Private Health Insurance (Prostheses) Rules 2012 (No. 1) (Cth)
Made under item 4 of the table in section 333-20 of the
This compilation was prepared on 15 May 2012 taking into account amendments up to the
Prepared by the Department of Health and Ageing, Canberra
1. Name of Rules These Rules are the
Private Health Insurance (Prostheses) Rules 20 12 (No. 1) .
These Rules commence on 3 March 2012.
These Rules revoke the
Private Health Insurance (Prostheses) Rules 2011 (No. 2) as amended by thePrivate Health Insurance (Prostheses) Amendment Rules 2011 (No. 2) and thePrivate Health Insurance (Prostheses) Amendment Rules 2011 (No. 3) .
4. Definitions Note: Terms used in these Rules have the same meaning as in the Act―see section 13 of the
Legislative Instruments Act 2003 . These terms include:complying health insurance policy
hospital-substitute treatment
hospital treatment
medicare benefit
In these Rules:
accredited podiatrist means a podiatric surgeon who holds specialist registration in the specialty of podiatric surgery under the National Law.Note: The registration requirements for an accredited podiatrist for the purposes of these Rules are the same registration requirements for podiatric surgeons as set out in rule 8 of the Private Health Insurance (Accreditation) Rules.
Act means thePrivate Health Insurance Act 2007 .
certified overnight Type C procedure has the same meaning as in rule 3 of the Private Health Insurance (Benefit Requirements) Rules.
certified Type C procedure has the same meaning as in rule 3 of the Private Health Insurance (Benefit Requirements) Rules.
consultant physician has the same meaning as in subsection 3(1) of theHealth Insurance Act 1973.
gap permitted prosthesis means a prosthesis of a kind listed in the Schedule where an amount is set out for that kind of prosthesis in the column under the heading 'Minimum Benefit' and a different amount is set out in the column under the heading 'Maximum Benefit'.
implantable cardiac event recorder includes a component of an implantable cardiac event recorder.
insulin infusion pump includes a component of an insulin infusion pump.
listed prosthesis means a kind of prosthesis listed in the Schedule to these Rules.
listing application has the same meaning as in subsection 72-10(6) of the Act.
listing criteria has the same meaning as in subsection 72-10(6) of the Act.
National Law means:(a) for a State or Territory other than Western Australia — the Health Practitioner Regulation National Law set out in the Schedule to the
Health Practitioner Regulation National Law Act 2009 (Qld)as it applies (with or without modification) as law of the State or Territory; or(b) for Western Australia — the legislation enacted by the
Health Practitioner Regulation National Law (WA) Act 2010 that corresponds to the Health Practitioner Regulation National Law.Note: The Intergovernmental Agreement for a National Registration and Accreditation Scheme for the Health Professions that was made on 26 March 2008 provides for the enactment of the State and Territory legislation mentioned in this definition.
no gap prosthesis means a prosthesis of a kind listed in the Schedule where an amount is set out for that kind of prosthesis in the column under the heading 'Minimum Benefit' and no amount is set out in the column under the heading 'Maximum Benefit'.
private hospital means a hospital in respect of which there is in force a statement under subsection 121-5 (8) of the Act that the hospital is a private hospital.Note: Section 15 of the
Private Health Insurance (Transitional Provisions and Consequential Amendments) Act 2007 deals withthe status ofcertainhospitals for which a declaration had been made before the commencement of the Act.
professional attendance has the same meaning as in clause 1.2.3 of the General Medical Services Table being the table prescribed under section 4 of theHealth Insurance Act 1973 .
professional service has the same meaning as in subsection 3(1) of theHealth Insurance Act 1973 .
public hospital means a hospital in respect of which there is in force a statement under subsection 121-5(8) of the Act that the hospital is a public hospital.Note: Section 15 of the
Private Health Insurance (Transitional Provisions and Consequential Amendments) Act 2007 deals withthe status ofcertainhospitals for which a declaration had been made before the commencement of the Act.
Schedule means the Schedule in these Rules.
5. Listing of, and benefits for, prostheses For item 4 of the table in subsection 72-1 (2) of the Act:
(a) the Schedule lists the kinds of prostheses:
(i) in relation to which the Minister has granted an application for listing under subsection 72-10 (5) of the Act; or
(ii) which are listed in accordance with section 12 of the
Private Health Insurance (Transitional Provisions and Consequential Amendments) Act 2007 ; andNote: Section 12 of the
Private Health Insurance (Transitional Provisions and Consequential Amendments) Act 2007 deals with the listing of a prosthesis that was a no gap prosthesis or a gap permitted prosthesis for the purposes of theNational Health Act 1953 immediately before the commencement of the Act.(aa) circumstances in which a listed prosthesis is provided for the purposes of paragraph (d) of item 4 of the table in subsection 72-1(2) are set out in rule 5A; and
(ab) conditions that must be satisfied in relation to the provision of a listed prosthesis for the purposes of paragraphs (c) and (d) of item 4 of the table in subsection 72-1(2) are set out in rule 5B; and
(b) rule 6 sets out the method for working out the minimum benefit and maximum benefit for hospital treatment, covered under a complying private health insurance policy, that is the provision of a listed prosthesis; and
(c) rule 7 sets out the method for working out the minimum benefit and maximum benefit for hospital-substitute treatment, covered under a complying private health insurance policy, that is the provision of a listed prosthesis.
For the purposes of paragraph (d) of item 4 of the table in subsection 72-1(2) of the Act, the following circumstances are set out:
(a) the provision of a listed prosthesis which is associated with podiatric treatment by an accredited podiatrist.
Note: Paragraph (c) of Item 4 of subsection 72-1(2) deals with the provision of a listed prosthesis in circumstances in which a medicare benefit is payable.
For the purposes of paragraphs (c) and (d) of item 4 of the table in subsection 72-1(2) of the Act, conditions that must be satisfied in relation to the provision of a listed prosthesis in the circumstances covered by paragraph (c) or (d) of that item, as the case may be, are:
(a) in relation to any kind of prosthesis where there is a statement of a requirement under the heading 'Condition' in the Schedule under the listing for that kind of prosthesis, that requirement; and
(b) in relation to a listed prosthesis that is an insulin infusion pump, also:
(i) the professional service associated with the provision of the insulin infusion pump must be a professional attendance by a consultant physician in the practice of his or her specialty; and
(ii) the professional service must be provided as a certified Type C procedure or certified overnight Type C procedure; and
(iii) the insulin infusion pump must be provided for the purpose of administering insulin.
Note: Item 4 of the table in subsection 72-1(2) of the Act states other requirements in relation to benefits for the provision of prostheses that a policy that covers hospital treatment must meet. These requirements relate to benefits for hospital treatment and, if the policy covers hospital-substitute treatment, to the benefits of that coverage as well.
(1) For a no gap prosthesis provided as part of an episode of hospital treatment by a private hospital, the minimum benefit and the maximum benefit are each the amount for that prosthesis listed in the column in the Schedule under the heading ‘Minimum Benefit’.
(2) For a gap permitted prosthesis provided as part of an episode of hospital treatment by a private hospital:
(a) the minimum benefit is the amount for that prosthesis in the column in the Schedule under the heading ‘Minimum Benefit’; and
(b) the maximum benefit is the amount for that prosthesis in the column in the Schedule under the heading ‘Maximum Benefit’.
(3) For a no gap prosthesis provided as part of an episode of hospital treatment by a public hospital:
(a) the minimum benefit is the lesser of the following amounts:
(i) the amount for that prosthesis listed in the column under the heading ‘Minimum Benefit’ in the Schedule; or
(ii) the amount of the insured person’s liability to the public hospital for that prosthesis; and
(b) the maximum benefit is the amount for that prosthesis listed in the column under the heading 'Minimum Benefit'.
(4) For a gap permitted prosthesis provided as part of an episode of hospital treatment by a public hospital:
(a) the minimum benefit is the lesser of the following amounts:
(i) the amount for that prosthesis listed in the column under the heading ‘Minimum Benefit’ in the Schedule; or
(ii) the amount of the insured person’s liability to the public hospital for that prosthesis; and
(b) the maximum benefit is the amount for that prosthesis listed in the column under the heading ‘Maximum Benefit’ in the Schedule.
Note: Paragraphs (d) and (e) of subsection 72-10(5) of the Act deal with the fixing of minimum and maximum benefits when the Minister is making or varying the Private Health Insurance (Prostheses) Rules.
(1) For a no gap prosthesis provided as part of an episode of hospital-substitute treatment the minimum benefit and the maximum benefit are each the amount for that prosthesis listed in the column in the Schedule under the heading ‘Minimum Benefit’.
(2) For a gap permitted prosthesis provided as part of an episode of hospital-substitute treatment:
(a) the minimum benefit is the amount for that prosthesis in the column in the Schedule under the heading ‘Minimum Benefit’; and
(b) the maximum benefit is the amount for that prosthesis in the column in the Schedule under the heading ‘Maximum Benefit’.
Note 1: Private health insurers cannot cover, as part of hospital-substitute treatment, a service for which medicare benefit is payable unless the service is specified in the
Private Health Insurance (Health Insurance Business) Rules ― see paragraph 121-10 (3) (a) of the Act.Note 2: Paragraphs (d) and (e) of subsection 72-10(5) of the Act deal with the fixing of minimum and maximum benefits when the Minister is making or varying the Private Health Insurance (Prostheses) Rules.
As a matter of normal administrative practice, applications made under subsection 72-10 (2) of the Act will be considered after they have been received and, if the Minister decides to grant the application, the kind of prosthesis will be listed in the Schedule the next time the Minister makes or varies the Rules.
Note 1: Under subsection 72-10 (5) of the Act the Minister must list the kind of prosthesis, set out the minimum benefit and, if the Minister considers it appropriate, the maximum benefit for the prosthesis in these Rules on the next occasion that the Minister makes or varies the Rules after he or she grants an application and the applicant has paid to the Commonwealth any initial listing fee within 14 days of being informed of the Minister's decision to grant the application.
Note 2: Under subsection 72-15 (3) of the Act, the Minister may remove a kind of prosthesis from the list in the Rules if the applicant fails to pay an ongoing listing fee.
In making the decision under subsection 72-10 of the Act, the Minister may have regard to a recommendation from the Prostheses List Advisory Committee.
For a listing application to be granted to list a kind of prosthesis in Part C of the Schedule, the listing criterion is that the kind of prosthesis is an:
(i) insulin infusion pump; or
(ii) implantable cardiac event recorder.
Note: 1. The power to make listing criteria is in subsection 72-10(6) of the Act.
2. Under subsection 72-10(7) of the Act the Minister must not grant a listing application if any applicable listing criteria are not satisfied in relation to the application.
3. Under the Act the Minister may refuse to grant a listing application even if the listing criteria are satisfied. See Note to subsection 72-10(7) of the Act.
Part A - Prostheses List February 2012
AL003 MTA2UO - MTA6UO PMMA +5 to +30 D $156.00
BL005 Storz (Coburn) Intraocular Lens PMMA Anterior Chamber Intraocular lens 13.75mm length. 6.0mm optic $156.00
121UV; L122UV PMMA Anterior 1 piece size, diopter range 3-30d.
