P.O.# DATE ANKLE AND FOOT SUPPORTS CODE UNIV XXS XS SM MD LG XL XXL XXXL

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1 ANKLE AND FOOT SUPPORTS ASO EVO - BLACK X N/A N/A N/A ASO EVO - WHITE X N/A N/A N/A ASO EVO - HINGE ONLY X N/A N/A N/A ASO EVO SPEEDLACER - BLACK X N/A N/A N/A ASO EVO QUATRO - BLACK X N/A N/A N/A ASO WITH STAYS - BLACK X N/A N/A N/A ASO WITH STAYS - WHITE X N/A N/A N/A ASO WITHOUT STAYS - BLACK X N/A N/A ASO SPEEDLACER - BLACK X N/A N/A N/A ASO SPEEDLACER - WHITE X N/A N/A N/A N/A ASO VORTEX - BLACK X N/A N/A N/A SUPINATOR PTT STABILIZER - LEFT x N/A N/A N/A SUPINATOR PTT STABILIZER x N/A N/A N/A ASO MAX - BLACK X N/A N/A N/A ASO FLEX-HINGE - BLACK X N/A N/A N/A PHANTOM DORSAL NIGHT SPLINT X N/A N/A N/A N/A TOE PULL STRAP FOR PHANTOM NIGHT SPLINT N/A N/A N/A N/A N/A N/A N/A N/A PFO-PLANTAR FACITIS ORTHOSIS N/A N/A N/A N/A N/A N/A N/A N/A POST-OP SHOE - MALE X N/A N/A N/A N/A N/A POST-OP SHOE - FEMALE X N/A N/A N/A N/A N/A N/A ROCKER BOTTOM CAST SHOE X N/A N/A N/A ELASTIC ANKLE SUPPORT WITH GEL PADS OS6240-X N/A N/A N/A N/A N/A N/A CROSSOVER ELASTIC ANKLE SUPPORT - BLACK TOB-500N-X N/A N/A N/A N/A CROSSOVER ELASTIC ANKLE SUPPORT - BEIGE TOB-500B-X N/A N/A N/A N/A TN-240 ELASTIC ANKLE SUPPORT TN-240-X N/A N/A N/A N/A N/A N/A HALLUX-VALGUS IN THERMOPLASTIC - LEFT HV-33I-X N/A N/A N/A N/A N/A N/A HALLUX-VALGUS IN THERMOPLASTIC - HV-33D-X N/A N/A N/A N/A N/A N/A CP04 POST OPERATIVE SHOE CP04-X N/A N/A N/A N/A ELEMENTS STRETCH-UP X N/A N/A N/A N/A N/A N/A M2 NIGHT SPLINT STANDARD 4457XX N/A N/A N/A N/A N/A N/A

2 ANKLE AND FOOT SUPPORTS - Cont'd FSX AIR WALKER - HIGH TOP T9842-X N/A N/A N/A N/A N/A N/A FSX AIR WALKER - LOW TOP T9852-X N/A N/A N/A N/A N/A N/A ADVANTAGE III WALKER - HIGH TOP T3202-X N/A N/A N/A N/A N/A ADVANTAGE III WALKER - LOW TOP T3212-X N/A N/A N/A N/A N/A 3 INCH X 9-1/16 INCH 3/4 LENGTH HEEL WEDGE/LIFT HWL N/A N/A N/A N/A N/A N/A N/A N/A TOE SPACER - LEFT NB10045 N/A N/A N/A N/A N/A N/A N/A N/A TOE SPACER - NB10046 N/A N/A N/A N/A N/A N/A N/A N/A RMI SAFEBOOT II II-X N/A N/A N/A N/A N/A BOXIA AFO FOOT DROP - BLACK AB01-x N/A N/A N/A N/A N/A BOXIA INTERIOR ARCH SUPPORT AB12D-x N/A N/A N/A N/A N/A N/A BOXIA INTERIOR ARCH SUPPORT LEFT AB12I-x N/A N/A N/A N/A N/A N/A EASY WALK STABILITY AFO - AFO10T=Rx N/A N/A N/A N/A N/A EASY WALK STABILITY AFO - LEFT AFO10T=Lx N/A N/A N/A N/A N/A EASY WALK ADVANCE II AFO - AFO12A=Rx N/A N/A N/A N/A N/A EASY WALK ADVANCE II AFO - LEFT AFO12A=Lx N/A N/A N/A N/A N/A CODE XS S/M L/XL NAVIGAIT DROP FOOT ORTHOSIS X NEUROFLEX RESTORATIVE FLEXBOOT (PEDIATRIC SAFEBOOT) CODE 3" 3 1/2" 4" 5" 6" 7" 8" X KNEE, THIGH, AND CALF SUPPORTS AKS WITH PLASTIC HINGES - COOLFLEX X N/A N/A AKS WITH METAL HINGES AND STRAPS - COOLFLEX DYNATRACK PLUS PATELLA STABILIZER W/PLASTIC HINGES - NEOPRENE DYNATRACK PLUS PATELLA STABILIZER W/PLASTIC HINGES - COOLFLEX DYNATRACK PATELLA STABILIZER W/ METAL HINGES - COOLFLEX LEFT DYNATRACK PATELLA STABILIZER W/ METAL HINGES - COOLFLEX X N/A N/A X N/A N/A X N/A N/A X N/A N/A N/A X N/A N/A N/A GRIPPER HINGED KNEE 12" - NEOPRENE ** X N/A N/A

