENS, 1.54-1.65 P/1.60-1.79P
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 B
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["V2783", "
LENS, >= 1.66 P/>=1.80G
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 B
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["E2329", "
HEAD CONTROL NONPROPORTIONAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["V2784", "
LENS POLYCARB OR EQUAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 B
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0067", "
PNEUMATIC TIRE ANY SIZE EACH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["V2786", "
OCCUPATIONAL MULTIFOCAL LENS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R60 B
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["E2331", "
ATTENDANT CONTROL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E2340", "
PWR W/C WIDTH 20-23 SEAT FRAME
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E2341", "
PWR W/C WIDTH 24-27 SEAT FRAME
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E2342", "
PWR W/C DEPTH 20-21 SEAT FRAME
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E2343", "
PWR W/C DEPTH 22-25 SEAT FRAME
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E2351", "
ELECTRONIC SGD INTERFACE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E2360", "
22NF NONSEAL LEAD ACID BATTERY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E2361", "
22NF SEAL LEADACID BATT(GEL)
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
100 D
\n", "
\n
\n\n
\n", ""], ["E2362", "
GR24 NONSEAL LEADACID BATTERY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
100 D
\n", "
\n
\n\n
\n", ""], ["K0068", "
PNEUMATIC TIRE TUBE EACH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E2363", "
GR24 SEAL LEADACID BATT(GEL)
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
100 D
\n", "
\n
\n\n
\n", ""], ["E2364", "
U1 NONSEALED LEADACID BATTERY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
100 D
\n", "
\n
\n\n
\n", ""], ["E2365", "
U1 SEAL LEADACID BATTERY GEL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
100 D
\n", "
\n
\n\n
\n", ""], ["E2366", "
PWR W/C BATT CHARGER,SING
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
100 D
\n", "
\n
\n\n
\n", ""], ["E2367", "
POWER WC BATTERY CHARGER, DUAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
100 D
\n", "
\n
\n\n
\n", ""], ["E2402", "
NEG PRESS WOUND THERAPY PUMP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E2500", "
SPCH GEN DIGIT PRE-REC<=8MIN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E2502", "
SPCH GEN DEV PREREC >8<=20MIN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E2504", "
SPCH GEN PREREC MSG >20<40MIN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E2506", "
SPCH GEN PREREC MSG >40 MIN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["K0069", "
REAR WHL COMPLETE SOLID TIRE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["E2508", "
SPCH GEN SPELLING PHYS CONTACT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E2510", "
SPCH GEN DEV W/MULT MSG/ACCS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E2511", "
SPCH GEN SFTWRE FOR PC/PDA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E2512", "
SPCH GEN ACC,MOUNTING SYSTEM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E2599", "
SPCH GEN ACCESSORY NOC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["K0601", "
INF PMP RPL BATT SILVOXID 1.5V
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
910 B
\n", "
\n
\n\n
\n", ""], ["SI132", "
H&N COIL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["SI133", "
H&N UNUSABLE PRODUCT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 A
\n", "
\n
\n\n
\n", "
1
\n"], ["SI224", "
ABD COIL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "
\n
\n\n
\n", "
1
\n"], ["SI225", "
ADB UNUSABLE PRODUCT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 B
\n", "", "
1
\n"], ["K0070", "
REAR WHL COMPL PNEUM TIRE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["SI308", "
UE HAND SCREW,ANCOR,PLT,RD,PN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 C
\n", "
\n
\n\n
\n", "
1
\n"], ["SI309", "
UE ARM SCREW,ANCOR,PLT,RD,PN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 C
\n", "
\n
\n\n
\n", "
1
\n"], ["SI310", "
UE WRIST SCREW,ANCOR,PLT,RD,PN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 C
\n", "
\n
\n\n
\n", "
1
\n"], ["SI311", "
UE BACK,ANCOR,PLT,RD,PN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 C
\n", "
\n
\n\n
\n", "
1
\n"], ["SI312", "
UE COIL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 C
\n", "
\n
\n\n
\n", "
1
\n"], ["SI313", "
UE UNUSABLE PRODUCT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 C
\n", "
\n
\n\n
\n", "
1
\n"], ["SI529", "
THORACIC COIL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["SI530", "
THORACIC AORTIC EXTENDER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["SI531", "
THORACIC UNUSABLE PRODUCT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 E
\n", "
\n
\n\n
\n", "
1
\n"], ["SI314", "
UE BEAD KIT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "
ACTIVE
\n", "", "", "", "
960 C
\n", "
\n
\n\n
\n", "
1
\n"], ["K0071", "
FRONT CASTR COMPL PNEUM TIRE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["D5915", "
ORBITAL PROSTHESIS
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
700 A
\n", "
\n
\n\n
\n", ""], ["K0072", "
FRNT CSTR CMPL SEM-PNEUM TIR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
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CASTER PIN LOCK EACH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["K0074", "
PNEUMATIC CASTER TIRE EACH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["K0075", "
SEMI-PNEUMATIC CASTER TIRE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["K0076", "
SOLID CASTER TIRE EACH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["K0077", "
FRONT CASTER ASSEM COMPLETE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["K0078", "
PNEUMATIC CASTER TIRE TUBE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["K0079", "
WHEEL LOCK EXTENSION PAIR
\n", "", "", "
E0961
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["K0080", "
ANTI-ROLLBACK DEVICE PAIR
\n", "", "", "
E0974
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["K0081", "
WHEEL LOCK ASSEMBLY COMPLETE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["D5916", "
OCULAR PROSTHESIS
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
700 A
\n", "
\n
\n\n
\n", ""], ["K0082", "
22 NF DEEP CYCL ACID BATTERY
\n", "", "", "
E2360
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0083", "
22 NF GEL CELL BATTERY EACH
\n", "", "", "
E2361
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0084", "
GRP 24 DEEP CYCL ACID BATTRY
\n", "", "", "
E2362
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0085", "
GROUP 24 GEL CELL BATTERY
\n", "", "", "
E2363
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0086", "
U-1 LEAD ACID BATTERY EACH
\n", "", "", "
E2361
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0087", "
U-1 GEL CELL BATTERY EACH
\n", "", "", "
E2365
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0088", "
BATTRY CHRGR ACID/GEL CELL
\n", "", "", "
E2366
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "", "
\n
\n\n
\n", ""], ["K0089", "
BATTERY CHARGER DUAL MODE
\n", "", "", "
E2367
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "", "
\n
\n\n
\n", ""], ["K0090", "
REAR TIRE POWER WHEELCHAIR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["K0091", "
REAR TIRE TUBE POWER WHLCHR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["D5919", "
FACIAL PROSTHESIS
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
700 B
\n", "
\n
\n\n
\n", ""], ["K0092", "
REAR ASSEM CMPLT POWR WHLCHR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["K0093", "
REAR ZERO PRESSURE TIRE TUBE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["K0094", "
WHEEL TIRE FOR POWER BASE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["K0095", "
WHEEL TIRE TUBE EACH BASE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["K0096", "
WHEEL ASSEM POWR BASE COMPLT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["K0097", "
WHEEL ZERO PRESURE TIRE TUBE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["K0098", "
DRIVE BELT POWER WHEELCHAIR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["K0099", "
FRONT CASTER POWER WHELCHAIR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["K0100", "
AMPUTEE ADAPTER PAIR
\n", "", "", "
E0959
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["K0101", "
ONE-ARM DRIVE ATTACHMENT
\n", "", "", "
E0958
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["D5922", "
NASAL SEPTAL PROSTHESIS
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
700 B
\n", "
\n
\n\n
\n", ""], ["K0102", "
CRUTCH AND CANE HOLDER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["K0103", "
TRANSFER BOARD < 25\"
\n", "", "", "
E0972
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["K0104", "
CYLINDER TANK CARRIER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["K0105", "
IV HANGER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["K0106", "
ARM TROUGH EACH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["K0107", "
WHEELCHAIR TRAY
\n", "", "", "
E0950
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["K0108", "
OTHER ACCESSORIES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["K0109", "
CUSTOMIZE WHLCHR BASE FRAME
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["K0112", "
TRUNK VEST SUPPRT INNR FRAME
\n", "", "", "
E0980
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["K0113", "
TRUNK VEST SUPRT W/O INR FRM
\n", "", "", "
E0980
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R90
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["D5926", "
REPLACEMENT NASAL PROSTHESIS
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
700 B
\n", "
\n
\n\n
\n", ""], ["K0114", "
WHLCHR BACK SUPRT INR FRAME
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["K0115", "
