| 11-3000-ADV |
Relief Medical |
11-3000-ADV |
1 |
1 |
LONG |
U |
Y |
N/A |
L1686 HIP BRACE LOG |
L1686 |
N/A |
715.95 |
$325 |
0 |
0 |
$1,830.00 |
| 11-3000-ADV-SHORT |
Relief Medical |
11-3000-ADV-SHORT |
0 |
1 |
SHORT |
U |
Y |
N/A |
L1686 HIP BRACE LOG |
L1686 |
N/A |
715.95 |
$325 |
0 |
0 |
$1,830.00 |
| 11-3000-LOGO |
Relief Medical |
11-3000-LOGO |
559 |
1 |
N/A |
N/A |
N |
N/A |
VELCRO LOGO LABEL - NORCAL PAIN |
N/A |
N/A |
N/A |
$5 |
0 |
0 |
$0.00 |
| 17H1040 |
Relief Medical |
17H1040 AFO SPRY FLEX - LT - S |
0 |
1 |
S |
LT |
Y |
N/A |
L1951 AFO SPRY FLEX - LT - S |
L1951 |
LT |
N/A |
$385 |
0 |
0 |
$0.00 |
| 17H1041 |
Relief Medical |
17H1041 AFO SPRY FLEX - LT - M |
1 |
1 |
M |
LT |
Y |
N/A |
L1951 AFO SPRY FLEX - LT - M |
L1951 |
LT |
N/A |
$385 |
0 |
0 |
$0.00 |
| 17H1042 |
Relief Medical |
17H1042 AFO SPRY FLEX - LT - L |
1 |
1 |
L |
LT |
Y |
N/A |
L1951 AFO SPRY FLEX - LT - L |
L1951 |
LT |
N/A |
$385 |
0 |
0 |
$0.00 |
| 17H1043 |
Relief Medical |
17H1043 AFO SPRY FLEX - LT - XL |
0 |
1 |
XL |
LT |
Y |
N/A |
L1951 AFO SPRY FLEX - LT - XL |
L1951 |
LT |
N/A |
$385 |
0 |
0 |
$0.00 |
| 17H1044 |
Relief Medical |
17H1044 AFO SPRY FLEX - LT - XS |
0 |
1 |
XS |
LT |
Y |
N/A |
L1951 AFO SPRY FLEX - LT - XS |
L1951 |
LT |
N/A |
$385 |
0 |
0 |
$0.00 |
| 17H2040 |
Relief Medical |
17H2040 AFO SPRY FLEX - RT - S |
0 |
1 |
S |
RT |
Y |
N/A |
L1951 AFO SPRY FLEX - RT - S |
L1951 |
RT |
N/A |
$385 |
0 |
0 |
$0.00 |
| 17H2041 |
Relief Medical |
17H2041 AFO SPRY FLEX - RT - M |
0 |
1 |
M |
RT |
Y |
N/A |
L1951 AFO SPRY FLEX - RT - M |
L1951 |
RT |
N/A |
$385 |
0 |
0 |
$0.00 |
| 17H2042 |
Relief Medical |
17H2042 AFO SPRY FLEX - RT - L |
0 |
1 |
L |
RT |
Y |
N/A |
L1951 AFO SPRY FLEX - RT - L |
L1951 |
RT |
N/A |
$385 |
0 |
0 |
$0.00 |
| 17H2043 |
Relief Medical |
17H2043 AFO SPRY FLEX - RT - XL |
0 |
1 |
XL |
RT |
Y |
N/A |
L1951 AFO SPRY FLEX - RT - XL |
L1951 |
RT |
N/A |
$385 |
0 |
0 |
$0.00 |
| 17H2044 |
Relief Medical |
17H2044 AFO SPRY FLEX - RT - XS |
0 |
1 |
XS |
RT |
Y |
N/A |
L1951 AFO SPRY FLEX - RT - XS |
L1951 |
RT |
N/A |
$385 |
0 |
0 |
$0.00 |
| 23870050609801 |
Relief Medical |
23870050609801 Genustart Knee KX 12" - 3XL |
0 |
1 |
3XL |
Custom |
Y |
N/A |
L1820 Genustart Knee KX 12" - 3XL |
L1820 |
KX |
N/A |
$70 |
0 |
0 |
$0.00 |
| 23870150509801 |
Relief Medical |
23870150509801 Genustart Knee KX 12" - 2XL |
0 |
1 |
2XL |
Custom |
Y |
N/A |
