alberta aids to daily living parts prices - maple leaf · 2020-03-26 · maple leaf wheelchair –...
TRANSCRIPT
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Table of Contents
REAR WHEEL - - - - - - - - 1-6 WHEEL LOCKS - - - - - - - - 7-10 FRONT CASTER - - - - - - - - 10-14 BACK UPHOLSTERY - - - - - - - - 14-22 SEAT UPHOLSTERY & BELTS - - - - - - 22-28 FRAMES - - - - - - - - - 28-37 WHEELCHAIR CROSSBRACE - - - - - - 37-38 ARMS - - - - - - - - - 38-45 FOOTREST & LEGREST - - - - - - - 46-61 PLATFORM WALKER - - - - - - - 61-63 HEADREST - - - - - - - - - 64-69 WHEELCHAIR ACCESSORIES - - - - - - 69-73 ANTI-TIPPERS - - - - - - - - 73-75 BUSHINGS - - - - - - - - - 75-76 BEARINGS - - - - - - - - - 76-77 CABLES & CYLINDERS - - - - - - - 77-79 HARDWARE - - - - - - - - - 79-88
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 1"
Maple Leaf Wheelchair – Parts Catalogue "
"Rear"Wheel"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
W24A138U
24 x 3/8” WHEEL ASSEMBLY (THREADED URETHANE TIRE)
$180.00
"
"
W24LPU
24 x 1” LOW PROFILE URETHANE TIRE
$40.00
"
"
W24TU
24 x 1 3/8” THREADED URETHANE TIRE
$60.00
"
"
W24AT
24 x 1 3/8” THREADED AIR TIRE
$60.00
"
"
W24ATT
24 x 1 3/8” INNER AIR TUBE
$16.00
"
"
W24CH
24” EIGHT POINT CHROME HANDRIM
$60.00
"
"
W24PHR
24” EIGHT POINT POLYCOMP HANDRIM
$60.00
"
"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 2"
Rear"Wheel""
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
W24PCH
24” EIGHT POINT PLASTIC COATED HANDRIM
$80.00
"
"
W22A138U
22 x 1 3/8” WHEEL ASSEMBLY (THREADED URETHANE TIRE)
$180.00
"
"
W22LPU
22 x 1” LOW PROFILE URETHANE TIRE
$40.00
"
"
W22TU
22 x 1 3/8” THREADED URETHANE TIRE
$60.00
"
"
W22AT
22 x 1 3/8” THREADED AIR TIRE
$60.00
"
"
W22ATT
22 x 1 3/8” INNER (AIR) TUBE
$16.00
"
"
W22CH
22” EIGHT POINT CHROME HANDRIM
$60.00
"
"
""Rear"Wheel""
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 3"
"Rear"Wheel""
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
W22PHR
22” EIGHT POINT POLYCOMP HANDRIM
$60.00
"
"
W22PCH
22” EIGHT POINT PLASTIC COATED HANDRIM
$80.00
"
"
W20A138U
20” WHEEL ASSEMBLY
$160.00
"
"
W20PCH
20” BLACK PLASTIC COATED ALUMINUM HANDRIM
$80.00
"
"
WH20HC
20” WHEEL HUB CAP
$3.75
"
"
WH22HC
22” WHEEL HUB CAP
$4.50
"
"
WH24HC
24” WHEEL HUB CAP
$4.50
"
"
""Rear"Wheel"
"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 4"
"Rear"Wheel""
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
W202224QR2
1/2 x 5” QUICK RELEASE AXLE (NRG + GOLD, EZ RIDE, SWIFT)
$75.00
"
"
W202224QR4
7/16 x 5” QUICK RELEASE AXLE (NRG + , NRG + RECLINE)
$75.00
"
"
W202224QR6
1/2" X 4” QUICK RELEASE AXEL (SUPERTILT)
$75.00
"
"
W202224RA1
1/2 x 3 1/2” GRADE 5 REAR AXLE AND NUT
$8.00
"
"
W202224RA2
1/2 x 3/4” GRADE 5 REAR AXLE AND NUT
$8.00
"
"
W202224RA3
1/2 x 5” GRADE 5 REAR AXLE AND NUT
(MLT 700)
$8.00
"
"
""
""Rear"Wheel"
"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 5"
"Rear"Wheel""
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
W202224RA6
7/16 x 4 1/2” GRADE 5 REAR AXLE AND NUT
$8.00
"
"
W202224RA7
7/16 x 5” GRADE 5 REAR AXLE AND NUT
$8.00
"
"
WL1HS
HANDRIM SPACERS (SET OF 8) (20, 22, 24” HANDRIMS)
5/8” SPACER & 1” SPACER
$8.00
"
"
W2HSC
HANDRIM SCREWS (SET OF 8) (20, 22, 24” HANDRIMS)
$16.00
"
"
WFST705
SUPERTILT WHEEL BUSHING BRACKET (OLD STYLE)
$60.00
"
"
W4RBBG
REEAR WHEEL BUSHING BRACKAT (NRG + GOLD, EZ RIDE, MLT 700)
$28.00
"
"
"
""Rear"Wheel"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 6"
""Rear"Wheel"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
W006APER
REAR WHEEL AXLE PLATE (SUPERTILT)
$60.00
"
"
W005APSW
REAR WHEEL AXLE PLATE EXTENDED (SUPERTILT)
$60.00
""
"
W001APEG
NEW GOLD / EZ RIDE AXLE PLATE
$60.00
""
"
W007AR
AXLE RECEIVER (2” LONG) (NRG + GOLD, EZ RIDE)
$10.00
"
"
W008ARN
RECEIVER LOCK NUT
$6.00 PAIR
"
"
W001AREG
AXLE RECEIVER (NEW STYLE) (SUPERTILT)
$22.00
"
"
W001ARNEG
AXLE RECEIVER NUT (NEW STYLE) (SUPERTILT)
$3.75
"
"
""Rear"Wheel"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 7"
""Wheel"Locks"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
B01SPTR
RIGHT 7/8” STEEL PULL TO LOCK
$55.00
"
"
B01SPTL
LEFT 7/8” STEEL PULL TO LOCK
$55.00
"
"
B02APTR
RIGHT 7/8” ALUMINUM PULL TO LOCK
$55.00
"
"
B02APTL
LEFT 7/8” ALUMINUM PULL TO LOCK
$55.00
"
"
B03APTR1
RIGHT 1” ALUMINUM PULL TO LOCK
$55.00
"
"
B03APTR1
RIGHT 1” ALUMINUM PULL TO LOCK
$55.00
"
"
ATTBRX
ATTENDANT BRAKE
$250.00
""
N/A
""Wheel"Locks"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 8"
""Wheel"Locks"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
B03APTL1
LEFT 1” ALUMINUM PULL TO LOCK
$55.00
"
"
B04SPHTR
RIGHT 7/8” STEEL PUSH TO LOCK
$55.00
"
"
B04SPHTL
LEFT 7/8” STEEL PUSH TO LOCK
$55.00
"
"
B05APHTR
RIGHT 7/8” ALUMINUM PUSH TO LOCK
$55.00
"
"
B05APHTL
LEFT 7/8” ALUMINUM PUSH TO LOCK
$55.00
"
"
B05APHTR1
RIGHT 1” ALUMINUM PUSH TO LOCK
$55.00
"
"
B05APHTL1
LEFT 1” ALUMINUM PUSH TO LOCK
$55.00
"
"
""Wheel"Locks"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 9"
""Wheel"Locks"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
BRX9
9” BRAKE EXTENSION
$60.00 PAIR
"
"
BRX6
6” BRAKE EXTENSION
$40.00
""
"
BRX4
4” BRAKE EXTENSION
$40.00 PAIR
""
"
BRX015C
BRAKE EXTENSION CAPS
$1.00
""
N/A"
BRX16
7/8” BRAKE CLAMP ALUMINUM
$15.00
""
N/A"
BRX17
1” BRAKE CLAMP ALUMINUM
$15.00
""
N/A"
W001BBEG
EZ RIDE / GOLD BRAKE BAR (LEFT/RIGHT)
$35.00 PAIR
""
"
""Wheel"Locks""
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 10"
Wheel"Locks""
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
UNIBRX
ONE HAND BRAKE SYSTEM FOLDING CHAIRS
*LEFT & RIGHT
$280.00 SET
"
"
