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“Phoenix Model 1850 Knee CPM” has been added to your cart.
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Product
Price
Quantity
Subtotal
Power Neb Ultra Nebulizer
$
39.99
Power Neb Ultra Nebulizer quantity
$
39.99
Phoenix Model 1850 Knee CPM
$
0.00
Phoenix Model 1850 Knee CPM quantity
$
0.00
Standard Offset Walking Cane Adjustable Aluminum
$
35.99
Standard Offset Walking Cane Adjustable Aluminum quantity
$
35.99
POLAR CARE COLD THERAPY
$
0.00
POLAR CARE COLD THERAPY quantity
$
0.00
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Order Summery
Subtotal
$
75.98
Total
$
75.98
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No Fault Claim Insurance Purchase Request
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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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(Required)
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Other Claim Insurance Purchase Request
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Name
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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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