L1820 Genustart Knee KX 12"- 2XL |
L1820 |
KX |
N/A |
$70 |
0 |
0 |
$0.00 |
| 23870250409801 |
Relief Medical |
23870250409801 Genustart Knee KX 12" - XL |
1 |
1 |
XL |
Custom |
Y |
N/A |
L1820 Genustart Knee KX 12" - XL |
L1820 |
KX |
N/A |
$70 |
0 |
0 |
$0.00 |
| 23870250409802 |
Relief Medical |
23870250409802 Genustart Knee KX 16" - XL |
0 |
1 |
XL |
Custom |
N |
N/A |
L1820 Genustart Knee KX 16" - XL |
L1820 |
KX |
N/A |
$70 |
0 |
0 |
$0.00 |
| 23870250509802 |
Relief Medical |
23870250509802 Genustart Knee KX 16" - 2XL |
0 |
1 |
2XL |
Custom |
Y |
N/A |
L1820 Genustart Knee KX 16" - 2XL |
L1820 |
KX |
N/A |
$70 |
0 |
0 |
$0.00 |
| 23870250609802 |
Relief Medical |
23870250609802 Genustart Knee KX 16" - 3XL |
0 |
1 |
3XL |
Custom |
Y |
N/A |
L1820 Genustart Knee KX 16" - 3XL |
L1820 |
KX |
N/A |
$70 |
0 |
0 |
$0.00 |
| 23870350009802 |
Relief Medical |
23870350009802 Genustart Knee KX 16" - XS |
0 |
1 |
XS |
Custom |
Y |
N/A |
L1820 Genustart Knee KX 16" - XS |
L1820 |
KX |
N/A |
$70 |
0 |
0 |
$0.00 |
| 23870350109802 |
Relief Medical |
23870350109802 Genustart Knee KX 16" - S |
0 |
1 |
S |
Custom |
Y |
N/A |
L1820 Genustart Knee KX 16" - XS |
L1820 |
KX |
N/A |
$70 |
0 |
0 |
$0.00 |
| 23870350209802 |
Relief Medical |
23870350209802 Genustart Knee KX 16" - M |
0 |
1 |
M |
Custom |
Y |
N/A |
L1820 Genustart Knee KX 16" - M |
L1820 |
KX |
N/A |
$70 |
0 |
0 |
$0.00 |
| 23870350309801 |
Relief Medical |
23870350309801 Genustart Knee KX 12" - L |
0 |
1 |
L |
Custom |
Y |
N/A |
L1820 Genustart Knee KX 12" - L |
L1820 |
KX |
N/A |
$70 |
0 |
0 |
$0.00 |
| 23870350309802 |
Relief Medical |
23870350309802 Genustart Knee KX 16" - L |
0 |
1 |
L |
Custom |
Y |
N/A |
L1820 Genustart Knee KX 16" - L |
L1820 |
KX |
N/A |
$70 |
0 |
0 |
$0.00 |
| 23870450209801 |
Relief Medical |
23870450209801 Genustart Knee KX 12" - M |
1 |
1 |
M |
Custom |
Y |
N/A |
L1820 Genustart Knee KX 12" - M |
L1820 |
KX |
N/A |
$70 |
0 |
0 |
$0.00 |
| 23870550109801 |
Relief Medical |
23870550109801 Genustart Knee KX 12" - S |
1 |
1 |
S |
Custom |
Y |
N/A |
L1820 Genustart Knee KX 12" - S |
L1820 |
KX |
N/A |
$70 |
0 |
0 |
$0.00 |
| 23870650009801 |
Relief Medical |
23870650009801 Genustart Knee KX 12" - XS |
0 |
1 |
XS |
Custom |
Y |
N/A |
L1820 Genustart Knee KX 12" - XS |
L1820 |
KX |
N/A |
$70 |
0 |
0 |
$0.00 |
| 51331 |
Bioskin |
Hinged Knee Sleeve - S |
0 |
1 |
S |
Custom |
N |
N/A |
PARTNER PATCH |
L1820 |