Chamber Lens L122UV: 6.0mm optic,
13.75mm length, power range;
5.0 to 30.0 Diopters
EG009 Artisan Anterior Chamber Intraocular Aphakia ModelComposition: PMMA 5.00mm Optic Diameter x 8.5 $156.00
Lens in overall length
AO019 Verisyse AC IOL Aphakic Model 5mm Optic Diameter x 8.5 $250.00
overall length
AO001 Intraocular Lens: Model AC 51L Duralens PMMA, Anterior Chamber IOL 6.00 mm Optic Diameter x $198.00
13.0mm in overall length
AO016 Verisyse AC IOL Phakic Intraocular Lens: Model Myopia. 5mm Optic Diameter x 8.5 $680.00
Composition: PMMA overall length; 6mm Optic
Diameter x 8.5 overall length
AO017 Verisyse AC IOL Phakic Intraocular Lens: Model 5mm Optic Diameter x 8.5 $680.00
Composition: PMMA overall length
Prostheses List by Category, Groups and Sponsor Page 1 of 944
EG012 Artisan Anterior Chamber IOL Phakic Intraocular Lens Myopic / 5.00mm Optic Diameter x 8.5 $680.00
Hyperopic in overall length;
AO030 Verisyse Toric (Custom) Phakic intraocular lens: Model toric 5mm Optic Diameter x 7.5mm $1,056.00
overall length
EG008 Artisan Anterior Chamber Intraocular Phakic Intraocular Lens: Model Toric 5.00mm Optic Diameter x 7.5 $1,056.00
Lens Composition: PMMA in overall length
AO029 Verisyse Toric (Custom) Phakic intraocular lens: Model toric 5mm Optic Diameter x 7.5mm $1,358.00
overall length
AL034 AcrySof Cachet Phakic Lens Anterior chamber foldable, acrylic, single -6.0 to -16.5 diopters, in 0.5 $723.00
piece phakic lens diopter increments
AO025 VeriFlex Foldable Phakic IOL Anterior chamber foldable phakic silicone -2 to -14.5d in 0.5d $723.00
intraocular lens increments. Overall diameter
8.5mm. Optic 6.0mm
EG010 Artiflex Anterior Chamber Intraocular Optic: Hydrophobic Polysiloxane. Haptic: 6mm optic diameter x 8.5 in $723.00
Lens PMMA overall length
AL002 Models MZ60BD, MC50BD, CZ70BD Other:PMMA Range of Powers :-10 to +34 D $156.00
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BL006 Posterior chamber IOLS model P359 PMMA Posterior Chamber lens 1 piece; 12.25mm to 13.75mm length. $156.00
UV, P399 UV, 68 UV, 95 BUV, or 5.5mm to 7mm optic size,
lolab PC One Piece, model 6741B, diopter range -4.5 - 45d to 10
8591B, 8191B; Model EZE-Fit 65 - 34d; EZE-Fit 65: 6.5mm
optic, 13.35mm length, Power
range: 10.0 to 30.0 Diopter
CZ016 CT ASPHINA 409M ZEISS Micro Incision Aaspheric 6mm optic, 11mm overall $364.00
(aberration neutral) IOL: Foldable, square- diameter. Diopter range 0.0 to
edged, single piece IOL for capsular bag +32.0D (0.5D steps from 10.0
fixation to 30.0D, 1.0D outside this
range)
CZ017 CT ASPHINA 509M ZEISS Micro Incision Aspheric 6mm Optic, 11mm overall $364.00
(aberration correcting) IOL: Foldable, diameter. Diopter range 0.0 to
square-edged, single piece IOL for +32.0D (0.5D steps from 10.0
capsular bag fixation to 30.0D, 1.0D outside this
range)
BL026 Akreos AO Micro Incision Lens Micro Incision, posterior chamber, 6mm optic overall diameter $374.00
foldable acrylic, aphakic, anterior & 11.0mm(10D-15D), 10.7mm
posterior edge modification, preloaded, (15.50-22D), 10.5mm (22.50-
with aberration contro, intraocular lens 30D)
CZ028 CT ASPHINA 409MP Preloaded, micro incision, aspheric Diopter range: 0.0 to 32.0D; $374.00
(aberration neutral), foldable square-edged Optic size: 6.0mm; Overall
single piece inraocular lens for capsular length: 11.0mm
bag fixation.
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CZ031 AT TORBI 709MP ( Standard Range ) Bitoric, preloaded, micro incision, aspheric Diopter range: Sph -10.0 to $760.00
(aberration neutral), foldable, square- 32.0, Cyl +1.0 to 6.5
edged, single-piece IOL for capsular bag Optic size: 6.0mm, Overall
fixation length: 11.0mm
CZ032 AT TORBI 709MP (high cyl) Bitoric, preloaded, micro incision, aspheric Diopter range: Sph -10.0 to $1,061.00
(aberration neutral), foldable, square- 32.0, Cyl +7.0 to 12.0, Optic
edged, single-piece IOL for capsular bag size: 6.0mm. Overall Length
fixation 11.0mm
CZ020 AT TORBI 709M STANDARD RANGE BITORIC - 6mm optic, 11mm overall $740.00
ZEISS Micro Incision Aspheric diameter. Diopter range: Sph
(abberation neutral) IOL: Foldable, +6.0 to +32.0D, Cyl +1.0 to
square-edged, single piece IOL for 6.5D (all 0.5D steps)
capsular bag fixation
CZ026 AT TORBI™709M LOW SPHERE BITORIC - ZEISS Micro 6mm optic, 11mm overall $740.00
Incision Aspheric (aberration neutral) diameter. Diopter range: Sph -
IOL: Foldable, square-edged, single piece 10.0 to +5.5D, Cyl +1.0 to
IOL for capsular bag fixation 6.5D (all 0.5D steps)
CZ027 AT TORBI 709M HIGH CYLINDER BITORIC - ZEISS 6mm optic, 11mm overall $1,041.00
Micro Incision Aspheric (aberration diameter. Diopter range: Sph -
neutral) IOL: Foldable square edged, 10.0 to +32.0D, +7.0 to 12.0D
single piece IOL for capsular bag fixation (all 0.5D steps)
XE002 Staar foldable silicone intraocular lens: Polyimide haptics 6.3mm optic - low 14.0mm length $281.00
Model AQ 5010V diopters
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XE001 Staar Toric foldable silicone intraocular Plate haptics 6.0mm optic 10.8mm - 11.2mm length $579.00
lens: Model AA4203TF; Model
AA4203TL
AL004 Acrysof Multipiece Models MA50BM, Foldable Acrylic Multi-piece Lens -5 D to +30 D $322.00
MA60AC
AL011 Acrysof Model SA60AT Foldable Acrylic Single-piece Lens, Range of Powers: +6 to +40 D $322.00
asymmetric optic/consistent edge
AO002 Sensar AR40 Monofocal Acrylic IOL, Soft Acrylic, Foldable, UV Absorbing, 6 mm Optic Diameter x 13mm $322.00
Sensar OptiEdge AR40e Foldable Posterior in overall length.
Acrylic IOL
AO006 Clariflex, Model CLRFLXB Posterior Foldable Silicone IOL with OptiEdge One size only $322.00
Chamber Intraocular Lens design
BL020 Akreos Adapt acrylic foldable posterior Composition: Hydrophilic acrylic polymer. 10.0 to 15.0 Diopter in 1.0 $322.00
chamber intraocular lens Packaged in lens folding device in a sterile Diopter increments15.0 to
Four haptic design 25.0 Diopter in 0.5 Diopter
increments25.0 to 30.0
Diopter in 1.0 Diopter
increments
BL021 SoflexSE, Intraocular lenses, Posterior Composition: silicone, Lenses - foldable, Range of powers: 5.0 to 30.0 $322.00
Chamber posterior chamber intraocular lenses Diopter - Optic diameter
6.0mm; 13.0mm length
CZ003 Intraocular Lens: Model Bigbag Hydrophilic acrylic, foldable, PC, single 6.5mm optic diameter x 10.35 $322.00
piece, Tri-haptic, square edge design, UV overall diameter
blocker
CZ029 CT 53N Foldable, 3-piece, monofocal, square- Diopter range: 0.0 to 40.0, $322.00
edged, hydrophilic acrylic (with Optic size: 6.0mm, Overall
hydrophobic surface properties) length: 13.0mm
intraocular lens for capsular bag or sulcus
fixation.
Prostheses List by Category, Groups and Sponsor Page 5 of 944
XE003 Staar foldable silicone IOLs: Models Plate haptics 6.0mm; Polymide haptics 5.5 10.8mm 0 13.5mm length $322.00
AQ2010V, AQ2017V and AO2003V or 6.3mm optic;
KG001 Rayner C-Flex Hydrophilic HEMA-MMA copolymer, 5.75mm dia optic, 12.00mm $322.00
foldable with injector dia overall
KG002 Superflex Hydrophilic HEMA-MMA copolymer, 6.25mm dia optic, 12.5mm dia $322.00
foldable with injector overall
AO014 TECNIS™ Intraocular Lens (Z9002 & Foldable Intraocular Lenses - Ultraviolet 5-10 dioptre in 1.0 dioptre $364.00
ZA9003) light absorbing posterior chamber increments; 10.5 - 30 dioptre in
intraocular lenses, Silicone/Acrylic 0.5 increments
AO024 Tecnis™ One Piece (ZCB00) One piece intraocular lens with edge +6 diopters to +30 diopters in $364.00
modification and 360 degree square edge 0.5d increments
BL022 SofPort Advanced Optic (AO) Posterior chamber, foldable silicone IOL 0 D to 30.0 D $364.00
with anterior optic-haptic square edge,
posteriof optic-haptic square edge, 360-
degree optic square edge and asperic optic
for aberration control
BL023 Akreos Advanced Optic Posterior chamber, foldable acrylic IOL, 0 D to 30.0 D $364.00
with anterior optic-haptic square edge,
posterior optic-haptic square edge, 360
degree optic square edge and aspheric
optic for aberration control
BL030 enVista The enVista, Model MX60, is an ultra- Overall diameter 12.5mm, optic $364.00
violet-absorbing, posterior chamber, body diameter 6.0mm in
hydrophobic acrylic one-piece intraocular dioptric powers ranging from
Has an aspheric lens optic, +0.0 to +34D
square posterior edge, modified C haptics 0.0D to 10.0D in 1 Diopter
and available in dioptric powers ranging increments
from +0.0 to +34.0D. 11.0D to 30.0D in 0.5 Diopter
increments
31.0D to 34.0D in 1 Diopter
increments
Prostheses List by Category, Groups and Sponsor Page 6 of 944
CZ030 CT ASPHINA 404 Small incision, foldable, single piece, Diopter range: -10.0 to 42.0, $364.00
monofocal, aspheric (aberration neutral), Optic size: 6.0mm, Overall
square-edged, hydrophilic acrylic (with length: 11.0mm
hydrophobic surface properties)
intraocular lens for capsular bag fixation.
(Monofocal lens for powers outside
standard 409MP MICS range).
IQ004 Softec Acrylic, single piece, foldable intraocular Available in dioptric powers $364.00
lens with anterior and posterior optic- from -5.0 to +36.0, 1D steps: -
haptic square edge, 360 degree optic 5.0 to +10.0 and +31.0 to
square edge design, precision power +36.0; 0.5D steps: +10.5 to
calculation and aberration technology +18.0 and +25.0 to +29.5;
0.25D steps: +18.0 to +25.0
IQ010 PreciSAL 302AC Acrylic, single piece, foldable intraocular Available in dioptric powers $364.00
lens with anterior and posterior optic- from 0.0 to +30.0. 1D steps:
haptic square edge, 360 degree optic 0.0 to +10.0; 0.5D steps:
square edge design, precision power +10.5 to + 17.5 and +28.5 to
calculation, aberration technology and UV +30.0; 0.25D steps: +18.0 to
light filter. +28.0
KG012 Rayner "C-Flex" and Superflex" Aspheric Intra Ocular Lenses with Amon- C-Flex -970C + 22.5D to $364.00
Aspheric IOL Apple enhanced 360 Degree square edge, +34D Superflex-920H - 10D
Anti-vaulting Haptics to +22D
CZ011 CT ASPHINA 603P Aspheric, pre-loaded, hydrophilic acrylic, 6.0mm Optic x 10.5mm Overall $374.00
single piece, trihaptic IOL with square Diameter
edge design, for use with SkyJet injector
XE004 Preloaded Aspheric Intraocular Lens Silicone intraocular lens 6.0mm $374.00
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DV253 HOYA AF-1 351 Toric T3/T4/T5 Preloaded injector system, correct corneal IOL Power: + 6.0D to 30.0D $800.00
astigmatism micro-incision, ashperic, blue- (0.5 steps), IOL Cylinder
blocker, single piece hydophobic. power: 1.50D (T3), 2.25D
(T4), 3.00D (T5).
AL024 AcrySert model SN60WS Foldable Acrylic Single-piece Lens with +6 to +30 D $405.00
Blue light protection and aspheric
correction, in cartridge.
AL031 AcrySert C Model SN6CWS Posterior chamber, UV absorbing, +6.0 to +30.0 D $405.00
foldable, acrylic, single piece lens with blue
light protection and aspheric correction, in
cartridge
DV250 Hoya-PS AF-1 (UY) PY-60AD Preloaded in cartridge, Aspheric, Blue +6.0D to +30.0D (0.5D steps) $405.00
blocker, Foldable, Single-Piece,
Hydrophobic Acrylic
DV252 HOYA iSert® 251 Preloaded injector system, Micro-incision, +6.0D to 30.0D (5 steps) $405.00
Aspheric, Blue-Blocker, Single Piece,
Hydrophobic
AO031 TECNIS® Toric 1-Piece IOL 1-piece IOL Posterior chamber +5.0 to +34.0 diopter powers $740.00
Intraocular lens, incorporates a proprietary in 0.5 diopter increments.
wavefront designed toric aspheric optic Cylinder power: 1.00 diopter,
with a squared posterior optic edge 1.50 diopter, 2.25 diopter,
designed to provide a 360 degree barrier. 3.00 diopter and 4.00 diopter
The edge of the optic has a frosted design (as measured at the IOL plane).
to reduce potential edge glare effects. Overall diameter 13mm, Optic
size 6mm.