CAS5100
5 x 1 1/4” CASTER ASSEMBLY (URETHANE TIRE)
$48.00
"
"
CAS5175
5 x 1 3/4” CASTER ASSEMBLY (URETHANE TIRE)
$60.00
"
"
CAS6125
6 x 1 1/4” CASTER ASSEMBLY (URETHANE TIRE)
$60.00
"
"
CAS6175
CAS6200
6 x 1 3/4” CASTER ASSEMBLY
6 x 2” CASTER ASSEMBLY
$60.00
$60.00
"
"
CAS8125
8 x 1 1/4” CASTER ASSEMBLY (URETHANE TIRE)
$70.00
"
"
CAS8175
8 x 1 3/4” CASTER ASSEMBLY (URETHANE TIRE)
$80.00
"
"
""Front"Caster"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 11"
"Front"Caster""
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
CAS8200
8 x 2” CASTER ASSEMBLY (URETHANE TIRE)
$80.00
"
"
CAS8125A
8 x 1 1/4” AIR CASTER ASSEMBLY
$80.00
"
"
CAS8125B
8 x 1 1/4” HUB (AIR TIRE ONLY)
$60.00
"
"
CAS8125C
8 x 1 1/4” AIR TIRE
$28.00
"
"
CAS8125D
8 x 1 1/4” INNER (AIR) TUBE
$15.00
"
"
CAS8200A
8 x 2” AIR CASTER ASSEMBLY
$80.00
"
"
CAS8200B
8 x 2” HUB (AIR TIRE ONLY)
$60.00
"
"
""Front"Caster"
"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 12"
""Front"Caster"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
CAS8200C
8 x 2” AIR TIRE
$30.00
"
"
CAS8200D
8 x 2” AIR TUBE
$15.00
"
"
CASF001
5 x 1 1/2” SHORT ALUMINUM FORK (2 HOLES)
$36.00
"
"
CASF017
6 1/2” x 1 1/2” STANDARD ALUMINUM FORK (3 HOLES)
$38.00
"
"
CASF002
8 x 1 1/2” STANDARD ALUMINUM FORK
(5 HOLES)
$40.00
"
"
CASF003
5 x 2” STEEL FORK (2 HOLES)
$36.00
"
""
CASF018
6 1/2 x 2” STEEL FORKS (3 HOLES)
$38.00
"
"
""Front"Caster""
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 13"
"Front"Caster""
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
CASF004
8 x 2 STEEL FORK (5 HOLES)
$60.00
"
"
CASF005
FORK STEM WITH NUT GRADE 5
$9.00
"
"
CASF006
5/16 x 2 3/4” GRADE 5 CASTER AXLE WITH NUT
(ALUMINUM FORK)
$3.00
"
"
CASF007
5/16 x 3 1/2” GRADE 5 CASTER AXLE WITH NUT
(STEEL FORK)
$3.00
"
"
CASF008
5/16 x 1/4” CASTER SPACER
$1.00
"
"
CASF009
5/16 x 1/2” CASTER SPACER
$1.00
"
"
CASF011
5” TOTAL LOCK CASTER (MLTR)
$60.00
"
"
""Front"Caster"
"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 14"
"Front"Caster""
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
CASF012
5” DIRECTIONAL LOCK CASTER (MLTR)
$64.00
"
"
CASF013
PLATFORM WALKER FORK ONLY
$28.00
"
"
CASF014
SHOWER COMMODE 5” BRAKE CASTER (PLASTIC)
$60.00
"
"
CASF015
SHOWER COMMODE 5” DIRECTIONAL CASTER
(PLASTIC)
$64.00
"
"
CASF016
CASTER HOUSING (EZ RIDE & NRG+ GOLD FRAME)
$45.00
"
"
CASF016T
CASTER HOUSING LONG (EZ RIDE & NRG + GOLD FRAME)
(LEFT/RIGHT)
$45.00
"
"
UPHB01
PADDED NYLON BACK *SPECIFY SIZE AND COLOUR
$60.00
"
"
""Back"Upholstery""
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 15"
"Back"Upholstery""
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
UPHB02
PADDED VINYL BACK *SPECIFY SIZE AND COLOUR
$60.00
"
"
UPHB03
PADDED BLACK SAIL CLOTH BACK *SPECIFY SIZE
$60.00
"
"
UPHB04
PADDED RECLINER BACK *SPECIFY SIZE AND COLOUR
$60.00
"
"
UPHB05
PADDED NYLON HEAVY DUTY BACK
*SPECIFY SIZE AND COLOUR
$80.00
"
"
UPHB06
PADDED VINYL HEAVY DUTY BACK
*SPECIFY SIZE AND COLOUR
$80.00
"
"
UPHB07
PADDED BLACK SAIL CLOTH HEAVY DUTY BACK
*SPECIFY SIZE
$80.00
"
"
UPHB08
PADDED RECLINER HEAVY DUTY BACK
*SPECIFY SIZE AND COLOUR
$80.00
"
"
""Back"Upholstery"
"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 16"
"Back"Upholstery""
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
UPHB09
PADDED NYLON EXTRA HEAVY DUTY BACK
*SPECIFY SIZE AND COLOUR
$88.00
"
"
UPH700B
UPH700T
MLT 700 BACK UPHOLSTERY
TERRY CLOTH *SPECIFY SIZE
$80.00
$80.00
""
N/A
N/A
STBH2211
UNIVERSAL BACK SUPPORT HARDWARE
$150.00
""
N/A
SU1818
SHALLOW U BACK STANDARD *SPECIFY WIDTH
$544.00
"
"
SU1821
SHALLOW U BACK TALL *SPECIFY WIDTH
$720.00
"
"
SU18C
SHALLOW U BACK CUSTOM *SPECIFY WIDTH AND HEIGHT
$608.00
""
"
DU1818
DEEP U BACK STANDARD *SPECIFY WIDTH
$608.00
"
"
""Back"Upholstery"
"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 17"
"Back"Upholstery""
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
DU1821
DEEP U BACK TALL *SPECIFY WIDTH
$784.00
"
"
DU18C
DEEP U BACK CUSTOM *SPECIFY WIDTH AND HEIGHT
$720.00
"
"
KTBSS1818
KYPHOTIC BACK SHALLOW U STD *SPECIFY SIZE
$832.00
"
"
KTBSS1821
KYPHOTIC BACK SHALLOW U TALL *SPECIFY SIZE
$1,008.00
"
"
KTBSS18C
KYPHOTIC BACK SHALLOW U CUSTOM
*SPECIFY HEIGHT AND SIZE
$1,008.00
"
"
KTBSS1819
KYPHOTIC BACK DEEP U STD *SPECIFY SIZE
$832.00
"
"
KTBSS1822
HD COMMODE PADDED BACK REST *SPECIFY SIZE
$1,008.00
"
"
""Back"Upholstery"
"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 18"
"Back"Upholstery""
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
KTBSS18C
KYPOTHIC BACK DEEP U CUSTOM *SPECIFY SIZE AND HEIGHT
$1,008.00
"
"
RLSHALLUL
REMOVABLE LATERAL SHALLOW LEFT
$192.50
N/A
RLSHALLUR
REMOVABLE LATERAL SHALLOW RIGHT
$192.50
N/A
RLDEEPUL
REMOVABLE LATERAL DEEP LEFT
$192.50
N/A
RLDEEPUR
REMOVABLE LATERAL DEEP RIGHT
$192.50
N/A
STBH2211
UNIVERSAL BACK SUPPORT HARDWARE
$150.00
""
N/A
UPHML306
CONTOUR UPPER BACK *SPECIFY SIZE AND COLOUR
(MLTR)
$160.00
"
"
""Back"Upholstery"
"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 19"
"Back"Upholstery"
""Back"Upholstery"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
UPHML308
CUSTOM TALLER CONTOUR UPPER BACK
(MLTR)
$220.00
"
"
UPHML309
CONTOUR LOWER BACK (16-18”) (MLTR)
$180.00
"
"
UPHML310
CONTOUR LOWER BACK (19-24”) (MLTR)
$200.00
"
"
UPHML402
HEADREST PAD (MLT 700, MLTR)
*SPECIFY COLOUR
$120.00
"
"
UPHML318
SIDE BOLSTER (MLTR, MLT 700)
*SPECIFY THICKNESS
$80.00
"
""
HDC008
HD COMMODE PADDED BACK REST *SPECIFY SIZE
$80.00
"
"
TSC015
SHOWER COMMODE SNAP ON BACKREST
$60.00
"
"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 20"
"Back"Upholstery"!
