Private Health Insurance (Prostheses) Rules 2014 (No. 1) (Cth)
I, Shane Porter, delegate of the Minister for Health, make these Rules under item 4 of the table in section 333-20 of the
Dated 31 January 2014
Shane Porter
Assistant Secretary
Medical Benefits Division
Department of Health
1. Name of Rules These Rules are the
Private Health Insurance (Prostheses) Rules 20 14 (No. 1) .
(1) These Rules commence on 28 February 2014.
(2) These Rules are made under item 4 of the table in section 333-20 of the
Private Health Insurance Act 2007 .
These Rules revoke the
Private Health Insurance (Prostheses) Rules 2013 (No.1) .
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.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
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 in 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 in 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 in 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' in the Schedule.
(4) For a gap permitted prosthesis provided as part of an episode of hospital treatment in 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 subsection 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.
Note 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.
Note 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.
Schedule - Part A - Prostheses List February 2014
AL003 MTA2UO - MTA6UO PMMA +5 to +30 D $156.00
BL005 Storz (Coburn) Intraocular Lens PMMA Anterior Chamber Intraocular 13.75mm length. 6.0mm $156.00
121UV; L122UV PMMA Anterior lens 1 piece optic size, diopter range 3-
Chamber Lens 30d. L122UV: 6.0mm optic,
13.75mm length, power
range; 5.0 to 30.0 Diopters
EG009 Artisan Anterior Chamber Aphakia ModelComposition: PMMA 5.00mm Optic Diameter x $156.00
Intraocular Lens 8.5 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 6.00 mm Optic Diameter x $198.00
IOL 13.0mm in overall length
AO016 Verisyse AC IOL Phakic Intraocular Lens: Model 5mm Optic Diameter x 8.5 $680.00
Composition: PMMA overall length; 6mm Optic
Diameter x 8.5 overall
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 1059
EG012 Artisan Anterior Chamber IOL Phakic Intraocular Lens Myopic / 5.00mm Optic Diameter x $680.00
Hyperopic 8.5 in overall length;
AO030 Verisyse Toric (Custom) Phakic intraocular lens: Model toric 5mm Optic Diameter x $1,056.00
7.5mm overall length
EG008 Artisan Anterior Chamber Phakic Intraocular Lens: Model Toric 5.00mm Optic Diameter x $1,056.00
Intraocular Lens Composition: PMMA 7.5 in overall length
AO029 Verisyse Toric (Custom) Phakic intraocular lens: Model toric 5mm Optic Diameter x $1,358.00
7.5mm overall length
AL034 AcrySof Cachet Phakic Lens Anterior chamber foldable, acrylic, -6.0 to -16.5 diopters, in 0.5 $723.00
single piece phakic lens diopter increments
AO025 VeriFlex Foldable Phakic IOL Anterior chamber foldable phakic -2 to -14.5d in 0.5d $723.00
silicone intraocular lens increments. Overall
diameter 8.5mm. Optic
6.0mm
EG010 Artiflex Anterior Chamber Optic: Hydrophobic Polysiloxane. 6mm optic diameter x 8.5 in $723.00
Intraocular Lens Haptic: PMMA overall length
AL002 Models MZ60BD, MC50BD, CZ70BD Other:PMMA Range of Powers:-10 to +34 $156.00
D
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CZ016 CT ASPHINA 409M ZEISS Micro Incision Aaspheric 6mm optic, 11mm overall $364.00
(aberration neutral) IOL: Foldable, diameter. Diopter range 0.0
square-edged, single piece IOL for to +32.0D (0.5D steps from
capsular bag fixation 10.0 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
square-edged, single piece IOL for to +32.0D (0.5D steps from
capsular bag fixation 10.0 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, (15.50-22D), 10.5mm
preloaded, with aberration contro, (22.50-30D)
CZ028 CT ASPHINA 409MP Preloaded, micro incision, aspheric Diopter range: 0.0 to $374.00
(aberration neutral), foldable square- 32.0D; Optic size: 6.0mm;
edged single piece inraocular lens for Overall length: 11.0mm
capsular bag fixation.
CZ037 CT ASPHINA 509MP Preloaded, micro incision, aspheric Diopter range: 0.0 to + $374.00
(aberration correcting), foldable 32.0D; Optic Size: 6.0mm;
square-edged single-piece intraocular Overall length: 11.0mm
lens for capsular bag fixation
CZ031 AT TORBI 709MP (Standard Bitoric, preloaded, micro incision, Diopter range: Sph -10.0 to $760.00
aspheric (aberration neutral), foldable, 32.0, Cyl +1.0 to 6.5
square-edged, single-piece IOL for Optic size: 6.0mm, Overall
capsular bag fixation length: 11.0mm
Prostheses List by Category, Groups and Sponsor Page 3 of 1059
CZ032 AT TORBI 709MP (high cyl) Bitoric, preloaded, micro incision, Diopter range: Sph -10.0 to $1,061.00
aspheric (aberration neutral), foldable, 32.0, Cyl +7.0 to 12.0,
square-edged, single-piece IOL for Optic size: 6.0mm. Overall
capsular bag fixation Length 11.0mm
CZ020 AT TORBI 709M STANDARD RANGE BITORIC - 6mm optic, 11mm overall $740.00
ZEISS Micro Incision Aspheric diameter. Diopter range:
(abberation neutral) IOL: Foldable, Sph -10.0 to +32.0D, Cyl
square-edged, single piece IOL for +1.0 to 6.5D (all 0.5D
capsular bag fixation
CZ027 AT TORBI 709M HIGH CYLINDER BITORIC - ZEISS 6mm optic, 11mm overall $1,041.00
Micro Incision Aspheric (aberration diameter. Diopter range:
neutral) IOL: Foldable square edged, Sph -10.0 to +32.0D, +7.0
single piece IOL for capsular bag to 12.0D (all 0.5D steps)
fixation
XE002 Staar foldable silicone intraocular Polyimide haptics 6.3mm optic - low 14.0mm length $281.00
lens: Model AQ 5010V diopters
XE001 Staar Toric foldable silicone Plate haptics 6.0mm optic 10.8mm - 11.2mm length $579.00
intraocular lens: Model AA4203TF;
Model AA4203TL
AL004 Acrysof Multipiece Models Foldable Acrylic Multi-piece Lens -5 D to +30 D $322.00
MA50BM, MA60AC
Prostheses List by Category, Groups and Sponsor Page 4 of 1059
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 Soft Acrylic, Foldable, UV 6 mm Optic Diameter x $322.00
Sensar OptiEdge AR40e Absorbing, Posterior 13mm in overall length.