AL021 Alcon AcrySof SN60WF Foldable Acrylic Single-piece Lens with + 6.0 D to +30.0 D $385.00
Blue Light Protection and Aspheric
Correction
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BL025 SofPort Advanced Optic (AO) Violet Posterior chamber, aphakic, foldable 6mm optic 13mm overall length $385.00
Shield silicone, anterior & posterior edge Modified C 5 degree
modification intraocular lens with angulation 0-30D, 0.5D steps
aberration technology, a violet light
DV247 HOYA AF-1 iMics1 NY-60 Mini Incision, Aspheric, Blue-blocker, +6.0D to 30.0D (0.5 steps) $385.00
Single-piece, Hydrophobic
IQ009 Softec HDY Acrylic, single piece, foldable intraocular Available in dioptric powers $385.00
lens with anterior and posterior optic- from -5.0 to + 36.0, 1D steps:
haptic square edge, 360 degree optic -5.0 to +10.0 and +31.0 to
square edge design, precision power +36.0; 0.5D steps: +10.5 to
calculation, aberration technology and blue +18.0 and +25.0 to 29.5;
light filter 0.25D steps: + 18.0 to +25.0
IQ011 PreciSAL 302A Acrylic, single piece, foldable intraocular Available in dioptric powers $385.00
lens with anterior and posterior optic- from 0.0 to +30.0. 1D steps:
haptic square edge, 360 degree optic 0.0 to +10.0; 0.5D steps:
square edge design, precision power +10.5 to +17.5 and +28.5 to
calculation, aberration technology and blue +30.0; 0.25D steps: +18.0 to
light filter. +28.0
XE005 Staar KS-Xs Preloaded Acrylic Preloaded acrylic lens with anterior and Optic diameter 6.0mm, overall $332.00
Intraocular Lens posterior edge modification length 12.5mm, diopter range
+10 to +28.0
BL028 Akreos Toric Astigmatism- Correcting Single piece, foldable, acrylic intraocular The overall diameter is 11 $698.00
Lens lens with a toric optic on the posterior millimetres for the entire lens
surface and axis marks on the posterior power range (spherical
optic's flat meridian. equivalent powers from +10.0
to +30.0 diopters in 0.5 diopter
steps and cylinder powers of
+1.25, +2.00 & +2.75
diopters).
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KG003 Rayner Standard Toric C-Flex Hydrophilic HEMA-MMA copolymer, 5.00mm dia optic, 12.00mm $698.00
foldable with injector dia overall, cyls 2.0D to 6.0D in
2D increments
AL032 AcrySof IQ Toric IOL Posterior chamber, UV absorbing, +6 to +30 D spherical; 1.00 to $780.00
foldable, acrylic, toric, single piece lens 6.00 D cylinder.
with blue light protection and aspheric
correction
DV251 HOYA AF - 1 311 Toric T3/T4/T5 Correct Corneal Astigmatism, Micro- lOL Power: 6.0D to 30.0D $780.00
incision,Aspheric, Blue-Blocker, Single (0.5 steps)lOL Cylinder
Piece, Hydrophobic Power: 1.50D (311T3), 2.25D
(311T4), 3.00D (311T5)
AL023 Alcon AcrySof Toric PC IOL Models Posterior chamber, UV absorbing, +6 to +34 D spherical; 1.50 to $740.00
foldable, acrylic, toric, single piece lens 6.00 D cylinder
with blue light protection
KG004 Rayner Premium Toric C-Flex HEMA-MMA copolymer, foldable with 5.75mm dia optic, 12.00mm $1,000.00
injector dia overall, cyls 1.5D to 11.0D
in 0.5D increments
KG013 Rayner Super Premium Toric I.O.L. Acrylic foldable toric single piece I.O.L -10.0D to 0.00D Sphere: 1D to $1,000.00
11.00D Cylinder in 0.25 steps
+31.00D to +35.00 Spit:
1D to 11.00D Cylinder in
0.25steps
AL016 Alcon Acrysof Natural Model SN60AT Foldable Acrylic Single-piece Lens, +6 to +40D $364.00
asymmetric optic/consistent edge, with
blue light protection
Prostheses List by Category, Groups and Sponsor Page 10 of 944
AL025 AcrySof Multipiece Models MN60MA, Foldable Acrylic multi-piece Lens with - 5 D to + 30 D $364.00
MN60AC Blue light Protection
AO020 ReZoom Acrylic Multifocal Intraocular Acrylic, foldable, posterior chamber, 6.0mm Optic Diameter x $780.00
Lens intraocular lens 13.0mm overall length
AO023 TECNIS™ Multifocal Intraocular Lens Tecnis Multifocal foldable Posterior +5.0 Diopter to 34.0 Diopter in $780.00
(ZM900) Chamber Diffractive Intraocular Lens 0.5 diopter increments
Posterior Chamber lens
with UV light-absorbing, foldable, silicone,
3 piece with a diffractive posterior optic
and a Modified Prolate Anterior Surface
Technology
AO026 TECNIS™ Multifocal Intraocular Lens Posterior chamber lens with UV light- +5 diopters to +34 diopters in $822.00
(ZMA00) absorbing, foldable acrylic, 3-piece with a 0.5d increments
diffractive posterior optic and a modified
anterior surface technology with edge
modification and 360 degree square edge.
AO027 Tecnis Multifocal 1-Piece Lens, Model A multifocal posterior chamber lens with 6.0mm Optic Diameter x $822.00
ZMB00 UV-blocking, foldable acrylic, 1-piece 13.0mm in overall length. +5.0
with a diffractive posterior optic and a Diopter to +34.0 Diopter in 0.5
modified anterior surface technology with Diopter increments.
edge modification and a 360 degree
square edge.
CZ015 AT LISA 809M ZEISS micro incision, aspheric multifocal 6mm optic, 11mm diameter. $822.00
Diffractive bifocal anterior surface Diopter range 0.0D to +32.0D
with asymmetric light distribution (65% (0.5D steps)
distance / 35% near), 3.75D addition for
near focus.
Prostheses List by Category, Groups and Sponsor Page 11 of 944
KG009 Rayner "M-Flex" Mulitfocal Foldable IOL Acrylic, Foldable, Single piece multi-zoned 6.5mm Optic-Overall diameter $822.00
refractive aspheric multifocal with Amon- 12.5mm: +3D or + 4D
Apple 360 Degree Square edge, Anti Addition: +14D to +25D in
Vaulting Haptics 1.0D increments: +8.5D to
+23.5D in 0.5D increments
CZ033 AT LISA 809MP Preloaded, micro incision, aspherical Diopter range: 0.0 to 32.0 $842.00
bifocal, square edged, single-piece IOL for Optic size: 6.0mm. Overall
capsular bag fixation. The anterior length: 11.0mm
aspheric bifocal surface has an asymmetric
light distribution 65/35 for distance/near
vision, and 3.75D add for the near focus.
AL028 AcrySof IQ ReSTOR SN6AD3 Posterior Chamber, UV absorbing, +6 D to + 34 D $864.00
foldable, acrylic, single piece lens with
apodised diffractive optic and blue light
protection
AL030 AcrySof IQ ReSTOR SN6AD1 and Posterior Chamber, UV absorbing, +6 D to + 34 D $864.00
MN6AD1 foldable, acrylic, single and multiple lenses
with apodised diffractive optic and blue
light protection
DV248 HOYA PY-60MV Preloaded in cartridge, Multifocal, +14.0D to 27.0D (0.5 steps) $864.00
Aspheric, Blue-blocker, Single Piece,
Hydrophobic
CZ025 AT LISA toric 909M ZEISS micro incision, multifocal toric IOL 6mm optic, 11mm diameter. $1,198.00
(standard cyl range). Aspheric toric Diopter range: Sph -10.0D to
anterior surface, diffractive bifocal +32.0D, Cyl +1.0 to 6.5D (all
posterior surface with asymmetric light 0.5D steps)
distribution (65% distance / 35% near),
3.75D addition for near focus.
Prostheses List by Category, Groups and Sponsor Page 12 of 944
KG010 Rayner M-Flex Toric (Standard) Acrylic, Foldable, Single Piece, Multi- 5.75mm / 12.0mm: 6.25mm / $1,198.00
zoned Refractive Aspheric Toric Mulitfocal 12.5mm +3.00D or +4.00D
with Amon-Apple enhanced 360 degree Addition FAR: +14.0D to
Square edge, Anti Vaulting Haptics +32.00D in 0.5 STEPS:
+4.00D
Cylinder. NEAR: +14.0D to
27.0D in 0.5 STEPS: +2.00D
+4.00D Cylinder
KG011 Rayner "M-Flex" Toric (Non Standard) Acrylic, Foldable, Single Piece, Muli- 5.75/12.0mm: 6.25/12.5mm $1,198.00
Zoned Refractive, Toric Multifocal with +3.00D to +4.00D Addition
Amon-Apple enhanced 360 Degree FAR: +14.0D to +32.0D in
square edge, Anti-vaulting Haptics, Patient 0.5D Increments: NEAR:
Specific. +14.0D to +27.0D in 0.50D
Increments Cylinder: 1.0D to
1.5D and 2.5D to 6.00D in 0.5
increments
AL033 AcrySof IQ ReSTOR multifocal toric IOL Posterior chamber UV absorbing foldable, +6 to +34 D spherical; 1.00 to $1,240.00
acrylic, aspheric, toric single piece lense 3.00 D cylinder
with apodised diffractive optic and blue
light protection.
CZ024 AT LISA toric 909M ZEISS micro incision, multifocal toric IOL 6mm optic, 11mm diameter. $1,500.00
(standard cyl range). Aspheric toric Diopter range: Sph -10.0D to
anterior surface, diffractive bifocal +32.0D, Cyl +7.0 to 12.0D (all
posterior surface with asymmetric light 0.5D steps)
distribution (65% distance / 35% near),
3.75D addition for near focus.
Prostheses List by Category, Groups and Sponsor Page 13 of 944
BL027 Crystalens HD Accommodating lens with > 3 Dioptres of 10.0 to 33.0 Dioptres in .05 $780.00
accommodation with dual mechanism of Dioptre steps
action: (1) forward axial movement of lens
Posterior chamber, polyspheric optics, 3-
piece, plate haptic, foldable UV light
filtering, bic
IQ003 Tetraflex Acrylic single piece, foldable Available in dioptric powers $780.00
accommodating intraocular lens with sqare from +5.0 to +36.0, 1D steps:
edge design, custom control precision and +31.0 to +36.0; 0.5D steps:
closed loop haptic design +5.0 to +18.0 and +25.0 to
+30.0; 0.2D steps; +18.0 to
+25.0
BL029 Crystalens AO Accommodating lens designed to provide 10.0 to 33.0 D in 0.50 Diopter $822.00
> 3 Diopters of accommodation with dual steps. 10.0 - 16.5 Diopters
mechanism of action: (1) forward axial (12mm length) and 17.0 - 33.0
movement of lens and (2) accommodative Diopters (11.5mm length).
Posterior chamber,
aspheric, aberration free optics, 3-piece,
plate haptic, fol
AO028 Synchrony Accommodating IOL Synchrony Dual Optic Accommodating 5.50mm Anterior Optic, $800.00
Posterior Chamber IOL 6.00mm Interior Optic,
9.80mm Overall Length,
Diopter Range: +16.00 to
+28.00 in 0.5D Increments
Prostheses List by Category, Groups and Sponsor Page 14 of 944
DV246 Rayner Sulcoflex Ashperic (Premium) Pseudophakic Supplementary I.O.L.O.L. -10.0D to -5.50D in 0.5D $323.00
I.O.L. increments. +5.50D
to 10.00D in 0.5D increments
KG008 Rayner "Sulcoflex" Pseudophakic I.O.L. Sulcoflex Aspheric Pseudophakic I.O.L -5D to +5D $365.00
KG005 Rayner Sulcoflex Aspheric Toric Acrylic, Aspheric, Toric Pseudophakic SE -3 to +3 in 0.5 D steps $698.00
Pseudophakic Secondary I.O.L - Secondary IOL: Sulcus fixated with Cyl +1 to +3 in 1D steps
Standard undulating Haptics and Posterior Haptic
Angulation (Standard)
KG007 Rayner Sulcoflex Aspheric Toric Acrylic, Aspheric, Toric Pseudophakic SE -6.00 to +6.00 in 0.5 D $698.00
Pseudophakic Secondary IOL (Premium) Secondary IOL: Sulcus fixated with steps Syl +1.00 to +6.00 in
undulating Haptics and Posterior Haptic 0.5D steps
Angulation (Premium)
KG006 Rayner "Sulcoflex" Aspheric Multi-focal Acrylic, Aspheric Multi-focal 6.5mm / 13.5mm - $822.00
Pseudophakic Secondary IOL Pseudophakic Secondary IOL: Sulcus- 5.00D+5.00D sphere with +
Fixated with Undulating Haptics and 3.00 Addition
Posterior Haptic Angulation
AL006 PROVISC VISCOELASTIC PROVISC contains sodium hyaluronate 0.85mL pack $80.00
SOLUTION
Prostheses List by Category, Groups and Sponsor Page 15 of 944
AL007 VISCOAT Viscoelastic Fluid Chondroitin sulfate and sodium hyaluronate 0.75mL $80.00
AL015 Cellugel viscoelastic fluid Hypromellose 2%. $80.00
AL029 DisCoVisc Ophthalmic Viscosurgical Sodium hyaluronate 17 mg/mL and 0.5 mL and 1.0 mL $80.00
Device chondroitin sulfate 40mg/mL
AO008 Healon, Intraocular Viscoelastic Fluid Sodium Hyaluronate 10mg/ml Healon 0.4ml, 0.55ml & 0.85ml $80.00
BL008 Ocucoat Intraocular Fluid 20mg/mL hydroxypropylmethyl cellulose 1mL sterile $80.00
for intraocular use
BL015 Amvisc Plus injection 15mg/mL Sodium Hyaluronate for 0.5mL and 0.8mL $80.00
intraocular use
CZ022 VISTHESIA 1.5% VISCOANAESTHETIC syringe contains 0.8ml syringe & 2x0.3ml $80.00
sodium hyaluronate ( NaHA, 1.5%) and ampoules
lidocaine hydrochloride (1%). Also
contains two topical ampoules with NaHA
(0.3%) and lidocaine (2%)
IQ002 Ocuvis and Ocumax 2% 20mg/mL hydroxypropylmethyl cellulose 2mL sterile $80.00
Hydroxypropylmethylcellulose for intraocular use. Pre-loaded in a sterile
syringe with one cannula for injection, in a
sterile Tyvek pouch
AO009 Healon 5, Intraocular Viscoelastic Fluid HEALON5- Sodium hyaluronate 23mg/ml 0.6ml $85.00
.