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
STBH2211
NEW HARDWARE UNIVERSAL BACK SUPPORT HARDWARE
$150.00
"
"
SFST705
ANGLE ADJUSTABLE BACK BRACK BRACKET TILT ONLY
$80.00 PAIR
"
"
SFST706
ANGLE ADJUSTABLE BACK BRACKET RECLINE BACK
$90.00 PAIR
"
"
SFEG700
NEW ANGLE ADJUSTABLE BACK BRACKET
$110.00 PAIR
"
"
SFEG701
NEW FIXED BACK BRACKET FOR FLIPBACK ARMS
$110.00 PAIR
"
"
STCLMP001
1” CLAMP (FOR BACK SUPPORT) OLD STYLE
$17.50
N/A
STCLMP002
7/8” CLAMP (FOR BACK SUPPORT) OLD STYLE
$17.50
N/A
""Back"Upholstery"
"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 21"
"Back"Upholstery""
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
SFEG702
NEW FIXED ANGLE BACK BRACKET
$110.00 PAIR
"
"
UPH001
PADDED NYLON SEAT *SPECIFY SIZE AND COLOUR
$60.00
"
"
UPH002
PADDED VINYL SEAT *SPECIFY SIZE AND COLOUR
$60.00
"
"
UPHS04
PADDED BLACK SAIL CLOTH SEAT
*SPECIFY SIZE
$60.00
"
"
UPHS05
PADDED RECLINER SEAT UPHOLSTERY
*SIZE AND COLOUR
$60.00
"
"
UPHS06
PADDED NYLON HEAVY DUTY SEAT *SPECIFY SIZE AND COLOUR
$80.00
"
"
UPHS07
PADDED VINYL HEAVY DUTY SEAT *SPECIFY SIZE AND COLOUR
$80.00
"
"
""Seat"Upholstery"&"Belts"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 22"
""Seat"Upholstery"&"Belts"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
UPHS08
PADDED BLACK SAIL CLOTH HEAVY DUTY SEAT
*SPECIFY SIZE
$80.00
"
"
UPH700S
MLT 700 SEAT UPHOLSTERY *SPECIFY COLOUR
$80.00
""
N/A
UPHS09
PADDED HEAVY DUTY RECLINER SEAT
*SPECIFY SIZE AND COLOUR
$80.00
"
""
UPHS10
PADDED NYLON EXTRA HEAVY DUTY SEAT
*SPECIFY SIZE AND COLOUR
$88.00
"
"
UPHS11
PADDED VINYL, EXTRA HEAVY DUTY SEAT
*SPECIFY SIZE AND COLOUR
$88.00
"
"
UPHS14
SOLID POCKETED SEAT WITH INSERT *SPECIFY SIZE
$98.00
"
""
UPHS15
DROP BASE WITH HOOKS *SPECIFY SIZE – 1”, 2” OR 3”
$260.00
"
""
""Seat"Upholstery"&"Belts"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 23"
""Seat"Upholstery"&"Belts"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
UPHS18
2” NYLSON CUSHION *SPECIFY COLOUR AND SIZE
$60.00
"
"
UPHS19
2” VINYL CUSHION *SPECIFY SIZE AND COLOUR
$60.00
"
"
UPHS20
2” BLACK DARLEX CUSHION *SPECIFY SIZE AND COLOUR
$60.00
"
"
UPHA510
16” DEEP SEAT UPHOLSTERY STRAP
$6.00
"
"
UPHA511
18” DEEP SEAT UPHOLSTERY STRAP
$7.00
"
!
UPHA512
RECLINER BACK UPHOLSTERY STRAP
$7.00
"
"
UPHT201
CONTOUR SEAT CUSHION (UP TO 20”) OLD STYLE
*SPECIFY SIZE
$180.00
"
"
""Seat"Upholstery"&"Belts"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 24"
""Seat"Upholstery"&"Belts"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
UPHA525
ABDUCTOR SIDE BOLSTER (SUPERTILT, MLT 700)
*SPECIFY COLOUR
$120.00 EACH
""
N/A
UPHT202
COUNTOUR SEAT CUSHION (OVER 20”)
*SPECIFY SIZE
$280.00
"
"
UPHT203
STANDARD COZY CUSHION *SPECIFY SIZE
$480.00
"
"
UPHT204
CUSTOM COZY CUSHION *SPECIFY SIZE
$640.00
"
"
UPHT205
COZY CUSHION COVER *SPECIFY SIZE
$160.00
"
"
UPHT206
COZY CUSHION FOAM ONLY *SPECIFY SIZE
$180.00
"
"
UPHT207
SOLID SEAT BASE (WHEELCHAIR) *SPECIFY SIZE
$80.00
"
"
""Seat"Upholstery"&"Belts"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 25"
""Seat"Upholstery"&"Belts"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
UPHT208
SOLID SEAT BASE (OVER 20”) (WHEELCHAIR) *SPECIFY SIZE
$90.00
"
"
DR0003
BLACK ELASTIC DARLEX
$30/YARD
""
N/A"
UPHML303
SEAT BASE ONLY UPHOLSTERED WITH VELCRO (16-18”)
(SUPERTILT)
$120.00
"
"
UPHML304
SEAT BASE ONLY UPHOLSTERED WITH VELCRO (19-24”)
(SUPERTILT)
$140.00
"
UPHML305
SEAT DEPTH ADJUSTMENT BRACKET
$30.00
"
"
UPHA525ADD
-L
UNIVERSAL ADDUCTOR LEFT SIDE
(ON ALL SEATING & CHAIRS)
$120.00
""
N/A
UPHA525ADD -R
UNIVERSAL ADDUCTOR RIGHT SIDE
(ON ALL SEATING & CHAIRS)
$120.00
""
N/A
""Seat"Upholstery"&"Belts"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 26"
""Seat"Upholstery"&"Belts"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
HDC005
HD COMMODE MOLDED URETHANE SEAT
$200.00
"
"
HDC006
HD COMMODE MOLDED URETHANE PAN COVER
$40.00
"
"
HDC007
HD COMMODE SANITARY BUCKET
$80.00
"
"
TSC011
SHOWER COMMODE SANITARY BUCKET
$30.00
"
"
TSC012
SHOWER COMMODE MOLDED PLASTIC SEAT
$80.00
"
"
TSC012A
EZCOM SEAT
$60.00
""
N/A
SPLG
MALE – SPLASH GUARD
$60.00
""
N/A"
""Seat"Upholstery"&"Belts"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 27"
""Seat"Upholstery"&"Belts"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
MCC
MAX COMFORT CUSHION *SPECIFY SIZE
$624.00
"
"
MCBC
MAX COMFORT BARIATRIC CUSHION
*SPECIFY SIZE
$784.00
"
"
UPHA501
VELCRO SEAT BELT
$30.00
"
"
UPHA502
PLASTIC (FASTEX) SEAT BELT
$30.00
"
"
UPHA503
AUTO STYLE SEAT BELT
$35.00
"
"
SFN601
NRG+ SIDE FRAME RIGHT (STANDARD & TALL ADULT)
*SPECIFY COLOUR
$220.00
"
"
SFN602
NRG + SIDE FRAME LEFT (STANDARD & TALL ADULT)
*SPECIFY COLOUR
$220.00
"
"
""Frames"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 28"
""Frames"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
SFN605
NRG+ RIGHT HEMI SIDE FRAME *SPECIFY COLOUR
$260.00
"
"
SFN606
NRG+ LEFT HEMI SIDE FRAME *SPECIFY COLOUR
$260.00
"
"
SFSW607
SWIFT RIGHT STANDARD SIDE FRAME
*SPECIFY COLOUR
$260.00
"
"
SFSW608
SWIFT LEFT STANDARD SIDE FRAME
*SPECIFY COLOUR
$260.00
"
"
SFSW609
SWIFT RIGHT HEMI SIDE FRAME *SPECIFY COLOUR
$260.00
"
"
SFSW610
SWIFT LEFT HEMI SIDE FRAME *SPECIFY COLOUR
$260.00
"
"
SFSW611
ACESS RIGHT STANDARD SIDE FRAME
*SPECIFY COLOUR
$220.00
"
"
""Frames"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 29"
""Frames"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
SFA612
ACCESS LEFT STANDARD SIDE FRAME
*SPECIFY COLOUR
$220.00
"
"
SFA613
ACCESS RIGHT HEMI SIDE FRAME *SPECIFY COLOUR
$220.00
"
"
SFA614
ACCESS LEFT HEMI SIDE FRAME *SPECIFY COLOUR
$220.00
"
"
SFNR615
NRG+ RECLINER RIGHT SIDE FRAME
HEMI OR STD *SPECIFY COLOUR
$260.00
SFNR616
NRG+ RECLINER LEFT SIDE FRAME
HEMI OR STD *SPECIFY COLOUR
$260.00
SFNG617
NRG+ GOLD STANDARD SIDE FRAME
*SPECIFY COLOUR
$280.00
SFNG618
NRG+ GOLD HEMI SIDE FRAME
*SPECIFY COLOUR
$280.00
""Frames"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 30"
