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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)

Call us to find out if you may qualify for a shoulder brace as a Medicare covered benefit.

866-712-0881
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Shoulder pain has a wide variety of sources. You may have had a fall or another type of accident that led to a sprain, strain, rotator cuff injury or dislocation. Alternatively, you may have a chronic condition such as bursitis, arthritis, frozen shoulder or neuropathy.

Regardless of what caused your shoulder pain, a shoulder brace can often help. Shoulder braces offer support and compression, which keeps your joint in place and relieves pain. Plus, some of our shoulder braces come with adjustable telescoping arms, so you only need one brace for all positions.

Our shoulder braces are comfortable and easy to get on and off — you never have to worry about needing help.

For more information about what type of shoulder brace is best for your condition or whether your insurance will cover your purchase, contact us today.

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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