BACK MODULE ORTHOTIC SYSTEM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 F
\n", "
\n
\n\n
\n", ""], ["K0116", "
BACK & SEAT MODUL ORTHOT SYS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 F
\n", "
\n
\n\n
\n", ""], ["K0117", "
UNLISTED ITEM, ORTHOTIC SEAT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R10 A
\n", "", "
\n
\n\n
\n", ""], ["K0163", "
VACUUM ERECTION SYSTEM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["L0100", "
CRANIAL ORTHOSIS/HELMET MOLD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L0110", "
CRANIAL ORTHOSIS/HELMET NONM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L0120", "
CERV FLEXIBLE NON-ADJUSTABLE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L0130", "
FLEX THERMOPLASTIC COLLAR MO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L0140", "
CERVICAL SEMI-RIGID ADJUSTAB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["D5927", "
AURICULAR REPLACEMENT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
700 B
\n", "
\n
\n\n
\n", ""], ["L0150", "
CERV SEMI-RIG ADJ MOLDED CHN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L0160", "
CERV SEMI-RIG WIRE OCC/MAND
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L0170", "
CERVICAL COLLAR MOLDED TO PT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L0172", "
CERV COL THERMPLAS FOAM 2 PI
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L0174", "
CERV COL FOAM 2 PIECE W THOR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L0180", "
CER POST COL OCC/MAN SUP ADJ
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L0190", "
CERV COLLAR SUPP ADJ CERV BA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L0200", "
CERV COL SUPP ADJ BAR & THOR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L0210", "
THORACIC RIB BELT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 G
\n", "
\n
\n\n
\n", ""], ["L0220", "
THOR RIB BELT CUSTOM FABRICA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 G
\n", "
\n
\n\n
\n", ""], ["D5928", "
ORBITAL REPLACEMENT
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
700 A
\n", "
\n
\n\n
\n", ""], ["L0300", "
TLSO FLEX SURGICAL SUPPORT
\n", "", "", "
L0450
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L0310", "
TLSO FLEXIBLE CUSTOM FABRICA
\n", "", "", "
L0452
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L0315", "
TLSO FLEX ELAS RIGID POST PA
\n", "", "", "
L0454
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L0317", "
TLSO FLEX HYPEXT ELAS POST P
\n", "", "", "
L0456
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L0320", "
TLSO A-P CONTRL W APRON FRNT
\n", "", "", "
L0466
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L0330", "
TLSO ANT-POS-LATERAL CONTROL
\n", "", "", "
L0470
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L0340", "
TLSO A-P-L-ROTARY WITH APRON
\n", "", "", "
L0474
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L0350", "
TLSO FLEX COMPRESS JACKET CU
\n", "", "", "
L0476
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L0360", "
TLSO FLEX COMPRESS JACKET MO
\n", "", "", "
L0478
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L0370", "
TLSO A-P-L-ROTARY HYPEREXTEN
\n", "", "", "
L0472
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["D5929", "
FACIAL REPLACEMENT
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
700 B
\n", "
\n
\n\n
\n", ""], ["L0380", "
TLSO A-P-L-ROT W/ POS EXTENS
\n", "", "", "
L0474
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L0390", "
TLSO A-P-L CONTROL MOLDED
\n", "", "", "
L0480
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L0400", "
TLSO A-P-L W INTERFACE MATER
\n", "", "", "
L0482
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L0410", "
TLSO A-P-L TWO PIECE CONSTR
\n", "", "", "
L0484
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L0420", "
TLSO A-P-L 2 PIECE W INTERFA
\n", "", "", "
L0486
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L0430", "
TLSO A-P-L W INTERFACE CUSTM
\n", "", "", "
L0488
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L0440", "
TLSO A-P-L OVERLAP FRNT CUST
\n", "", "", "
L0490
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L0500", "
LSO FLEX SURGICAL SUPPORT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 G
\n", "
\n
\n\n
\n", ""], ["L0510", "
LSO FLEXIBLE CUSTOM FABRICAT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 G
\n", "
\n
\n\n
\n", ""], ["L0515", "
LSO FLEX ELAS W/ RIG POST PA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 G
\n", "
\n
\n\n
\n", ""], ["E0100", "
CANE ADJUST/FIXED WITH TIP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 A
\n", "
\n
\n\n
\n", ""], ["L0520", "
LSO A-P-L CONTROL WITH APRON
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L0530", "
LSO ANT-POS CONTROL W APRON
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L0540", "
LSO LUMBAR FLEXION A-P-L
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L0550", "
LSO A-P-L CONTROL MOLDED
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L0560", "
LSO A-P-L W INTERFACE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L0565", "
LSO A-P-L CONTROL CUSTOM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L0600", "
SACROILIAC FLEX SURG SUPPORT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 G
\n", "
\n
\n\n
\n", ""], ["L0610", "
SACROILIAC FLEXIBLE CUSTM FA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 G
\n", "
\n
\n\n
\n", ""], ["L0620", "
SACROILIAC SEMI-RIG W APRON
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 G
\n", "
\n
\n\n
\n", ""], ["L0700", "
CTLSO A-P-L CONTROL MOLDED
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["A4363", "
LIQUID SKIN BARRIER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["E0105", "
CANE ADJUST/FIXED QUAD/3 PRO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 A
\n", "
\n
\n\n
\n", ""], ["L0710", "
CTLSO A-P-L CONTROL W/ INTER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L0810", "
HALO CERVICAL INTO JCKT VEST
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L0820", "
HALO CERVICAL INTO BODY JACK
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L0830", "
HALO CERV INTO MILWAUKEE TYP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L0860", "
MAGNETIC RESONANC IMAGE COMP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L0900", "
TORSO/PTOSIS SUPPORT
\n", "", "", "
L0500
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L0910", "
TORSO & PTOSIS SUPP CUSTM FA
\n", "", "", "
L0510
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L0920", "
TORSO/PENDULOUS ABD SUPPORT
\n", "", "", "
L0500
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 G
\n", "
\n
\n\n
\n", ""], ["L0930", "
PENDULOUS ABDOMEN SUPP CUSTM
\n", "", "", "
L0510
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 G
\n", "
\n
\n\n
\n", ""], ["L0940", "
TORSO/POSTSURGICAL SUPPORT
\n", "", "", "
L0500
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 G
\n", "
\n
\n\n
\n", ""], ["E0110", "
CRUTCH FOREARM PAIR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 A
\n", "
\n
\n\n
\n", ""], ["L0950", "
POST SURG SUPPORT CUSTOM FAB
\n", "", "", "
L0510
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 G
\n", "
\n
\n\n
\n", ""], ["L0960", "
POST SURGICAL SUPPORT PADS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 G
\n", "
\n
\n\n
\n", ""], ["L0970", "
TLSO CORSET FRONT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 G
\n", "
\n
\n\n
\n", ""], ["L0972", "
LSO CORSET FRONT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 G
\n", "
\n
\n\n
\n", ""], ["L0974", "
TLSO FULL CORSET
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 G
\n", "
\n
\n\n
\n", ""], ["L0976", "
LSO FULL CORSET
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 G
\n", "
\n
\n\n
\n", ""], ["L0978", "
AXILLARY CRUTCH EXTENSION
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
900 A
\n", "
\n
\n\n
\n", ""], ["L0980", "
PERONEAL STRAPS PAIR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L0982", "
STOCKING SUPP GRIPS SET OF 4
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
999 A
\n", "
\n
\n\n
\n", ""], ["L0984", "
PROTECTIVE BODY SOCK EACH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["E0111", "
CRUTCH FOREARM EACH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 A
\n", "
\n
\n\n
\n", ""], ["L1000", "
CTLSO MILWAUKE INITIAL MODEL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L1010", "
CTLSO AXILLA SLING
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L1020", "
KYPHOSIS PAD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L1025", "
KYPHOSIS PAD FLOATING
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L1030", "
LUMBAR BOLSTER PAD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L1040", "
LUMBAR OR LUMBAR RIB PAD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L1050", "
STERNAL PAD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L1060", "
THORACIC PAD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L1070", "
TRAPEZIUS SLING
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L1080", "
OUTRIGGER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["E0112", "
CRUTCH UNDERARM PAIR WOOD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 A
\n", "
\n
\n\n
\n", ""], ["L1085", "
OUTRIGGER BIL W/ VERT EXTENS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L1090", "
LUMBAR SLING
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L1100", "
RING FLANGE PLASTIC/LEATHER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L1110", "
RING FLANGE PLAS/LEATHER MOL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L1120", "
COVERS FOR UPRIGHT EACH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L1200", "
FURNSH INITIAL ORTHOSIS ONLY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L1210", "
LATERAL THORACIC EXTENSION
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L1220", "
ANTERIOR THORACIC EXTENSION
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L1230", "
MILWAUKEE TYPE SUPERSTRUCTUR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L1240", "
LUMBAR DEROTATION PAD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["E0113", "