3 KNEE, THIGH, CALF SUPPORTS - Cont'd GRIPPER HINGED KNEE 12" - COOLFLEX ** X N/A N/A GRIPPER HINGED KNEE 16" - ALUMINUM HINGES - NEOPRENE GRIPPER HINGED KNEE 16" - ALUMINUM HINGES - COOLFLEX GRIPPER HINGED KNEE 16" - ROM HINGES - COOLFLEX X N/A N/A N/A X N/A N/A N/A X N/A N/A N/A N/A PATELLAVATOR X N/A N/A N/A N/A PADDED KNEE SLEEVE X N/A N/A UNIVERSAL FOAM KNEE IMMOBILIZER - 12" N/A N/A N/A N/A N/A N/A N/A N/A UNIVERSAL FOAM KNEE IMMOBILIZER - 16" N/A N/A N/A N/A N/A N/A N/A N/A UNIVERSAL FOAM KNEE IMMOBILIZER - 18" N/A N/A N/A N/A N/A N/A N/A N/A UNIVERSAL FOAM KNEE IMMOBILIZER - 20" N/A N/A N/A N/A N/A N/A N/A N/A UNIVERSAL FOAM KNEE IMMOBILIZER - 22" N/A N/A N/A N/A N/A N/A N/A N/A UNIVERSAL FOAM KNEE IMMOBILIZER - 24" N/A N/A N/A N/A N/A N/A N/A N/A RODISIL CLOSED PATELLA KNEE BRACE WITH POLYCENTRIC HINGE RODISIL CLOSED PATELLA KNEE BRACE WITH LATERAL STABILIZERS 3-TEX 7104 KNEE BRACE WITH POLYCENTRIC JOINTS ELASTIC KNEE SUPPORT WITH LATERAL STABILIZERS 9106-X N/A N/A 9104-X N/A N/A 7104-X N/A N/A N/A OS6211-X N/A N/A N/A N/A N/A N/A ELASTIC CALF SUPPORT OS6804-X N/A N/A N/A N/A N/A N/A ELASTIC THIGH SUPPORT OS6801-X N/A N/A N/A N/A N/A N/A ELASTIC KNEE SUPPORT TN-210-X N/A N/A N/A N/A N/A N/A POST-OP ADJUSTABLE KNEE BRACE K80032 N/A N/A N/A N/A N/A N/A N/A N/A AIRSHIFT OA KNEE BRACE - LEFT MEDIAL/ LATERAL AIRSHIFT OA KNEE BRACE - MEDIAL/LEFT LATERAL CODE SM/MD LG/XL 2XL/3XL X X HIP PROTECTORS AND SUPPORTS COMFIHIPS HIP PROTECTOR SET - WOMENS' CH-W-X N/A N/A N/A COMFIHIPS HIP PROTECTOR SET - MENS' CH-M-X N/A N/A N/A COMFIHIPS UNDERGARMENT- WOMENS' (2/PK) CH-W-X-UG N/A N/A N/A