Foldable Acrylic IOL
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.
DE398 Oculentis LENTIS L-302-1 Foldable one-piece monofocal C loop Optic Size 6.0mm, Overall $322.00
acrylic IOL. Length 12.00mm. +-0.0D to
+35.0D (1.0D steps) and
+15.5D to +26.5D (0.5D
steps).
XE003 Staar foldable silicone IOLs: Plate haptics 6.0mm; Polymide 10.8mm 0 13.5mm length $322.00
Models AQ2010V, AQ2017V and haptics 5.5 or 6.3mm optic;
KG001 Rayner C-Flex Hydrophilic HEMA-MMA 5.75mm dia optic, 12.00mm $322.00
copolymer, foldable with injector dia overall
KG002 Superflex Hydrophilic HEMA-MMA 6.25mm dia optic, 12.5mm $322.00
copolymer, foldable with injector dia overall
AO014 TECNIS™ Intraocular Lens (Z9002 Foldable Intraocular Lenses - 5-10 dioptre in 1.0 dioptre $364.00
& ZA9003) Ultraviolet light absorbing posterior increments; 10.5 - 30
chamber intraocular lenses, dioptre in 0.5 increments
Silicone/Acrylic
AO024 Tecnis™ One Piece (ZCB00) One piece intraocular lens with edge +5 diopters to +34 diopters $364.00
modification and 360 degree square in 0.5d increments
edge
Prostheses List by Category, Groups and Sponsor Page 5 of 1059
BL022 SofPort Advanced Optic (AO) Posterior chamber, foldable silicone 0 D to 30.0 D $364.00
IOL 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 0 D to 30.0 D $364.00
IOL, with anterior optic-haptic square
edge, posterior optic-haptic square
edge, 360 degree optic square edge
and aspheric optic for aberration
BL030 enVista The enVista, Model MX60, is an ultra- Overall diameter 12.5mm, $364.00
violet-absorbing, posterior chamber, optic body diameter 6.0mm
hydrophobic acrylic one-piece in dioptric powers ranging
Has from +0.0 to +34D
an aspheric lens optic, square 0.0D to 10.0D in 1 Diopter
posterior edge, modified C haptics and increments
available in dioptric powers ranging 11.0D to 30.0D in 0.5
from +0.0 to +34.0D. Diopter increments
31.0D to 34.0D in 1
Diopter increments
CZ030 CT ASPHINA 404 Small incision, foldable, single piece, Diopter range: -10.0 to $364.00
monofocal, aspheric (aberration 42.0, Optic size: 6.0mm,
neutral), square-edged, hydrophilic Overall length: 11.0mm
acrylic (with hydrophobic surface
properties) intraocular lens for
capsular bag fixation. (Monofocal lens
for powers outside standard 409MP
MICS range).
DE399 Oculentis LENTIS L-312 Foldable one-piece monofocal acrylic Optic size 6.0mm, Overall $364.00
C Loop IOL Length 12.00mm. Central
Thickness 1.02mm
(+22.0D). Available
Diopters: -10.0D to35.0D
(1.0D steps). +10.5D to
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DE400 Oculentis LENTIS L-313 Foldable one-piece monofocal acrylic Optic size 6.0mm, Overall $364.00
IOL Length 11.00mm. Available
Diopters: +-0.0D to 35.0D
(1.0D steps). +10.5D to
29.5D (0.5D steps)
DE401 Oculentis LENTIS L-402 Foldable three piece monofocal acrylic Optic Size 6.0mm, Overall $364.00
IOL. Length 13.00mm. +-0.0D to
+35.0D (1.0D) + 15.5D to
+26.5D (0.5D). Minus range
on demand.
IQ004 Softec Acrylic, single piece, foldable Available in dioptric $364.00
intraocular lens with anterior and powers from -5.0 to +36.0,
posterior optic-haptic square edge, 1D steps: -5.0 to +10.0 and
360 degree optic square edge design, +31.0 to +36.0; 0.5D steps:
precision power calculation and +10.5 to +18.0 and +25.0 to
aberration technology +29.5; 0.25D steps: +18.0
to +25.0
IQ013 PreciSAL 302AC Acrylic, single piece, foldable Available in dioptric $364.00
intraocular lens with anterior and powers from 0.0 to +30.0.
posterior optic-haptic square edge, 1D steps: 0.0 to +10.0;
360 degree optic square edge design, 0.5D steps: +10.5 to + 17.5
precision power calculation, and +28.5 to +30.0; 0.25D
aberration technology and UV light steps: +18.0 to +28.0
KG012 Rayner "C-Flex" and Superflex" Aspheric Intra Ocular Lenses with C-Flex -970C + 22.5D to $364.00
Aspheric IOL Amon-Apple enhanced 360 Degree +34D Superflex-920H - 10D
square edge, Anti-vaulting Haptics to +22D
AO034 TECNIS® 1-Piece Pre-Loaded IOL 1-piece IOL Posterior Chamber +5.0 to +34.0 diopter $374.00
Intraocular lens, incorporates a powers in 0.5 diopter
proprietary wavefront-designed increments. Overall
aspheric optic with a squared diameter 13mm, Optic size
posterior optic edge designed to
provide a 360 degree barrier. The edge
of the optic has a frosted design to
reduce potential edge glare effects.