CRUTCH UNDERARM EACH WOOD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 A
\n", "
\n
\n\n
\n", ""], ["L1250", "
ANTERIOR ASIS PAD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L1260", "
ANTERIOR THORACIC DEROTATION
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L1270", "
TLSO ABDOM PAD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 G
\n", "
\n
\n\n
\n", ""], ["L1280", "
RIB GUSSET (ELASTIC) EACH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 G
\n", "
\n
\n\n
\n", ""], ["L1290", "
LATERAL TROCHANTERIC PAD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L1300", "
BODY JACKET MOLD TO PATIENT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L1310", "
POST-OPERATIVE BODY JACKET
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L1499", "
SPINAL ORTHOSIS, NOS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 C
\n", "
\n
\n\n
\n", ""], ["L1500", "
THKAO MOBILITY FRAME
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L1510", "
THKAO STANDING FRAME
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["E0114", "
CRUTCH UNDERARM PAIR NO WOOD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 A
\n", "
\n
\n\n
\n", ""], ["L1520", "
THKAO SWIVEL WALKER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L1600", "
HO,ABDUCT HIP FLEX FREJKA/CVR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L1610", "
HO,ABD HIP FLEX/FREJKA COVR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L1620", "
HO ABDUCT HIP FLEX PAVLIK
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L1630", "
HO, AB CONTR HIP VON ROSEN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L1640", "
HO,ABD CONTRL HIP,ST PELVIC BA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L1650", "
HO,ABD HIP ADJ (ILLFLED)
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L1660", "
HO ABD STATIC PLASTIC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L1680", "
HO,ABD CTL,DYNAMIC(RANCHO)
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L1685", "
HO. ABD CTRL HIP POST-OP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["E0116", "
CRUTCH UNDERARM EACH NO WOOD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 A
\n", "
\n
\n\n
\n", ""], ["L1686", "
HO POST-OP HIP ABDUCTION
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L1700", "
LEGG PERTHES ORTH TORONTO TYP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L1710", "
LEGG PERTHES ORTH NEWINGTON
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L1720", "
L/P ORTHOSIS, TACHDIJAN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L1730", "
L/P ORTHOSIS, SCOTTISH RITE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L1750", "
LPO/LPS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L1755", "
LPO,PATTEN BOTTOM TYPE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L1800", "
KNEE ORTHOSES ELAS W STAYS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 F
\n", "
\n
\n\n
\n", ""], ["L1810", "
KO ELASTIC WITH JOINTS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 F
\n", "
\n
\n\n
\n", ""], ["L1815", "
KO,ELASTIC/CONDYLAR PADS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 F
\n", "
\n
\n\n
\n", ""], ["E0130", "
WALKER RIGID ADJUST/FIXED HT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 A
\n", "
\n
\n\n
\n", ""], ["L1820", "
KO ELAS W/ CONDYLE PADS & JO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 F
\n", "
\n
\n\n
\n", ""], ["L1825", "
KO ELASTIC KNEE CAP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 F
\n", "
\n
\n\n
\n", ""], ["L1830", "
KO IMMOBILIZER CANVAS LONGIT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 F
\n", "
\n
\n\n
\n", ""], ["L1832", "
KO ADJ JNT POS RIGID SUPPORT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 F
\n", "
\n
\n\n
\n", ""], ["L1834", "
KO W/0 JOINT RIGID CTM FAB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 F
\n", "
\n
\n\n
\n", ""], ["L1840", "
KO DEROT ANT CRUCIATE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 F
\n", "
\n
\n\n
\n", ""], ["L1844", "
KO W/ADJ JT ROT CNTRL CUSTOM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 F
\n", "
\n
\n\n
\n", ""], ["L1845", "
KO DBL UPRIGHT THIGH & CALF
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 F
\n", "
\n
\n\n
\n", ""], ["L1846", "
KO DBL UPRIGHT,PREFAB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 F
\n", "
\n
\n\n
\n", ""], ["L1850", "
KO SWEDISH TYPE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 F
\n", "
\n
\n\n
\n", ""], ["E0135", "
WALKER FOLDING ADJUST/FIXED
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 A
\n", "
\n
\n\n
\n", ""], ["L1855", "
KO MOLDED PLAS,CUSTOM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 F
\n", "
\n
\n\n
\n", ""], ["L1858", "
KO MOLDED PLASTIC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 F
\n", "
\n
\n\n
\n", ""], ["L1860", "
KO MODIFICATION
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 F
\n", "
\n
\n\n
\n", ""], ["L1870", "
KO DOUB UPRIGHT LACERS CUSTOM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 F
\n", "
\n
\n\n
\n", ""], ["L1880", "
KO DOUB UPRIGHT CUFFS/LACERS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 F
\n", "
\n
\n\n
\n", ""], ["L1900", "
AFO SPRNG WIR DRSFLX CALF BD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 A
\n", "
\n
\n\n
\n", ""], ["L1902", "
AFO ANKLE GAUNTLET
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 A
\n", "
\n
\n\n
\n", ""], ["L1904", "
AFO MOLDED ANKLE GAUNTLET
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 A
\n", "
\n
\n\n
\n", ""], ["L1906", "
AFO MULTILIGAMENTUS ANKLE SU
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 A
\n", "
\n
\n\n
\n", ""], ["L1910", "
AFO POSTERIOR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 A
\n", "
\n
\n\n
\n", ""], ["E0141", "
RIGID WALKER WHEELED WO SEAT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 A
\n", "
\n
\n\n
\n", ""], ["L1920", "
AFO SING UPRIGHT W/ ADJUST S
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 A
\n", "
\n
\n\n
\n", ""], ["L1930", "
AFO PLASTIC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 A
\n", "
\n
\n\n
\n", ""], ["L1940", "
AFO PLASTIC, CSTM FAB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 A
\n", "
\n
\n\n
\n", ""], ["L1945", "
AFO MOLDED PLAS RIG ANT TIB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 A
\n", "
\n
\n\n
\n", ""], ["L1950", "
AFO SPIRAL IRM TYPE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 A
\n", "
\n
\n\n
\n", ""], ["L1960", "
AFO POS SOLID ANK PLASTIC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 A
\n", "
\n
\n\n
\n", ""], ["L1970", "
AFO PLASTIC W/ANKLE J
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 A
\n", "
\n
\n\n
\n", ""], ["L1980", "
AFO SING UPRIGHT FREE PLANTAR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 A
\n", "
\n
\n\n
\n", ""], ["L1990", "
AFO DOUB UPRIGHT STIRRUP CALF
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 A
\n", "
\n
\n\n
\n", ""], ["L2000", "
KAFO,SINGLE BAR AK ORTHOSIS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["A4367", "
OSTOMY BELT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["E0142", "
WALKER RIGID WHEELED WITH SE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 A
\n", "
\n
\n\n
\n", ""], ["L2010", "
KAFO SNG SOLID STIRRUP W/O J
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2020", "
KAFO DBL SOLID STIRRUP BAND/
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2030", "
KAFO DBL SOLID STIRRUP W/O J
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2036", "
KAFO PLAS DOUB FREE KNEE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2037", "
KAFO PLAS SING FREE KNEE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2038", "
KAFO W/O JOINT MULTI-AXIS AN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2040", "
HKAFO TORSION BIL ROT STRAPS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2050", "
HKAFO TORSION CABLE HIP PELV
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2060", "
HKAFO TORSION BALL BEARING J
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2070", "
HKAFO TORSION UNILAT ROT STR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["E0143", "
WALKER FOLDING WHEELED W/O S
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 A
\n", "
\n
\n\n
\n", ""], ["L2080", "
HKAFO UNILAT TORSION CABLE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2090", "
HKAFO UNILAT TORSION BALL BR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2102", "
AFO TIBIAL FX CAST PLSTR
\n", "", "", "
L2106
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 A
\n", "
\n
\n\n
\n", ""], ["L2104", "
AFO TIB FX CAST SYNTHETIC
\n", "", "", "
L2108
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 A
\n", "
\n
\n\n
\n", ""], ["L2106", "
AFO TIB FX CAST PLASTER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 A
\n", "
\n
\n\n
\n", ""], ["L2108", "
AFO TIB FX CAST CSTM FAB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 A
\n", "
\n
\n\n
\n", ""], ["L2112", "
AFO TIBIAL FX ORTH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 A
\n", "
\n
\n\n
\n", ""], ["L2114", "
AFO TIB FX SEMI-RIGID
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 A
\n", "
\n
\n\n
\n", ""], ["L2116", "
AFO TIBIAL FRACTURE RIGID
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 A
\n", "
\n
\n\n
\n", ""], ["L2122", "
KAFO FEM FX CAST PLASTER
\n", "", "", "
L2126
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["E0145", "
WALKER WHLED SEAT/CRUTCH ATT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 A
\n", "
\n
\n\n
\n", ""], ["L2124", "
KAFO FEM FX CAST SYNTHETIC
\n", "", "", "
L2128
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2126", "
KAFO FEM FX CAST THERMOPLAS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2128", "
KAFO FEM FX CAST CSTM FAB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2132", "
KAFO FEMORAL FX CAST SOFT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2134", "
KAFO FEM FX CAST SEMI-RIGID
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2136", "
KAFO FEMORAL FX CAST RIGID