""Frames"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
SFEZ619
EZ RIDE STANDARD SIDE FRAME
*SPECIFY COLOUR
$320.00
SFEZ620
EZ RIDE HEMI SIDE FRAME
*SPECIFY COLOUR
$320.00
SF621
ADJUSTABLE HEIGHT STANDARD BACK CANE (NRG+)
$140.00
SF622
ADJUSTABLE HEIGHT TALL BACK CANE (NRG+)
$160.00
SF623
ADJUSTABLE HEIGHT STANDARD BACK CANE
(NRG+ GOLD, EZ RIDE)
$140.00
SF624
ADJUSTABLE HEIGHT TALL BACK CANE (NRG+ GOLD, EZ RIDE)
$160.00
SF5EG
BACKPOST SLEEVE (NRG+ GOLD, EZ RIDE)
$80.00
""Frames"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 31"
""Frames"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
UPHA519
RECLINER HEADREST EXTENSION TUBE
$30.00
SFST701
SUPERTILT LOWER BASE
$220.00
SFST702
SUPERTILT UPPER FRAME
$180.00
SFST701-D
DYNAMIC LOWER BASE
$220.00
SFST702-D
DYNAMIC UPPER FRAME
$180.00
SFST701-R
ROCK AND ROLL LOWER BASE
$220.00
SFST702-R
ROCK AND ROLL UPPER FRAME
$180.00
"
"Frames"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 32"
""Frames"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
UPHT225
RECLINER HEADREST ASSEMBLY
$140.00
N/A
STWHAS
STABILIZER BAR
$160.00
N/A
SFST703
PIVOT TUBE
$30.00
SFST704
PIVOT “H”
$120.00
RNR001
ROCK AND ROLL STABILIZER BAR COMPLETE
$75.00
RNR001-1
ROCK AND ROLL RELEASE SYSTEM (CABLE HANDLE, CABLE, PIN)
$75.00
N/A
RNR002
ROCK AND ROLL STABILIZER BAR SLEEVE
$35.00
"
"Frames"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 33"
""Frames"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
RNR003
ROCK AND ROLL STABILIZER BAR INSERT
$40.00
RNR005
ROCK AND ROLL SPRING ASSEMBLY
$350.00
N/A
SFST710
SUPERTILT STANDARD BACK CANE
$140.00
SFST712
STROLLER HANDLE
$160.00
SFST712-1
STROLLER HANDLE 19” WIDTH AND UP
$180.00
SFST716
SUPERTILT RECLINER CROSS TIE
$160.00
UPHA257
ELBOW BLOCK STRAIGHT
$65.00
N/A
""Frames"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 34"
""Frames"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
UPHA258
ELBOW BLOCK CURVED
$65.00
N/A
UPHA259
ELBOW BLOCK EXTENDED
$65.00
N/A
UPHA260
HAND BLOCK
$65.00
N/A
SFML801
MLTR 500 LOWER BASE (16” - 24”)
$220.00
SFML803
MLTR 600 LOWER BASE (16” - 24”)
$220.00
SFML804
MLTR 500/600 UPPER FRAME (16” - 24”)
$260.00
SFML809
MLTR 500/600 UPPER BACK (16” - 24”)
$160.00
"
"Frames""
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 35"
""Frames"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
SFML810
MLTR 500/600 LOWER BACK (16” - 24”)
$140.00
SMFL805
MLT 700A/B LOWER BASE (16” - 24”)
$220.00
SFML806
MLT 700A/B UPPER FRAME (16” - 24”)
$260.00
SFML807
MLT 700A/B BACK FRAME (16” - 24”)
$180.00
UPHML401
ESLASTO STRAP WITH HOOK (MLT 700) *SPECIFY SIZE
$20.00
HDC001
HD COMMODE COM1 FRAME
$700.00
HDC002
HD COMMODE COME2 FRAME
$800.00
"
"Frames"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 36"
""Frames"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
HDC003
HD COMMODE COM3 FRAME
$900.00
TSC001
SHOWER COMMODE LOWER BASE *SPECIFY SIZE
$140.00
TSC002
SHOWER COMMODE UPPER FRAME *SPECIFY SIZE
$180.00
JTSC001
JUNIOR GROWING COMMODE LOWER BASE
*SPECIFY SIZE
$140.00
JTSC002
JUNIOR GROWING COMMODE SIDE FRAME
*LEFT OR RIGHT
$100.00
TSC003
HEIGHT ADJUSTMENT EXTENSION (COMMODES)
$15.00
CX001
RIGHT CROSS BRACE (NRG+, SWIFT, ACCESS, NRG+
RECLINE) (14”-18”)
$80.00
"
"Wheelchair"Cross"Brace"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 37"
"Wheelchair"Cross"Brace""
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
CX002
LEFT CROSS BRACE (NRG+, SWIFT, ACCESS, NRG+
RECLINER) (14” - 18”)
$80.00
CX003
RIGHT CROSS BRACE (NRG+, SWIFT, ACCESS, NRG+
RECLINER) (19” - 24”)
$120.00
CX004
LEFT CROSS BRACE (NRG+, SWIFT, ACCESS, NRG+
RECLINER)(19” - 24”)
$120.00
CX005
RIGHT CROSS BRACE (NRG+ GOLD, EZ RIDE)
(14” - 18”)
$110.00
CX006
LEFT CROSS BRACE (NRG+ GOLD, EZ RIDE)
(14” - 18”)
$110.00
CX007
RIGHT CROSS BRACE (NRG+ GOLD, EZ RIDE)
(19” - 20”)
$140.00
CX008
LEFT CROSS BRACE (NRG+ GOLD, EZ RIDE)
(19” - 20”)
$140.00
""Wheelchair"Cross"Brace"""
*PART #-D MEANS DOUBLE CROSS BRACE – PRICE $220.00 EXAMPLE: CX001-D"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 38"
"Wheelchair"Cross"Brace
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
CX009
CROSS BRACE LINKS *SPECIFY SIZE
$12.00
ARM001
RIGHT ARM BASE (NRG+ GOLD, EZ RIDE)
$140.00
ARM002
LEFT ARM BASE (NRG+ GOLD, EZ RIDE)
$140.00
ARM003
RIGHT ARM BASE (SWIFT, NRG+)
$130.00
ARM004
LEFT ARM BASE (SWIFT, NRG+)
$130.00
ARM005
COMPLETE ARM RIGHT SIDE (NRG+ GOLD, EZ RIDE)
$160.00
ARM006
COMPLETE ARM LEFT SIDE (NRG+ GOLD, EZ RIDE)
$160.00
"
"Arms""
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 39"
"Arms""
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
ARM007
COMPLETE ARM RIGHT SIDE (SWIFT, NRG+)
$160.00
ARM008
COMPLETE ARM LEFT SIDE (SWIFT, NRG+)
$160.00
ARM009
RIGHT FULL LENGTH ARM TOP (NRG+, SWIFT, NRG+ GOLD EZ RIDE
FIXED ANGLE BACK)
$85.00
ARM010
LEFT FULL LENGTH ARM TOP (NRG+, SWIFT, NRG+ GOLD EZ RIDE
FIXED ANGLE BACK)
$85.00
ARM011
RIGHT DESK LENGTH ARM TOP (NRG+, SWIFT, NRG+ GOLD EZ RIDE
FIXED ANGLE BACK)
$80.00
ARM013
LEFT DESK LENGTH ARM TOP (NRG+, SWIFT, NRG+ GOLD EZ RIDE
FIXED ANGLE BACK)
$80.00
ARM00T
T STYLE ARMREST (NRG+ GOLD, EZ RIDE
ANGLE BACK)
$150.00
"
"Arms"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 40"
""Arms"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
ARM01T
T STYLE ARMREST ARM TOP (NRG+ GOLD, EZ RIDE
ANGLE BACK)
$80.00
ARM02T
T STYLE ARMREST ARM SLOT (NRG+ GOLD, EZ RIDE
ANGLE BACK)
$40.00
ARM03T
T STYLE ARMREST ARM SLEEVE (NRG+ GOLD, EZ RIDE
ANGLE BACK)
$30.00
ARM124
NRG+ RECLINER RIGHT ARM BASE
$130.00
ARM125
NRG+ RECLINER LEFT ARM BASE
$130.00
ARM126
NRG+ RECLINER RIGHT ARM TOP
$90.00
ARM127
NRG+ RECLINER LEFT ARM TOP
$90.00
"
"Arms"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 41"
""Arms"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
ARM128
ACCESS RIGHT ARM
$160.00
ARM129
ACCESS LEFT ARM
$160.00