Supplied pre-loaded in a screw style
disposable injector.
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XE004 Preloaded Aspheric Intraocular Silicone intraocular lens 6.0mm $374.00
IQ014 PreciSAL P302AC Preloaded Acrylic, single piece, Available in dioptric $374.00
foldable intraocular lens with anterior powers from 0.0 to +30.0.
and posterior optic-haptic square 1D steps: 0.0 to +10.0;
edge, 360 degree optic square edge 0.5D steps: +10.5 to + 17.5
design, precision power calculation, and +28.5 to +30.0; 0.25D
aberration technology and UV light steps: +18.0 to +28.0
BL032 enVista Toric The enVista toric (Model MX60T) is a Overall diameter is 12.5mm $760.00
one-piece glistening-free for the entire lens power
hydrophobic foldable IOL. The range, with spherical
enVista Toric, model MX60T IOL has equivalent powers from +6.0
a Toric aspheric lens optic, a square to +30.0 Diopters in 0.5
posterior edge and modified C haptics, Diopter steps and cylinder
an overall diameter of 12.5mm and an powers from +1D to 6D
It is available in Diopters (at the IOL plane).
multiple spherical and cylindrical
powers.
IQ017 PreciSAL Toric T302AC Acrylic single piece, foldable Available in spherical $760.00
intraocular lens with anterior and dioptric powers from 0.0 to
posterior optic-haptic square edge, +30.0. 1D steps: 0.0 to
360 degree optic square edge design, +10.0; 0.5D steps: +10.5 to
precision power calculation, +17.5 and +28.5 to +30.0;
aberration technology, toric 0.25D steps: +18.0 to
correction on anterior surface with +28.0; Cylinder powers
cylinder marks to indicate flat from 1.0D to 6.0D
meridian plus the cylinder axis to
allow alignment for astigmatic
correction, and UV filter.
Prostheses List by Category, Groups and Sponsor Page 8 of 1059
IQ018 PreciSAL Toric PT302AC Pre-loaded acrylic single piece, Available in spherical $760.00
foldable intraocular lens with anterior dioptric powers from 0.0 to
and posterior optic-haptic square +30.0. 1D steps: 0.0 to
edge, 360 degree optic square edge +10.0; 0.5D steps: +10.5 to
design, precision power calculation, +17.5 and +28.5 to +30.0;
aberration technology, toric 0.25D steps: +18.0 to
correction on anterior surface with +28.0; Cylinder powers
cylinder marks to indicate flat from 1.0D to 6.0D
meridian plus the cylinder axis to
allow alignment for astigmatic
correction, and UV filter.
DV253 HOYA AF-1 351 Toric Preloaded injector system, correct IOL Power: + 10.0 to 30.0 $800.00
T3/T4/T5/T6/T7/T8/T9 corneal astigmatism micro-incision, (0.5 steps), IOL Cylinder
ashperic, blue-blocker, single piece power: 1.50D (351T3),
hydophobic. 2.25D (351T4), 3.00D
(351T5), 3.75D (351T6),
4.50D (351T7), 5.25D
(351T8), 6.00D (351T9)
AL024 AcrySert model SN60WS Foldable Acrylic Single-piece Lens +6 to +30 D $405.00
with 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 $405.00
blocker, Foldable, Single-Piece,
Hydrophobic Acrylic
DV252 HOYA iSert® 251 Preloaded injector system, Micro- +6.0D to 30.0D (5 steps) $405.00
incision, Aspheric, Blue-Blocker,
Single Piece, Hydrophobic
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IQ016 PreciSAL P302A Preloaded Acrylic, single piece, Available in dioptric $405.00
foldable intraocular lens with anterior powers from 0.0 to +30.0.
and posterior optic-haptic square 1D steps: 0.0 to +10.0;
edge, 360 degree optic square edge 0.5D steps: +10.5 to +17.5
design, precision power calculation, and +28.5 to +30.0; 0.25D
aberration technology and blue light steps: +18.0 to +28.0
AO031 TECNIS® Toric 1-Piece IOL 1-piece IOL Posterior chamber +5.0 to +34.0 diopter $740.00
Intraocular lens, incorporates a powers in 0.5 diopter
proprietary wavefront designed toric increments. Cylinder
aspheric optic with a squared power: 1.00 diopter, 1.50
posterior optic edge designed to diopter, 2.25 diopter, 3.00
provide a 360 degree barrier. The edge diopter and 4.00 diopter (as
of the optic has a frosted design to measured at the IOL plane).
reduce potential edge glare effects. Overall diameter 13mm,
Optic size 6mm.
