EnlargeDrive DeVilbiss Healthcare
Viper Plus GT 16-inch wheelchair, swing-away footrest
Item DRIPLA416FBUARADSF
Wheelchairs & seating
View productRoscoe foam wheelchair cushion, 18 × 16 × 3 inches. Match the cushion dimensions to the seat and prescribed seating setup.
Wheelchairs & seatingItem ROSWCF183
Ask about the exact model, availability, documentation and your expected cost.
Medrax is an out-of-network supplier. Coverage and costs depend on the plan, item and required documentation.
Use the cushion dimensions and the prescribed seating arrangement to identify this accessory. The chair itself is a separate item.
This record is for a foam cushion, not a wheelchair. The listed cushion measures 18 × 16 × 3 inches.
Your plan may require a prescription, supporting records or authorization. Medrax’s out-of-network status also affects the review. A benefits estimate does not guarantee payment.
Confirm the exact item, availability, quantity and expected costs with Medrax. Use current manufacturer instructions and your clinician’s guidance for fitting, compatible parts and use.
How to request equipment