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2180", "
PLAS SHOE INSERT W ANK JOINT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 A
\n", "
\n
\n\n
\n", ""], ["L2182", "
DROP LOCK KNEE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["A4618", "
BREATHING CIRCUITS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
800 D
\n", "
\n
\n\n
\n", ""], ["E0243", "
TOILET RAIL
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
900 I
\n", "
\n
\n\n
\n", ""], ["E0146", "
FOLDING WALKER WHEELS W SEAT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 A
\n", "
\n
\n\n
\n", ""], ["E0560", "
HUMIDIFIER SUPPLEMENTAL W/ I
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R91 C
\n", "
800 D
\n", "
\n
\n\n
\n", ""], ["E0690", "
ULTRAVIOLET CABINET
\n", "", "", "
E0691
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["E0958", "
WHLCHR ATT- CONV 1 ARM DRIVE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R10 A
\n", "
100 D
\n", "
\n
\n\n
\n", ""], ["L2240", "
ROUND CALIPER AND PLATE ATTA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L2250", "
FOOT PLATE MOLDED STIRRUP AT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L2260", "
REINFORCED SOLID STIRRUP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["E0147", "
WALKER VARIABLE WHEEL RESIST
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 A
\n", "
\n
\n\n
\n", ""], ["L2270", "
VARUS/VALGUS STRAP PADDED/LI
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L2265", "
LONG TONGUE STIRRUP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L2275", "
PLASTIC MOD LOW EXT PAD/LINE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L2280", "
MOLDED INNER BOOT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L2300", "
ABDUCTION BAR JOINTED ADJUST
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L2310", "
ABDUCTION BAR-STRAIGHT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L2320", "
NON-MOLDED LACER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L2230", "
SPLIT FLAT CALIPER STIRR & P
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L2330", "
LACER MOLDED TO PATIENT MODE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L2340", "
PRE-TIBIAL SHELL MOLDED TO P
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 A
\n", "
\n
\n\n
\n", ""], ["E0153", "
FOREARM CRUTCH PLATFORM ATTA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 A
\n", "
\n
\n\n
\n", ""], ["L2360", "
EXTENDED STEEL SHANK
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L2370", "
PATTEN BOTTOM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2375", "
TORSION ANK & HALF SOLID STI
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2380", "
TORSION STRAIGHT KNEE JOINT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2385", "
STRAIGHT KNEE JOINT HEAVY DU
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2390", "
OFFSET KNEE JOINT EACH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2395", "
OFFSET KNEE JOINT HEAVY DUTY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2397", "
SUSPENSION SLEEVE LOWER EXT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L2405", "
KNEE JOINT DROP LOCK EA JNT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["E0154", "
WALKER PLATFORM ATTACHMENT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 A
\n", "
\n
\n\n
\n", ""], ["L2415", "
KNEE LOCK W/INTEGRATED RELEASE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2425", "
KNEE DISC/DIAL LOCK/ADJ FLEX
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2435", "
KNEE JOINT POLYCENTRIC JOINT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2492", "
KNEE LIFT LOOP DROP LOCK RIN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2500", "
THI/GLUT/ISCHIA WGT BEARING
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2510", "
TH/WGHT BEAR QUAD-LAT BRIM M
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2520", "
TH/WGHT BEAR QUAD-LAT BRIM C
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2525", "
TH/WGHT BEAR NAR M-L BRIM MO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2526", "
TH/WGHT BEAR NAR M-L BRIM CU
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2530", "
THIGH/WGHT BEAR LACER NON-MO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 F
\n", "
\n
\n\n
\n", ""], ["E0155", "
WALKER RIGD PICK-UP/WHEEL AT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 A
\n", "
\n
\n\n
\n", ""], ["L2540", "
THIGH/WGHT BEAR LACER MOLDED
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 F
\n", "
\n
\n\n
\n", ""], ["L2550", "
THIGH/WGHT BEAR HIGH ROLL CU
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 F
\n", "
\n
\n\n
\n", ""], ["L2570", "
HIP CLEVIS TYPE 2 POSIT JNT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2580", "
PELVIC CONTROL PELVIC SLING
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2600", "
HIP CLEVIS/THRUST BEARING FR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2610", "
HIP CLEVIS/THRUST BEARING LO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2620", "
PELVIC CONTROL HIP HEAVY DUT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2622", "
HIP JOINT ADJUSTABLE FLEXION
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2624", "
HIP ADJ FLEX EXT ABDUCT CONT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2627", "
PLASTIC MOLD RECIPRO HIP & C
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["E0156", "
WALKER SEAT ATTACHMENT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 A
\n", "
\n
\n\n
\n", ""], ["L2628", "
METAL FRAME RECIPRO HIP & CA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L3630", "
TRANS SHOE SOLID STIRRUP NEW
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "", "
\n
\n\n
\n", ""], ["L2640", "
PELVIC CONTROL BAND & BELT B
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2650", "
PELV & THOR CONTROL GLUTEAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2660", "
THORACIC CONTROL THORACIC BA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2680", "
THORAC CONT LAT SUPPORT UPRI
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L2750", "
PLATING CHROME/NICKEL PR BAR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "", "
\n
\n\n
\n", ""], ["L2760", "
EXTENSION PER EXTENSION PER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "", "
\n
\n\n
\n", ""], ["L2770", "
LOW EXT ORTHOSIS PER BAR/JNT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "", "
\n
\n\n
\n", ""], ["L2780", "
NON-CORROSIVE FINISH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "", "
\n
\n\n
\n", ""], ["E0157", "
WALKER CRUTCH ATTACHMENT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 A
\n", "
\n
\n\n
\n", ""], ["L2785", "
DROP LOCK RETAINER EACH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "", "
\n
\n\n
\n", ""], ["L2795", "
KNEE CONTROL FULL KNEECAP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "", "
\n
\n\n
\n", ""], ["L2800", "
KNEE CAP MEDIAL OR LATERAL P
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "", "
\n
\n\n
\n", ""], ["L2810", "
KNEE CONTROL CONDYLAR PAD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "", "
\n
\n\n
\n", ""], ["L2820", "
SOFT INTERFACE BELOW KNEE SE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "", "
\n
\n\n
\n", ""], ["L2830", "
SOFT INTERFACE ABOVE KNEE SE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "", "
\n
\n\n
\n", ""], ["L2840", "
TIBIAL LENGTH SOCK FX OR EQU
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "", "
\n
\n\n
\n", ""], ["L2999", "
LOWER EXTREMITY ORTHOSIS, NOS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 A
\n", "
\n
\n\n
\n", ""], ["L3000", "
FT INSERT UCB BERKELEY SHELL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 C
\n", "
500 A
\n", "
\n
\n\n
\n", ""], ["L3001", "
FOOT INSERT REMOV MOLDED SPE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 C
\n", "
500 E
\n", "
\n
\n\n
\n", ""], ["A4398", "
OSTOMY IRRIGATION BAG
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["E0158", "
WALKER LEG EXTENSIONS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 A
\n", "
\n
\n\n
\n", ""], ["L3002", "
FOOT INSERT PLASTAZOTE OR EQ
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 C
\n", "
500 E
\n", "
\n
\n\n
\n", ""], ["L3003", "
FOOT INSERT SILICONE GEL EAC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 C
\n", "
500 E
\n", "
\n
\n\n
\n", ""], ["L3010", "
FOOT LONGITUDINAL ARCH SUPPO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 C
\n", "
500 A
\n", "
\n
\n\n
\n", ""], ["L3020", "
FOOT LONGITUD/METATARSAL SUP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 C
\n", "
500 A
\n", "
\n
\n\n
\n", ""], ["L3030", "
FOOT ARCH SUPPORT REMOV PREM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 C
\n", "
500 A
\n", "
\n
\n\n
\n", ""], ["L3040", "
FT ARCH SUPRT PREMOLD LONGIT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 C
\n", "
500 A
\n", "
\n
\n\n
\n", ""], ["L3050", "
FOOT ARCH SUPP PREMOLD METAT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 C
\n", "
500 A
\n", "
\n
\n\n
\n", ""], ["L3060", "
FOOT ARCH SUPP LONGITUD/META
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 C
\n", "
500 A
\n", "
\n
\n\n
\n", ""], ["L3070", "
ARCH SUPRT ATT TO SHO LONGIT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 C
\n", "
500 A
\n", "
\n
\n\n
\n", ""], ["L3080", "
ARCH SUPP ATT TO SHOE METATA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 C
\n", "
500 A
\n", "
\n
\n\n
\n", ""], ["E0160", "
SITZ TYPE BATH OR EQUIPMENT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["L3090", "
ARCH SUPP ATT TO SHOE LONG/M
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 C
\n", "
500 A
\n", "
\n
\n\n
\n", ""], ["L3100", "
HALLUS-VALGUS NGHT DYNAMIC S
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L3140", "
ABDUCTION ROTATION BAR SHOE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L3150", "
ABDUCT ROTATION BAR W/O SHOE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L3170", "
FOOT PLASTIC HEEL STABILIZER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "", "
\n
\n\n
\n", ""], ["L3215", "
ORTHOPEDIC FTWEAR LADIES OXF