N/A |
N/A |
$0 |
0 |
0 |
$0.00 |
| 51332 |
Bioskin |
Hinged Knee Sleeve - M |
0 |
1 |
M |
Custom |
N |
N/A |
PARTNER PATCH |
L1820 |
N/A |
N/A |
$0 |
0 |
0 |
$0.00 |
| 51333 |
Bioskin |
Hinged Knee Sleeve - L |
2 |
1 |
L |
Custom |
N |
N/A |
PARTNER PATCH |
L1820 |
N/A |
N/A |
$0 |
0 |
0 |
$0.00 |
| 51800 |
Bioskin |
51800 CrossFire ROM - Wraparound - XS |
1 |
1 |
XS |
U |
Y |
N/A |
L1832 CrossFire ROM - Wraparound - XS |
L1832 |
KX |
715.16 |
$118 |
0 |
0 |
$1,095.00 |
| 51801 |
Bioskin |
51801 CrossFire ROM - Wraparound - S |
2 |
1 |
S |
U |
Y |
N/A |
L1832 CrossFire ROM - Wraparound - S |
L1832 |
KX |
715.16 |
$118 |
0 |
0 |
$1,095.00 |
| 51802 |
Bioskin |
51802 CrossFire ROM - Wraparound - M |
5 |
1 |
M |
U |
Y |
N/A |
L1832 CrossFire ROM - Wraparound - M |
L1832 |
KX |
715.16 |
$118 |
0 |
0 |
$1,095.00 |
| 51803 |
Bioskin |
51803 CrossFire ROM - Wraparound - L |
3 |
1 |
L |
U |
Y |
N/A |
L1832 CrossFire ROM - Wraparound - L |
L1832 |
KX |
715.16 |
$118 |
0 |
0 |
$1,095.00 |
| 51804 |
Bioskin |
51804 CrossFire ROM - Wraparound - XL |
3 |
1 |
XL |
U |
Y |
N/A |
L1832 CrossFire ROM - Wraparound - XL |
L1832 |
KX |
715.16 |
$118 |
0 |
0 |
$1,095.00 |
| 51805 |
Bioskin |
81505 CrossFire ROM - Wraparound - XXL |
3 |
1 |
XXL |
U |
Y |
N/A |
L1832 CrossFire ROM - Wraparound - XXL |
L1832 |
KX |
715.16 |
$118 |
0 |
0 |
$1,095.00 |
| 51806 |
Bioskin |
51806 CrossFire ROM - Wraparound -3XL |
4 |
1 |
3XL |
U |
Y |
N/A |
L1832 CrossFire ROM - Wraparound -3XL |
L1832 |
KX |
715.16 |
$118 |
0 |
0 |
$1,095.00 |
| 51807 |
Bioskin |
51807 CrossFire ROM - Wraparound - 4XL |
2 |
1 |
4XL |
U |
Y |
N/A |
L1832 CrossFire ROM - Wraparound - 4XL |
L1832 |
KX |
715.16 |
$118 |
0 |
0 |
$1,095.00 |
| 51808 |
Bioskin |
51808 CrossFire ROM - Wraparound - 5XL |
0 |
1 |
5XL |
U |
Y |
N/A |
L1832 CrossFire ROM - Wraparound - 5XL |
L1832 |
KX |
715.36 |
$118 |
0 |
0 |
$1,095.00 |
| 51900L |
Bioskin |
51900L CrossFire OA - LT MED/RT LAT - XS |
1 |
1 |
XS |
LT |
Y |
N/A |
L1843 CrossFire OA - LT MED/RT LAT - Dynamic Unloader |
L1843 |
KX, LT |
715.16 |
$223 |
0 |
0 |
$1,410.00 |
| 51900R |
Bioskin |
51900R CrossFire OA - RT MED/LT LAT - XS |
2 |
1 |
XS |
RT |
Y |
N/A |
L1843 CrossFire OA - RT MED/LT LAT - Dynamic Unloader |
L1843 |
KX, RT |
715.16 |
$223 |
0 |
0 |
$1,410.00 |
| 51901L |
Bioskin |
51901L CrossFire OA - LT MED/RT LAT - S |
1 |
1 |
S |
LT |
Y |
N/A |
L1843 CrossFire OA - LT MED/RT LAT - Dynamic Unloader |