ARM114
SUPERTILT RIGHT ARM BASE
$130.00
ARM115
SUPERTILT LEFT ARM BASE
$130.00
ARM116
SUPERTILT RIGHT ARM TOP
$90.00
ARM117
SUPERTILT LEFT ARM TOP
$90.00
ARM118
MLTR 500/600 ARM BASE
$130.00
"
"Arms"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 42"
""Arms"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
ARM119
MLTR 500/600 RIGHT ARM TOP
$80.00
ARM120
MLTR 500/600 LEFT ARM TOP
$80.00
UPHML319
MLTR 500/600 PADDED ARM PAD
$36.00
UPHML320
MLTR 500/600 SKIRT GUARD
$30.00
ARM121
MLT 700 ARM BASE
$130.00
ARM122
MLT 700 RIGHT ARM TOP
$80.00
ARM123
MLT 700 LEFT ARM TOP
$80.00
"
"Arms""
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 43"
""Arms"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
ARM135
MLT ARM BLOCK ASSEMBLY
$65.00
N/A
ARM136
MLT ARM BLOCK
$35.00
N/A
HDC004
HD COMMODE FLIP BACK ARMREST
$120.00
TSC008
SHOWER COMMODE FLIP BACK ARMREST
$120.00
UPHA515
DESK LENGTH URETHANE ARMPAD
$18.00
UPHA516
FULL LENGTH URETHANE ARMPAD
$22.00
UPHA517
DESK LENGTH PADDED ARMPAD
$16.00
""Arms"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 44"
""Arms"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
UPHA518
FULL LENGTH PADDED ARMPAD
$22.00
UPHA519
WATEFALL ARMPAD
$36.00
N/A
UPHA523
WIDE PADDED ARMPAD
$50.00
N/A
ARM130R
FRONT ARM SOCKET RIGHT
$18.00
ARM130L
FRONT ARM SOCKET LEFT
$18.00
SF627
REAR FRAME SADDLE (PILLOW BLOCK)
$12.00
ARM132
REAR ARM SOCKET (NRG+, NRG+ GOLD, EZ RIDE
NON-ANGLE ADJUSTABLE BACK)
$4.00
""Arms"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 45"
""Arms""
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
ARM133
REAR ARM SOCKET (EZ RIDE ANGLE
ADJUSTABLE BACK)
$15.00
STSG
SUPERTILT SKIRTGUARD
$18.00
SWSG
SWIFT SKIRT GUARD
$22.00
ARM134
ARM BASE INSERT
$26.00
FR9001
RIGHT FOOTREST COMPLETE ASSEMBLY
(NRG+, SWIFT, ACCESS, SUPERTILT)
$160.00
FR9001AAF
ANGLE ADJUSTABLE FOOTREST RIGHT COMPLETE ASSEMBLY
(NRG+, SWIFT, ACCESS, SUPERTILT)
$200.00
FR9002
LEFT FOOTREST COMPLETE ASSEMBLY
(NRG+, SWIFT, ACCESS, SUPERTILT)
$160.00
""Footrest"&"Legrest"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 46"
""Footrest"&"Legrest"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
FR9002AAF
ANGLE ADJUSTABLE FOOTREST LEFT COMPLETE ASSEMBLY
(NRG+, SWIFT, ACCESS, SUPERTILT)
$200.00
FR9003
RIGHT FOOTREST BRACKET ONLY
(NRG+, SWIFT, ACCESS, SUPERTILT)
$80.00
FR9004
LEFT FOOTREST BRACKET ONLY
(NRG+, SWIFT, ACCESS, SUPERTILT)
$80.00
FR9005
FOOTREST EXTENSION ONLY (PLASTIC & ANGLE ADJUSTABLE)
(NRG+, SWIFT, ACCESS, SUPERTILT)
$60.00
FR9006
FOOTREST EXTENSION ONLY (ALUMINUM FOOTPLATE)
(NRG+, SWIFT, ACCESS, SUPERTILT)
$60.00
FR9007
FOOTREST RELEASE HANDLE (NRG+, SWIFT, ACCESS, SUPERTILT)
$10.00
FR9008
RIGHT FOOTREST RELEASE SPRING
(NRG+, SWIFT, ACCESS, SUPERTILT)
$4.00
""Footrest"&"Legrest"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 47"
""Footrest"&"Legrest"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
FR9009
LEFT FOOTREST RELEASE SPRING
(NRG+, SWIFT, ACCESS, SUPERTILT)
$4.00
UPHA524
IMPACT GUARD
$60 PAIR
N/A
FR9013
ANGLE ADJUSTABLE FOOTREST EXTENSION
(ELEVATING WITH AAF)
$60.00
N/A
FR9015
RIGHT ELEVATING LEGREST COMPLETE ASSEMBLY
(NRG+, SWIFT, ACCESS, SUPERTILT)
$180.00
FR9016
LEFT ELEVATING LEGREST COMPLETE ASSEMBLY
(NRG+, SWIFT, ACCESS, SUPERTILT)
$180.00
FR9017
RIGHT ELEVATING LEGREST BRACKET (FRAME)
(NRG+, SWIFT, ACCESS, SUPERTILT)
$80.00
""Footrest"&"Legrest"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 48"
""Footrest"&"Legrest"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
FR9018
LEFT ELEVATING LEGREST BRACKET (FRAME)
(NRG+, SWIFT, ACCESS, SUPERTILT)
$80.00
SFST713
SUPERTILT FOOTREST SUPPORT BRACKET
*LEFT OR RIGHT
$80.00
FR9019
RIGHT ARTICULATING LEGREST COMPLETE ASSEMBLY
(NRG+, SWIFT, ACCESS, SUPERTILT)
$240.00
FR9020
LEFT ARTICULATING LEGREST COMPLETE ASSEMBLY
(NRG+, SWIFT, ACCESS, SUPERTILT)
$240.00
FR9021
RIGHT ARTICULATING ELEVATING LEGREST BRACKET
(NRG+, SWIFT, ACCESS, SUPERTILT)
$90.00
FR9022
LEFT ARTICULATING ELEVATING LEGREST BRACKET
(NRG+, SWIFT, ACCESS, SUPERTILT)
$90.00
FR9023
ARTICULATING LEGREST EXTENSION
*LEFT OR RIGHT
$60.00
""Footrest"&"Legrest"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 49"
""Footrest"&"Legrest"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
FR9024
ARTICULATING LEGREST HEIGHT ADJUSTMENT ASSEMBLY
$80.00
FR9025
RIGHT ELEVATING MECHANISM COMPLETE EXCLUDING HANGERS
$60.00
FR9025-G
RIGHT ELEVATING MECHANISM COMPLETE EXCLUDING HANGERS
(NRG+ GOLD, EZ RIDE)
$60.00
N/A
FR9026
LEFT ELEVATING MECHANISM COMPLETE EXCLUDING HANGERS
$60.00
FR9026-G
LEFT ELEVATING MECHANISM COMPLETE EXCLUDING HANGERS
(NRG+ GOLD, EZ RIDE)
$60.00
N/A
FR9027
ELEVATING “L” ROD AND NUT ONLY
$20.00
FR9027-G
ELEVATING “L” ROD AND NUT ONLY
(NRG+ GOLD, EZ RIDE)
$20.00
N/A
""Footrest"&"Legrest"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 50"
""Footrest"&"Legrest"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
FR9028
FOOTREST HANDLE
$20.00
FR9029
ELEVATING RELEASE (LOCKING SPRING)
$6.00
FR9030
ELEVATING LEGREST HANGER (PAD TUBE)
(NRG+, SWIFT, ACCESS, SUPERTILT)
$80.00
FR9031
ELEVATING LEGREST EXTENSION (NRG+, SWIFT, ACCESS, SUPERTILT)
$80.00
FR9032
90 DEGREE FOOTREST RIGHT COMPLETE ASSEMBLY
(NRG+, SWIFT, ACCESS, SUPERTILT)
$120.00
FR9033
90 DEGREE FOOTREST LEFT COMPLETE ASSEMBLY
(NRG+, SWIFT, ACCESS, SUPERTILT)
$120.00
FR9034
90 DEGREE FOOTREST RIGHT BRACKET ONLY
(NRG+, SWIFT, ACCESS, SUPERTILT)
$80.00
"
"Footrest"&"Legrest"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 51"
""Footrest"&"Legrest"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
FR9035
90 DEGREE FOOTREST LEFT BRACKET ONLY
(NRG+, SWIFT, ACCESS, SUPERTILT)
$80.00
ES
ELEVATING LEGREST SYSTEM COMPLETE ASSEMBLY
$440.00
ESSUP
ES SYSTEM LEGREST
$160.00
ESAXT
ES SYSTEM LEGREST INSERT
$100.00
ESFPT
ES SYSTEM FOLDING FOOTREST
$70.00
ESBAC
ES SYSTEM BRACKET
$25.00
ESHAN
ES SYSTEM HANGER SUPPORT
$90.00
"