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 A
\n", "
500 D
\n", "
\n
\n\n
\n", ""], ["L3216", "
ORTHOPED LADIES SHOES DPTH I
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 A
\n", "
500 B
\n", "
\n
\n\n
\n", ""], ["L3217", "
LADIES SHOES HIGHTOP DEPTH I
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 A
\n", "
500 B
\n", "
\n
\n\n
\n", ""], ["L3218", "
LADIES SURGICAL BOOT EACH
\n", "", "
YES
\n", "
L3260
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R50 A
\n", "
500 F
\n", "
\n
\n\n
\n", ""], ["L3219", "
ORTHOPEDIC MENS SHOES OXFORD
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 A
\n", "
500 D
\n", "
\n
\n\n
\n", ""], ["E0161", "
SITZ BATH/EQUIPMENT W/FAUCET
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["L3221", "
ORTHOPEDIC MENS SHOES DPTH I
\n", "", "
YES
\n", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 A
\n", "
500 B
\n", "
\n
\n\n
\n", ""], ["L3222", "
MENS SHOES HIGHTOP DEPTH INL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 A
\n", "
500 B
\n", "
\n
\n\n
\n", ""], ["L3223", "
MENS SURGICAL BOOT EACH
\n", "", "
YES
\n", "
L3260
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R50 A
\n", "
500 F
\n", "
\n
\n\n
\n", ""], ["L3230", "
CUSTOM SHOES DEPTH INLAY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 A
\n", "
500 B
\n", "
\n
\n\n
\n", ""], ["L3250", "
CUSTOM MOLD SHOE REMOV PROST
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 A
\n", "
500 C
\n", "
\n
\n\n
\n", ""], ["L3251", "
SHOE MOLDED TO PT SILICONE S
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 A
\n", "
500 C
\n", "
\n
\n\n
\n", ""], ["L3252", "
SHOE MOLDED PLASTAZOTE CUST
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 A
\n", "
500 C
\n", "
\n
\n\n
\n", ""], ["L3253", "
SHOE MOLDED PLASTAZOTE CUST
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 A
\n", "
500 C
\n", "
\n
\n\n
\n", ""], ["L3254", "
ORTH FOOT NON-STNDARD SIZE/W
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 C
\n", "
500 F
\n", "
\n
\n\n
\n", ""], ["L3255", "
ORTH FOOT NON-STANDARD SIZE/
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 C
\n", "
500 F
\n", "
\n
\n\n
\n", ""], ["E0162", "
SITZ BATH CHAIR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["L3257", "
ORTH FOOT ADD CHARGE SPLIT S
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 C
\n", "
500 F
\n", "
\n
\n\n
\n", ""], ["L3260", "
AMBULATORY SURGICAL BOOT EAC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 C
\n", "
500 F
\n", "
\n
\n\n
\n", ""], ["L3265", "
PLASTAZOTE SANDAL EACH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 C
\n", "
500 F
\n", "
\n
\n\n
\n", ""], ["L3300", "
SHO LIFT TAPER TO METATARSAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "", "
\n
\n\n
\n", ""], ["L3310", "
SHOE LIFT ELEV HEEL/SOLE NEO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "", "
\n
\n\n
\n", ""], ["L3320", "
SHOE LIFT ELEV HEEL/SOLE COR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "", "
\n
\n\n
\n", ""], ["L3330", "
LIFTS ELEVATION METAL EXTENS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "", "
\n
\n\n
\n", ""], ["L3332", "
SHOE LIFTS TAPERED TO ONE-HA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "", "
\n
\n\n
\n", ""], ["L3334", "
SHOE LIFTS ELEVATION HEEL /I
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "", "
\n
\n\n
\n", ""], ["L3340", "
SHOE WEDGE SACH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "", "
\n
\n\n
\n", ""], ["E0163", "
COMMODE CHAIR STATIONRY FXD
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 I
\n", "
\n
\n\n
\n", ""], ["L3350", "
SHOE HEEL WEDGE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "", "
\n
\n\n
\n", ""], ["L3360", "
SHOE SOLE WEDGE OUTSIDE SOLE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "", "
\n
\n\n
\n", ""], ["L3370", "
SHOE SOLE WEDGE BETWEEN SOLE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "", "
\n
\n\n
\n", ""], ["L3380", "
SHOE CLUBFOOT WEDGE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "", "
\n
\n\n
\n", ""], ["L3390", "
SHOE OUTFLARE WEDGE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "", "
\n
\n\n
\n", ""], ["L3400", "
SHOE METATARSAL BAR WEDGE RO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "", "
\n
\n\n
\n", ""], ["L3410", "
SHOE METATARSAL BAR BETWEEN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "", "
\n
\n\n
\n", ""], ["L3420", "
FULL SOLE/HEEL WEDGE BTWEEN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "", "
\n
\n\n
\n", ""], ["L3430", "
SHO HEEL COUNT PLAST REINFOR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "", "
\n
\n\n
\n", ""], ["L3440", "
HEEL LEATHER REINFORCED
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "", "
\n
\n\n
\n", ""], ["E0164", "
COMMODE CHAIR MOBILE FIXED A
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 I
\n", "
\n
\n\n
\n", ""], ["L3450", "
SHOE HEEL SACH CUSHION TYPE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "", "
\n
\n\n
\n", ""], ["L3455", "
SHOE HEEL NEW LEATHER STANDA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "", "
\n
\n\n
\n", ""], ["L3460", "
SHOE HEEL NEW RUBBER STANDAR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "", "
\n
\n\n
\n", ""], ["L3465", "
SHOE HEEL THOMAS WITH WEDGE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "", "
\n
\n\n
\n", ""], ["L3470", "
SHOE HEEL THOMAS EXTEND TO B
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "", "
\n
\n\n
\n", ""], ["L3480", "
SHOE HEEL PAD & DEPRESS FOR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "", "
\n
\n\n
\n", ""], ["L3485", "
SHOE HEEL PAD REMOVABLE FOR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "", "
\n
\n\n
\n", ""], ["L3500", "
SHOE MISC ADD INSOLE LEATHER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "", "
\n
\n\n
\n", ""], ["L3510", "
SHOE MISC ADDITION INSOLE RU
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "", "
\n
\n\n
\n", ""], ["L3520", "
SHOE INSOLE FELT CVER W/ LEA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "", "
\n
\n\n
\n", ""], ["E0165", "
COMMODE CHAIR STATIONRY DET
\n", "", "", "
E0166
\n", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R80 C
\n", "
900 I
\n", "
\n
\n\n
\n", ""], ["L3530", "
SHOE MISC ADDITIONS SOLE HAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "", "
\n
\n\n
\n", ""], ["L3540", "
SHOE MISC ADDITIONS SOLE FUL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "", "
\n
\n\n
\n", ""], ["L3550", "
SHOE MISC ADD TOE TAP STANDA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "", "
\n
\n\n
\n", ""], ["L3560", "
SHOE MISC ADD TOE TAP HORSES
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "", "
\n
\n\n
\n", ""], ["L3570", "
SHOE SPECIAL EXTENSION TO IN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "", "
\n
\n\n
\n", ""], ["L3580", "
SHOE CONVERT INSTEP VELCRO C
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "", "
\n
\n\n
\n", ""], ["L3590", "
SHOE CONVERT FIRM TO SOFT CN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "", "
\n
\n\n
\n", ""], ["L3595", "
SHOE MISC ADDITIONS MARCH BA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "", "
\n
\n\n
\n", ""], ["L3600", "
TRANS SHOE CALIP PLATE EXIST
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "", "
\n
\n\n
\n", ""], ["E0166", "
COMMODE CHAIR MOBILE DETACH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 I
\n", "
\n
\n\n
\n", ""], ["L3620", "
TRANS SHOE SOLID STIRRUP EXI
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "", "
\n
\n\n
\n", ""], ["L2630", "
PELVIC CONTROL BAND & BELT U
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 B
\n", "
\n
\n\n
\n", ""], ["L3640", "
SHOE DENNIS BROWNE SPLINT BO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "", "
\n
\n\n
\n", ""], ["L3649", "
UNLIST PROC ORTH SHOE MODIF/
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R50 B
\n", "", "
\n
\n\n
\n", ""], ["L3650", "
SO FIG 8 ABDUCT RESTRAIN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L3660", "
SO.FIG 8 ABD REST CANVAS/WEB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L3670", "
SO, ACROMIO/CLAVICULAR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L3700", "
ELBOW ORTHOSES ELAS W STAYS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L3710", "
EO, ELASTIC WITH METAL JOI
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L3720", "
EO,DOUBLE UPRIGHT, CUSTOM FAB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["E0167", "
COMMODE CHAIR PAIL OR PAN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
900 I
\n", "
\n
\n\n
\n", ""], ["L3730", "
EO, DOUBLE UPRIGHT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L3740", "
EO, ADJ LOCK W/ ACTIVE CON
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L3800", "
WHFO SHORT OPPONEN NO ATTACH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
\n", ""], ["L3805", "
WHFO LONG OPPONENS NO ATTACH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
\n", ""], ["L3810", "
WHFO THUMB ABDUCTION BAR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
\n", ""], ["L3815", "
WHFO SECOND M.P. ABDUCTION A
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
\n", ""], ["L3820", "
WHFO IP EXT ASST W/ MP EXT S
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
\n", ""], ["L3825", "
WHFO M.P. EXTENSION STOP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
\n", ""], ["L3830", "
WHFO M.P. EXTENSION ASSIST
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
\n", ""], ["L3835", "
WHFO M.P. SPRING EXTENSION A
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
\n", ""], ["E0175", "
COMMODE CHAIR FOOT REST
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 I
\n", "
\n
\n\n
\n", ""], ["L3840", "
WHFO SPRING SWIVEL THUMB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
\n", ""], ["L3845", "
WHFO THUMB IP EXT ASS W/ MP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
\n", ""], ["L3850", "
ACTION WRIST W/ DORSIFLEX AS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
\n", ""], ["L3855", "
WHFO ADJ M.P. FLEXION CONTRO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
\n", ""], ["L3860", "
WHFO ADJ M.P. FLEX CTRL & I.
