Golden Technologies GP620SSの取扱説明書

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GP620SS
Phone: 1-800-624-6374
Compass HD
Fax: 1-800-628-5165
Power Wheelchair
Company:
Evaluated By:
Mark For: Address:
Date:
Phone:
Account # :
K0824 - Group II, Heavy Duty, Power Wheelchair Totals
GOLDEN COMPASS HD ™ - Center-Wheel Drive MSRP
X GP620SS
with 20" X 20" Van / Pan Seat
$6,697.00
450 lb weight capacity
SPECIFICATIONS
Turning Top Range*
Model Length Width
Radius Speed (miles)
39.8" 25" 20" 4 mph 12
GP620SS - Center Wheel
* Battery range will vary due to rider weight, dr

ページ2に含まれる内容の要旨

Power Wheel Chair (PWC) Documentation Checklist Group I PWCs HCPCS Codes K0813 - K0816 and Group II PWCs HCPCS Codes K0820 - K0829 All PWC Codes Detailed Written Order must contain ALL of the following elements: Beneficiary’s name Length of need Description of the item (may be general – e.g., “power mobility device” The treating physician’s signature or may be more specific Date of completion of the face-to-face examination The date the treating physician signed the order Pertinent diagnoses/con