Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Sunrise Manual 1 Manual Parts Pricing Item Number Description Unit Price Unit of Measure 000 138 014 ROSETTE FOR M6 PLASTIC$ 1.00 EA 000 138 017 ROSETTE FOR M6 STEEL$ 1.00 EA 000 858 016 SPACER SIA 13.5X8.3X3.5$ 2.00 EA 000 859 202 ANTI-TIP TUBE S/A CMPLT 24-26$ 318.00 EA 000 861 156-ET B4 WHEEL LOCK GRIPS QTY 5EA$ 19.00 EA 000 861 263 CRANKED EXTENSION KIT$ 87.00 PR 000283015.01 SOLID TYRE 24" X 1$ 156.00 EA 010065 M6 CHANNEL NUT $ 3.00 EA 010124-002 ARMPAD RIGIDIZER FULL LENGTH$ 23.00 EA 010517 M8 X 1.25 X 90 HHCS GD 10.9$ 9.00 EA 010679-009 CROSS BRACE WDMNT 1"OD 20W$ 99.00 EA 010679-013 CROSS BRACE WDMNT 1"OD 24W$ 141.00 EA 010973 CLAMP BELT $ 22.00 EA 011111 WASHER M6 X 18 $ 1.00 EA 011322 DUAL M6 CHANNEL NUT$ 3.00 EA 011648 WASHER $ 1.00 EA 011649-001 SHLDR SCREW 8MM OD X 16MM LG$ 10.00 EA 011649-003 SHLDR SCREW M6 X 8MM OD X 45MM$ 8.00 EA 011650 WASHER NYLON M8 $ 2.00 EA 011917-001 WELDMENT MNT TUBE MNT R 12-19W$ 29.00 EA 011946 CLAMP NUT TAPER 3/4" TUBE$ 29.00 EA 011947 CLAMP THROUGH TAPER 3/4" TUBE$ 29.00 EA 011956 CAP TUBE 3/4" $ 15.00 EA 011958 CLAMP PLASTIC CABLE GUIDE$ 15.00 EA 011959 INSERT PLASTIC DELPHI CLAMP$ 21.00 EA 012065 SET SCREW CONE PT M3X8$ 2.00 EA 012189 S/A HNGR 70D R W/ REG REC ASSM$ 220.00 EA 012190 S/A HNGR 70D L W/ REG REC ASSM$ 220.00 EA 012351 EU KIT REAR PIVOT BRT ASSM L$ 103.00 EA 012370 DESK W/F ARMPAD ASSM L$ 100.00 EA 012371 DESK W/F ARMPAD ASSM R$ 100.00 EA 012420 EU KIT REAR PIVOT BRT ASSM R$ 98.00 EA 012931 BHCS M5 X 10 W/PL BLK CL 10.9$ 4.00 EA 013035 HHCS M6 X 1.0 X 55 10.9$ 5.00 EA 013143 BHCS M5 X .8 X 14 BLK W/PL$ 1.00 EA 013144 BHCS M5 X .8 X 8 BLK W/PL$ 1.00 EA 013152 BHCS M8 X 1.25 X 55 BLK$ 3.00 EA 013216 SCREW M6 X 60 SKT BTN BLK$ 2.00 EA 013223-001 WLDMNT FOOTPLATE HNGR SHORT$ 112.00 EA 013223-002 WELDMENT FOOTPLATE HANGER LNG$ 112.00 EA 013305-001 EXT TUBE SHORT S/A$ 22.00 EA 013305-002 EXT TUBE MED S/A $ 22.00 EA 013369 TUBE INSERT S/A $ 18.00 EA © 2018 Government of Alberta December 1, 2018 Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Sunrise Manual 2 Manual Parts Pricing Item Number Description Unit Price Unit of Measure 013421 ANGLE CONTROL MOUNT STD$ 24.00 EA 013448 WLDMNT REC HANGER PF 19-25W$ 67.00 EA 013450 FHCS M6 X 1 X 10MM W/PCH$ 3.00 EA 013475 QUICKIE SIDE POCKET$ 13.00 EA 