DE390 Oculentis LENTIS Tplus LU-313T Patient Specific: Foldable one-piece Optic Size 6.0mm, overall $740.00
monofocal toric acrylic IOL length 11.0mm. Sph +/-0.0D
to +35.0D (in 0.01D
increments) Cyl +0.25 to
+6.99D cyl (in 0.01D
increments)
DE397 Oculentis LENTIS Tplus LS-313 Foldable one-piece monofocal toric Optic Size 6.0mm, Overall $740.00
T1-T6 acrylic IOL. Length 11.00mm. Available
diopters: +10.0D to +30.0D
(0.5D). Cyl: (T1 +1.5D) (T2
+2.25D) (T3 +3.0D) (T4
+3.75D) (T5 +4.5D) (T6
+5.25D)
Prostheses List by Category, Groups and Sponsor Page 10 of 1059
IQ020 PreciSAL Toric PT302A Pre-loaded acrylic single piece, Available in spherical $800.00
foldable intraocular lens with anterior dioptric powers from 0.0 to
and posterior optic-haptic square +30.0. 1D steps: 0.0 to
edge, 360 degree optic square edge +10.0; 0.5D steps: +10.5 to
design, precision power calculation, +17.5 and +28.5 to +30.0;
aberration technology, toric 0.25D steps: +18.0 to
correction on anterior surface with +28.0; Cylinder powers
cylinder marks to indicate flat from 1.0D to 6.0D
meridian plus the cylinder axis to
allow alignment for astigmatic
correction, and UV and blue light
filters.
DE392 Oculentis LENTIS LU-313-TY Patient Specific: Foldable one-piece Optic Size: 6.0mm, overall $780.00
monofocal toric acrylic IOL. Violet length 11.00mm. Sph +/-
Light Filter 0.0D to +35.0D (in 0.01D
increments) Cyl +0.25D to
+6.99D cyl (in 0.01D
increments)
IQ019 PreciSAL Toric T302A Acrylic single piece, foldable Available in spherical $780.00
intraocular lens with anterior and dioptric powers from 0.0 to
posterior optic-haptic square edge, +30.0. 1D steps: 0.0 to
360 degree optic square edge design, +10.0; 0.5D steps: +10.5 to
precision power calculation, +17.5 and +28.5 to +30.0;
aberration technology, toric 0.25D steps: +18.0 to
correction on anterior surface with +28.0; Cylinder powers
cylinder marks to indicate flat from 1.0D to 6.0D
meridian plus the cylinder axis to
allow alignment for astigmatic
correction, and UV and blue light
filters.
Prostheses List by Category, Groups and Sponsor Page 11 of 1059
DE391 Oculentis LENTIS Tplus LU-313T Patient Specific: Foldable one-piece Optic Size: 6.0mm, overall $1,042.00
monofocal toric acrylic IOL length 11.00mm. Sph +/-
0.0D to +35.0D (in 0.01D
increments) Cyl +6.99D to
+12.0D cyl (in 0.01D
increments)
DE393 Oculentis LENTIS T plus LU-313-TY Patient Specific: Foldable one-piece Optic Size: 6.0mm, overall $1,084.00
monofocal toric acrylic IOL. Violet length 11.00mm. Available
Light Filter. diopters: Cyl +7.00D to
+12.0D inclusive in 0.01D
increments.
AL021 Alcon AcrySof SN60WF Foldable Acrylic Single-piece Lens + 6.0 D to +30.0 D $385.00
with Blue Light Protection and
Aspheric Correction
BL025 SofPort Advanced Optic (AO) Posterior chamber, aphakic, foldable 6mm optic 13mm overall $385.00
Violet Shield silicone, anterior & posterior edge lengthModified C 5
modification intraocular lens with degree angulation 0-30D,
aberration technology, a violet light 0.5D steps
DV247 HOYA AF-1 iMics1 NY-60 Mini Incision, Aspheric, Blue- +6.0D to 30.0D (0.5 steps) $385.00
blocker, Single-piece, Hydrophobic
DE402 Oculentis LENTIS LS-312Y Foldable one-piece monofocal C Loop Optic Size 6.0mm, Overall $385.00
Acrylic IOL. Violet Light filter. Length 12.0mm. Available
Diopters: +-0.0D to 35.0D
(1.0D steps) +15.5D to
26.5D (0.5D steps).
Prostheses List by Category, Groups and Sponsor Page 12 of 1059
DE403 Oculentis LENTIS LS-313Y Foldable one-piece monofocal acrylic Optic Size 6.0mm, Overall $385.00
plate haptic IOL. Violet Light Filter Length 11.00mm. Available
Diopters: +-0.0D to 35.0D
(1.0D steps). +15.5D to
26.5D (0.5D steps).
IQ009 Softec HDY Acrylic, single piece, foldable Available in dioptric $385.00
intraocular lens with anterior and powers from -5.0 to + 36.0,
posterior optic-haptic square edge, 1D steps: -5.0 to +10.0 and
360 degree optic square edge design, +31.0 to +36.0; 0.5D steps:
precision power calculation, +10.5 to +18.0 and +25.0 to
aberration technology and blue light 29.5; 0.25D steps: + 18.0 to
+25.0
IQ015 PreciSAL 302A Acrylic, single piece, foldable Available in dioptric $385.00
intraocular lens with anterior and powers from 0.0 to +30.0.
posterior optic-haptic square edge, 1D steps: 0.0 to +10.0;
360 degree optic square edge design, 0.5D steps: +10.5 to +17.5
precision power calculation, and +28.5 to +30.0; 0.25D
aberration technology and blue light steps: +18.0 to +28.0
XE005 Staar KS-Xs Preloaded Acrylic Preloaded acrylic lens with anterior Optic diameter 6.0mm, $332.00
Intraocular Lens and posterior edge modification overall length 12.5mm,
diopter range +10 to +28.0
KG003 Rayner Standard Toric C-Flex Hydrophilic HEMA-MMA 5.00mm dia optic, 12.00mm $698.00
copolymer, 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 $780.00
foldable, acrylic, toric, single piece to 6.00 D cylinder.