AO010 Healon GV Intraocular Viscoelastic Fluid Sodium Hyaluronate 14mg/mL 0.5mm and 0.85ml $85.00
CZ012 Z-HYALIN Viscoelastic Cohesive Viscoelastic Solution - sodium Volume 1.0ml $85.00
(previously called
Ophthalin)
Prostheses List by Category, Groups and Sponsor Page 16 of 944
CZ013 Z-HYALIN Plus Viscoelastic Cohesive Viscoelastic Solution - sodium Volume 1.0ml $85.00
(previously called
Opthalin Plus)
AL005 DUOVISC VISCOELASTIC PROVISC contains sodium hyaluronate, Small & large packs $110.00
SYSTEM VISCOAT contains chondroitin sulfate
and sodium hyaluronate
CZ019 TWINVISC Viscoelastic TWINVISC includes a cohesive and a Total volume 1.4 ml $110.00
dispersive viscoelastic in one syringe,
Dispersive: sodium
Cohesive: sodium
hyaluronate (1%)
DV231 Vision Blue Trypan blue dye for ophthalmic applications 0.5ml syringe $48.00
AL001 Capsular Tension Rings - 10.0 - 12.0 compressed, 12.3 $159.00
- 14.5 uncompressed
AO021 Stabileyes Capsular Tension Ring Polymethylmethacrylate (PMMA) Implant 12mm ring, and 13mm ring $159.00
CZ002 Tensiobag: Capsular Tension Ring PMMA Diameter 10 - 14mm $159.00
Prostheses List by Category, Groups and Sponsor Page 17 of 944
DV009 Morcher Capsular Tension Ring PMMA Implant 14, 14A, 14C $159.00
EG001 Capsular Tension Rings Clear PMMA Implant 10/08, 12/10, 13/11mm $159.00
DV029 Eyejet CRT Capsular tension ring made of PMMA 14 (10mm), 14C (11mm), 14A $243.00
per-load on disposable injector (12mm)
IS001 Preloaded Capsulan Tension Ring Capsular tension ring preloaded (acrylic) 13/11mm $243.00
DV010 Morcher Coloboma Diaphram PMMA Implant 96G, 96L $334.00
AO012 Baerveldt Glaucoma Implant BG 101- Non-valved artificial drainage device, Surface area 250, 350, 425mm2 $425.00
350, Baerveldt Glaucoma Implant BG composition silicone - smooth, tumble-
103-425, Baerveldt Glaucoma Implant polished finish
BG 103-250
DV020 Molteno Implant Double plate - dual chamber One size only $425.00
DV242 Molteno Implant Glaucoma Drainage Device - Single N/A $425.00
Plate/Single Plate-Dual Chamber/Double
Plate
DV230 Molteno 3 Drainage implant for glaucoma, made of 2 Sizes: *230 mm square $625.00
silicon *175mm square
Prostheses List by Category, Groups and Sponsor Page 18 of 944
AL037 ExPress Minature Glaucoma Shunt Miniature Glaucoma Shunt 50 & 200 microns $715.00
SO017 FCI Ptose-up Expanded PTFE 15cm long x 2 or 3mm wide x $348.00
0.35mm thick
DE183 Lid Load Gold Eyelid Weights; Gold 0.6, 0.8, 1.0, 1.2, 1.4, 1.6 $425.00
grams
DE182 Lid Load Gold Eyelid Weights; Gold 1.8, 2.0, 2.2, 2.4, 2.6, 2.8 $800.00
grams
RC001 LIDCHAIN Platinum Eyelid Implant Platinum Weights - 0.8, 1.0, 1.2, 1.4, $1,300.00
1.6, 1.8 grams
Prostheses List by Category, Groups and Sponsor Page 19 of 944
DV022 Eyetec DCR Tubes Stainless steel, silicone tubing, Bodkin 30cm $135.00
lacrimal intubation set
DV241 Eyetec DCR Tubes Crawford and Cannaliculus Intubation Sets N/A $135.00
DE191 Canaliculus Intubation Sets Silicone, SS & Nylon 17.7 x .064 x 29cm, 15.5 x $135.00
.051 x 33cm
DE278 BD Visitec Lacrimal Intubation Sets Stainless steel probes with solid silicone 1. Probes 0.90mm x 4.5cm, $135.00
rods or silicone tubing - packaged sterile rod 40cm x 0.80mm. 2. Probes
0.40mm x 11cm, tubing 35cm
x 0.64mm. Probes 0.60mm x
11mm, tubing 35cm x 0.30mm.
SO021 FCI Lacrimal Intubation Set PVP Coated Silicone Tubing/PVP Coated PVP Bika: 0.64mm O.D. $135.00
Silicone Plug/Metal Probes/Polypropylene Tube/80 x 0.8mm probes, PVP
Thread Differential Bika: 0.64 &
1.18mm O.D. Tube/40 x
1.2mm probes, PVP Bika for
DCR: 0.94mm O.D. Tube/50 x
0.8mm probes, PVP Infant
Bika 0.64mm O.D. Tube/55 x
0.7mm probes, PVP Infant
Bika II: 0.64mm O.D. Tube/
SO043 FCI Bi-Canalicular Lacrimal Intubation Silicone tubing swaged, imbedded into or Probes: 40mm to 120mm x $135.00
Set around malleable and flexible stainless steel 0.7mm to 1.2mm. Tube:
probes. PEEK thread. 0.64mm to 1.18mm x 25mm to
PEEK Thread: 0.2mm
to 0.4mm x 500mm.
Prostheses List by Category, Groups and Sponsor Page 20 of 944
SO044 FCI Mono-Canalicular Lacrimal Silicone tubing with plug swaged, Probes: 40mm to 120mm x $180.00
Intubation Set imbedded into or around malleable or 0.7mm to 1.2mm. Tube:
flexible stainless steel probes or guides. 0.64mm to 1.18mm x 30mm to
PEEK thread. Introducer. 350mm. PEEK Thread: 0.2mm
Plug
Collar: 2mm to 4mm.
DE177 Lester Jones Tear Duct Tubes Glass 3 x 9 to 16mm, 3.5 x 9 to $84.00
18mm, 4.0 x 9 to 24mm, 5.0 x
9mm
DE188 Acrylic Implant Acrylic 12, 14, 16, 18, 20mm. $55.00
DE202 John Weiss Glass Mule Globes Glass No: 12, 14, 16, 18, 20mm $55.00
SO040 FCI Orbital Implants Silicone - Sterile 12mm to 22mm $55.00
SO006 FCI Orbital Implants Orbital Implant, Bioceramic (Aluminium Bioceramic diameter, 12, 14, $1,200.00
Oxide)/Hydroxyapatite (Synthetic) 16, 18, 20, 21, 22mm;
Synthetic Diameter, 10, 12, 14,
16, 18, 20, 22mm
Prostheses List by Category, Groups and Sponsor Page 21 of 944
SK521 Sphere Orbital Sphere Models 6316, 6326, 6327, Orbital Sphere Models 6316: $785.00
6317 and 6322 8702-8704. COI implant, 14mm, 6326: 16mm, 6327:
models 7222, 7223 & 80026. MCOI 18mm, 6317: 20mm, 6322:
implant, models 7207 - 7209 Quad 22mm, 8702: 19mm, 8703:
Motility Implants 9866 - 9868 & 80022 21mm, 8704: 23mm, COI
Implants 7222: Approx 4ml,
7223: Approx 5ml, 80026:
Approx 6ml, MCOI 7207:
Approx 3ml, 7208: Approx
7209: Approx 5.6ml,
QUAD Motility Small 16ml,
Medium: 18ml, Large: 20ml,
Extra Large: 22ml.
SO007 FCI Orbital Implants Mesh wrapped orbital implant: mesh Bioceramic diameter: 16, 18, $1,600.00
wrapped bioceramic (aluminium oxide), 20, 22mm; Synthetic
mesh wrapped hydroxyapatite (synthetic), Hydroxyapatite diameter: 16,
mesh wrap (polyglycolic acid) 18, 20, 22mm
SO019 FCI Orbital Implants Peg & Sleeve Standard Large $863.00
DE277 Frontalis Suspension Set Stainless steel needles with solid silicone needles 0.90mm x 6.5cm, rod $315.00
rods and silicone tubing - packaged sterile 40cm - 0.80mm, sleeve 10 x
2mm
Prostheses List by Category, Groups and Sponsor Page 22 of 944
SO045 FCI Ptosis Probes Stainless steel needle probes swaged with 80mm x 0.8mm needle probes, $315.00
silicone tubing. 280mm 0.64mm tubing.
AP003 Mira: Scleral Implants Solid Silicone- Tires-Mira 286 Wendel $45.00
Tire/Meridional/Wedge/Pad. Retinal Symmetrical Oval Tire 6mm,
Implant used in Scleral Buckling Mira Symmetrical Oval Tire
(Dimethylmethylvinyl Siloxane Copolymer) 7mm, Mira 287WG Murray
wide (3.5mm) grooved
symmetrical tire, 10mm wide,
Mira 288 ross symmetrical
grooved tire, low profile 10mm
wide by 2.5mm, Mira 289
Symmetrical oval tire 10m
AP004 Mira: Scleral Implants Solid Silicone-Sleeve. Retinal Implant used Sleeves-Mira 70 Sleeve 1mm $45.00
in Scleral Buckling (Dimethylmethylvinyl I.D., Mira 71 Sleeve 1mm I.D.,
Siloxane Copolymer) Mira 72 McNutt Sleeve
1.57mm I.D., Mira 270 Sleeve
0.76mm I.D.