013611 SPACER KNEE SUPPORT$ 22.00 EA 013617 LED BULB LOCATER $ 12.00 EA 013618 LED LIGHT FRONT COVER $ 12.00 EA 013803 HHCS M8 X 1.25 X 50 BLK$ 4.00 EA 014056 EXT TBE 1PC LCKNG FT LNG ASSM$ 361.00 EA 014183 ANTI PITCH ASSEMBLY RIGHT$ 310.00 EA 014184 ANTI PITCH ASSEMBLY LEFT$ 310.00 EA 014196 CASTER FORK ASSEMBLY$ 176.00 EA 014202 WELDMENT HANGER 65D$ 148.00 EA 014203 WELDMENT HANGER 65D LH$ 148.00 EA 015259 IN LINE ELR CALF PAD BRKT ASSY$ 68.00 EA 040001-001 STRUT BASE FRAME W/HDWR 10-14$ 76.00 EA 040001-002 STRUT BASE FRAME W/HDWR 12-16$ 76.00 EA 040001-003 STRUT BASE FRAME W/HDWR 14-18$ 76.00 EA 040002-003 BASE FRAME ASSY 14-18$ 578.00 EA 040002-003BLK BATTERY BASE FRAME ASSY 14-18$ 578.00 EA 040004 UPPER ROLLER W/HDWR PR$ 40.00 EA 040005 LOWER ROLLER W/HDWR PR$ 54.00 EA 040006 ROLLER REPL KIT COMPL ZP IRIS$ 176.00 EA 040007 ROLLER ASSEMBLY EA$ 171.00 EA 040009-002 STRUT ROCKER W/HDWR 12-16$ 40.00 EA 040010-001 ROCKER ASSM SHORT 10-14$ 417.00 EA 040011-002 ROCKER ASSM MED 12-16$ 472.00 EA 040011-002BKO ROCKER ASSM M 12-16 BLACK OPAL$ 472.00 EA 040011-003 ROCKER ASSM MED 14-18$ 472.00 EA 040012-002 ROCKER ASSM LONG 12-16$ 331.00 EA 040012-003 ROCKER ASSM LONG 14-18$ 331.00 EA 040012-003BLK STRUT ROCKER W/HDWR 14-18" BLK$ 331.00 EA 040014-003 REAR ANTI TIP ASSM SML 5P R$ 76.00 EA 040015-003 REAR ANTI TIP ASSM SML 5P L$ 76.00 EA 040016-001 REAR ANTI TIP ASSM KIDS 5P PR$ 181.00 EA 040016-003 REAR ANTI TIP ASSM SML 5P PR$ 163.00 EA 040016-004 REAR ANTI TIP ASSM REG 6P PR$ 200.00 EA 040016-006 REAR ANTI TIP ASSM 22" PR$ 163.00 EA 040017-001 ANTI-TIP RECEIVER STD W/HDWR$ 54.00 EA 040017-002 ANTI-TIP RECEIVER EXT W/HDWR$ 54.00 EA 040018-001 LOWER HUBLOCK ASSM W/HDWR R$ 266.00 EA 040019-001 LOWER HUBLOCK ASSM W/HDWR L$ 266.00 EA 040021-002 AXLE PLATE ASSM AT$ 61.00 EA © 2018 Government of Alberta December 1, 2018 Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Sunrise Manual 3 Manual Parts Pricing Item Number Description Unit Price Unit of Measure 040023-001 HT ADJ PH PED STD R$ 115.00 EA 040023-002 HT ADJ PH PED LONG R$ 115.00 EA 040024-001 HT ADJ PH PED STD L$ 115.00 EA 040024-002 HT ADJ PH PED LONG L$ 115.00 EA 040025-001 STROLLER HANDLE PED STD 10-14$ 220.00 EA 040025-004 STROLLER HANDLE PED LONG 10-14$ 298.00 EA 040025-006 STROLLER HANDLE PED LONG 14-18$ 298.00 EA 040026-001 HT ADJ BACK PED