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
\n", ""], ["L3900", "
WHFO EXTENSION/FLEX WRIST/F
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
\n", ""], ["L3901", "
WHFO, EXT/FLEX WRIST FINGER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
\n", ""], ["L3902", "
WHFO EXT POWER COMPRESS GAS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
\n", ""], ["L3904", "
WHFO ELECTRIC CUSTOM FAB
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
\n", ""], ["L3906", "
WHO, WRIST GAUNTLET
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
\n", ""], ["A4399", "
OSTOMY IRRIG CONE/CATH W BRS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
\n", "
\n
\n\n
\n", ""], ["E0176", "
AIR PRESSRE PAD/CUSHION NONP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
100 F
\n", "
\n
\n\n
\n", ""], ["L3907", "
WHFO WRST GAUNTLT THMB SPICA
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
\n", ""], ["L3908", "
WHO, WRIST EXTENSION
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
\n", ""], ["L3910", "
WHFO, SWANSON DESIGN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
\n", ""], ["L3912", "
HFO, FLEX GLOVE, FINGER C
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
\n", ""], ["L3914", "
WHO WRIST EXTENSION COCK-UP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
\n", ""], ["L3916", "
WHFO WRIST EXTENS W/ OUTRIGG
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
\n", ""], ["L3918", "
HFO KNUCKLE BENDER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
\n", ""], ["L3920", "
HFO, KB W/ OUTRIGGER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
\n", ""], ["L3922", "
HFO, KNUCLE BENDER,FLEX JTS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
\n", ""], ["L3924", "
WHFO, OPPEN
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
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R40
\n", "
400 H
\n", "
\n
\n\n
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WATER PRESS PAD/CUSHION NONP
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
100 F
\n", "
\n
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File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
\n", ""], ["L3932", "
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
\n", ""], ["L3934", "
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
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WHFO, PALMER, PREFABRICATED
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
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\n", ""], ["L3942", "
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
\n", ""], ["L3944", "
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
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\n", ""], ["E0178", "
GEL PRESSRE PAD/CUSHION NONP
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File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
100 F
\n", "
\n
\n\n
\n", ""], ["L3946", "
HFO COMPOSITE ELASTIC
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
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\n", ""], ["L3948", "
FO,FKB PREFAB
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
\n", ""], ["L3950", "
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
\n", ""], ["L3952", "
WHFO, COMBO OPPENHEIM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
\n", ""], ["L3954", "
HFO SPREAD HAND
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 H
\n", "
\n
\n\n
\n", ""], ["L3960", "
SEWHO AIRPLAN DESIG ABDU POS
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File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L3962", "
SEWHO ERBS PALSEY DESIGN ABD
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File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L3963", "
SEWHO, MOLDED SHOULDER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L3965", "
SEO, MOBILE ARM,RANCHO TYPE
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["E0179", "
DRY PRESSRE PAD/CUSHION NONP
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File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
100 F
\n", "
\n
\n\n
\n", ""], ["L3966", "
SEO, MA SUPPORT TO W/C, RECL
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File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L3968", "
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\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L3969", "
SEO, MONOSUSPENSION ARM/HAND
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L3970", "
ELEVAT PROXIMAL ARM SUPPORT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L3972", "
OFFSET/LAT ROCKER ARM W/ ELA
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File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L3974", "
MOBILE ARM SUPPORT SUPINATOR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L3980", "
UPP EXT FX ORTHOSIS HUMERAL
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File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L3982", "
UPPER EXT FX ORTHOSIS RAD/UL
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File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L3984", "
UPPER EXT FX ORTHOSIS WRIST
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L3985", "
FOREARM HAND FX ORTH W/ WR H
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["E0180", "
PRESS PAD ALTERNATING W PUMP
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 F
\n", "
\n
\n\n
\n", ""], ["L3986", "
HUMERAL RAD/ULNA WRIST FX OR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L3995", "
SOCK FRACTURE OR EQUAL EACH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L3999", "
UPPER LIMB ORTHOSIS, NOS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L4000", "
REPL GIRDLE MILWAUKEE ORTH
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File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "", "
\n
\n\n
\n", ""], ["L4010", "
REPLACE TRILATERAL SOCKET BR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "", "
\n
\n\n
\n", ""], ["L4020", "
REPLACE QUADLAT SOCKET BRIM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "", "
\n
\n\n
\n", ""], ["L4030", "
REPLACE SOCKET BRIM CUST FIT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "", "
\n
\n\n
\n", ""], ["L4040", "
REPLACE MOLDED THIGH LACER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "", "
\n
\n\n
\n", ""], ["L4045", "
REPLACE NON-MOLDED THIGH LAC
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "", "
\n
\n\n
\n", ""], ["L4050", "
REPLACE MOLDED CALF LACER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "", "
\n
\n\n
\n", ""], ["E0181", "
PRESS PAD ALTERNATING W/ PUM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 F
\n", "
\n
\n\n
\n", ""], ["L4055", "
REPLACE NON-MOLDED CALF LACE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "", "
\n
\n\n
\n", ""], ["L4060", "
REPLACE HIGH ROLL CUFF
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "", "
\n
\n\n
\n", ""], ["L4070", "
REPLACE PROX & DIST UPRIGHT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "", "
\n
\n\n
\n", ""], ["L4080", "
REPL MET BAND KAFO-AFO PROX
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "", "
\n
\n\n
\n", ""], ["L4090", "
REPL MET BAND KAFO-AFO CALF/
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File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "", "
\n
\n\n
\n", ""], ["L4100", "
REPL LEATH CUFF KAFO PROX TH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "", "
\n
\n\n
\n", ""], ["L4110", "
REPL LEATH CUFF KAFO-AFO CAL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "", "
\n
\n\n
\n", ""], ["L4130", "
REPLACE PRETIBIAL SHELL
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "", "
\n
\n\n
\n", ""], ["L4200", "
ORTHOTIC DEVICE REPAIR HRLY
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "", "
\n
\n\n
\n", ""], ["L4210", "
ORTH DEV REPAIR/REPL MINOR P
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "", "
\n
\n\n
\n", ""], ["E0182", "
PRESSURE PAD ALTERNATING PUM
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 K
\n", "
\n
\n\n
\n", ""], ["L4310", "
MULT-PODUS/EQ ORTH PREP MGMT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L4320", "
LOW EXT MGMT SYS FT POS AFO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
INACTIVE
\n", "", "", "
R40
\n", "", "
\n
\n\n
\n", ""], ["L4350", "
PNEUMATIC ANKLE CNTRL SPLINT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L4360", "
PNEUMATIC WALKING SPLINT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L4370", "
PNEUMATIC FULL LEG SPLINT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L4380", "
PNEUMATIC KNEE SPLINT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R40
\n", "
400 D
\n", "
\n
\n\n
\n", ""], ["L5000", "
SHO INSERT W ARCH TOE FILLER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 D
\n", "
200 C
\n", "
\n
\n\n
\n", "
1
\n"], ["L5010", "
MOLD SOCKET ANK HGT W/ TOE F
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 D
\n", "
200 C
\n", "
\n
\n\n
\n", "
1
\n"], ["L5020", "
TIBIAL TUBERCLE HGT W/ TOE F
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 D
\n", "
200 C
\n", "
\n
\n\n
\n", "
1
\n"], ["MISSING", "", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "", "", "", "", "", "", "
\n
\n\n
\n", ""], ["E0184", "
DRY PRESSURE MATTRESS
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
\n", "
900 F
\n", "
\n
\n\n
\n", ""], ["L5060", "
SYMES MET FR LEATH SOCKET AR
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File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 D
\n", "
200 E
\n", "
\n
\n\n
\n", "
1
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MOLDED SOCKET SHIN SACH FOOT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 C
\n", "
200 F
\n", "
\n
\n\n
\n", "
1
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PLAST SOCKET JTS/THGH LACER
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 C
\n", "
200 F
\n", "
\n
\n\n
\n", "
1
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MOLD SCKT EXT KNEE SHIN SACH
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 C
\n", "
200 G
\n", "
\n
\n\n
\n", "
1
\n"], ["L5160", "
MOLD SOCKET BENT KNEE SHIN S
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 C
\n", "
200 G
\n", "
\n
\n\n
\n", "
1
\n"], ["L5200", "
KNE SING AXIS FRIC SHIN SACH
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File: 81, IEN: 104840
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ACTIVE
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R20 A
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200 H
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1
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NO KNEE/ANKLE JOINTS W/ FT B
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File: 81, IEN: 104840
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\n
\n\n
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ACTIVE
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R20 C
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200 G
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1
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NO KNEE JOINT WITH ARTIC ALI
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File: 81, IEN: 104840
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\n
\n\n
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ACTIVE
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R20 C
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200 G
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1
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FEM FOCAL DEFIC CONSTANT FRI
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File: 81, IEN: 104840
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\n
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ACTIVE
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R20 A
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200 H
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1
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HIP CANAD SING AXI CONS FRIC
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 D
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200 G
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1
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GEL PRESSURE MATTRESS PAD
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
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900 F
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\n
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TILT TABLE LOCKING HIP SING
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File: 81, IEN: 104840
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\n
\n\n
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ACTIVE
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R20 D
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200 G
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1
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HEMIPELVECT CANAD SING AXIS
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File: 81, IEN: 104840
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\n
\n\n
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ACTIVE
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R20 D
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200 G
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1
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BK SACH SOFT COVER & FINISH
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File: 81, IEN: 104840
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\n
\n\n
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INACTIVE
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R20 B
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200 F
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\n
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1
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KNEE DISART SACH SOFT CV/FIN
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File: 81, IEN: 104840
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\n
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INACTIVE
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R20 D
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200 G
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\n
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1
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AK OPEN END SACH SOFT CV/FIN
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File: 81, IEN: 104840
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\n
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INACTIVE
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R20 A
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200 H
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1
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HIP CANADIAN SACH SFT CV/FIN
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File: 81, IEN: 104840
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\n
\n\n
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INACTIVE
\n", "", "", "
R20 D
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200 G
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\n
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1
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HEMIPELVECTOMY CANAD CV/FIN
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File: 81, IEN: 104840
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\n
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INACTIVE
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R20 D
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200 G
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1
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POSTOP DRESS & 1 CAST CHG BK
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File: 81, IEN: 104840
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\n
\n\n
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ACTIVE
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R20 D
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200 A
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\n
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1
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POSTOP DSG BK EA ADD CAST CH
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File: 81, IEN: 104840
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\n
\n\n
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ACTIVE
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R20 D
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200 A
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1
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POSTOP DSG & 1 CAST CHG AK/D
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File: 81, IEN: 104840
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\n
\n\n
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ACTIVE
\n", "", "", "
R20 D
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200 A
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\n
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1
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AIR PRESSURE MATTRESS
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File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
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900 F
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\n
\n\n
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POSTOP DSG AK EA ADD CAST CH
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File: 81, IEN: 104840
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\n
\n\n
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ACTIVE
\n", "", "", "