L1843 |
KX, LT |
715.16 |
$223 |
0 |
0 |
$1,410.00 |
| 51901R |
Bioskin |
51901R CrossFire OA - RT MED/LT LAT - S |
1 |
1 |
S |
RT |
Y |
N/A |
L1843 CrossFire OA - RT MED/LT LAT - Dynamic Unloader |
L1843 |
KX, RT |
715.16 |
$223 |
0 |
0 |
$1,410.00 |
| 51902L |
Bioskin |
51902L CrossFire OA - LT MED/RT LAT - M |
1 |
1 |
M |
LT |
Y |
N/A |
L1843 CrossFire OA - LT MED/RT LAT - Dynamic Unloader |
L1843 |
KX, LT |
715.16 |
$223 |
0 |
0 |
$1,410.00 |
| 51902R |
Bioskin |
51902R CrossFire OA - RT MED/LT LAT - M |
1 |
1 |
M |
RT |
Y |
N/A |
L1843 CrossFire OA - RT MED/LT LAT - Dynamic Unloader |
L1843 |
KX, RT |
715.16 |
$223 |
0 |
0 |
$1,410.00 |
| 51903L |
Bioskin |
51903L CrossFire OA - LT MED/RT LAT - L |
2 |
1 |
L |
LT |
Y |
N/A |
L1843 CrossFire OA - LT MED/RT LAT - Dynamic Unloader |
L1843 |
KX, LT |
715.16 |
$223 |
0 |
0 |
$1,410.00 |
| 51903R |
Bioskin |
51903R CrossFire OA - RT MED/LT LAT - L |
1 |
1 |
L |
RT |
Y |
N/A |
L1843 CrossFire OA - RT MED/LT LAT - Dynamic Unloader |
L1843 |
KX, RT |
715.16 |
$223 |
0 |
0 |
$1,410.00 |
| 51904L |
Bioskin |
51904L CrossFire OA - LT MED/RT LAT - XL |
1 |
1 |
XL |
LT |
Y |
N/A |
L1843 CrossFire OA - LT MED/RT LAT - Dynamic Unloader |
L1843 |
KX, LT |
715.16 |
$223 |
0 |
0 |
$1,410.00 |
| 51904R |
Bioskin |
51904R CrossFire OA - RT MED/LT LAT - XL |
1 |
1 |
XL |
RT |
Y |
N/A |
L1843 CrossFire OA - RT MED/LT LAT - Dynamic Unloader |
L1843 |
KX, RT |
715.16 |
$223 |
0 |
0 |
$1,410.00 |
| 51905L |
Bioskin |
51905L CrossFire OA - LT MED/RT LAT - 2XL |
1 |
1 |
2XL |
LT |
Y |
N/A |
L1843 CrossFire OA - LT MED/RT LAT - Dynamic Unloader |
L1843 |
KX, LT |
715.16 |
$223 |
0 |
0 |
$1,410.00 |
| 51905R |
Bioskin |
51905R CrossFire OA - RT MED/LT LAT - 2XL |
1 |
1 |
2XL |
RT |
Y |
N/A |
L1843 CrossFire OA - RT MED/LT LAT - Dynamic Unloader |
L1843 |
KX, RT |
715.16 |
$223 |
0 |
0 |
$1,410.00 |
| 51906L |
Bioskin |
51906L CrossFire OA - LT MED/RT LAT - 3XL |
1 |
1 |
3XL |
LT |
Y |
N/A |
L1843 CrossFire OA - LT MED/RT LAT - Dynamic Unloader |
L1843 |
KX, LT |
715.16 |
$223 |
0 |
0 |
$1,410.00 |
| 51906R |
Bioskin |
51906R CrossFire OA - RT MED/LT LAT - 3XL |
1 |
1 |
3XL |
RT |
Y |
N/A |
L1843 CrossFire OA - RT MED/LT LAT - Dynamic Unloader |
L1843 |
KX, RT |
715.16 |
$223 |
0 |
0 |
$1,410.00 |
| 51907L |
Bioskin |
51907L CrossFire OA - LT MED/RT LAT - 4XL |
0 |
1 |
4XL |
LT |
Y |
N/A |
L1843 CrossFire OA - LT MED/RT LAT - Dynamic Unloader |