AP006 Mira: Scleral Implants Solid Silicone-Band/Strip/Boat/Clip. Bands-Mira 40 Circling Band $45.00
Retinal Implant used in Scleral Buckling 2mm, Mira 240 Circling Band
(Dimethylmethylvinyl Siloxane Copolymer) 2.5mm. Strips-Mira 41 Strip
3.5mm, Mira 42 Strip 4mm,
Mira 20 Strip 4mm, Mira 219
Strip 4.5mm, Mira 31 Strip
4.5mm, Mira 32 Strip 5mm,
Mira 225 Oval Strip 5mm,
Mira 220 Strip 6mm. Boats-
Mira 60 Boat
DE179 Silicon Retinal Implant Tire 7.0, 9.0, 12.5, 6.0, 8.5, 10.0mm $45.00
Prostheses List by Category, Groups and Sponsor Page 23 of 944
DE181 Silicon Retinal Implant Band 0.75 x 2.0 x 125mm, 0.60 x $45.00
2.5 x 125mm, 0.75 x 2.5 x
125mm
SO009 FCI Scleral Buckling Devices Band/strip: solid silicone Band - 2.0 x 0.75mm Type 40, $45.00
3.5 x 0.75mm Type 41, 4.0 x
1.25mm Type 42, 2.5 x 0.6mm
Type 240, Morin 3.5 x 0.6mm
Strip - 5.7mm Type 20,
7.2mm Type 31, 9.2mm Type
32, 6mm Type 219, 7.5mm
Type 220, 8mm Type 225
SO011 FCI Scleral Buckling Devices Tire: Solid Silicone Symmetrical: (2.5 mm Groove, $45.00
7 to 9mm wide), Biconvex:
(2.5mm Groove, 7 to 10mm
wide), Asymetrical: (2.5mm
Groove, 7 to 10mm wide)
SO013 FCI Scleral Buckling Devices Strip: Solid Silicone Strip: 1.4 x 4.4 x 100mm, $45.00
Morin Strip: 7mm wide x
100mm long, Caputo Zip Strip:
7 to 9mm wide x 120mm long,
Korobelnik Oval Strip: 2 x
5mm
AP002 Mira: Scleral Implants Silicone Sponge- Retinal Implant Used in Sponge- Mira 502 Cylinder $90.00
Scleral Buckling (Silicone Elastomer 2mm, Mira 5025 Cylinder
Sponge) 2.5mm, Mira 503 Cylinder
3mm, Mira 504 Cylinder 4mm,
Mira 505 Cylinder 5mm, Mira
505G Grooved cylinder 5mm,
Mira 505T Packer tunnel
cylinder 5mm, Mira 510 Half
cylinder 5mm, Mira 515
Brucker two-thirds cyl
Prostheses List by Category, Groups and Sponsor Page 24 of 944
DE178 Silicon Retinal Implant Sponge 2.5 x 4.0 x 80mm, 3.0 x 5.0 x $90.00
100mm, 3.25 x 7.0 x 80mm,
5.5 x 7.5 x 80mm, 1.5 x 80mm,
2.0 x 80mm, 2.5 x 80mm, 3.0
x 80mm, 4.0 x 80mm, 5.0 x
80mm, 7.0 x 80mm
SO012 FCI Scleral Buckling Devices Sponge/Cord: Silicone Cord: 1.0 to 5.0mm O.D. x $90.00
150mm length; Half Cord:
3.0mm to width x1.5mm to
2.5mm height x150mm;
Circular Sponge: 3 to 5mm;
Oval Sponge: 2 to 5.5mm x 4
to 12mm; Half Sponge: 2 to
3.1mm x 4 to 7.5mm; Grooved
12mm; Gain Sponge: 6 x
DE201 Labtician Tantalum Clips Tantalum 2, 2.5mm $50.00
DE180 Silicon Retinal Implant Sleeve 1mm, .76mm, 1.5mm $25.00
SO010 FCI Scleral Buckling Devices Fixation Sleeve: Solid silicone O.D: 1.65 to 2.41mm, Length $25.00
30mm
Prostheses List by Category, Groups and Sponsor Page 25 of 944
AL035 ISPAN Retinal Gases for Constellation® Tamponade gases for retinal surgery C3F8 125g cylinder, dispensed in $75.00
Vision System and SF6 single dose syringe
AL036 ISPAN retinal gases Tamponade gases for retinal surgery C3F8 125 g cylinder, dispensed in $75.00
and SF6 single dose syringe
DE284 Single Dose Ophthalmic Gases Single dose tamponading gas for retinal 30ml $75.00
surgery
AL013 Perfluoron Kits Perfluoro-n-octane for use as a retinal 5mL $240.00
surgery additive
AL014 Perfluoron Kits Perfluoro-n-octane for use as a retinal 7mL $240.00
surgery additive
BL017 Perfluo-octane (Oktaline) Okta-Line Perfluorocarbon Liquid for use as a retinal 5mL $240.00
surgery additive
BL018 DK Line 100% purified perfluorodecalin Perfluorodecalin 7ml $240.00
DV244 D.O.R.C. Eftiar Eftiar Decaline and Octane 5ml 5ml $240.00
DE204 Arcaline (Perfluorodecaline) Liquid perfluorocarbon aid for retinal 3ml, 5ml, 7ml $240.00
surgery, operative device for retinal
surgery, in particular retinal detachment
(RD), RD with giant tear etc.
Prostheses List by Category, Groups and Sponsor Page 26 of 944
DE205 Arcotane (Perfloro-N-Octane) Liquid perfluoro-N-Octane aid for retinal 5ml, 7ml $240.00
surgery, pre-operative device for retinal
surgery, in particular retinal detachment
(RD), RD with giant tear, RD with
proliferative vitreal retinopathy (PVR) etc.
IQ005 Densiron Heavy Tamponade Liquid Medium, 10 ml, Sterile $240.00
Postoperative
IQ008 Octane & Decalin Perfluorocarbon retinal tamponade 5ml & 7ml, Sterile $240.00
medium, intraoperative
SO023 FCI - DECA, FCI - OCTA FCI - DECA: Purified perfluorodecalin, 5ml $240.00
FCI - OCTA: Purified perfluoro-N-octane
SO024 FCI - DECA, FCI - OCTA FCI - DECA: Purified perfluorodecalin, 7ml $240.00
FCI - OCTA: Purified perfluoro-N-
Octane
BL016 Oxane LMWC Fractioned Silicone Oil Purified fractioned silicone oil 10mL $195.00
BL024 Oxane HD Silicone oil - RMN3 mixture 10ml $195.00
DV243 D.O.R.C. Silicon Oil D.O.R.C. Silicon Oil 1000/5000CS 10ml $195.00
DE228 LSO Silicone Oil Silicone oil for tamponade use in 10ml, vial or syringe $195.00
vitreoretinal surgery
IQ006 Siluron 1000 & Siluron 5000 Silicone Oils 10 ml, Sterile $195.00
SO022 FCI Purified Silicone Oil (Solvent Free) Viscosity: 1000 cst/5000 cst: solvent free 10ml $195.00
purified silicone oil
Prostheses List by Category, Groups and Sponsor Page 27 of 944
AY022 Cobalt Chromium Balloon Expandable Cobalt Chromium Diameter 4-10mm, Length 12- $1,800.00
Peripheral Stent 58mm
AY024 Omnilink Stainless Steel Balloon Stainless Steel Balloon Expandable 018 & 035 system: 5-10mm $1,800.00
Deployable Peripheral Stent Peripheral Stent on 018/035 system diameter by 12, 16, 18, 28, 38,
58mm length
BB244 Coroflex Blue Cobalt Chromium Alloy L605 2-4mm diameter, 8-25mm length $1,800.00
BA218 Lifestent Valeo Stainless Steel Balloon Expandable 6-10mm diameter 17-56mm $1,800.00
Peripheral Stent length
BT094 Dynamic PTA Balloon Expandable Stent Diameters: 5-10mm, Lengths: $1,800.00
15, 25, 38, 56mm
BS059 Express Vascular LD Stent; Express Stainless Steel, Balloon Expanding Stent Stent Diameters up to 10mm $1,800.00
Vascular SD Stent and lengths up to 60mm
WC234 Formula 414 Rx Renal Stent System Balloon Expandable Vasc/Biliary Stent Rapid exchange 014/018, 80- $1,800.00
135cm delivery system.
Diameters 4-10mm, lengths 0.8
- 4cm
JJ057 Palmaz Balloon Expandable Stent Stainless steel stent Diameter 4-12mm, length 20- $1,800.00
30mm
JJ058 Palmaz Balloon Expandable Stent Stainless steel stent Extra-large $1,800.00
JJ304 Palmaz Genesis Peripheral Stent and Stainless steel balloon expandable stent Diameter 3-8mm, length 12- $1,800.00
Delivery System on Slalom mounted on a slalom balloon 39mm
JJ305 Palmaz Genesis Peripheral Stent and Stainless steel balloon expandable stent Diameter 4-8mm, length 12- $1,800.00
Delivery System on Opta Pro mounted on an Opta Pro Balloon 39mm
Prostheses List by Category, Groups and Sponsor Page 28 of 944
JJ306 Palmaz Genesis Peripheral Stent Stainless steel peripheral stent Diameter 4-12mm, length 11- $1,800.00
79mm
JJ479 PALMAZ GENESIS on CORDIS Peripheral balloon expandable stent and Lengths: 12, 15, 18, 24mm. $1,800.00
AMIIA RX .014 Delivery System rapid exchange delivery system Diameter: 4, 4.5, 5, 5.5, 6, 6.5,
7mm
JJ567 PALMAZ® BLUE™ .018 Peripheral L605 Cobalt Chromium Alloy Balloon 12, 15, 18, 24mm length 4, 5, $1,800.00
Stent System Expandable Stent 6, 7mm diameter
JJ688 Palmaz Blue .014 Renal Stent System CoCr balloon expandable stent 12, 15, 18, 24mm Lengths $1,800.00
(on Aviator Plus) 40, 50,
80, 142cm shaft
lengths
MS059 Thalis Inert Stent Implantation System Balloon-Expandable Peripheral Stent Diameter: 5-12mm; Length: 18- $1,800.00
Implantation System 58mm
MF015 CP Stent CP Stent Uncovered 16, 22, 28, 24, 39 & 45mm $1,800.00
length
MF017 CP Stent CP Stent Uncovered, mounted on BIB 16, 22, 28, 24, 39 & 45mm $1,800.00
balloon length
MC328 Racer Renal Stent System Cobalt Alloy Diameter: 4-7mm; Lengths: 12 $1,800.00
&18mm
MC773 Assurant Cobalt Stent Iliac balloon expandable stent system Diameter: 6 - 10mm, Length: $1,800.00
20 - 80mm
MC959 Hippocampus Renal Stent System Hippocampus Renal Rapid Exchange Diameter 4.0mm - 7.00mm $1,800.00
Stainless Steel Stent system, 5F sheath, Length: 10mm - 24mm
0.014" guide wire compatible
MC977 Chromis deep cobalt Chromium, Chromis deep - Cobalt Chromium, pre- Diameter: 2.0 mm 4.0mm $1,800.00
infrapopliteal OTW stent mounted balloon expandable, 0.014" Length: 10mm - 76mm
compatable stent
Prostheses List by Category, Groups and Sponsor Page 29 of 944
AY015 Xact/ Xact Flex Carotid Stent Nitinol Self-Expanding stent on rapid Diameter 7-10mm Length 20 + $1,800.00
exchange delivery system 30mm Straight; Diameter 8-6,
9-7, 10-8mm Length 20 +
30mm Tapered
AY021 Nitinol Self Expanding Peripheral Stent Nitinol Diameter 3-10mm $1,800.00
AY031 Xpert Xpert is a laser cut nitinol self expanding 3 - 8mm in diameter, 20 - $1,800.00
stent, used to treat peripheral vessel 80mm in length
disease, Xpert is a low profile system
designed for small vessels and is 4 french.
AY032 ACCULINK Peripheral Stent System Nickel-Titanium Intra-vascular stent 4-10mm diameter, 13-56mm $1,800.00
length
AY035 Absolute Pro (Long Length) Laser cut nitinol self expanding stent Diameter 5mm to 10mm; length $1,800.00
<150mm 120mm
BA178 Luminex Vascular Stent Luminex nitinol self-expanding stent 4mm - 20mm diameters, 2cm - $1,800.00
12cm lengths
BA199 Lifestent Laser cut nitinol self expanding stent, used Diameter: 6-8mm, Length: $1,800.00
to treat peripheral disease 120mm
BA216 Lifestent Lifestent cut nitinol self expanding stent 6-10mm diameter 20mm- $1,800.00
120mm length
BT072 Astron Peripheral self expanding nitinol, coated Diameters: 6 - 12mm, Lengths: $1,800.00
stent 30 - 100mm
BT103 Astron Pulsar Self-expanding nitinol stent for peripheral Diameters: 4-12.0mm, Lengths: $1,800.00
vessel disease. Stent is 4Fr compatible and 20-200mm
a rapid exhange delivery system
BT126 Pulsar 18 Peripheral self expanding Pulsar 18 self expanding Nitinol stent Stent: 4-7mm Stent length: 100- $1,800.00
Nitinol stent system system 120mm Catheter length: 90-
135mm
Prostheses List by Category, Groups and Sponsor Page 30 of 944
BS035 Expandable Endoprosthesis Biomedical superalloy, self expanding stent Stent Diameters up to 30mm $1,800.00
and lengths up to 100mm
BS056 Carotid Wall Stent Elgiloy self expanding stent Stent diameters up to 10mm $1,800.00
and lengths up to 40mm
BS077 Sentinol Nitinol Vascular Stent System Nitinol Stent with Uniflex Delivery System Diameter: 5 to 10mm. Length: $1,800.00
20 to 120mm
BS137 EPIC Nitinol Stent Nitinol self expanding stent Stent diameters up to 14mm $1,800.00
and lengths up to 120mm
BS167 Placehit Wallstent Biomedical cobalt-based alloy, self Stent diameters up to 19mm $1,800.00
expanding stent and lengths up to 100mm
BS168 Wallstent RP Tracheobronchial, Iliac, Biomedical 20-24mm; length 18-90mm $1,800.00
Superalloy Wire, Braided Mesh, Stainless
Steel Stent with Unistep Delivery System
BS189 Adapt Monorail Carotid Stent System Nitinol self expanding stent 21-40mm length, 4-9mm $1,800.00
diameter
BS196 Innova Self-Expanding Stent Nitinol, self expanding stent Diameters up to 8mm, lengths $1,800.00
less than 150mm
WC168 Cook Vascular/Biliary Stent Vascular/Biliary stent 5/6 Fr delivery system, 4 - $1,800.00
14mm diameter, 2 - 8cm length
WC278 Zilver Vascular Stent with Rapid Zilver Stent Vascular Design, self- Delivery System 5Fr, 125cm. $1,800.00
Exchange Delivery System expandable nitinol stent. Preloaded in a 5.0 Stent diameter 4mm-10mm.
French Rapid Exchange delivery catheter. Stent length 2cm-8cm.
Prostheses List by Category, Groups and Sponsor Page 31 of 944
WC287 Zilver® Flex 35™ Vascular Stent The Zilver® Flew 35™ Stent (ZFV) is a The Zilver® Flex 35™ Stent is $1,800.00
The available in the following sizes:
special laser-cut pattern of the nitinol tube stent outer diameters of 5 -
provides a construction with a strong radial 10mm and stent lengths of 20 -
The stent has 140mm.