R20 D
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200 A
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\n
\n\n
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1
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POSTOP APP NON-WGT BEAR DSG
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 D
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200 A
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\n
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1
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POSTOP APP NON-WGT BEAR DSG
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File: 81, IEN: 104840
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\n
\n\n
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ACTIVE
\n", "", "", "
R20 D
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200 A
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1
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INIT BK PTB PLASTER DIRECT
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File: 81, IEN: 104840
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\n
\n\n
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ACTIVE
\n", "", "", "
R20 C
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200 F
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\n
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1
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INIT AK ISCHAL PLSTR DIRECT
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File: 81, IEN: 104840
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\n
\n\n
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ACTIVE
\n", "", "", "
R20 A
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200 B
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\n
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1
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PREP BK PTB PLASTER MOLDED
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File: 81, IEN: 104840
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\n
\n\n
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ACTIVE
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R20 D
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200 B
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\n
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1
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PERP BK PTB THERMOPLS DIRECT
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File: 81, IEN: 104840
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\n
\n\n
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ACTIVE
\n", "", "", "
R20 D
\n", "
200 B
\n", "
\n
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1
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PREP BK PTB THERMOPLS MOLDED
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 D
\n", "
200 B
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\n
\n\n
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1
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PREP BK PTB OPEN END SOCKET
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File: 81, IEN: 104840
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\n
\n\n
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ACTIVE
\n", "", "", "
R20 D
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200 B
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\n
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1
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PREP BK PTB LAMINATED SOCKET
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 D
\n", "
200 B
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\n
\n\n
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1
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OSTOMY SUPPLY MISC
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File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "", "
910 A
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\n
\n\n
\n", ""], ["E0187", "
WATER PRESSURE MATTRESS
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
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900 F
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\n
\n\n
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PREP AK ISCHIAL PLAST MOLDED
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File: 81, IEN: 104840
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\n
\n\n
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ACTIVE
\n", "", "", "
R20 D
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200 B
\n", "
\n
\n\n
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1
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PREP AK ISCHIAL DIRECT FORM
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 D
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200 B
\n", "
\n
\n\n
\n", "
1
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PREP AK ISCHIAL THERMO MOLD
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 D
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200 B
\n", "
\n
\n\n
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1
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PREP AK ISCHIAL OPEN END
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 D
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200 B
\n", "
\n
\n\n
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1
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PREP AK ISCHIAL LAMINATED
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File: 81, IEN: 104840
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\n
\n\n
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ACTIVE
\n", "", "", "
R20 D
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200 B
\n", "
\n
\n\n
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1
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HIP DISARTIC SACH THERMOPLS
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
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R20 D
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200 B
\n", "
\n
\n\n
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1
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HIP DISART SACH LAMINAT MOLD
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File: 81, IEN: 104840
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\n
\n\n
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ACTIVE
\n", "", "", "
R20 D
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200 B
\n", "
\n
\n\n
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1
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ABOVE KNEE HYDRACADENCE
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 A
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L5611", "
AK 4 BAR LINK W/FRIC SWING
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 A
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L5613", "
AK 4 BAR LING W/HYDRAUL SWIG
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 A
\n", "
200 I
\n", "
\n
\n\n
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SYNTHETIC SHEEPSKIN PAD
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
910 A
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\n
\n\n
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4-BAR LINK ABOVE KNEE W/SWNG
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 A
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L5616", "
AK UNIV MULTIPLEX SYS FRICT
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
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R20 A
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200 I
\n", "
\n
\n\n
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TEST SOCKET SYMES
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 D
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200 I
\n", "
\n
\n\n
\n", ""], ["L5620", "
TEST SOCKET BELOW KNEE
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 C
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200 I
\n", "
\n
\n\n
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TEST SOCKET KNEE DISARTICULA
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 D
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200 I
\n", "
\n
\n\n
\n", ""], ["L5624", "
TEST SOCKET ABOVE KNEE
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 A
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200 I
\n", "
\n
\n\n
\n", ""], ["L5626", "
TEST SOCKET HIP DISARTICULAT
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 D
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200 I
\n", "
\n
\n\n
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TEST SOCKET HEMIPELVECTOMY
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
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R20 D
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200 I
\n", "
\n
\n\n
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BELOW KNEE ACRYLIC SOCKET
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 D
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L5630", "
SYME TYP EXPANDABL WALL SCKT
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 D
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200 I
\n", "
\n
\n\n
\n", ""], ["E0189", "
LAMBSWOOL SHEEPSKIN PAD
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
910 A
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\n
\n\n
\n", ""], ["L5631", "
AK/KNEE DISARTIC ACRYLIC SOC
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 A
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L5632", "
SYMES TYPE PTB BRIM DESIGN S
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 D
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L5634", "
SYMES TYPE POSTER OPENING SO
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 D
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L5636", "
SYMES TYPE MEDIAL OPENING SO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 D
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L5637", "
BELOW KNEE TOTAL CONTACT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 C
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L5638", "
BELOW KNEE LEATHER SOCKET
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 C
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L5639", "
BELOW KNEE WOOD SOCKET
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 C
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L5640", "
KNEE DISARTICULAT LEATHER SO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 D
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L5642", "
ABOVE KNEE LEATHER SOCKET
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 A
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L5643", "
HIP FLEX INNER SOCKET EXT FR
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 D
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["E0191", "
PROTECTOR HEEL OR ELBOW
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R90
\n", "
910 A
\n", "
\n
\n\n
\n", ""], ["L5644", "
ABOVE KNEE WOOD SOCKET
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 A
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L5645", "
AK FLEXIBL INNER SOCKET EXT
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 C
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L5646", "
BELOW KNEE AIR CUSHION SOCKE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 C
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L5647", "
BELOW KNEE SUCTION SOCKET
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 C
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L5648", "
ABOVE KNEE AIR CUSHION SOCKE
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
\n", "
\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 A
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L5649", "
ISCH CONTAINMT/NARROW M-L SO
\n", "", "", "", "", "", "", "", "", "
File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R20 A
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L5650", "
TOT CONTACT AK/KNEE DISART S
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File: 81, IEN: 104840
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200 I
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AK FLEX INNER SOCKET EXT FRA
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File: 81, IEN: 104840
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ACTIVE
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200 I
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File: 81, IEN: 104840
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ACTIVE
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R20 A
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200 I
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KNEE DISART EXPAND WALL SOCK
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File: 81, IEN: 104840
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ACTIVE
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200 I
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File: 81, IEN: 104840
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ACTIVE
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R80 C
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100 F
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SOCKET INSERT SYMES
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File: 81, IEN: 104840
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ACTIVE
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R20 D
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200 I
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SOCKET INSERT BELOW KNEE
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File: 81, IEN: 104840
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ACTIVE
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R20 C
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200 I
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SOCKET INSERT KNEE ARTICULAT
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File: 81, IEN: 104840
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ACTIVE
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R20 D
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200 I
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File: 81, IEN: 104840
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ACTIVE
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R20 A
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200 I
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SOCK INSRT SYME SILICONE GEL
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File: 81, IEN: 104840
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INACTIVE
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R20 D
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200 I
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MULTI-DUROMETER SYMES
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File: 81, IEN: 104840
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ACTIVE
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R20 D
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200 I
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SOCKET INSERT BK SILICONE GE
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File: 81, IEN: 104840
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INACTIVE
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R20 B
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200 I
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SOCK KNEE DISARTIC SILICONE
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File: 81, IEN: 104840
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INACTIVE
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R20 D
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200 I
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SOCKET INSERT AK SILICONE GE
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File: 81, IEN: 104840
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INACTIVE
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R20 A
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200 I
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MULTI-DUROMETER BELOW KNEE
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File: 81, IEN: 104840
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ACTIVE
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R20 C
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200 I
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File: 81, IEN: 104840
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ACTIVE
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R80 C
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900 F
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BELOW KNEE CUFF SUSPENSION
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File: 81, IEN: 104840
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ACTIVE
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R20 C
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200 I
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SOCKET INSERT W LOCK LOWER
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File: 81, IEN: 104840
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INACTIVE
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R20 B
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200 I
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MOLDED DISTAL CUSHION BK
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File: 81, IEN: 104840
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ACTIVE
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R20 C