L1843 |
KX, LT |
715.16 |
$223 |
0 |
0 |
$1,410.00 |
| 51907R |
Bioskin |
51907R CrossFire OA - RT MED/LT LAT - 4XL
|
0 |
1 |
4XL |
RT |
Y |
N/A |
L1843 CrossFire OA - RT MED/LT LAT - Dynamic Unloader |
L1843 |
KX, RT |
715.16 |
$223 |
0 |
0 |
$1,410.00 |
| 51908L |
Bioskin |
51908L CrossFire OA - LT MED/RT LAT - 5XL |
0 |
1 |
5XL |
LT |
Y |
N/A |
L1843 CrossFire OA - LT MED/RT LAT - Dynamic Unloader |
L1843 |
KX, LT |
715.16 |
$223 |
0 |
0 |
$1,410.00 |
| 51908R |
Bioskin |
51908R CrossFire OA - RT MED/LT LAT - 5XL |
0 |
1 |
5XL |
RT |
Y |
N/A |
L1843 CrossFire OA - RT MED/LT LAT - Dynamic Unloader |
L1843 |
KX, RT |
715.16 |
$223 |
0 |
0 |
$1,410.00 |
| BCKBRACEEXT |
Relief Medical |
N/A |
64 |
1 |
N/A |
N/A |
N |
N/A |
Back brace extension panel, 8 |
N/A |
N/A |
N/A |
$12 |
0 |
0 |
$0.00 |
| CL-301-2-L |
Relief Medical |
L1906 Small Left Ankle (M up to 8, W up to 9) |
0 |
1 |
S |
L |
Y |
N/A |
L1906 Small Left Ankle (M up to 8, W up to 9) |
L1906 |
LT |
718.87 |
$70 |
0 |
0 |
$945.72 |
| CL-301-2-R |
Relief Medical |
L1906 Small Right Ankle (M up to 8, W up to 9) |
0 |
1 |
S |
R |
Y |
N/A |
L1906 Small Right Ankle (M up to 8, W up to 9) |
L1906 |
RT |
718.87 |
$70 |
0 |
0 |
$945.72 |
| CL-301-3-L |
Relief Medical |
L1906 Medium Left Ankle (M 8.5- 12, W 9.5- 13) |
0 |
1 |
M |
L |
Y |
N/A |
L1906 Medium Left Ankle (M 8.5- 12, W 9.5- 13) |
L1906 |
LT |
718.87 |
$70 |
0 |
0 |
$945.72 |
| CL-301-3-R |
Relief Medical |
L1906 Medium Right Ankle (M 8.5- 12, W 9.5- 13) |
0 |
1 |
M |
R |
Y |
N/A |
L1906 Medium Right Ankle (M 8.5- 12, W 9.5- 13) |
L1906 |
RT |
718.87 |
$70 |
0 |
0 |
$945.72 |
| CL-301-4-L |
Relief Medical |
L1906 Large Left Ankle (M 12+, W 13.5+) |
2 |
1 |
L |
L |
Y |
N/A |
L1906 Large Left Ankle (M 12+, W 13.5+) |
L1906 |
LT |
718.87 |
$70 |
0 |
0 |
$945.72 |
| CL-301-4-R |
Relief Medical |
L1906 Large Right Ankle (M 12+, W 13.5+) |
0 |
1 |
L |
R |
Y |
N/A |
L1906 Large Right Ankle (M 12+, W 13.5+) |
L1906 |
RT |
718.87 |
$70 |
0 |
0 |
$945.72 |
| DCT-0901-2-L |
Relief Medical |
L1843 DCT-0901-2-L KNEE |
4 |
1 |
U |
L |
Y |
N/A |
L1843 LEFT UNLOADER PRO |
L1843 |
KX, LT |
715.36 |
$130 |
0 |
0 |
$1,410.00 |
| DCT-0901-2-R |
Relief Medical |
L1843 DCT-0901-2-R KNEE |
2 |
1 |
U |
R |
Y |
N/A |
L1843 RIGHT UNLOADER PRO |
L1843 |
KX, RT |
715.36 |
$130 |
0 |
0 |
$1,410.00 |
| DCT-37 |
Relief Medical |
L0637 DCT-37 LSO |
0 |
1 |
U |
U |
Y |
Y |