STD 10-14$ 586.00 EA 040026-002 HT ADJ BACK PED STD 12-16$ 586.00 EA 040026-004 HT ADJ BACK PED LONG 10-14$ 617.00 EA 040026-005 HT ADJ BACK PED LONG 12-16$ 617.00 EA 040026-006 HT ADJ BACK PED LONG 14-18$ 540.00 EA 040029-001 RECL BACK MED RTRO KIT 10-15$ 938.00 EA 040029-002 RECL BACK MED RTRO KIT 13-18$ 872.00 EA 040029-003 RECL BACK TALL RTRO KIT 10-15$ 963.00 EA 040029-004 RECL BACK TALL RTRO KIT 13-18$ 662.00 EA 040030-001 STROLLER ASSM STD R$ 103.00 EA 040030-002 STROLLER ASSM MED R$ 127.00 EA 040030-003 STROLLER ASSM TALL R$ 75.00 EA 040032-002 CASTER PLATE HDWR KIT EXT PED$ 6.00 EA 040036-006 SEAT PAN REAR VELCRO 14W 10-16$ 95.00 EA 040039-001 SEAT PAN ASSM 10W 10-16$ 226.00 EA 040039-002 SEAT PAN ASSM 11W 10-16$ 226.00 EA 040039-003 SEAT PAN ASSM 12W 10-16$ 226.00 EA 040039-004 SEAT PAN ASSM 13W 10-16$ 226.00 EA 040039-005 SEAT PAN ASSM 14W 10-16$ 226.00 EA 040039-006 SEAT PAN ASSM 15W 10-16$ 226.00 EA 040039-007 SEAT PAN ASSM 16W 10-16$ 226.00 EA 040039-014 SEAT PAN ASSM 14W 14-18$ 291.00 EA 040039-015 SEAT PAN ASSM 15W 14-18$ 298.00 EA 040039-016 SEAT PAN ASSM 16W 14-18$ 242.00 EA 040039-017 SEAT PAN ASSM 17W 14-18$ 237.00 EA 040040-003 DROP SEAT PAN ASSM 12W 10-16$ 486.00 EA 040040-016 DROP SEAT PAN ASSM 16W 14-18$ 398.00 EA 040040-017 DROP SEAT PAN ASSM 17W 14-18$ 464.00 EA 040042-001 WHEEL LOCK PUSH ASSM L STD$ 93.00 EA 040043-001 WHEEL LOCK PUSH ASSM STD (PR)$ 149.00 EA 040043-002 WHEEL LOCK PUSH ASSM EXT (PR)$ 168.00 EA 040044-001 ATTENDANT WHLLCK ASSM SHT STD$ 496.00 EA 040044-002 ATTENDANT WHLLCK ASSM LNG STD$ 441.00 EA 040044-003 ATTENDANT WHLLCK ASSM SHT EXT$ 496.00 EA 040044-004 ATTENDANT WHLLCK ASSM LNG EXT$ 441.00 EA 040047-005 1AD 12-16 24 STD HR$ 703.00 EA © 2018 Government of Alberta December 1, 2018 Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Sunrise Manual 4 Manual Parts Pricing Item Number Description Unit Price Unit of Measure 040049 TILT STOP W/HDWR ZP IRIS$ 12.00 EA 050017 PIN PLUNGER BACKREST$ 22.00 EA 050019 PLUG BACKREST M6$ 23.00 EA 050020 SPRINGCOMP.312OD1.131G.025WSS$ 7.00 EA 050021-001 FTRST TBLR ALUM 11 STD$ 130.00 EA 050021-002 FTRST TBLR ALUM 11 LNG$ 149.00 EA 050021-003 FTRST TBLR ALUM 12 STD$ 175.00 EA 050021-004 FTRST TBLR ALUM 12 LNG$ 175.00 EA 050021-005 FTRST TBLR ALUM 13 STD$ 137.00 EA 050021-006 FTRST TBLR ALUM 13 LNG$ 176.00 EA 050021-007 