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“Drive Medical Wheelchair Transport Lightweight” has been added to your cart.
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Product
Price
Quantity
Subtotal
Ortho Wedge Healing Shoe
$
30.84
Ortho Wedge Healing Shoe quantity
$
30.84
BlueJay Folding Cane
$
25.00
BlueJay Folding Cane quantity
$
25.00
Drive Medical Wheelchair Transport Lightweight
$
229.99
Drive Medical Wheelchair Transport Lightweight quantity
$
229.99
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Subtotal
$
285.83
Total
$
285.83
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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.
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Other
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(Required)
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(Required)
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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)
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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
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DD dash MM dash YYYY
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Mediciad
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Other
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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
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