The
stent is supplied preloaded in a 6.0 French
inducer catheter. A radiopaque marker on
the distal tip of the sheath is used to
visualize deployment of the stent. Stent
deployment is controlled by means of a
hand held device.
WC290 Zilver® Vena ™ Venous Stent The Zilver® Vena™ Venous Stent is a 14mm and 16mm diameters, $1,800.00
self-expanding, flexible, slotted-tube nitinol and 60mm/100mm/140mm
stent. Post-deployment, the stent is lengths.
designed to impart an outward radial force
upon the inner lumen of the vessel,
establishing patency in the stented region.
ET037 SX-Ella Endovascular Stent Uncovered, self-expanding nitinol stent Dia 6-16mm, length 22-77mm $1,800.00
EE006 Protégé GPS Peripheral Stent Protégé RX Peripheral Stent Diameter 6-10mm Length 20- $1,800.00
60mm
EE024 Protégé EverFlex Peripheral Stent Protégé EverFlex is a self expanding Diameter 5-8, Length 20-100mm $1,800.00
Nitinol stent premounted on an OTW
delivery system.
JJ419 SMART Control Peripheral Stent SMART Control is a laser cut nitinol self Dia 6 – 14mm; Length 20 – $1,800.00
System expanding stent, used to treat peripheral 100mm
vessel disease.
JJ463 PRECISE RX Nitinol Stent System Nitinol self expandable stent and repid Stent Lengths 20, 30, 40mm; $1,800.00
exchange delivery system Stent Diameter: 5, 6, 7, 8, 9,
10mm
JJ592 SMART Nitinol Stent System Long 120mm Stent, 6F compatible 6-8mm diameter, 120mm stent $1,800.00
length, 120cm delivery system
Prostheses List by Category, Groups and Sponsor Page 32 of 944
JJ646 Precise Pro Rx Nitinol Stent System Nitinol self expanding stent Diameter: 5, 6, 7, 8, 9, 10mm; $1,800.00
20, 30, 40mm
MC743 Complete SE Stent Nitinol 20mm - 80mm $1,800.00
MC744 Complete SE Stent Nitinol 100mm - 120mm $1,800.00
MC978 Cristallo Ideale Carotid Self Expanding Cristallo Ideale Nitinol, Carotid Self Cylinder Diameter: 7.0mm - $1,800.00
Stent System Expanding Hybrid Stent system, 5F 11.0 mm. Taper Diameter
introducer sheath compatible, Rapid 6.0/9.0 - 7.0/10.0. Length
Exchange design, .014" guide wire 20mm - 40 mm.
compatible.
MI010 Maris Plus Peripheral Self-Expanding Nitinol, self expanding, peripheral stent Diameter: 6.0-12.0mm; Length: $1,800.00
Stent System system 30-120mm
PY006 Optimed Femoral Sinus Stent Sinus-wave nitinol Stent 3 - 10mm x 20-130mm $1,800.00
PY015 Optimed Iliac Sinus Stent Sinus-wave nitinol stent 6 - 14mm x 30 -120mm $1,800.00
PY028 Sinus-XL Stent Self-expanding Nitinol stent Diameter: 16mm, 18mm. $1,800.00
Length: 40-100mm nominal;
41-100 expanded.
PY029 Sinus-XL Stent ≥20mm Self-expanding Nitinol stent Diameter: 20mm, 22mm, $1,800.00
24mm, 26mm, 28mm, 30mm,
32mm, 34mm. Length: 30-
100mm nominal; 32-102
expanded.
AY036 Absolute Pro (Long Length) Laser cut nitinol self expanding stent ≥150 Diameter 5mm to 10mm; length $2,970.00
150mm, 170mm, 200mm
BA217 Lifestent Laser cut nitinol self expanding stent Diameter 5mm to 10mm; length $2,970.00
150mm - 200mm
Prostheses List by Category, Groups and Sponsor Page 33 of 944
BT127 Pulsar 18 Peripheral self expanding Pulsar 18 self expanding Nitinol stent Stent: 4-7mm Stent length: 150- $2,970.00
Nitinol stent system system 200mm Catheter length: 90-
135mm
BS197 Innova Self-Expanding Stent Nitinol, self expanding stent Diameters up to 8mm, Lengths $2,970.00
greater than 150mm
WC285 Zilver® Flex35™ Vascular Stent The Zilver® Flex35™ Stent (ZFV) is a Diameter: 5-8mm; $2,970.00
The Length:170mm and 200mm
special laser-cut pattern of the nitinol tube
provides a construction with a strong radial
The stent has
radiopaque markers at both ends.
EE025 Protégé EverFlex Peripheral Stent Protégé EverFlex is a self expanding Diameter 5-8mm, Length 150- $2,970.00
Nitinol stent premounted on an OTW 200mm
delivery system.
JJ617 SMART Nitinol Stent System Long 150mm stent, 6F compatible 6-8mm diameter, 150mm $2,970.00
length, 120cm delivery system
MC760 Complete SE Stent Nitinol 150mm $2,970.00
MI011 Maris Plus Peripheral Self-Expanding Nitinol, self expanding, peripheral stent Diameter: 6.0-12.0mm; Length: $2,970.00
Stent System system 150mm
PY016 Optimed Iliac Sinus Stent - extra long Sinus-wave nitinol stent - extra long 6-8 mm x 150-200mm $2,970.00
Prostheses List by Category, Groups and Sponsor Page 34 of 944
WC289 Zilver PTX The Zilver PTX Drug Eluting Peripheral 6French: 5, 6, 7, 8, 9, 10mm $2,400.00
Stent is a self-expanding stent made of diameters in 20, 30, 40, 60, 80,
nitinol and coated with the drug Paclitaxel. 100, 120mm lengths
The stent is preloaded in a 6.0 French
Stent deployment is
controlled by retraction of the handle while
holding the metal cannula stationary.
KA001 Tenckhoff Peritoneal Dialysis Catheter Adult 2 cuff, Adult 1 cuff, Adult 0 Cuff 42cm to 47cm length. All $175.00
Peritoneal Catheters excluding
the Swan Neck Fast Flow
Catheter, have an internal
diameter of 2.67mm and an
external diameter of 4.95 mm.
KA002 Tenckhoff Peritoneal Dialysis Catheter Paediatric 2 cuff, Paediatric 1 cuff, 31cm to 37 cm length. All $175.00
Neonatal 1 cuff Peritoneal Catheters excluding
the Swan Neck Fast Flow
Catheter, have an internal
diameter of 2.67mm and an
external diameter of 4.95 mm.
KA003 Fast Flow Peritoneal Dialysis Catheter Swan Neck, 2 cuff Int.diam: 3.2mm; ext diam $175.00
5.49mm.All Peritoneal
Catheters excluding the Swan
Neck Fast Flow Catheter, have
an internal diameter of 2.67mm
and an external diameter of
4.95 mm.
Prostheses List by Category, Groups and Sponsor Page 35 of 944
KA004 Swan Neck Curl Peritoneal Dialysis Adult 2 cuff, left 62 cm length. All Peritoneal $175.00
Catheter Catheters excluding the Swan
Neck Fast Flow Catheter, have
an internal diameter of 2.67mm
and an external diameter of
4.95 mm.
KA005 Swan Neck or Swan neck Tenckhoff Adult-left, Adult-right, Adult, 2 cuff-left, 20 to 25cm external segment or $175.00
Peritoneal Dialysis Catheter Adult, 2 cuff-right 43cm length. All Peritoneal
Catheters excluding the Swan
Neck Fast Flow Catheter, have
an internal diameter of 2.67mm
and an external diameter of
4.95 mm.
KA006 Tenckhoff Peritoneal Dialysis Catheter, Adult, 2 cuffs 57 to 62cm length. All $175.00
Curl Peritoneal Catheters excluding
the Swan Neck Fast Flow
Catheter, have an internal
diameter of 2.67mm and an
external diameter of 4.95 mm.
WC238 Zenith Thoracic Endovascular Graft Thoracic Proximal Graft 22mm to 42mm diameter, $11,027.00
115mm to 179mm Length
WC240 Zenith Thoracic Endovascular Graft Thoracic Distal Graft 26mm to 42mm diameter, $11,027.00
127mm to 179mm Length
WC275 Zenith TX2 TAA Endovascular Graft Short Thoracic Proximal Graft Diameter 22mm - 42mm. $11,027.00
with Pro_Form and the Z-Trak Plus Length 115mm - 162mm
Introduction System - Short Proximal
Component
MS052 Relay Thoracic Stent Graft Duralloy Nitinol Surgical Graft Material Diameter 22 - 46mm, Length $11,027.00
Braided Polyester PFTE impregnated 103 - 179mm
Suture Dual Sheath Delivery System
Prostheses List by Category, Groups and Sponsor Page 36 of 944
MC206 Talent Thoracic Stent Graft Talent Endoluminal Stent Graft - Thoracic 22 - 46mm x 130mm $11,027.00
Stent Graft System
MC747 Valiant Endovascular Stent Graft Nitinol and polyester system 22-46mm diameter, 110mm $11,027.00
length
MC748 Valiant Endovasculat Stent Graft Nitinol and polyester system 22-46mm diameter, 150mm $11,027.00
length
MC809 Valliant Endovascular Stent Graft Nitinol and polyester system 24 - 46 diameter, up to 179mm $11,027.00
MC952 Valiant Captivia Valient Stent Graft with Captivia Delivery 22-46mm diameter, 150mm $11,027.00
System length
MC960 Valiant Captivia Valiant Stent Graft with captivia delivery 22 - 46 mm diameter: 100mm $11,027.00
system length
GT191 Excluder Endovascular Prostheses Thoracic Stent Graft Nitinol & ePTFE Diameter 26-40mm x 10cm $11,027.00
Length
GT259 Conformable GORE TAG Thoracic Conformable GORE TAG Straight Stent Grafts: $11,027.00
Endoprosthesis Diameters (mm): 21, 26, 28,
31, 34, 37, 40, 45
Length (cm): 10
Tapered Stent Grafts:
Diameters (mm): 26x21; 31x26
Lengths (cm): 10
GT260 Conformable GORE TAG Thoracic Conformable GORE TAG Diameters (mm): 28, 31, 34, $11,027.00
Endoprosthesis 37, 40, 45
Length (cm) 15
MF016 CP Stent CP Stent Covered 16, 22, 28, 24, 39 & 45mm $3,000.00
length
MF018 CP Stent CP Stent Covered, mounted on BIB 16, 22, 28, 24, 39 & 45mm $3,000.00
balloon length
Prostheses List by Category, Groups and Sponsor Page 37 of 944
WC239 Zenith Thoracic Endovascular Graft Thoracic Proximal Grft 22mm to 42mm diameter, $14,500.00
180mm to 216mm Length
WC241 Zenith Thoracic Endovascular Graft Thoracic Distal Graft 26mm to 42mm diameter, $14,500.00
180mm to 207mm Length
WC276 Zenith TX2 TAA Endovascular Graft Long Thoracic Proximal Endovascular Diameter 28mm-42mm Length $14,500.00
with Pro-Form and the Z-Trak Plus Graft 197mm-216mm
Introduction System - Long Proximal
Component
MS053 Relay Thoracic Stent Graft Duralloy Nitinol Surgical Graft Material Diamter 22 - 46mm, Length $14,500.00
Braided Polyester PFTE impregnated 180 - 271mm
Suture Dual Sheath Delivery System
MC810 Valliant Endovascular Stent Graft Nitinol and polyester system 24 - 46 diameter, 180 - $14,500.00
227mm length
MC958 Valiant Captivia Valiant Stent Graft with Captivia Delivery 24-46mm diameter, 200mm $14,500.00
System length
GT023 Excluder Endovascular Prostheses Thoracic Stent Graft Nitinol & ePTFE 34, 37 & 40mm Diameter x $14,500.00
20cm Lengths
GT261 Conformable GORE TAG Thoracic Conformable GORE TAG Diameters (mm): 34, 37, 40, 45 $14,500.00
Endoprosthesis
Length (cm): 20
AC023 Advant PTFE V12 Stent Graft System Balloon Expandable PTFE Encapsulated 5mm - 12mm Diameter $4,185.00
Stainless Steel Peripheral Vascular Stent
Prostheses List by Category, Groups and Sponsor Page 38 of 944
BA219 Encapsulated Carbon Lined Stent Graft PTFE covered nitinol self-expanding stent 4mm - 13.5mm diameter, 2cm $3,395.00
- 12cm length
GT020 Viabahn Endoprosthesis ePTFE & Nitinol Self Expanding Viabahn 2.5mm - 13mm $3,395.00
Endoluminal Graft System Diameter, 5cm Length;
Hemobahn 6 - 13mm Diameter,
5cm Length
GT021 Viabahn/Hemobahn Endoprosthesis ePTFE & Nitinol Self Expanding Viabahn 2.5mm - 13mm, 10cm $3,395.00
