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/ EXOS® FORM™ II 621

EXOS® FORM™ II 621
EXOS® FORM™ II 621
EXOS® FORM™ II 621
EXOS® FORM™ II 621
EXOS® FORM™ II 621
EXOS® FORM™ II 621
EXOS® FORM™ II 621
EXOS® FORM™ II 621

EXOS® FORM™ II 621

The EXOS FORM™ II 621 provides superior stabilization of the sacroiliac (SI) joint through direct compression. Silicone grip strips prevent the brace from migrating.

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HCPCS Code

L0621

Key Features
  • ComfortCORE™ Foam
    Conforms to the unique contours of a patient’s body, adjusts instantly to individual movements.
  • Diamond2 Grid™
    Uniquely designed construct, delivers patients’ a more durable, longer-wearing brace.
  • BOA® Fit System
    The micro-adjustable BOA® Fit System allows for a fast, effortless, precision fit through a customizable and seamless level of support.
  • Adjustable Belt Wings
    Modifiable belt accommodates varying patient body structures for optimal fit.
  • Modular Design
    Step-up / Step-down design allows for single brace use through rehabilitation and recovery.
  • Semi-Universal Sizing
    Removable circumference tape allows for accurate patient sizing.
Indications for Use
  • Sacroiliac pain
  • low back pain
  • low pack sprains/strains
Manufacturer
DJO
Manuf. Part No.
  • 300621-40
    S/M
  • 300621-60
    L/XL
Size Chart
Size Measurement
S/M 28 - 50 in (71 - 127 cm)
L/XL 51 - 61 in (130 - 155cm)

Medicare Patients

Contact us with any questions about bracing or eligibility. We’ll make it easy for you. We'll even handle the paperwork should you qualify.

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Non-Medicare Patients

We are in-network with over 150 insurance plans, workers’ compensation, and no-fault insurance companies.

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Providers

Send us a referral and we will make sure your patient receives the right brace – fast. Our staff of professionals are on-hand and ready to serve.

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All of the staff is extremely helpful. Quality of product and business practices make it easy to do business with them.

Robert Dudzik

Great products for helping injured spinal patients through rehabilitation with chiropractic care. Highly recommended.

Office Caprow

Elite Medical Supply helped me with my knee brace that could not be located anywhere else near by. Kind people and very helpful.

Crystal Herberger

The quality of the braces have been excellent. They are a great asset in helping my patients obtain equipment to improve their health and speed up their recoveries.

Thomas Taylor

I have been working the Elite Medical for over 5 years. I have to say that of all the DME providers I have worked with in the past Elite by far is the best in this business.

Seth Blocker