4 HIP PROTECTORS AND SUPPORTS COMFIHIPS UNDERGARMENT- MENS' (2/PK) CH-M-X-UG N/A N/A N/A COMFIHIPS REPLACEMENT PAD (2/PK) CH-PAD N/A N/A N/A N/A N/A N/A N/A N/A HIP ABDUCTION PILLOW N/A N/A N/A N/A N/A N/A N/A N/A BACK SUPPORTS ARCHIMED SPINAL BRACE X N/A N/A N/A ARCHIMED SPINAL BRACE 631 UNIVERSAL N/A N/A N/A N/A N/A N/A N/A N/A ARCHIMED JR. 627 SPINAL BRACE X N/A N/A N/A ARCHIMED JR. 627 SPINAL BRACE UNIVERSAL N/A N/A N/A N/A N/A N/A N/A N/A ARCHIMED 637 SPINAL BRACE X N/A N/A N/A ARCHIMED 637 SPINBAL BRACE UNIVERSAL N/A N/A N/A N/A N/A N/A N/A N/A BACK N' BLACK X N/A N/A BACK N' BLACK LOW PROFILE X N/A N/A N/A BACK N' BLACK W/ THERMOFORMABLE POCKET X N/A N/A N/A BACK N' BLACK DUAL PANEL X N/A N/A N/A N/A BACK N' SHAPE II WITH DOUBLE SIDE PULLS X N/A N/A N/A SACROILIAC (S.I.) BELT X N/A N/A N/A N/A EV-300 SEMI RIGID LUMBAR BACK SUPPORT EV-300-X N/A N/A COOLER BELT 0200-X N/A N/A N/A N/A LUMBO THORACIC - LONG 0240-X N/A N/A N/A LUMBO THORACIC - SHORT 0241-X N/A N/A N/A N/A N/A MOTHER TO BE 0055-X N/A N/A N/A LOVING COMFORT MATERNITY SUPPORT 0230-X N/A N/A N/A N/A N/A N/A POST PARTUM SUPPORT 0250-X N/A N/A N/A N/A N/A N/A CRISS CROSS BEIGE 0130 BEI-X N/A N/A N/A SPINA LIGHTWEIGHT SPINAL ORTHOSIS- FEMALE SPINA LIGHTWEIGHT SPINAL ORTHOSIS - MALE SPINA II KNIGHT TAYLOR SPINAL ORTHOSIS - FEMALE SPINA II KNIGHT TAYLOR SPINAL ORTHOSIS - MALE 1201-F-X N/A N/A N/A N/A N/A 1200-M-X N/A N/A N/A N/A N/A 1276-W-X N/A N/A N/A N/A N/A 1275-M-X N/A N/A N/A N/A N/A SPINA II FRONT PANEL - FEMALE 1206F N/A N/A N/A N/A N/A N/A N/A N/A