"Footrest"&"Legrest"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 52"
""Footrest"&"Legrest"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
FR9036
FOOTREST RIGHT COMPLETE ASSEMBLY (NRG+ GOLD, EZ RIDE)
$180.00
FR9037
FOOTREST LEFT COMPLETE ASSEMBLY (NRG+ GOLD, EZ RIDE)
$180.00
FR9038
FOOTREST BRACKET ONLY RIGHT
(NRG+ GOLD, EZ RIDE)
$90.00
FR9039
FOOTREST BRACKET ONLY LEFT
(NRG+ GOLD, EZ RIDE)
$90.00
FR9040
FOOTREST EXTENSION (PLASTIC & ANGLE ADJUSTABLE)
(NRG+ GOLD, EZ RIDE)
$60.00
FR9041
FOOTREST EXTENSION (ALUMINUM FOOTPLATE)
(NRG+ GOLD, EZ RIDE)
$60.00
FR9043
FOOTREST LOCKING PIN OLD STYLE
(NRG+ GOLD, EZ RIDE FRONT POST)
$15.00
"
"Footrest"&"Legrest"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 53"
""Footrest"&"Legrest"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
FR9044
FOOTREST PIVOT BUSHING WITH SCREW
$6.00 PAIR
FR9045
FOOTREST ASSEMBLY RIGHT (NRG+ GOLD, EZ RIDE)
SPECIFY ANGLE
$140.00
FR9046
FOOTREST ASSEMBLY LEFT (NRG+ GOLD, EZ RIDE)
SPECIFY ANGLE
$140.00
FR9047
FOOTREST BRACKET ONLY RIGHT (NRG+ GOLD, EZ RIDE)
SPECIFY ANGLE AND COLOUR
$95.00
FR9048
FOOTREST BRACKET ONLY LEFT (NRG+ GOLD, EZ RIDE)
SPECIFY ANGLE AND COLOUR
$95.00
FR9049
ELEVATING LEGREST RIGHT COMPLETE ASSEMBLY
(NRG+ GOLD, EZ RIDE PRE-MAY’09)
$180.00
FR9050
ELEVATING LEGREST LEFT COMPLETE ASSEMBLY
(NRG+ GOLD, EZ RIDE PRE-MAY’09)
$180.00
"
"Footrest"&"Legrest"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 54"
""Footrest"&"Legrest"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
FR9051
ELEVATING BRACKET RIGHT (FRAME)
(NRG+ GOLD, EZ RIDE PRE-MAY’09)
$95.00
FR9052
ELEVATING BRACKET (FRAME)
(NRG+ GOLD, EZ RIDE PRE-MAY’09)
$95.00
FR9053
ELEVATING HANGER (PAD TUBE)
(NRG+ GOLD, EZ RIDE PRE-MAY’09)
$95.00
FR9054
ELEVATING RELEASE ASSEMBLY RIGHT
(NRG+ GOLD, EZ RIDE PRE-MAY’09)
$30.00
FR9055
ELEVATING RELEASE ASSEMBLY LEFT
(NRG+ GOLD, EZ RIDE PRE-MAY’09)
$30.00
FREG1
FOOTREST COMPLETE ASSEMBLY
$180.00
FREG2
FOOTREST HANGER 60 DEGREE
$80.00
"
"Footrest"&"Legrest"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 55"
""Footrest"&"Legrest"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
FREG3
FOOTREST HANGER 70 DEGREE
$80.00
FREG4
FOOTREST HANGER 80 DEGREE
$80.00
FREG5
LOCKING MECHANISM COMPLETE
$40.00
FREG6
LOCKING MECHANISM HANDLE
$9.00
N/A
FREG7
LOCKING MECHANISM INSERT PIN
$10.00
UPHA056
1 PIECE FOOTBOARD *SPECIAL SIZE
$140.00
N/A
FR9056
ELEVATING RLEASE RIGHT (LOCKING MECHANISM)
$60.00
"
"Footrest"&"Legrest"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 56"
""Footrest"&"Legrest"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
FR9056-H
ELEVATING PIVOT BLOCK ONLY (NRG+ GOLD, EZ RIDE)
$60.00
N/A
FR9057
ELEVATING RELEASE LEFT (LOCKING MECHANISM)
$60.00
FR9058
MOLDED PLASTIC FOOTPLATE (SPECIFY SIZE)
$40.00
FR9059
ALUMINUM FOOTPLATE (SPECIFY SIZE)
$40.00
FR9060
ANTI SKID ALUMINUM FOOTPLATE (SPECIFY SIZE)
$48.00
FR9061
ANGLE ADJUSTABLE FOOTPLATE (SPECIFY SIZE)
$65.00
FR9062
ALUMINUM FOOTPLATE SPRING
$4.00 PAIR
"
"Footrest"&"Legrest"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 57"
""Footrest"&"Legrest"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
FR9063
EXTRA LARGE ALUMINUM FOOTPLATE
$60.00
FR9064
EXTRA LARGE ABS FOOTPLATE
$75.00
FR9065
PADDED LEGPAD
$20.00
UPHA522
FOOTPLATE PADDED COVER
$40.00
N/A
FR9066
MOLDED URETHANE LEGPAD
$26.00
FR9066P
LEGPAD HARDWARE
$20.00
N/A
FR9067T
FOOTREST BRACKET TOP PIN (SHORT)
$2.75
""Footrest"&"Legrest"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 58"
""Footrest"&"Legrest"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
FR9067B
FOOTREST BRACKET BOTTOM PIN
(LONG)
$2.75
UPHA509
HEEL LOOP
$30.00
UPHA506
NYLON PADDED LEGSTRAP (8” HIGH)
$66.00
UPHA507
NYLON PADDED LEGSTRAP (12” HIGH)
$86.00
SFML811
MLTR 500/600 LEGREST EXTENSION
(UNDER CHAIR)
$120.00
SFML812
MLTR 500/600 LEGREST HANGER
$60.00
SFML813
MLTR 500/600 FOOTREST EXTENSION
$60.00
""Footrest"&"Legrest"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 59"
""Footrest"&"Legrest"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
SFML814
MLTR 500/600 FOOTPAD SUPPORT BRACKET
$80.00
UPHA522
FOOTPLATE PADDED COVER
$40.00
N/A
UPHA523
WIDE PADDED ARMPAD
$50.00
N/A
UPHA524
IMPACT GUARD
$60.00
N/A
SFML701
MLT 700 LEGREST HANGER
$160.00
SFML702
MLT 700 FOOTREST EXTENSION
$100.00
"
"Footrest"&"Legrest"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 60"
""Footrest"&"Legrest"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
SFML703
MLT 700 FOOTPAD SUPPORT BRACKET
$70.00
UPHML324
ONE PIECE LEGPAD
$140.00
UPHML325
LEGPAD COVER ONLY
$60.00
UPHML326
LEGPAD FOAM AND BASE
$110.00
UPHML327
1 PIECE FOOTBOARD (MLT)
$140.00
UPHML328
FOOTBOARD COVER
$60.00
UPHML329
FOOTBOARD AND FOAM ONLY
$60.00
""Footrest"&"Legrest"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 61"
""Footrest"&"Legrest"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
PFPC0016
ANGLE ADJUSTABLE PADDED FOOTPLATE COVER
16”
$25.00
N/A
PFPC0018
ANGLE ADJUSTABLE PADDED FOOTPLATE COVER
18”
$25.00
N/A
PFPC0020
ANGLE ADJUSTABLE PADDED FOOTPLATE COVER
20”
$25.00
N/A
PFPC0068
PADDED FOOTPLATE COVER *SPECIFY SIZE
$25.00
N/A
UPHML404
MLT 700 ONE PIECE LEGREST AND FOOTBOARD
PAD
$160.00
PW005
ADULT UPRIGHT FRAME
$130.00
PW006
JUNIOR UPRIGHT FRAME
$120.00
"
"Platform"Walker"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 62"
""Platform"Walker"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
PW007
ADULT BASE
$150.00
PW008
JUNIOR BASE
$140.00
PW009
ADULT UPRIGHT BRACE
$130.00
PW010
JUNIOR UPRIGHT BRACE
$120.00
PW004
HEIGHT ADJUSTMENT BRACKET
$60.00
PW001
ADULT PLATFORM
$160.00
PW002
JUNIOR PLATFORM
$140.00
"
"Platform"Walker"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 63"
""Platform"Walker"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
PW003
ARTHRITIC HANDLE WITH GRIPS
$120.00
PW011
BRAKE COMPLETE ASSEMBLY
$95.00
PW012
BRAKE HANDLE ONLY
$30.00
PW013
BRAKE CABLE