lens with blue light protection and
aspheric correction
Prostheses List by Category, Groups and Sponsor Page 13 of 1059
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, (0.5 steps)lOL Cylinder
Single 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 $740.00
foldable, acrylic, toric, single piece to 6.00 D cylinder
lens with blue light protection
KG004 Rayner Premium Toric C-Flex HEMA-MMA copolymer, foldable 5.75mm dia optic, 12.00mm $1,000.00
with 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 -10.0D to 0.00D Sphere: 1D $1,000.00
to 11.00D Cylinder in 0.25
+31.00D to +35.00
Spit: 1D to 11.00D
Cylinder in 0.25steps
AL016 Alcon Acrysof Natural Model Foldable Acrylic Single-piece Lens, +6 to +40D $364.00
SN60AT asymmetric optic/consistent edge,
with blue light protection
AL025 AcrySof Multipiece Models Foldable Acrylic multi-piece Lens - 5 D to + 30 D $364.00
MN60MA, MN60AC with Blue light Protection
Prostheses List by Category, Groups and Sponsor Page 14 of 1059
AO026 TECNIS™ Multifocal Intraocular Posterior chamber lens with UV light- +5 diopters to +34 diopters $822.00
Lens (ZMA00) absorbing, foldable acrylic, 3-piece in 0.5d increments
with a diffractive posterior optic and a
modified anterior surface technology
with edge modification and 360
degree square edge.
AO027 Tecnis Multifocal 1-Piece Lens, A multifocal posterior chamber lens 6.0mm Optic Diameter x $822.00
Models ZMB00, ZKB00, ZLB00 with UV-blocking, foldable acrylic, 1- 13.0mm in overall length.
piece with a diffractive posterior optic +5.0 Diopter to +34.0
and a modified anterior surface Diopter in 0.5 Diopter
technology with edge modification increments. ZCB00 +4.00
and a 360 degree square edge. Diopter add, ZKB00 +2.75
add, ZLB00 +3.25 add
CZ015 AT LISA 809M ZEISS micro incision, aspheric 6mm optic, 11mm diameter. $822.00
Diffractive bifocal Diopter range 0.0D to
anterior surface with asymmetric light +32.0D (0.5D steps)
distribution (65% distance / 35%
near), 3.75D addition for near focus.
DE396 Oculentis LENTIS Mplus LS-313 Foldable one-piece multifocal plate Overall Length 11.0mm and $822.00
haptic acrylic IOL. Optic Size 6.0mm Available
diopters +-0.0D to +36.0D
(0.05D steps)
IQ021 Lenstec SBL-3 Acrylic single piece, foldable Available in dioptric $822.00
intraocular lens with anterior and powers from 10.0 to +36.0.
posterior optic-haptic square edge, 1D steps: 30.0 to +36.0;
360 degree optic square edge design, 0.5D steps: +10.0 to +15.0
precision power calculation, and +25.0 to +29.5; 0.25D
aberration technology, segmented bi- steps: +15.25 to +24.75
focal optic with +3.0 D of near power,
and UV filter.
Prostheses List by Category, Groups and Sponsor Page 15 of 1059
KG009 Rayner "M-Flex" Mulitfocal Acrylic, Foldable, Single piece multi- 6.5mm Optic-Overall $822.00
Foldable IOL zoned refractive aspheric multifocal diameter 12.5mm: +3D or +
with Amon-Apple 360 Degree Square 4D Addition: +14D to
edge, Anti Vaulting Haptics +25D in 1.0D increments:
+8.5D to +23.5D in 0.5D
CZ033 AT LISA 809MP Preloaded, micro incision, aspherical Diopter range: 0.0 to 32.0 $842.00
bifocal, square edged, single-piece Optic size: 6.0mm. Overall
IOL for capsular bag fixation. The length: 11.0mm
anterior aspheric bifocal surface has an
asymmetric light distribution 65/35
for distance/near vision, and 3.75D
add for the near focus.
CZ034 AT LISA tri 839MP Trifocal (aspheric) micro incision, Diopter range: 0.0 to $842.00
single-piece IOL for capsular bag +32.0D (0.5D increments).
fixation, implantable with preloaded Optic size: 6.0mm. Overall
The trifocal (anterior) Length: 11.0mm
optic provides two diffractive focal
points (+3.33D near focus and +1.66D
intermediate focus) with asymmetric
light distribution 50% distance / 20%
intermediate / 30% near vision.
CZ035 AT LISA toric 909MP ZEISS pre-loaded, micro incision, 6mm optic, 11mm diameter. $1,218.00
multifocal toric IOL. Aspheric toric Diopter range: Sph +6.0D
anterior surface, diffractive bifocal to 24.0D, Cyl +1.0 to 4.0D
posterior surface with asymmetric (all 0.5D steps)
light distribution (65% distance/ 35%
near), and 3.75D addition for near
Prostheses List by Category, Groups and Sponsor Page 16 of 1059
CZ036 AT LISA tri Toric 939MP Trifocal (aspheric), bitoric, micro Diopter range -10.00 to $1,218.00
incision, single-piece IOL for +28.0 and +1 to +4.0 DC
capsular bag fixation, implantable Optic size: 6..00mml;
with preloaded injector system. The Overall length: 11.mm
trifocal (anterior) optic provides two
diffractive focal points (+3.33D near
focus and + 1.66D intermediate focus)
with asymmetric light distribution
50% distance / 20% intermediate /
30% near vision,
AO033 Tecnis Multifocal Toric Toric Multifocal Intraocular Lens +5.0 Diopters to +34.0 $1,198.00
Diopters in 0.5 Diopter
Cylinder
powers 1.50D, 2.25D,
3.00D and 4.00D
CZ038 AT LISA tri toric 939M low cylinder Trifocal (aspheric), bitoric, micro Diopter range: -10.00 to + $1,198.00
incision, single-piece IOL for 32.0 DS and +1 to +6.5DC
The trifocal Optic Size: 6.0mm. Overall
(anterior) optic provides two Length: 11.0mm
diffractive focal points (+3.33D near
focus and +1.66D intermediate focus)
with asymmetric light distribution
50% distance / 20% intermediate /
30% near vision.