5 BACK SUPPORTS - Cont'd SPINA II FRONT PANEL - MALE 1206M N/A N/A N/A N/A N/A N/A N/A N/A 0101 MOLDABLE INSERT (MEDSPEC COMPATIBLE) 0101 WHI UN N/A N/A N/A N/A N/A N/A N/A N/A 0110 MOLDABLE INSERT 0110 WHI UN N/A N/A N/A N/A N/A N/A N/A N/A DORSOTECH - DORSOLUMBAR BRACE TC-300 N/A N/A N/A N/A N/A N/A N/A N/A CODE XS/SM MD/LG XL/2XL CRISS CROSS WHITE 0130 WHI-X BELTS AND BINDERS REINFORCED HERNIA TRUSS - LEFT I-112-X N/A N/A N/A REINFORCED HERNIA TRUSS - D-111-X N/A N/A N/A REINFORCED HERNIA TRUSS - BILATERAL B-110-X N/A N/A N/A UNIVERSAL ELASTIC RIB BELT 1632-X N/A CODE UNIV MALE FEMALE UNIV. 9" ELASTIC ABDOMINAL BINDER N/A N/A UNIV. 12" ELASTIC ABDOMINAL BINDER N/A N/A SHOULDER AND ARM SUPPORTS PLEASE INDICATE A QUANTITY WHEN SELECTING A PRODUCT UNLESS OTHERWISE SPECIFIED, THE BELOW BRACES ARE BILATER ** LARGEST SIZE MAY BE MORE EXPENSIVE - PLEASE CALL FOR INFORMATION PADDED ARM SLING - BLACK X N/A N/A UNIVERSAL HEMI-SLING N/A N/A N/A N/A N/A N/A N/A N/A SHOULDER IMMOBILIZER X N/A N/A N/A OUTRIGGER II SHOULDER IMMOBILIZER X N/A N/A N/A N/A N/A FOAM SLING & SWATHE SHOULDER IMMOBILIZER N/A N/A N/A N/A N/A N/A N/A N/A VECTOR ABDUCTED SHOULDER SLING - LEFT X N/A N/A N/A N/A N/A N/A VECTOR ABDUCTED SHOULDER SLING X N/A N/A N/A N/A N/A N/A STRONG SHOULDER SUPPORT E-240-X N/A N/A N/A VISSION SHOULDER STABILIZER N/A N/A N/A N/A N/A N/A N/A N/A VISSION MESH CONTOURED SLING 3101XX N/A N/A N/A N/A N/A SHOULDER SUPPORT WITH ARM AND FOREARM STRAP SHOULDER SUPPORT WITH ARM AND FOREARM STRAP LEFT 94303D-x N/A N/A N/A N/A N/A N/A 94303I-x N/A N/A N/A N/A N/A N/A

6 CERVICAL AND CLAVICLE SUPPORTS OVER THE SHOULDER-NEUTRAL HFB..EXTENDED HFB-OS-X00-X N/A N/A N/A N/A N/A VERSION CONTOUR COLLAR X N/A N/A N/A N/A N/A CONTOUR CLAVICLE STRAP X N/A N/A N/A CAROLINA COLLAR X N/A N/A N/A N/A N/A N/A NEUROFLEX RESTORATIVE KENTUCKY KOLLAR X N/A N/A N/A N/A N/A CERVICAL UNIVERSAL COLLAR 1231-X CODE 3" 4" ELBOW SUPPORTS PLEASE INDICATE A QUANTITY WHEN SELECTING A PRODUCT ELASTIC ELBOW SUPPORT WITH GEL PADS OS6230-X N/A N/A N/A N/A N/A N/A TN-230 ELASTIC ELBOW SUPPORT TN-230-X N/A N/A N/A N/A N/A N/A EPITEC ELBOW BAND EP-21G N/A N/A N/A N/A N/A N/A N/A N/A EPIGEL ELBOW SUPPORT N/A N/A N/A N/A N/A N/A N/A N/A EPIFOAM ELBOW SUPPORT N/A N/A N/A N/A N/A N/A N/A N/A TENNIS ELBOW SLEEVE 0605 BLA-X N/A N/A N/A CODE XS SM/MD LG/XL XXL CUBITAL TUNNEL BRACE X N/A N/A EPILOCK TENNIS ELBOW 1013 BEI-X N/A N/A RADIAL TENNIS ELBOW 0610 BLA-X WRIST, HAND AND THUMB SUPPORTS SUEDE WRIST LACER - 8" BLACK LEFT X N/A N/A SUEDE WRIST LACER - 8" BEIGE LEFT X N/A N/A N/A N/A SUEDE WRIST LACER - 8" BLACK X N/A N/A SUEDE WRIST LACER - 8" BEIGE X N/A N/A N/A N/A SUEDE WRIST LACER " BLACK LEFT X N/A N/A N/A N/A SUEDE WRIST LACER " BEIGE LEFT X N/A N/A N/A N/A N/A SUEDE WRIST LACER " BLACK X N/A N/A N/A N/A SUEDE WRIST LACER " BEIGE X N/A N/A N/A N/A N/A