Endoluminal Graft System Length; Hemobahn 6 - 13mm
Diameter 10cm Length
GT029 Gore Tips Endoprosthesis ePTFE 8-12mm Diameter 4-8cm $3,395.00
Graft-Lined Length 2cm
Unlined Length
GT225 Gore Viabahn ® endoprosthesis with Gore Viabahn ® endoprosthesis with 5mmx2.5cm 120cm 5mmx5cm $3,495.00
heparin bioactive surface heparin bioactive surface is a flexible, self 120cm 6mmx2.5cm 120cm
expanding endoluminal device consisting of 6mmx5cm 75cm 6mmx5cm
an ePTFE lining with external nitinol 120cm 7mmx2.5cm 120cm
support 7mmx5cm 75cm
7mmx5cm 120cm 8mmx2.5cm
120cm 8mmx5cm 75cm
8mmx5cm 120cm 9mmx 5cm
75cm 9mmx 5cm 120cm
10mmx 5cm 75cm
10mmx 5cm 120cm 11mmx
5cm 75cm
11mmx 5cm 120cm 13mmx
5cm 75cm 13mmx 5cm 120cm
Prostheses List by Category, Groups and Sponsor Page 39 of 944
GT227 Gore Viabahn ® endoprosthesis with Gore Viabahn ® endoprosthesis with 5mmx 10cm 120cm 6mmx $3,495.00
heparin bioactive surface heparin bioactive surface is a flexible, self 10cm 75cm 6mmx 10cm
expandinbg endoluminal device consisting 120cm 7mmx 10cm 75cm
of an ePTFE lining with external nitinol 7mmx 10cm 120cm 8mmx
support 10cm 75cm 8mmx 10cm
120cm
9mmx 10cm 75cm 9mmx 10cm
120cm
10mmx 10cm 75cm 10mmx
10cm 120cm
11mmx 10cm 75cm 11mmx
10cm 120cm
13mmx 10cm 75cm 13mmx
10cm 120cm
GT022 Viabahn/Hemobahn Endoprosthesis ePTFE & Nitinol Self Expanding Viabahn 2.5mm - 13mm $4,025.00
Endoluminal Graft System Diameter, 15cm Length;
Hemobahn 6 - 11mm Diameter,
15cm Length
GT226 Gore Viabahn ® endoprosthesis with Gore Viabahn ® endoprosthesis with 5mmx 15cm 120cm, 6mmx $4,125.00
heparin bioactive surface heparin bioactive surface is a flexible, self 15cm 75cm 6mmx 15cm
expanding endoluminal device consisting of 120cm 7mmx 15cm 75cm
an ePTFE lining with external nitinol 7mmx 15cm 120cm 8mmx
support 15cm 75cm 8mmx 15cm
120cm 9mmx 15cm 75cm
9mmx 15cm 120cm 10mmx
15cm 75cm, 10mmx 15cm
120cm 11mmx 15cm 75cm
11mmx 15cm 120cm 13mmx
75cm 13mmx 15cm
120cm
Prostheses List by Category, Groups and Sponsor Page 40 of 944
GT262 GORE VIABAHN® Endoprosthesis GORE VIABAHN® Endoprosthesis with 5mm x 25cm x 120CATH $5,625.00
with Heparin Bioactive Surface Heparin Bioactive Surface is a flexible, self 6mm x 25cm x 120CATH
expanding endoluminal device consisting 7mm x 25cm x 120CATH
of an ePTFE lining with external nitinol 8mm x 25cm x 120CATH
support
WC232 Zenith Renu AAA Ancillary Graft - Main Stent graft indicated for the repair of in situ Proximal diameter 22 - 36mm, $4,850.00
Body Extension AAA stent grafts Length (covered section) 43 -
100mm
MC850 Endurant AAA Abdominal Tube Endurant Endoluminal Stent Graft System - 23 - 36mm X 85mm $4,850.00
Abdominal Tube
WC235 Zenith Renu AAA Ancillary Graft - Stent graft indicated for the repair of in situ Proximal diameter 22-36mm, $10,200.00
Converter AAA stent grafts distal diameter 12mm, lengths
91-161mm
MC153 Talent AAA Aorto Uni lliac Stent Graft Talent Endoluminal Stent Graft System - 22 - 36mm x 75 - 310mm $10,200.00
Tapered System.
MC847 Endurant Aorto-Uni-Iliac (AUI) Endurant Endoluminal Stent Graft System - 23 - 36mm X 120mm $10,200.00
AUI
Prostheses List by Category, Groups and Sponsor Page 41 of 944
TU002 Anaconda Endovascular Graft System Bifurcated Aortic System, Ultrathin woven 18 - 34mm $12,405.00
polyester, nitinol ring stents, tantalum
surface of catheter material (chlorhexidine Lumen CS-42703E - 7Fr x
and silver sulphadiazine) 2. The entire 16cm, Triple Lumen CS-
internal fluid pathway including catheter, 45703E - 7Fr x 20cm, Triple
extension-lines and hubs (chlorhexidine Lumen
acetate)
BA182 PowerPICC Triple Lumen Power Injector Catheter 6F, 55cm length $230.00
Prostheses List by Category, Groups and Sponsor Page 943 of 944
BA183 PowerPICC Dual Lumen Power Injector Catheters 5F, 6F, 55cm Length $225.00
WC280 Turbo-Ject Peripherally Inserted Central 4/5 Fr Double Lumen Polyurethane PICC 4 and 5 French, 60 cm $225.00
Catheter Set ( Double Lumen) with Micropuncture Peel-Away Sheath Catheter length, double lumen
Introducer and Echogenic needle catheter
CM021 Arrow double lumen pressure injectable Arrow double lumen pressure injectable 5Fr x 50cm, Double Lumen $225.00
peripherally inserted central catheter PICC (peripherally inserted central
(PICC) set catheter) set
CM024 Arrow Pressure Injectable Triple-Lumen Pressure injectable triple lumen PICC 6Fg x 50cm, triple lumen $230.00
PICC. (Peripherally Inserted Central Catheter) Set
Prostheses List by Category, Groups and Sponsor Page 944 of 944
PART B - Human Tissue List February 2012
LEM03 Lions Eye Donation Service $770.00
LEM01 Lions Eye Donation Service $2,000.00
LEN01 Lions NSW Eye Bank $1,633.00
LEW01 Lions Eye Bank of Western Australia $2,500.00
QEB01 Queensland Eye Bank $2,100.00
SAE01 The Eye Bank of South Australia $1,838.00
LEM04 Lions Eye Donation Service $2,660.00
LEN03 Lions NSW Eye Bank $980.00
LEM02 Lions Eye Donation Service $150.00
LEN02 Lions NSW Eye Bank $245.00
LEW02 Lions Eye Bank of Western Australia $250.00
QEB02 Queensland Eye Bank $298.00
SAE02 The Eye Bank of South Australia $196.00
TBV56 Donor Tissue Bank of Victoria $1,013.00
QHV09 The Prince Charles Hospital - Queensland Heart Valve Bank $6,000.00
SHV03 Sydney Heart Valve Bank, St. Vincent's Hospital $987.00
TBV03 Donor Tissue Bank of Victoria $1,012.00
QHV08 The Prince Charles Hospital - Queensland Heart Valve Bank $6,000.00
Page 1 of 15
QHV07 The Prince Charles Hospital - Queensland Heart Valve Bank $1,660.00
QHV03 The Prince Charles Hospital - Queensland Heart Valve Bank $1,660.00
QHV05 The Prince Charles Hospital - Queensland Heart Valve Bank $1,660.00
QHV04 The Prince Charles Hospital - Queensland Heart Valve Bank $1,660.00
TBV50 Donor Tissue Bank of Victoria $490.00
QHV11 The Prince Charles Hospital - Queensland Heart Valve Bank $1,662.00
QHV01 The Prince Charles Hospital - Queensland Heart Valve Bank $6,000.00
RPH01 Royal Perth Hospital T/A Heart Valve Bank $6,406.00
SHV01 Sydney Heart Valve Bank, St. Vincent's Hospital $5,350.00
TBV01 Donor Tissue Bank of Victoria $6,598.00
QHV10 The Prince Charles Hospital - Queensland Heart Valve Bank $6,000.00
QHV02 The Prince Charles Hospital - Queensland Heart Valve Bank $6,000.00
RPH02 Royal Perth Hospital T/A Heart Valve Bank $6,406.00
SHV02 Sydney Heart Valve Bank, St. Vincent's Hospital $5,350.00
TBV02 Donor Tissue Bank of Victoria $6,598.00
MVS23 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $1,396.00
QBB60 The Queensland Bone Bank $1,568.00
RNB02 Hunter New England Bone Bank $1,470.00
QBB56 The Queensland Bone Bank $1,986.00
Page 2 of 15
TBV52 Victorian Institute of Forensic Medicine $619.00
TBV53 Victorian Institute of Forensic Medicine $1,237.00
NBB62 New South Wales Bone Bank $903.00
NBB61 New South Wales Bone Bank $1,647.00
NBB60 New South Wales Bone Bank $2,498.00
QBB09 The Queensland Bone Bank $1,609.00
QBB10 The Queensland Bone Bank $680.00
TBV09 Donor Tissue Bank of Victoria $973.00
TBV10 Donor Tissue Bank of Victoria $1,853.00
NBB65 New South Wales Bone Bank $903.00
NBB64 New South Wales Bone Bank $1,647.00
NBB63 New South Wales Bone Bank $2,498.00
AUB08 Australian Biotechnologies $2,215.00
AUB04 Australian Biotechnologies $2,070.00
TBV55 Donor Tissue Bank of Victoria $1,049.00
Page 3 of 15
TBV54 Donor Tissue Bank of Victoria $524.00
PBT37 Perth Bone and Tissue Bank $750.00
PBT08 Perth Bone and Tissue Bank $2,209.00
PBT10 Perth Bone and Tissue Bank $3,245.00
QBB45 The Queensland Bone Bank $1,993.00
QBB03 The Queensland Bone Bank $2,524.00
PBT09 Perth Bone and Tissue Bank $2,830.00
PBT38 Perth Bone and Tissue Bank $900.00
TBV11 Donor Tissue Bank of Victoria $1,165.00
TBV12 Donor Tissue Bank of Victoria $2,084.00
AUB02 Australian Biotechnologies $2,457.00
QBB68 The Queensland Bone Bank $2,022.00
QBB67 The Queensland Bone Bank $2,524.00
NBB05 New South Wales Bone Bank $1,224.00
PBT03 Perth Bone and Tissue Bank $500.00
TBV07 Donor Tissue Bank of Victoria $691.00
Page 4 of 15
TBV08 Donor Tissue Bank of Victoria $750.00
PBT11 Perth Bone and Tissue Bank $300.00
QBB12 The Queensland Bone Bank $210.00
TBV17 Donor Tissue Bank of Victoria $390.00
AUB05 Australian Biotechnologies $2,451.00
QBB52 The Queensland Bone Bank $441.00
TBV14 Donor Tissue Bank of Victoria $763.00
PBT07 Perth Bone and Tissue Bank $2,364.00
PBT48 Perth Bone and Tissue Bank $2,532.00
PBT06 Perth Bone and Tissue Bank $1,981.00
QBB04 The Queensland Bone Bank $713.00
QBB14 The Queensland Bone Bank $2,205.00
TBV18 Donor Tissue Bank of Victoria $5,247.00
NBB09 New South Wales Bone Bank $922.00
TBV21 Donor Tissue Bank of Victoria $806.00
PBT15 Perth Bone and Tissue Bank $1,590.00
QBB11 The Queensland Bone Bank $5.00
PBT16 Perth Bone and Tissue Bank $854.00
ACT01 ACT Bone Bank $2,432.00
Page 5 of 15
APH01 The Avenue Private Hospital Bone Bank $1,131.00
AUB03 Australian Biotechnologies $2,354.00
CSA01 Rachel Forster Bone Bank $802.00
DHR01 Barwon Health Bone Bank $3,028.00
HBB01 The Hobart Private Hospital Bone Bank $2,113.00
LPH01 Lingard Private Hospital Bone Bank $1,103.00
MMH01 Mater Misericordiae Hospital Bone Bank Theatres $400.00
MVS05 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,370.00
NBB16 New South Wales Bone Bank $2,354.00
PBT22 Perth Bone and Tissue Bank $2,432.00
QBB27 The Queensland Bone Bank $2,163.00
RNB01 Hunter New England Bone Bank $2,050.00
SVN01 Mater Hospital $731.00
TBV26 Donor Tissue Bank of Victoria $2,354.00
QBB61 The Queensland Bone Bank $2,163.00
QBB28 The Queensland Bone Bank $2,163.00
NBB59 New South Wales Bone Bank $2,271.00
PBT21 Perth Bone and Tissue Bank $2,295.00
TBV46 Donor Tissue Bank of Victoria $1,206.00
NBB17 New South Wales Bone Bank $1,606.00
PBT24 Perth Bone and Tissue Bank $1,662.00
QBB30 The Queensland Bone Bank $1,591.00
QBB31 The Queensland Bone Bank $670.00
QBB23 The Queensland Bone Bank $2,247.00
QBB66 The Queensland Bone Bank $2,811.00
Page 6 of 15
NBB57 New South Wales Bone Bank $2,778.00
NBB13 New South Wales Bone Bank $2,507.00
TBV24 Donor Tissue Bank of Victoria $2,137.00
NBB56 New South Wales Bone Bank $1,687.00
NBB55 New South Wales Bone Bank $1,687.00
PBT19 Perth Bone and Tissue Bank $2,791.00
MVS02 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