L0637 TREND PRO LSO |
L0637 |
N/A |
721.3 |
$150 |
0 |
0 |
$1,900.00 |
| DCT-3915 |
Relief Medical |
L3915 DCT-3915 PROWRIST |
0 |
1 |
U |
U |
Y |
N/A |
L3915 PRO WRIST |
L3915 |
N/A |
354 |
$55 |
0 |
0 |
$760.00 |
| DCT-3916 |
Relief Medical |
L3916 DCT-3916 PROWRIST |
10 |
1 |
U |
U |
Y |
N/A |
L3916 PRO WRIST |
L3916 |
N/A |
354 |
$55 |
0 |
0 |
$760.00 |
| DCT-50 |
Relief Medical |
L0650 DCT-50 LSO |
25 |
1 |
U |
U |
Y |
N/A |
L0650 RELIEF LSO REVEL PLUS |
L0650 |
N/A |
721.3 |
$135 |
0 |
0 |
$1,900.00 |
| DCT-5657 |
Relief Medical |
L0456 DCT-5657 |
13 |
1 |
U |
N/A |
Y |
N/A |
L0456 TREND CORREX TLSO |
L0456 |
N/A |
721.3, 724.1 |
$180 |
0 |
0 |
$1,560.00 |
| DCT-QF21 |
Relief Medical |
DCT-QF21 SI Belt |
13 |
1 |
U |
U |
Y |
N/A |
L0621 SI Belt |
L0621 |
N/A |
724.6 |
$45 |
0 |
0 |
$312.67 |
| DCT-QF37 Medi-cal |
Relief Medical |
L0637 Relief LSO Revel (Medi-cal LSO) |
30 |
1 |
U |
U |
Y |
N/A |
L0637 TREND RELIEF LSO REVEL |
L0637 |
N/A |
721.3 |
$75 |
0 |
0 |
$1,900.00 |
| KNEESLEEVE |
Relief Medical |
N/A |
0 |
1 |
N/A |
N/A |
N |
N/A |
UNDER KNEE SLEEVE |
N/A |
N/A |
N/A |
$10 |
0 |
0 |
$124.04 |
| L0180 |
Relief Medical |
L0180 Cervical Collar |
13 |
1 |
U |
U |
Y |
N/A |
L0180 Medical Vista Cervical Collar |
L0180 |
N/A |
721 |
$100 |
0 |
0 |
$715.00 |
| L0621 |
Breg |
Breg SI Belt Large |
0 |
1 |
L |
U |
Y |
N/A |
Breg SI Belt Large |
N/A |
N/A |
N/A |
$0 |
0 |
0 |
$0.00 |
| L1005 |
Relief Medical |
L1005 Aspen Scoliosis Brace |
1 |
1 |
N/A |
U |
Y |
N/A |
L1005 Aspen Scoliosis Brace |
L1005 |
N/A |
737.3 |
$895 |
0 |
0 |
$5,017.41 |
| LSE-31 |
Relief Medical |
LSE-31 LSO Revel Extend KX - U |
0 |
1 |
U |
Custom |
Y |
N/A |
L0639 LSO Revel Extend KX - U |
L0639/L0651 |
KX |
N/A |
$160 |
0 |
0 |
$0.00 |
| N/A |
Aspen |
Aspen 457 |
0 |
1 |
U |
U |
Y |
N/A |
Aspen 457 |
N/A |
N/A |
N/A |
$0 |
0 |
0 |
$0.00 |
| RM-NCPP001 |
Relief Medical |
RM-NCPP001 |
0 |
1 |
N/A |
N/A |
N |
N/A |
PARTNER PATCH |
N/A |
N/A |
N/A |
$5 |
0 |
0 |
$0.00 |
| SA702401 |
Breg |
Hinged Wraptor with Speed Laces - XSmall |
1 |
1 |
XS |
N/A |
N |
N/A |
PARTNER PATCH |
N/A |
N/A |
N/A |
$0 |
0 |
0 |
$0.00 |
| SA702403 |
Breg |
Hinged Wraptor with Speed Laces - Small |
0 |
1 |
S |
N/A |
N |
N/A |
N/A |
N/A |
N/A |
N/A |
$0 |
0 |
0 |
$0.00 |
| SA702405 |
Breg |
Hinged Wraptor with Speed Laces - Medium |
1 |
1 |
M |
N/A |
N |
N/A |
N/A |
N/A |
N/A |
N/A |
$0 |
0 |
0 |
$0.00 |
| SA702407 |