$45.00
PW014
BRAKE SHOE
$15.00
PW015
BRAKE SPRING
$5.00
UPHT218
CONTOUR HEADREST COMPLETE ASSEMBLY
$260.00
"
"Headrest"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 64"
""Headrest"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
UPHT220
CUSTOM HEADREST *SPECIFY DIMENSIONS
$280.00
UPHT221
CONTOUR HEADREST ONLY
$120.00
UPHT222
SWIVEL HEADREST COMPLETE ASSEMBLY
$280.00
UPHT226
HEAD WING RIGHT COMPLETE ASSEMBLY
(SUPERTILT)
$160.00
UPHT227
HEAD WING LEFT COMPLETE ASSEMBLY
(SUPERTILT)
$160.00
UPHT228
HEAD WING COVER ONLY
$80.00
MAHF
MULTIAXIS HEADREST COMPLETE ASSEMBLY
$460.00
N/A
""Headrest"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 65"
""Headrest"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
MAHH
MULTIAXIS HEADREST HORIZONTAL BRACKET
$40.00
MAHV
MULTIAXIS HEADREST VERTICAL BRACKET
$90.00
MAHC
MULTIAXIS HEADREST COVER
$80.00
N/A
UPHT225
RECLINER HEADREST COMPLETE ASSEMBLY
$140.00
N/A
VOSV
VERTICAL OFFSET HEADREST VERTICAL EXTENSION
$30.00
HBAL
HEADREST BLOCK COMPLETE ASSEMBLY
$65.00
HKH
HEADREST KNOB HANDLE
$18.00
""Headrest"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 66"
""Headrest"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
HBS
HEADREST BLOCK (SET)
$35.00
UPHML311
HEAD WINGS COMPLETE ASSEMBLY
*SPECIFY LEFT OR RIGHT
$120.00
UPHML312
HEAD WING ONLY RIGHT
$120.00
UPHML313
HEAD WING ONLY LEFT
$120.00
UPHML314
HEAD WING COVER RIGHT
$80.00
UPHML315
HEAD WING COVER LEFT
$80.00
""Headrest"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 67"
""Headrest"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
UPHML321
CONTOUR HEADREST
$120.00
UPHML322
CONTOUR HEADREST FOAM ONLY
$85.00
UPHML323
CONTOUR HEADREST COVER ONLY
$40.00
UPHML405
CONTOUR HEADREST ONLY (MLT 700)
$160.00
UPHML409
LEFT HEAD WING WITH BRACKET
(MLT 700)
$120.00
UPHML410
RIGHT HEAD WING WITH BRACKET
(MLT 700)
$120.00
TSC003
HEIGHT ADJUSTMENT EXTENSION
$60.00
""Headrest"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 68"
""Headrest"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
TSC004
MOLDED SWIVEL HEADREST ONLY
$120.00
TSC005
HORIZONTAL HEADREST BRACKET
(SUPERTILT)
$60.00
TSC006
VERTICAL HEADREST BRACKET
(SUPERTILT)
$60.00
UPHT229
HEAD WING “L” BRACKET ONLY
$40.00
UPHT230
HEAD WING PLATE
$24.00
UPHT225
HEAD REST PLATE
$40.00
ACC001
ADJUSTABLE I.V. POLE (SUPERTILT)
$160.00
""Wheelchair"Accessories"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 69"
""Wheelchair"Accessories"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
ACC001-A
ADJUSTABLE I.V. TOP WITH KNOB
$80.00
N/A
ACC002
NON-ADJUSTABLE I.V. POLE
(SUPERTILT)
$140.00
ACC003
ADJUSTABLE I.V. POLE
(WHEELCHAIRS)
$160.00
ACC004
NON-ADJUSTABLE I.V. POLE
(WHEELCHAIRS)
$140.00
RCHR
REMOVABLE CUP HOLDER RIGHT HAND SIDE
$40.00
N/A
RCHL
REMOVABLE CUP HOLDER LEFT HAND SIDE
$40.00
N/A
ACC005
ADJUSTABLE I.V. POLE (MLTR)
$160.00
""Wheelchair"Accessories"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 70"
""Wheelchair"Accessories"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
ACC006
NON-ADJUSTABLE I.V. POLE
(SUPERTILT)
$140.00
ACC007
CANE AND CRUTCH HOLDER
$120.00
ACC008
OXYGEN TANK HOLDER
$180.00
ACC009
MLTR TRAY *SPECIFY SIZE
$240.00
ACC010
FULL PADDED LAP TRAY (COMPLETE WITH BRACKET)
$280.00
ACC011
FULL CLEAR LAP TRAY (COMPLETE WITH BRACKET)
$280.00
ACC012
FULL UNPADDED LAP TRAY (COMPLETE WITH BRACKET)
$240.00
""Wheelchair"Accessories"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 71"
"Wheelchair"Accessories""
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
ACC013
HALF PADDED LAP TRAY RIGHT
(COMPLETE WITH BRACKET)
$240.00
ACC014
HALF PADDED LAP TRAY LEFT
(COMPLETE WITH BRACKET)
$240.00
VENT0001
VENT TRAY
$425.00
N/A
ACC015
HALF CLEAR TRAY RIGHT
(COMPLETE WITH BRACKET)
$260.00
ACC016
HALF CLEAR TRAY LEFT
(COMPLETE WITH BRACKET)
$260.00
ACC017
ALUMINUM SLIDE ON BRACKET
$40.00
ACC017F
FLIP UP BRACKET (FOR HALF TRAY)
$80.00
N/A
""Wheelchair"Accessories"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 72"
""Wheelchair"Accessories"
"
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
ACC018
WHEELCHAIR TRAY ROD RIGHT
$40.00
ACC019
WHEELCHAIR LEFT
(LOCKING)
$48.00
ACC020
WHEELCHAIR TRAY BRACKET RIGHT
(ARMPAD)
$40.00
N/A
ACC021
WHEELCHAIR TRAY BRACKET LEFT
(LOCKING) (ARMPAD)
$48.00
N/A
ACC022
MLTR TRAY ROD RIGHT
$40.00
ACC023
MLTR TRAY ROD LEFT
(LOCKING)
$48.00
SF625
ADJUSTABLE HEIGHT REAR ANTI-TIPPERS
(WHEELCHAIRS)
$120.00 PAIR
""AntiLtippers"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 73"
AntiLtippers""
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
SFST714
SUPERTILT REAR ANTI-TIPPERS STANDARD
$120.00
SFST714-A
SUPERTILT REAR ANTI-TIPPERS SHORT
$120.00
SFST715-S
SUPERTILT SIDE ANTI-TIPPERS
$120.00
SFST715
SUPERTILT FRONT ANTI-TIPPERS
$120.00
SFML816
MLTR 500/600 REAR ANTI-TIPPERS
$120.00
SFML817
MLTR 500/600 FRONT ANTI-TIPPERS
$120.00
CATRR
ANTI-TIPPER STABILIZER ROUND
$240.00 PAIR
""AntiLtippers"
"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 74"
"AntiLtippers""
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
CATRS
ANTI-TIPPER STABILIZER SQUARE
$240.00 PAIR
SFST717
ANTI-TIPPER EXTENSION TUBE
$25.00
N/A
SF626
ANTI-TIPPER WHEEL
$8.00 PAIR
SFML815
MLTR DELRIN PIVOT BUSHING
$10.00
CX010
BOTTOM RAIL BUSHINGS (SET OF 4)
$12.00
CX011
1” RADIUS WASHERS (SET OF 12)
$12.00
TSC007
COMMODE PIVOT BUSHING
$15.00
"
"Bushings""
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 75"
"Bushings""
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
BSH001
1/4” x 7/8” O.D. x 1/4” T BUSHING
$2.00
BSH002
1/4” x 7/8” O.D. x 3/4” T BUSHING
$4.00
EGBSH001
FOOTREST PIVOT BUSHING VERTICAL
$9.50
EGBSH002
FOOTREST PIVOT BUSHING HORIZONTAL
$9.50
W202224BR1
1 1/8” X 1/2” PRECISION BEARING 20”, 22”, 24” HUBS - REAR WHEEL
NRG+ GOLD CASTER SOCKET
$10.00
W202224BR3
1 1/8” X 7/16” PRECISION BEARING 20”, 22”, 24” HUBS - REAR WHEEL
$10.00
W202224BR4