FTRST TBLR ALUM 14 STD$ 137.00 EA 050021-009 FTRST TBLR ALUM 15 STD$ 130.00 EA 050021-010 FTRST TBLR ALUM 15 LNG$ 175.00 EA 050021-011 FTRST TBLR ALUM 16 STD$ 175.00 EA 050021-012 FTRST TBLR ALUM 16 LNG$ 175.00 EA 050021-014 FTRST TBLR ALUM 17 LNG$ 165.00 EA 050021-019 FTRST TBLR ALUM 20 STD$ 175.00 EA 050021-020 FTRST TBLR ALUM 20 LNG$ 175.00 EA 050024-003 FTRST ALUM FLAT CVR 12 STD$ 205.00 EA 050024-004 FTRST ALUM FLAT CVR 12 LNG$ 220.00 EA 050024-005 FTRST ALUM FLAT CVR 13 STD$ 220.00 EA 050024-007 FTRST ALUM FLAT CVR 14 STD$ 204.00 EA 050024-008 FTRST ALUM FLAT CVR 14 LNG$ 205.00 EA 050024-010 FTRST ALUM FLAT CVR 15 LNG$ 175.00 EA 050024-011 FTRST ALUM FLAT CVR 16 STD$ 205.00 EA 050024-012 FTRST ALUM FLAT CVR 16 LNG$ 220.00 EA 050024-014 FTRST ALUM FLAT CVR 17 LNG$ 166.00 EA 050024-015 FTRST ALUM FLAT CVR 18 STD$ 190.00 EA 050024-019 FTRST ALUM FLAT CVR 20 STD$ 205.00 EA 050024-020 FTRST ALUM FLAT CVR 20 LNG$ 220.00 EA 050025 CLAMP FOOTREST $ 26.00 EA 050026 BUSHING FOOTREST $ 3.00 EA 050027-002 TUBE FTRST PLTFRM 11-13 LNG$ 28.00 EA 050027-003 TUBE FTRST PLTFRM 14-16 STD$ 37.00 EA 050027-004 TUBE FTRST PLTFRM 14-16 LNG$ 44.00 EA 050027-005 TUBE FTRST PLTFRM 16-18 STD$ 37.00 EA 050027-006 TUBE FTRST PLTFRM 16-18 LNG$ 44.00 EA 050027-007 TUBE FTRST PLTFRM 18-20 STD$ 28.00 EA 050027-008 TUBE FTRST PLTFRM 18-20 LNG$ 44.00 EA 050039 CUP SPLINE ANG ADJ BLK$ 29.00 EA 050040 PIN PIVOT ANG ADJ $ 9.00 EA 050041 BARREL PIVOT ANG ADJ$ 46.00 EA 050042 AXLE CASTER 52MM$ 12.00 EA © 2018 Government of Alberta December 1, 2018 Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Sunrise Manual 5 Manual Parts Pricing Item Number Description Unit Price Unit of Measure 050043-001 SPCR BRNG CSTR 9.65MM$ 4.00 EA 050043-002 SPCR BRNG CSTR 2.20MM$ 4.00 EA 050044 CLAMP OUTBRD SIDEGUARD$ 54.00 EA 050045 CLAMP INBRD SIDEGUARD$ 54.00 EA 050047 PLATE CASTER LOCK ANG ADJ$ 61.00 EA 050050 KEY CASTER LOCK ANG ADJ$ 24.00 EA 050052 KEY CLAMP FOOTREST$ 20.00 EA 050053 SADDLE 17.8MM OD 8MM HOLE$ 4.00 EA 050054 PLATE NUT AXLE $ 21.00 EA 050057 CLAMP AXLE PLATE $ 24.00 EA 050066 PLATE AXLE XTENDER$ 65.00 EA 050067 BRACKET AXLE XTENDER$ 113.00 EA 050068 MOUNT AXLE PLATE XTENDER$ 36.00 EA 050069 SLEEVE AXLE M20 X 51MM$ 41.00 EA 050073 PLATE POSITIONING FOOT$ 44.00 EA 050074 O-RING .625 ID X .125W$ 1.00 EA 050075-001 SPACER FOOTREST