Breg |
Hinged Wraptor with Speed Laces - Large |
2 |
1 |
N/A |
N/A |
N |
N/A |
N/A |
N/A |
N/A |
N/A |
$0 |
0 |
0 |
$0.00 |
| SA702409 |
Breg |
Hinged Wraptor with Speed Laces - X-Large |
3 |
1 |
XL |
N/A |
N |
N/A |
N/A |
N/A |
N/A |
N/A |
$0 |
0 |
0 |
$0.00 |
| SA702411 |
Breg |
Hinged Wraptor with Speed Laces - 2X-Large |
1 |
1 |
2XL |
N/A |
N |
N/A |
PARTNER PATCH |
N/A |
N/A |
N/A |
$0 |
0 |
0 |
$0.00 |
| SPINALQ-M2XL |
SpinalQ |
SPINALQ-M2XL |
2 |
1 |
2XL |
U |
Y |
N/A |
L0457 MENS SPINAL Q 2XL |
L0457 |
N/A |
721.3, 724.1 |
$210 |
0 |
0 |
$1,560.00 |
| SPINALQ-M3XL |
SpinalQ |
SPINALQ-M3XL |
1 |
1 |
3XL |
U |
Y |
N/A |
L0457 MENS SPINAL Q 3XL |
L0457 |
N/A |
721.3, 724.1 |
$210 |
0 |
0 |
$1,560.00 |
| SPINALQ-M4XL |
SpinalQ |
SPINALQ-M4XL |
1 |
1 |
4XL |
U |
Y |
N/A |
L0457 MENS SPINAL Q 4XL |
L0457 |
N/A |
721.3, 724.1 |
$210 |
0 |
0 |
$1,560.00 |
| SPINALQ-ML |
SpinalQ |
SPINALQ-ML |
3 |
1 |
L |
U |
Y |
N/A |
L0457 MENS SPINAL Q L |
L0457 |
N/A |
721.3, 724.1 |
$210 |
0 |
0 |
$1,560.00 |
| SPINALQ-MM |
SpinalQ |
SPINALQ-MM |
3 |
1 |
M |
U |
Y |
N/A |
L0457 MENS SPINAL Q M |
L0457 |
N/A |
721.3, 724.1 |
$210 |
0 |
0 |
$1,560.00 |
| SPINALQ-MS |
SpinalQ |
SPINALQ-MS |
3 |
1 |
S |
U |
Y |
N/A |
L0457 MENS SPINAL Q S |
L0457 |
N/A |
721.3, 724.1 |
$210 |
0 |
0 |
$780.00 |
| SPINALQ-MXL |
SpinalQ |
SPINALQ-MXL |
5 |
1 |
XL |
U |
Y |
N/A |
L0457 MENS SPINAL Q XL |
L0457 |
N/A |
721.3, 724.1 |
$210 |
0 |
0 |
$1,560.00 |
| SPINALQ-W2XL |
|
SPINALQ-W2XL |
0 |
1 |
2XL |
U |
Y |
N/A |
L0457 WOMENS SPINAL Q 2XL |
L0457 |
N/A |
721.3, 724.1 |
$210 |
0 |
0 |
$1,560.00 |
| SPINALQ-WL |
|
SPINALQ-WL |
0 |
1 |
L |
U |
Y |
N/A |
L0457 WOMENS SPINAL Q L |
L0457 |
N/A |
721.3, 724.1 |
$210 |
0 |
0 |
$1,560.00 |
| SPINALQ-WM |
|
SPINALQ-WM |
0 |
1 |
M |
U |
Y |
N/A |
L0457 WOMENS SPINAL Q M |
L0457 |
N/A |
721.3, 724.1 |
$210 |
0 |
0 |
$1,560.00 |
| SPINALQ-WS |
|
SPINALQ-WS |
0 |
1 |
S |
U |
Y |
N/A |
L0457 WOMENS SPINAL Q S |
L0457 |
N/A |
721.3, 724.1 |
$210 |
0 |
0 |
$1,560.00 |
| SPINALQ-WXL |
|
SPINALQ-WXL |
0 |
1 |
XL |
U |
Y |
N/A |
L0457 WOMENS SPINAL XL |
L0457 |
N/A |
721.3, 724.1 |
$210 |
0 |
0 |
$1,560.00 |
| SPINALQ-WXS |
|
SPINALQ-WXS |
0 |
1 |
XS |
U |
Y |
N/A |
L0457 WOMENS SPINAL Q XS |
L0457 |
N/A |
721.3, 724.1 |
$210 |
0 |
0 |
$1,560.00 |
| TESTING-DME |
Bioskin |
TESTING-DME |
5 |
1 |
2XL |
Custom |
Y |
Y |
PARTNER PATCH |
L0180 |
KX |
354 |
$0 |
0 |
0 |
$0.00 |