7 WRIST, HAND AND THUMB SUPPORTS SUEDE WRIST LACER II - 8" BLACK LEFT X N/A N/A SUEDE WRIST LACER II - 8" BLACK X N/A N/A SUEDE WRIST LACER II " BLACK X N/A N/A N/A N/A N/A SUEDE WRIST LACER II " BLACK LEFT X N/A N/A N/A N/A N/A TRIPOD 8" WRIST LACER - LEFT X N/A N/A N/A N/A TRIPOD 8" WRIST LACER X N/A N/A N/A N/A 7.5" SUEDE THUMB SUPPORT N/A N/A N/A N/A N/A N/A N/A N/A 9" SUEDE THUMB SUPPORT N/A N/A N/A N/A N/A N/A N/A N/A BOXER SPLINT WRIST SUPPORT - LEFT X N/A N/A N/A N/A BOXER SPLINT WRIST SUPPORT X N/A N/A N/A N/A COMPRESSOR WRIST SUPPORT - LEFT X N/A N/A N/A N/A N/A COMPRESSOR WRIST SUPPORT X N/A N/A N/A N/A N/A GELFLEX WRIST - LEFT X N/A N/A N/A N/A N/A GLEFLEX WRIST X N/A N/A N/A N/A N/A MOTION MANAGER UNIVERSAL WRIST X N/A N/A N/A N/A ELASTIC WRIST SUPPORT OS6260-X N/A N/A N/A N/A N/A N/A ADJUSTABLE WRIST SUPPORT OS6261 N/A N/A N/A N/A N/A N/A N/A N/A FINGER IMMOBILIZING GLOVE SPLINT - M710D-X N/A N/A N/A N/A N/A FINGER IMMOBILIZING GLOVE SPLINT - LEFT M710I-X N/A N/A N/A N/A N/A WRIST ORTHOSIS WITH MODLABLE INSERT - LEFT WRIST ORTHOSIS WITH MODLABLE INSERT X-L N/A N/A N/A N/A N/A N/A 3920-X-R N/A N/A N/A N/A N/A N/A RESTORATIVE HAND ADULT - LEFT X N/A N/A N/A N/A RESTORATIVE HAND ADULT X N/A N/A N/A N/A MODIFIED RESTORATIVE HAND - LEFT X-MOD N/A N/A N/A N/A N/A N/A MODIFIED RESTORATIVE HAND X-MOD N/A N/A N/A N/A N/A N/A WRIST HAND ORTHOSIS - LEFT WHO-LX N/A N/A N/A N/A N/A N/A WRIST HAND ORTHOSIS - WHO-RX N/A N/A N/A N/A N/A N/A FUNCTIONAL POSITIONING ORTHOSIS - LEFT FPO-LX N/A N/A N/A N/A N/A N/A FUNCTIONAL POSITIONING ORTHOSIS - FPO-RX N/A N/A N/A N/A N/A N/A RYNO LACER WRIST/THUMB - SHORT LEFT UNIVERSAL N/A N/A N/A N/A N/A N/A N/A N/A

8 WRIST, HAND AND THUMB SUPPORTS RYNO LACER WRIST/THUMB - BLACK SHORT X N/A N/A N/A LEFT RYNO LACER WRIST/THUMB - BEIGE SHORT LEFT X N/A N/A N/A N/A RYNO LACER WRIST/THUMB - SHORT UNIVERSAL RYNO LACER WRIST/THUMB - BLACK SHORT RYNO LACER WRIST/THUMB - BEIGE SHORT RYNO LACER WRIST/THUMB - LONG LEFT UNIVERSAL RYNO LACER WRIST/THUMB - LONG UNIVERSAL N/A N/A N/A N/A N/A N/A N/A N/A X N/A N/A N/A X N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A RYNO LACER WRIST/THUMB - BEIGE LONG LEFT X N/A N/A N/A N/A RYNO LACER WRIST/THUMB - BEIGE LONG X N/A N/A N/A N/A RYNO LACER II WRIST/THUMB - BLACK SHORT RYNO LACER II WRIST/THUMB - BLACK SHORT LEFT RYNO LACER II WRIST/THUMB - BLACK LONG RYNO LACER II WRIST/THUMB - BLACK LONG LEFT X N/A N/A N/A N/A X N/A N/A N/A N/A X N/A N/A N/A N/A X N/A N/A N/A N/A CMC THUMB SUPPORT - LEFT X N/A N/A N/A N/A CMC THUMB SUPPORT X N/A N/A N/A N/A TEE PEE THUMB SUPPORT X N/A N/A N/A N/A CMC-X THUMB STABILIZER - LEFT X N/A N/A N/A N/A CMC-X THUMB STABILIZER X N/A N/A N/A N/A BREATHABLE THUMB IMMOBILIZING SPLINT M770X N/A N/A N/A N/A N/A N/A N/A MANUTEC BREATHABLE THUMB IMMOBILIZING SPLINT - MANUTEC BREATHABLE THUMB IMMOBILIZING SPLINT - LEFT MANUTEC SEMI-RIGID WRIST SUPPORT WITH PALMER SPLINT - SHORT MANUTEC SEMI-RIGID WRIST SUPPORT WITH PALMER SPLINT - SHORT LEFT MANUTEC SEMI-RIGID WRIST SUPPORT WITH THUMB SPLINT - SHORT MANUTEC SEMI-RIGID WRIST SUPPORT WITH THUMB SPLINT - SHORT LEFT FP-D74-X N/A N/A N/A N/A N/A N/A FP-I74-X N/A N/A N/A N/A N/A N/A MF-D52 x N/A N/A N/A N/A N/A N/A MF-I52 x N/A N/A N/A N/A N/A N/A MP-D72 x N/A N/A N/A N/A N/A N/A MP-I72 x N/A N/A N/A N/A N/A N/A CMC CARE THUMB BRACE - LEFT 8712L-X N/A N/A N/A N/A N/A N/A