DE388 Oculentis LENTIS Mplus Toric LU- Patient specific one-piece multifocal- Overall Length 11.0mm and $1,198.00
313MFT toric plate haptic acrylic IOL Optic Size 6.0mm + 0.0D to
+36.0D inclusive in 0.01D
increments. Cyl +0.25 to
+6.99D inclusive in 0.01D
increments
Prostheses List by Category, Groups and Sponsor Page 17 of 1059
DE394 Oculentis LENTIS Mplus Toric LU- Patient specific one-piece multifocal- Overall Length 11.0mm and $1,240.00
313 MF30TY toric plate haptic acrylic IOL. Optic Size 6.0mm, +-0.0D to
+36.0D inclusive in 0.01D
increments. Cyl +0.25D to
+6.99D inclusive in 0.01D
increments.
CZ039 AT LISA tri toric 939M high Trifocal (aspheric), bitoric, micro Diopter range: -10.00 to + $1,500.00
powered cylinder incision, single-piece IOL for 32.0 DS and +7 to +12 DC
capsular bag fixation. The trifocal Optic Size: 6.0mm. Overall
(anterior) optic provides two Length: 11.0mm
diffractive focal points (+3.33D near
focus and +1.66D intermediate focus)
with asymmetric light distribution
50% distance / 20% intermediate /
30% near vision.
DE389 Oculentis LENTIS Mplus LU- Patient specific one-piece multifocal- Overall Length 11.0mm and $1,500.00
313MFT toric acrylic plate haptic IOL Optic size 6.0mm +-0.0D to
+36.0D inclusive in 0.01D
increments. Cyl +6.99D to
+12.0D inclusive in 0.01D
increments
DE395 Oculentis LENTIS Mplus LU-313 Patient specific one-piece multifocal Overall Length 11.00mm $1,542.00
MFTY toric plate haptic acrylic IOL. Violet and Optic Size 6.0mm +-
Light Filter 0.0D to +36.0D inclusive in
Cyl
+7.00D to +12.0D inclusive
in 0.01D increments.
Prostheses List by Category, Groups and Sponsor Page 18 of 1059
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, Posterior Chamber, UV absorbing, +6 D to + 34 D $864.00
SV25T0 and MN6AD1 foldable, acrylic, single piece lens
with apodised diffractive optic and
blue light protection
BL033 FineVision POD F Posterior chamber, UV absorbing, An overall diameter of $864.00
foldable, aspheric, acrylic, single 11.40mm and optic diameter
piece lens with apodised diffractive, of 6.00mm. From 0 to +35
trifocal optic and blue light diopters with 0.5 diopters
with 0.5 diopter increments.
BL034 FineVision Micro F Posterior chamber, UV absorbing, An overall diameter of $864.00
foldable, aspheric, acrylic, single 10.75mm and optic diameter
piece lens with apodised diffractive, of 6.15mm. From 0 to +35
trifocal optic and blue light dopters with 0.5 diopter
increments.
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 6mm optic, 11mm diameter. $1,198.00
IOL (standard cyl range). Aspheric Diopter range: Sph -10.0D
toric anterior surface, diffractive to +32.0D, Cyl +1.0 to 6.5D
bifocal posterior surface with (all 0.5D steps)
asymmetric light distribution (65%
distance / 35% near), 3.75D addition
for near focus.
Prostheses List by Category, Groups and Sponsor Page 19 of 1059
KG010 Rayner M-Flex Toric (Standard) Acrylic, Foldable, Single Piece, 5.75mm / 12.0mm: 6.25mm / $1,198.00
Multi-zoned Refractive Aspheric 12.5mm +3.00D or +4.00D
Toric Mulitfocal with Amon-Apple Addition FAR: +14.0D to
enhanced 360 degree Square edge, +32.00D in 0.5 STEPS:
Anti Vaulting Haptics +2.00D +3.00D +4.00D
Cylinder. NEAR: +14.0D to
27.0D in 0.5 STEPS:
+4.00D
Cylinder
KG011 Rayner "M-Flex" Toric (Non Acrylic, Foldable, Single Piece, Muli- 5.75/12.0mm: 6.25/12.5mm $1,198.00
Standard) Zoned Refractive, Toric Multifocal +3.00D to +4.00D Addition
with Amon-Apple enhanced 360 FAR: +14.0D to +32.0D in
Degree square edge, Anti-vaulting 0.5D Increments: NEAR:
Haptics, Patient 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 Posterior chamber UV absorbing +6 to +34 D spherical; 1.00 $1,240.00
IOL (SND1T2-5; SV25T2-6) foldable, acrylic, aspheric, toric single to 3.00 D cylinder
piece lens with apodised diffractive
optic and blue light protection.