1 1/16” X 1/2” FLANGE NON-PRECISION
CASTER SOCKET-SUPERTILT, SWIFT
$10.00
N/A
""Bearings"
"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 76"
"Bearings""
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
CASBR001
22 X 8MM CASTER BEARING
$6.00
FSBEG001
1/2” X 3/4” FOOTREST SWIVEL BEARING
(NRG+ GOLD)
$8.00
CABM001
SINGLE TILT CABLE (PORTER CYLINDER) (SUPERTILT, MLTR)
$60.00
CABM002
SINGLE RECLINE CABLE DUAL HEAD
(PL PORTER CYLINDER)
$120.00
CABM003
RECLINE CABLE (PL PORTER CYLINDER)
(MLTR)
$60.00
CABW001
PLATFORM WALKER BRAKE CABLE
$60.00
CABG001
SINGLE GAS CABLE SINGLE HEAD
(TILT COMMODE)
$60.00
""Cables"&"Cylinders"
"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 77"
"Cables"&"Cylinders""
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
CABG002
SINGLE GAS CABLE DUAL HEAD (SUPERTILT)
$120.00
CABG003
GAS CABLE ES SYSTEM
(SUPERTILT ES, MLT 700)
$60.00
TRP004G200
GAS TILT/ RECLINE PISTON 200N – 14”, 16” SUPERTILT
(SUPERTILT RECLINE SYSTEM)
$220.00
TRP004G400
GAS TILT/ RECLINE PISTON 400N – 18”, 20” SUPERTILT
$220.00
TRP004G500
GAS TILT/ RECLINE PISTON 500N – 22”+ SUPERTILT
$220.00
TRP004G150
GAS TILT/ RECLINE PISTON 150N – SUPERTILT ES SYSTEM
$220.00
TRP004G350
GAS PISTON 350N – DYNAMIC SUPERTILT
$220.00
""Cables"&"Cylinders"
"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 78"
"Cables"&"Cylinders""
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
TRP004G550
GAS PISTON 550N – DYNAMIC SUPERTILT
$220.00
TRCH006
CABLE RELEASE HANDLE
$30.00
CC003-1
7/8” CABLE CLAMP
$4.20
CC003-2
1” CABLE CLAMP
$4.20
MLTTS0001L
SELF-TILTING SWITCH (SUPERTILT)
$150.00
N/A
HWF001
3/4” ROUND UNIVERSAL
$1.00
HWF002
7/8” ROUND UNIVERSAL
$1.00
""Hardware"
"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 79"
"Hardware""
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
HWF003
1” ROUND UNIVERSAL
$1.00
HWF004
1 1/16” CASTER HOUSING (DUST CAP)
$1.00
HWF004G
1 1/4” CASTER HOUSING (DUST CAP)
$1.00
HWF005
1” TO 7/8” SILENCER
$1.00
HWF006
7/8” TO 3/4” SILENCER
$1.00
HWF007
3/4” SQUARE UNIVERSAL
$1.00
HWF008
7/8” SQUARE UNIVERSAL
$1.00
""Hardware"""
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 80"
"Hardware""
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
HWF009
1” SQUARE UNIVERSAL
$1.00
HWF009A
1/2” SQUARE END CAP (HEADREST)
$1.00
N/A
HWF011
3/4” DOME END CAP (TRAY ROD)
$1.00
HWF010
5/8” DOME END CAP
$1.00
TSC014
TRIANGLE KNOB
$4.00
ARM131
ARM RELEASE ASSEMBLY (KNOB, PIN, SPRING)
$10.00
ARM131A
ARM RELEASE KNOB ONLY
$1.00
N/A
""Hardware"
"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 81"
"Hardware""
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
UPHA514
1” FOAM GRIP SPREADER BAR
$8.00
UPHA514-2
3/4” FOAM GRIP SUPERTILT STROLLER HANDLE
$8.00
UPHA514-3
3/4” FOAM GRIP NRG+ GOLD, EZ RIDE
$8.00
UPHA514-4
7/8” FOAM GRIP ALL OTHER CHAIRS + EZ RIDE W/
ANGLE ADJUSTABLE BACK
$8.00
N1L
5/16” NYLON LOCK NUT
$0.45
N1LT
5/16” NYLON LOCK NUT THIN
$0.45
HWF012
3/8” BOLT CAP (HEADREST)
$1.00
N/A
""Hardware"
"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 82"
"Hardware""
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
N1R
5/16” TORQUE NUT
$0.45
N2L
1/4” NYLON LOCK NUT
$0.45
N2LT
1/4” NYLON LOCK NUT THIN
$0.45
N2F
1/4” FLANGE NUT
$0.45
N2R
1/4” ROUND NUT
$0.45
N3LT
3/16” NYLON LOCK NUT THIN
$0.45
N5T
3/4” THIN NUT
$2.55
""Hardware"
"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 83"
"Hardware""
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
UPHA513
SEAT UPHOLSTERY SCREW (10-32 x 3/4” – SET OF 6)
$4.00
B1H14
5/16” x 1 1/2” HEX CAP BOLT
$1.75
B1H20
5/16” x 2” HEX CAP BOLT
$1.75
B1H26
5/16” x 2 3/4” HEX CAP BOLT
$1.75
B1H32
5/16” x 3 1/4” HEX CAP BOLT
$2.50
B2R006S
1/4" x 0.6” ROUND CAP BOLT SLOT PAN
$0.45
B2H10
1/4” x 1” HEX CAP BOLT
$0.45
""Hardware"
"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 84"
"Hardware""
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
B2H12
1/4" x 1 1/4” HEX CAP BOLT
$0.45
B2R12C
1/4" x 1 1/4" ROUND CAP BOLT CROSS PAN
$0.45
B2H14
1/4" x 1 1/2” HEX CAP BOLT
$0.45
B2H16
1/4" x 1 3/4" HEX CAP BOLT
$0.45
B2B16H
1/4" x 1 3/4” BUTTON CAP BOLT HEX PAN
$0.85
B2H20
1/4” x 2” HEX CAP BOLT
$0.85
B2R2C
1/4" x 2” ROUND CAP BOLT CROSS PAN
$0.95
""Hardware"
"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 85"
"Hardware""
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
B2H20-1
1/4" x 2 1/4" HEX CAP BOLT
$1.25
B2B22H
1/4” x 2 1/4" BUTTON CAP BOLT HEX PAN
$1.25
B3R05Q
3/16” x 5/8” ROUND CAP BOLT SQUARE PAN
$0.45
B3F065C
3/16” x 0.8” FLAT CAP BOLT CROSS PAN
$0.45
B3R12C
3/16” x 1 1/4” ROUND CAP BOLT CROSS PAN
$0.75
W1HM2
5/16” HALF MOON WASHER (7/8” TUBING)
$1.95
W2HM1
1/4" HALF MOON WASHER (7/8” TUBING)
$1.70
""Hardware"
"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 86"
"Hardware""
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
WP10401
5/16” x 3/4" O.D. x 1/16” T PLASTIC WASHER
$0.85
WP11003
5/16” x 5/8” O.D. x 3/16” T PLASTIC WASHER
$0.85
WP11204
5/16” x 3/4" O.D. x 1/4" T PLASTIC WASHER
$0.85
WS11202
5/16” x 3/4” O.D. x 0.08” T STEEL WASHER
$0.85
WP11203
5/16” x 3/4" O.D. x 3/16” T PLASTIC WASHER
$0.85
WP11003
1/4" x 5/8” O.D. x 3/16” T PLASTIC WASHER
$0.85
WS11003
1/4" x 5/8” O.D. x 3/16” T STEEL WASHER
$0.85
""Hardware"
"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018
Effective January 2014
Maple Leaf Wheelchair © 2014 www.mapleleafwheelchair.com 87"
"Hardware""
PART%NUMBER%
PART%DESCRIPTION% RETAIL%PRICE%
IMAGE%
WS31001P
3/16” x 5/8” O.D. x 1/16” T STEEL WASHER
$0.85
WS40801
1/8” x 1/2" O.D. x 1/16” T STEEL WASHER
$0.85
WS4C1002
1/8” x 5/8” O.D. x 1/8” T STEEL WASHER CUP
$0.85
MLPTLC
BATTERY EXTENSION CORD
$70.00
N/A
BR0028
BRAKE WASHER (PLASTIC)
$0.45
N/A
WBSP001
REAR WHEEL BEARING SPACER
$0.60
N/A
""
"
Alberta Health - Pharmaceutical and Supplementary Benefits Alberta Aids to Daily Living Parts Prices - Maple Leaf
© 2018 Government of Alberta December 1, 2018