9 WRIST, HAND AND THUMB SUPPORTS CMC CARE THUMB BRACE R-X N/A N/A N/A N/A N/A N/A MANUTEC FIX RIZART PLUS CMC THUMB BRACE - MANUTEC FIX RIZART PLUS CMC THUMB BRACE - LEFT ADJUSTABLE ELASTIC WRIST SUPPORT - UNIVERSAL M780D-x N/A N/A N/A N/A N/A N/A M780I-x N/A N/A N/A N/A N/A N/A ACE501 N/A N/A N/A N/A N/A N/A N/A N/A RESTORATIVE HYPER HAND - LEFT X N/A CODE ADULT INFANT TODDLER JR. TODDLER CHILD YOUTH RESTORATIVE HYPER HAND X N/A MODIFIED RESTORATIVE HYPER HAND - LEFT X - MOD N/A N/A N/A MODIFIED RESTORATIVE HYPER HAND X - MOD N/A N/A N/A NEUROFLEX RESTORATIVE FLEX HAND - LEFT 20721L N/A N/A N/A N/A N/A NEUROFLEX RESTORATIVE FLEX HAND R N/A N/A N/A N/A N/A NEUROFLEX RESTORATIVE FLEX HAND - LEFT REVERSE CONES NEUROFLEX RESTORATIVE FLEX HAND - REVERSE CONES NEUROFLEX RESTORATIVE PEDIATRIC FLEX HAND - LEFT NEUROFLEX RESTORATIVE PEDIATRIC FLEX HAND - NEUROFLEX RESTORATIVE PEDIATRIC FLEX HAND - LEFT REVERSE CONES NEUROFLEX RESTORATIVE PEDIATRIC FLEX HAND - REVERSE CONES 20721LRC N/A N/A N/A N/A N/A 20721RRC N/A N/A N/A N/A N/A 20720X N/A N/A N/A 20720X N/A N/A N/A 20720X N/A N/A N/A 20720X N/A N/A N/A REPLACEMENT LINERS AND STRAPS CODE UNIV. XXS XS SM MD LG XL XXL XXXL LINER FOR ADVANTAGE III TALL WALKER T3202x-SG N/A N/A N/A N/A N/A N/A LINER FOR ADVANTAGE III SHORT WALKER T3212x-SG N/A N/A N/A N/A N/A N/A LINER FOR FSX TALL PNEUMATIC WALKER T9842x-SG N/A N/A N/A N/A N/A N/A LINER FOR FSX SHORT PNEUMATIC WALKER T9852x-SG N/A N/A N/A N/A N/A N/A LINER FOR FP74 THUMB SPLINT FORRO-FP74-x N/A N/A N/A N/A N/A N/A

10 COMMENTS PLEASE FAX YOUR ORDER TO OR TO

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