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“Phoenix Model 1850 Knee CPM” has been added to your cart.
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Product
Price
Quantity
Subtotal
Inspire Reusable Absorbent Underpad
$
44.99
Inspire Reusable Absorbent Underpad quantity
$
44.99
Adjustable Back Support with Tension Straps
$
39.99
Adjustable Back Support with Tension Straps quantity
$
39.99
Reusable Absorbent Chair Pad
$
25.99
Reusable Absorbent Chair Pad quantity
$
25.99
Aircast SP Walker Low Rocker Sole Walking Boot
$
109.90
Aircast SP Walker Low Rocker Sole Walking Boot quantity
$
109.90
Phoenix Model 1850 Knee CPM
$
0.00
Phoenix Model 1850 Knee CPM quantity
$
0.00
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Subtotal
$
220.87
Total
$
220.87
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Medicare Claim Insurance Purchase Request
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Medicaid Claim Insurance Purchase Request
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Max. file size: 2 GB.
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(Required)
Agree
No Fault Claim Insurance Purchase Request
To complete this order we need some information, please fill out below to the best of your ability and our team will contact you if there are any additional requirements.
Name
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DD dash MM dash YYYY
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(Required)
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(Required)
Documents Section Upload (i.e. prescriptions)
Max. file size: 2 GB.
I agree to allow CapsuleAID and its authorized representatives to contact me about my medical supplies, orders, and related subject.
(Required)
Agree
Workers Comp Claim Insurance Purchase Request
To complete this order we need some information, please fill out below to the best of your ability and our team will contact you if there are any additional requirements.
Name
(Required)
First Name
Last Name
Phone Number
(Required)
Email
(Required)
Date of Birth
(Required)
DD dash MM dash YYYY
Insurance Type
Medicare
Mediciad
No Fault
Workers Comp
Other
Insurance Provider
(Required)
Insurance ID
(Required)
Documents Section Upload (i.e. prescriptions)
Max. file size: 2 GB.
I agree to allow CapsuleAID and its authorized representatives to contact me about my medical supplies, orders, and related subject.
(Required)
Agree
Other Claim Insurance Purchase Request
To complete this order we need some information, please fill out below to the best of your ability and our team will contact you if there are any additional requirements.
Name
(Required)
First Name
Last Name
Phone Number
(Required)
Email
(Required)
Date of Birth
(Required)
DD dash MM dash YYYY
Insurance Type
Medicare
Mediciad
No Fault
Workers Comp
Other
Insurance Provider
(Required)
Insurance ID
(Required)
Documents Section Upload (i.e. prescriptions)
Max. file size: 2 GB.
I agree to allow CapsuleAID and its authorized representatives to contact me about my medical supplies, orders, and related subject.
(Required)
Agree
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