CZ024 AT LISA toric 909M ZEISS micro incision, multifocal toric 6mm optic, 11mm diameter. $1,500.00
IOL (high cyl range). Aspheric toric Diopter range: Sph -10.0D
anterior surface, diffractive bifocal to +32.0D, Cyl +7.0 to
posterior surface with asymmetric 12.0D (all 0.5D steps)
light distribution (65% distance /
35% near), 3.75D addition for near
Prostheses List by Category, Groups and Sponsor Page 20 of 1059
AO035 Synchrony Vu Accommodating IOL Synchrony Vu Dual Optic 5.50mm Anterior Optic, $822.00
Accommodating Posterior Chamber 6.00mm Interior Optic,
IOL 9.80mm Overall Length,
Diopter Range: +16.00 to
+28.00 in 0.5D Increments
BL031 TruLign Toric The TruLign Toric IOL, Models Overall diameter is 11.5mm $1,198.00
BL1AT/BL2AT and BL1UT/BL2UT (BL1AT,BL1UT,AT50T) or
is an accommodating IOL 12.0mm (BL2AT/BL2UT)
incorporating a toroidal posterior for the entire lens power
surface. The foldable IOL has a square range. Spherical equivalent
posterior edge with polyimide powers range from +5.0 to
footplates and is available in multiple +33.0 Diopters in 0.5
spherical and cylindrical powers. Diopter steps and cylinder
powers of +1.25, +2.00 and
+2.75 Diopters (at the IOL
plane).
BL027 Crystalens HD Accommodating lens with > 3 10.0 to 33.0 Dioptres in .05 $780.00
Dioptres of accommodation with dual Dioptre steps
mechanism of action: (1) forward axial
movement of lens and (2)
Posterior chamber, polyspheric
optics, 3-piece, plate haptic, foldable
UV light filtering, bic
IQ003 Tetraflex Acrylic single piece, foldable Available in dioptric $780.00
accommodating intraocular lens with powers from +5.0 to +36.0,
sqare edge design, custom control 1D steps: +31.0 to +36.0;
precision and closed loop haptic 0.5D steps: +5.0 to +18.0
and +25.0 to +30.0; 0.2D
steps; +18.0 to +25.0
Prostheses List by Category, Groups and Sponsor Page 21 of 1059
BL029 Crystalens AO Accommodating lens designed to 10.0 to 33.0 D in 0.50 $822.00
provide > 3 Diopters of Diopter steps. 10.0 - 16.5
accommodation with dual mechanism Diopters (12mm length) and
of action: (1) forward axial movement 17.0 - 33.0 Diopters
of lens and (2) accommodative arching (11.5mm length).
Posterior chamber, aspheric,
aberration free optics, 3-piece, plate
haptic, fol
DV246 Rayner Sulcoflex Ashperic Pseudophakic Supplementary -10.0D to -5.50D in 0.5D $323.00
(Premium) I.O.L. I.O.L.O.L. increments. +5.50D
to 10.00D in 0.5D
KG008 Rayner "Sulcoflex" Pseudophakic Sulcoflex Aspheric Pseudophakic I.O.L -5D to +5D $365.00
I.O.L.
KG005 Rayner Sulcoflex Aspheric Toric Acrylic, Aspheric, Toric SE -3 to +3 in 0.5 D steps $698.00
Pseudophakic Secondary I.O.L - Pseudophakic Secondary IOL: Cyl +1 to +3 in 1D steps
Standard Sulcus fixated with undulating
Haptics and Posterior Haptic
KG007 Rayner Sulcoflex Aspheric Toric Acrylic, Aspheric, Toric SE -6.00 to +6.00 in 0.5 D $698.00
Pseudophakic Secondary IOL Pseudophakic Secondary IOL: Sulcus steps Syl +1.00 to +6.00 in
(Premium) fixated with undulating Haptics and 0.5D steps
Posterior Haptic Angulation
Prostheses List by Category, Groups and Sponsor Page 22 of 1059
KG006 Rayner "Sulcoflex" Aspheric Multi- Acrylic, Aspheric Multi-focal 6.5mm / 13.5mm - $822.00
focal Pseudophakic Secondary IOL Pseudophakic Secondary IOL: 5.00D+5.00D sphere with
Sulcus-Fixated with Undulating + 3.00 Addition
Haptics and Posterior Haptic
DV254 Rayner Premium Sulcoflex 653Z-Premium Multifocal Toric -7D to +7D (Spherical $1,198.00
Multifocal Toric Supplementary IOL Supplementary IOL Equivalent) Cylinder 1D,
4D, 5D, 6D Addition 3.5D
DV255 Rayner Standard Sulcoflex 653Z-Standard Multifocal Toric -3D to +3D (Spherical $1,198.00
Multifocal Toric Supplementary IOL Supplementary IOL Equivalent) Cylinders 2D
and 3D Addition 3.5D
AL006 PROVISC VISCOELASTIC PROVISC contains sodium 0.85mL pack $80.00
SOLUTION
AL007 VISCOAT Viscoelastic Fluid Chondroitin sulfate and sodium 0.75mL $80.00
hyaluronate
AL015 Cellugel viscoelastic fluid Hypromellose 2%. $80.00
AL029 DisCoVisc Ophthalmic Sodium hyaluronate 17 mg/mL and 0.5 mL and 1.0 mL $80.00
Viscosurgical Device chondroitin sulfate 40mg/mL
AO008 Healon, Intraocular Viscoelastic Sodium Hyaluronate 10mg/ml Healon 0.4ml, 0.55ml & $80.00
0.85ml
AO032 Healon Endocoat Viscoelastic 0.85ml $80.00
BL008 Ocucoat Intraocular Fluid 20mg/mL hydroxypropylmethyl 1ml and 2ml Sterile $80.00
cellulose for intraocular use
Prostheses List by Category, Groups and Sponsor Page 23 of 1059
BL015 Amvisc Plus injection 15mg/mL Sodium Hyaluronate for 0.5mL and 0.8mL $80.00
intraocular use
CZ012 Z-HYALIN Viscoelastic Cohesive Viscoelastic Solution - Volume 1.0ml $80.00
(previously called Ophthalin)
CZ013 Z-HYALIN Plus Viscoelastic Cohesive Viscoelastic Solution - Volume 1.0ml $80.00
(previously called Opthalin Plus)
CZ022 VISTHESIA 1.5% VISCOANAESTHETIC syringe 0.8ml syringe & 2x0.3ml $80.00
contains sodium hyaluronate (NaHA, ampoules
1.5%) and lidocaine hydrochloride
(1%). Also contains two topical
ampoules with NaHA (0.3%) and
lidocaine (2%)
IQ002 Ocuvis and Ocumax 2% 20mg/mL hydroxypropylmethyl 2mL sterile $80.00
Hydroxypropylmethylcellulose cellulose for intraocular use. Pre-
loaded in a sterile syringe with one
cannula for injection, in a sterile
Tyvek pouch
AO009 Healon 5, Intraocular Viscoelastic HEALON5- Sodium hyaluronate 0.6ml $85.00
Fluid 23mg/ml.
