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“Softie Surgical Shoe Womens” has been added to your cart.
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Product
Price
Quantity
Subtotal
Artromot Elbow CPM Machine with Full Range of Motion and Anatomical Motion Design
$
0.00
Artromot Elbow CPM Machine with Full Range of Motion and Anatomical Motion Design quantity
$
0.00
POLAR CARE COLD THERAPY
$
0.00
POLAR CARE COLD THERAPY quantity
$
0.00
FIXED ANKLE WALKER BOOT
$
0.00
FIXED ANKLE WALKER BOOT quantity
$
0.00
OPTIFLEX ANKLE CPM
$
0.00
OPTIFLEX ANKLE CPM quantity
$
0.00
Visco-GEL Achilles Protection Sleeve
$
28.59
Visco-GEL Achilles Protection Sleeve quantity
$
28.59
Softie Surgical Shoe Womens
$
16.12
Softie Surgical Shoe Womens quantity
$
16.12
Update Cart
Order Summery
Subtotal
$
44.71
Total
$
44.71
Proceed to checkout
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Medicare 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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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.
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Agree
Medicaid 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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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
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
(Required)
First Name
Last Name
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(Required)
Email
(Required)
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(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
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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Artromot Elbow CPM Machine with Full Range of Motion and Anatomical Motion Design
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0.00
Semi-Solid Ankle Foot Orthosis Drop Foot Brace Medium Right
$
34.59
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