COVERED ITEMS/FORMULARY

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  COVERED ITEMS/FORMULARY

  Adult and Junior Front Wheel Walkers

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  BED FRAMES & RELATED

  BED MATTRESS QUICK ‘N’ EASY COMFORT PRESSURE REDISTRIBUTION TYPE

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  BED FRAMES & RELATED

  DynaRest Airfloat Deluxe Air Mattress w/ Digital Pump

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  COVERED ITEMS/FORMULARY

  DynaRest Alternating Pressure Pump and Pad System

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  BED FRAMES & RELATED

  DynaRest Multizone Foam Pressure Mattress

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  COVERED ITEMS/FORMULARY

  DynaRide S2 Wheelchair – 18″ x 16″ w/ Detach Full Arm FR

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  COVERED ITEMS/FORMULARY

  E-Tank Cylinder Holder for wheelchairs

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  COVERED ITEMS/FORMULARY

  Elite Compressor Nebulizer

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  BATH SAFETY

  Folding Bedside Commode

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  COVERED ITEMS/FORMULARY

  Full Body Sling w/ Commode Opening Mesh (Medium & Large)

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  BED FRAMES & RELATED

  Full Electric Beds with Multi Zone Mattress

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  Bed Frames and Related Products

  Full Electric Low Beds (3 Motor) with Multi Zone Mattress