PBT17 Perth Bone and Tissue Bank $3,471.00
TBV22 Donor Tissue Bank of Victoria $3,854.00
NBB10 New South Wales Bone Bank $2,778.00
QBB20 The Queensland Bone Bank $2,800.00
NBB11 New South Wales Bone Bank $2,606.00
MVS03 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
NBB12 New South Wales Bone Bank $6,200.00
QBB22 The Queensland Bone Bank $4,268.00
TBV23 Donor Tissue Bank of Victoria $6,455.00
PBT18 Perth Bone and Tissue Bank $5,882.00
MVS04 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
PBT20 Perth Bone and Tissue Bank $3,471.00
TBV25 Donor Tissue Bank of Victoria $3,826.00
Page 7 of 15
NBB15 New South Wales Bone Bank $2,921.00
QBB25 The Queensland Bone Bank $3,020.00
NBB14 New South Wales Bone Bank $1,306.00
TBV51 Donor Tissue Bank of Victoria $3,713.00
MVS07 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
NBB18 New South Wales Bone Bank $6,041.00
PBT25 Perth Bone and Tissue Bank $2,667.00
QBB32 The Queensland Bone Bank $2,651.00
TBV27 Donor Tissue Bank of Victoria $6,222.00
NBB54 New South Wales Bone Bank $2,359.00
PBT28 Perth Bone and Tissue Bank $1,472.00
MVS14 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
TBV29 Donor Tissue Bank of Victoria $1,055.00
MVS13 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
TBV28 Donor Tissue Bank of Victoria $691.00
TBV30 Donor Tissue Bank of Victoria $2,193.00
NBB21 New South Wales Bone Bank $2,905.00
PBT29 Perth Bone and Tissue Bank $2,940.00
QBB33 The Queensland Bone Bank $2,762.00
TBV31 Donor Tissue Bank of Victoria $2,992.00
MVS08 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
Page 8 of 15
NBB24 New South Wales Bone Bank $6,500.00
PBT30 Perth Bone and Tissue Bank $5,411.00
QBB37 The Queensland Bone Bank $4,268.00
TBV32 Donor Tissue Bank of Victoria $6,788.00
NBB22 New South Wales Bone Bank $2,705.00
PBT31 Perth Bone and Tissue Bank $1,174.00
QBB34 The Queensland Bone Bank $2,478.00
TBV33 Donor Tissue Bank of Victoria $2,705.00
NBB23 New South Wales Bone Bank $1,195.00
PBT32 Perth Bone and Tissue Bank $1,067.00
QBB35 The Queensland Bone Bank $1,195.00
TBV34 Donor Tissue Bank of Victoria $1,042.00
QBB36 The Queensland Bone Bank $735.00
TBV37 Donor Tissue Bank of Victoria $1,653.00
NBB26 New South Wales Bone Bank $1,545.00
NBB50 New South Wales Bone Bank $3,090.00
QBB39 The Queensland Bone Bank $1,612.00
NBB51 New South Wales Bone Bank $1,671.00
MVS19 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
NBB25 New South Wales Bone Bank $2,359.00
TBV49 Donor Tissue Bank of Victoria $2,241.00
MVS20 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
Page 9 of 15
NBB29 New South Wales Bone Bank $3,142.00
QBB43 The Queensland Bone Bank $3,035.00
NBB30 New South Wales Bone Bank $3,182.00
PBT33 Perth Bone and Tissue Bank $3,343.00
NBB27 New South Wales Bone Bank $2,769.00
PBT35 Perth Bone and Tissue Bank $1,174.00
TBV36 Donor Tissue Bank of Victoria $2,769.00
NBB28 New South Wales Bone Bank $2,778.00
MVS09 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
PBT34 Perth Bone and Tissue Bank $2,886.00
TBV35 Donor Tissue Bank of Victoria $2,646.00
NBB53 New South Wales Bone Bank $1,448.00
NBB31 New South Wales Bone Bank $1,781.00
TBV38 Donor Tissue Bank of Victoria $1,781.00
PBT47 Perth Bone and Tissue Bank $1,921.00
QBB05 The Queensland Bone Bank $1,400.00
TBV40 Donor Tissue Bank of Victoria $1,184.00
TBV39 Donor Tissue Bank of Victoria $2,147.00
PBT60 Perth Bone and Tissue Bank $1,067.00
QBB47 The Queensland Bone Bank $788.00
Page 10 of 15
TBV41 Donor Tissue Bank of Victoria $1,020.00
PBT40 Perth Bone and Tissue Bank $2,654.00
MVS18 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
NBB06 New South Wales Bone Bank $3,024.00
PBT13 Perth Bone and Tissue Bank $1,800.00
QBB15 The Queensland Bone Bank $2,258.00
TBV19 Donor Tissue Bank of Victoria $3,115.00
NBB49 New South Wales Bone Bank $1,854.00
NBB47 New South Wales Bone Bank $2,975.00
MVS21 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $382.00
PBT41 Perth Bone and Tissue Bank $300.00
TBV43 Donor Tissue Bank of Victoria $487.00
AUB07 Australian Biotechnologies $1,854.00
AUB10 Australian Biotechnologies $2,184.00
NBB01 New South Wales Bone Bank $1,922.00
PBT61 Perth Bone and Tissue Bank $1,985.00
QBB62 The Queensland Bone Bank $1,922.00
TBV05 Donor Tissue Bank of Victoria $1,024.00
QBB65 The Queensland Bone Bank $1,433.00
NBB02 New South Wales Bone Bank $2,228.00
PBT01 Perth Bone and Tissue Bank $2,301.00
Page 11 of 15
QBB01 The Queensland Bone Bank $1,922.00
TBV06 Donor Tissue Bank of Victoria $2,085.00
AUB09 Australian Biotechnologies $2,228.00
NBB69 New South Wales Bone Bank $2,728.00
QBB69 The Queensland Bone Bank $1,922.00
QBB59 The Queensland Bone Bank $1,922.00
QBB48 The Queensland Bone Bank $2,055.00
QBB63 The Queensland Bone Bank $1,570.00
PBT02 Perth Bone and Tissue Bank $1,918.00
NBB33 New South Wales Bone Bank $2,147.00
TBV42 Donor Tissue Bank of Victoria $2,147.00
NBB68 New South Wales Bone Bank $2,647.00
NBB72 New South Wales Bone Bank $2,184.00
NBB73 New South Wales Bone Bank $2,184.00
NBB70 New South Wales Bone Bank $2,185.00
QBB70 The Queensland Bone Bank $1,922.00
PBT46 Perth Bone and Tissue Bank $2,198.00
Page 12 of 15
NBB67 New South Wales Bone Bank $2,184.00
QBB58 The Queensland Bone Bank $1,922.00
TBV57 Donor Tissue Bank of Victoria $2,085.00
NBB71 New South Wales Bone Bank $2,184.00
QBB57 The Queensland Bone Bank $1,922.00
TBV47 Donor Tissue Bank of Victoria $1,661.00
MVS17 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
QBB51 The Queensland Bone Bank $1,892.00
TBV48 Donor Tissue Bank of Victoria $2,177.00
NBB35 New South Wales Bone Bank $2,518.00
NBB36 New South Wales Bone Bank $2,551.00
PBT45 Perth Bone and Tissue Bank $2,635.00
QBB54 The Queensland Bone Bank $2,365.00
TBV45 Donor Tissue Bank of Victoria $2,468.00
TBV44 Donor Tissue Bank of Victoria $2,562.00
MVS11 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
AUB06 Australian Biotechnologies $2,562.00
QBB08 The Queensland Bone Bank $2,800.00
PBT44 Perth Bone and Tissue Bank $4,118.00
Page 13 of 15
NBB46 New South Wales Bone Bank $3,986.00
NBB45 New South Wales Bone Bank $1,448.00
MVS16 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
NBB37 New South Wales Bone Bank $4,065.00
QBB55 The Queensland Bone Bank $4,248.00
QBB64 The Queensland Bone Bank $4,268.00
NBB44 New South Wales Bone Bank $5,455.00
QBB53 The Queensland Bone Bank $992.00
NBB41 New South Wales Bone Bank $3,747.00
NBB43 New South Wales Bone Bank $2,450.00
NBB42 New South Wales Bone Bank $2,645.00
QBB02 The Queensland Bone Bank $872.00
NBB66 New South Wales Bone Bank $1,208.00
MVS15 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
NBB07 New South Wales Bone Bank $2,787.00
PBT14 Perth Bone and Tissue Bank $1,500.00
QBB16 The Queensland Bone Bank $2,258.00
TBV20 Donor Tissue Bank of Victoria $2,871.00
Page 14 of 15
NBB40 New South Wales Bone Bank $1,854.00
NBB38 New South Wales Bone Bank $2,450.00
Page 15 of 15
Part C - Other Prostheses February 2012
MC763 Reveal XT Reveal XT Insertable Cardiac Monitor 61 x 19 x 8 mm with a volume $3,900.00
of 9cc
MC768 Reveal DX Insertable Cardiac Monitor 61 x 19 x 8 mm with a volume $3,900.00
of 9cc
SJ152 SJM Confirm Model DM2102 Implantable cardiac monitor with atrial 6.5cc, 12g $3,900.00
fibrillation monitoring.
SJ159 SJM Confirm Model DM2100 Implantable cardiac monitor 6.5cc, 12g $3,900.00
Page 1 of 3
RO020 Accu-chek Spirit Insulin Pump Insulin infusion pump One size only $4,000.00 $5,000.00
DF001 DANAIIS Insulin Pump Continuous insulin infusion pump 75mm x 45mm x 19mm $4,000.00
RO044 Accu-Chek Combo System Insulin delivery device capable of remotely The Accu-Chek Combo $8,000.00
receiving and acting on information about System is only available in one
blood glucose levels, performing bolus size.
calculation and bolus advice on additional
parameters than what is normally provided.
AN011 Animas Vibe Insulin Pump & CGM Ambulatory insulin infusion pump with real- Pump/Monitor: 8.26 x 5.08 x $8,000.00
System time continuous glucose monitoring (CGM) 2.18cm
capability Sensor/Transmitter: 3.8 x 2.3 x
1.3cm
DF002 DANAR Insulin Pump The DANAR Insulin Pump is a small 75 x 45 x 19mm, 60grams $5,100.00
device about the size of a pager. It holds
up to 300 units of insulin, which is
delivered continuously through a small tube
to the patient. The DANAR Insulin Pump
also has an integrated blood glucose meter
and remote control via bluetooth
communication.
MC353 Medtronic MiniMed Insulin Infusion Pump Paradigm Model MMT-722. 'Smart' Pump dimensions: 5.1 x 9.4 x $8,000.00 $8,950.00
Insulin Pump with REAL-Time continuous 2.0cm
glucose monitoring capability and with
remote control
Page 2 of 3
MC354 Medtronic MiniMed Insulin Infusion Pump Paradigm Model MMT-522. 'Smart' Pump Dimensions: 5.1 x 7.6 x $8,000.00 $8,950.00
Insulin Pump with REAL-Time continuous 2.0cm
glucose monitoring capability and with
remote control
AN005 Animas 2020 Insulin Pump. Ambulatory Insulin Infusion Pump 7.4cm x 5cm x 1.9cm $7,750.00
MS031 Medical Specialties "Deltec Cozmo Ambulatory Insulin Infusion Pump Deltec Cozmo Insulin Pump - $8,000.00 $9,360.00
Insulin Pump" each
MC351 Medtronic MiniMed Insulin Infusion Pump Paradigm Model MMT - 715 Pump Dimensions: 5.1 x 9.4 x $8,000.00
2.0cm
MC352 Medtronic MiniMed Insulin Infusion Pump Paradigm Model MMT - 515 Pump Dimensions: 5.1 x 7.6 x $8,000.00
2.0cm
MC839 Medtronic MiniMed Insulin Infusion Pump Paradigm Veo Model MMT-554. 'Smart' 5.1 x 7.6 x 2.0cm $8,000.00 $9,500.00
Insulin Pump with REAL-Time continuous
glucose monitoring capability,
incorporating a low glucose suspend and
with remote control.
MC840 Medtronic MiniMed Insulin Infusion Pump Paradigm Veo Model MMT-754. 'Smart' 5.1 x 9.4 x 2.0cm $8,000.00 $9,500.00
Insulin Pump with REAL-Time continuous
glucose monitoring capability,
incorporating a low glucose suspend and
with remote control.
Page 3 of 3
Notes
The
amended as indicated in the tables below.
Table of Instruments
| 17 February 2012 (see F2012L00335) | 3 March 2012 | ||
| 2012 (see F2012L00788) | 9 April 2012 |
Table of Amendments
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