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200 I
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SOCKET INSERT BK W/O LOCK
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File: 81, IEN: 104840
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INACTIVE
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R20 B
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200 I
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BK MOLDED SUPRACONDYLAR SUSP
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File: 81, IEN: 104840
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ACTIVE
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R20 C
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200 I
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BK REMOVABLE MEDIAL BRIM SUS
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File: 81, IEN: 104840
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ACTIVE
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R20 C
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200 I
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ADDITION TO LOWER EXTREMITY
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File: 81, IEN: 104840
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ACTIVE
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R20 C
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200 I
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File: 81, IEN: 104840
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ACTIVE
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R20 C
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200 I
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BK KNEE JOINTS SINGLE AXIS P
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File: 81, IEN: 104840
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ACTIVE
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R20 C
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200 I
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BK KNEE JOINTS POLYCENTRIC P
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File: 81, IEN: 104840
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ACTIVE
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R20 C
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200 I
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AIR FLUIDIZED BED
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File: 81, IEN: 104840
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ACTIVE
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R80 C
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900 F
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BK JOINT COVERS PAIR
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File: 81, IEN: 104840
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ACTIVE
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R20 C
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200 I
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File: 81, IEN: 104840
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ACTIVE
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200 I
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File: 81, IEN: 104840
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ACTIVE
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R20 C
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200 I
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BK FORK STRAP
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File: 81, IEN: 104840
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ACTIVE
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R20 C
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200 I
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BK BACK CHECK
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File: 81, IEN: 104840
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ACTIVE
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R20 C
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200 I
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BK WAIST BELT WEBBING
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File: 81, IEN: 104840
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ACTIVE
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R20 C
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200 I
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BK WAIST BELT PADDED AND LIN
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File: 81, IEN: 104840
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ACTIVE
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R20 C
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200 I
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AK PELVIC CONTROL BELT LIGHT
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File: 81, IEN: 104840
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ACTIVE
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R20 A
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200 I
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AK PELVIC CONTROL BELT PAD/L
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File: 81, IEN: 104840
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ACTIVE
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R20 A
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200 I
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AK SLEEVE SUSP NEOPRENE/EQUA
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File: 81, IEN: 104840
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ACTIVE
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R20 A
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200 I
\n", "
\n
\n\n
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GEL PRESSURE MATTRESS
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File: 81, IEN: 104840
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\n
\n\n
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ACTIVE
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R80 C
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900 F
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AK/KNEE DISARTIC PELVIC JOIN
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File: 81, IEN: 104840
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ACTIVE
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R20 A
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200 I
\n", "
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\n\n
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AK/KNEE DISARTIC PELVIC BAND
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File: 81, IEN: 104840
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ACTIVE
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R20 A
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200 I
\n", "
\n
\n\n
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AK/KNEE DISARTIC SILESIAN BA
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File: 81, IEN: 104840
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ACTIVE
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R20 A
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200 I
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\n\n
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SHOULDER HARNESS
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File: 81, IEN: 104840
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\n\n
\n", "
INACTIVE
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R30
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300 D
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\n
\n\n
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REPLACE SOCKET BELOW KNEE
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File: 81, IEN: 104840
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\n\n
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ACTIVE
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R20 C
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200 I
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REPLACE SOCKET ABOVE KNEE
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File: 81, IEN: 104840
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ACTIVE
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R20 A
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200 I
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\n", ""], ["L5702", "
REPLACE SOCKET HIP
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File: 81, IEN: 104840
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\n\n
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ACTIVE
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R20 D
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200 I
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\n
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CUSTOM SHAPE COVR BELOW KNEE
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File: 81, IEN: 104840
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ACTIVE
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R20 C
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200 I
\n", "
\n
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CUSTM SHAPE COVER ABOVE KNEE
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File: 81, IEN: 104840
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ACTIVE
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R20 A
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200 I
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CUSTM SHAPE CVR KNEE DISART
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File: 81, IEN: 104840
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\n\n
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ACTIVE
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R20 D
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200 I
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AIR PRESSURE PAD FOR MATTRES
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
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R80 C
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900 K
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CUSTM SHAPE COVER HIP DISART
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File: 81, IEN: 104840
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ACTIVE
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R20 D
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200 I
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KNE-SHIN EXO SNG AXI MNL LOC
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File: 81, IEN: 104840
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ACTIVE
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R20 A
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200 I
\n", "
\n
\n\n
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KNEE-SHIN EXO MNL LOCK ULTRA
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File: 81, IEN: 104840
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ACTIVE
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R20 A
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200 I
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\n
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KNEE-SHIN EXO FRICT SWG & ST
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File: 81, IEN: 104840
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\n", "
ACTIVE
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R20 A
\n", "
200 I
\n", "
\n
\n\n
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KNEE-SHIN EXO VARIABLE FRICT
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File: 81, IEN: 104840
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\n", "
ACTIVE
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R20 A
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200 I
\n", "
\n
\n\n
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KNEE-SHIN EXO MECH STANCE PH
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File: 81, IEN: 104840
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ACTIVE
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R20 A
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200 I
\n", "
\n
\n\n
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KNEE-SHIN EXO FRCT SWG & STA
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File: 81, IEN: 104840
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\n\n
\n", "
ACTIVE
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R20 D
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200 I
\n", "
\n
\n\n
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KNEE-SHIN PNEUM SWG FRCT EXO
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File: 81, IEN: 104840
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\n", "
ACTIVE
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R20 A
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200 I
\n", "
\n
\n\n
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KNEE-SHIN EXO FLUID SWING PH
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
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R20 A
\n", "
200 I
\n", "
\n
\n\n
\n", ""], ["L5726", "
KNEE-SHIN EXT JNTS FLD SWG E
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File: 81, IEN: 104840
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\n
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\n", "
ACTIVE
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R20 A
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200 I
\n", "
\n
\n\n
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WATER PRESSURE PAD FOR MATTR
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
\n", "", "", "
R80 C
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900 K
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\n
\n\n
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KNEE-SHIN FLUID SWG & STANCE
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File: 81, IEN: 104840
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\n
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ACTIVE
\n", "", "", "
R20 A
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200 I
\n", "
\n
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KNEE-SHIN PNEUM/HYDRA PNEUM
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File: 81, IEN: 104840
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\n
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ACTIVE
\n", "", "", "
R20 A
\n", "
200 I
\n", "
\n
\n\n
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EXOSKELETAL BK ULTRALT MATER
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File: 81, IEN: 104840
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\n
\n\n
\n", "
ACTIVE
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R20 C
\n", "
200 I
\n", "
\n
\n\n
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EXOSKELETAL AK ULTRA-LIGHT M
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File: 81, IEN: 104840
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\n
\n\n
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ACTIVE
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R20 A
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200 I
\n", "
\n
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EXOSKEL HIP ULTRA-LIGHT MATE
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File: 81, IEN: 104840
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\n
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ACTIVE
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R20 D
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200 I
\n", "
\n
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ENDOSKEL KNEE-SHIN MNL LOCK
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File: 81, IEN: 104840
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\n
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ACTIVE
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R20 A
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200 I
\n", "
\n
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ENDO KNEE-SHIN MNL LCK ULTRA
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File: 81, IEN: 104840
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ACTIVE
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R20 A
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200 I
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\n
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ENDO KNEE-SHIN FRCT SWG & ST
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File: 81, IEN: 104840
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ACTIVE
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R20 A
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200 I
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\n
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ENDO KNEE-SHIN POLYC MCH STA
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File: 81, IEN: 104840
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\n
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ACTIVE
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R20 A
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200 I
\n", "
\n
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ENDO KNEE-SHIN FRCT SWG & ST
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File: 81, IEN: 104840
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ACTIVE
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R20 A
\n", "
200 I
\n", "
\n
\n\n
\n", ""]]}