AO010 Healon GV Intraocular Viscoelastic Sodium Hyaluronate 14mg/mL 0.5mm and 0.85ml $85.00
Fluid
AL005 DUOVISC VISCOELASTIC SYSTEM PROVISC contains sodium Small & large packs $110.00
hyaluronate, VISCOAT contains
chondroitin sulfate and sodium
hyaluronate
Prostheses List by Category, Groups and Sponsor Page 24 of 1059
CZ019 TWINVISC Viscoelastic TWINVISC includes a cohesive and a Total volume 1.4 ml $110.00
dispersive viscoelastic in one
Dispersive: sodium hyaluronate
Cohesive: sodium
DV231 Vision Blue Trypan blue dye for ophthalmic 0.5ml syringe $48.00
applications
AL001 Capsular Tension Rings - 10.0 - 12.0 compressed, $159.00
12.3 - 14.5 uncompressed
AO021 Stabileyes Capsular Tension Ring Polymethylmethacrylate (PMMA) 12mm ring, and 13mm ring $159.00
Implant
CZ002 Tensiobag: Capsular Tension Ring PMMA Diameter 10 - 14mm $159.00
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), $243.00
per-load on disposable injector 14A (12mm)
Prostheses List by Category, Groups and Sponsor Page 25 of 1059
IS001 Preloaded Capsulan Tension Ring Capsular tension ring preloaded 13/11mm $243.00
(acrylic)
DV010 Morcher Coloboma Diaphram PMMA Implant 96G, 96L $334.00
AO012 Baerveldt Glaucoma Implant BG Non-valved artificial drainage device, Surface area 250, 350, $425.00
101-350, Baerveldt Glaucoma composition silicone - smooth, 425mm2
Implant BG 103-425, Baerveldt tumble-polished finish
Glaucoma Implant 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 2 Sizes: *230 mm square $625.00
of silicon *175mm square
AL037 ExPress Minature Glaucoma Shunt Miniature Glaucoma Shunt 50 & 200 microns $715.00
Prostheses List by Category, Groups and Sponsor Page 26 of 1059
RQ072 iStent Trabecular Micro-Bypass The iStent GTS100R and GTS100L 1.0mm in length, 0.33mm in $800.00
are micro-invasive glaucoma surgical height with a snorkel
devices which are implanted in an "ab length of 0.25mm
interno" procedure into the trabecular
meshwork to create a bypass through
the trabecular meshwok to Schlemm's
Canal to improve aqueous outflow
through the natural physiologic
pathway.
SO017 FCI Ptose-up Expanded PTFE 15cm long x 2 or 3mm wide $348.00
x 0.35mm thick
DV260 Meddev Eyelid Weight, Implantable Thin Profile eyelid implants for Gold Thin 0.6, 0.8, 1.0, 1.2, $425.00
patients with facial palsy 1.4, 1.6g
DE183 Lid Load Gold Eyelid Weights; Gold 0.6, 0.8, 1.0, 1.2, 1.4, 1.6 $425.00
grams
SO047 Meddev Eyelid Weight, Implantable Thin Profile eyelid implants for Gold Thin 0.6, 0.8, 1.0, 1.2, $425.00
patients with facial palsy 1.4, 1.6g
Prostheses List by Category, Groups and Sponsor Page 27 of 1059
DV259 Meddev Eyelid Weight, Implantable Thin Profile eyelid implants for Contour Gold 0.6, 0.8, 1.0, $800.00
patients with facial palsy. 1.2, 1.4, 1.6, 1.8g
DE182 Lid Load Gold Eyelid Weights; Gold 1.8, 2.0, 2.2, 2.4, 2.6, 2.8 $800.00
grams
SO046 Meddev Eyelid Weight, Implantable Thin Profile eyelid implants for Contour Gold 0.6, 0.8, 1.0, $800.00
patients with facial palsy. 1.2, 1.4, 1.6, 1.8g
RC001 LIDCHAIN Platinum Eyelid Implant Platinum Weights - 0.8, 1.0, 1.2, 1.4, $1,300.00
1.6, 1.8 grams
DV261 Meddev Eyelid Weight, Implantable Thin Profile eyelid implants for Platinum Thin 0.6, 0.8, 1.0, $1,300.00
Platinum patients with facial palsy 1.2, 1.4, 1.6g
Contour Platinum 0.6, 0.8,
1.0, 1.2, 1.4, 1.6, 1.8g
SO048 Meddev Eyelid Weight, Implantable Thin Profile eyelid implants for Platinum Thin 0.6, 0.8, 1.0, $1,300.00
Platinum patients with facial palsy 1.2, 1.4, 1.6g
Contour Platinum 0.6, 0.8,
1.0, 1.2, 1.4, 1.6, 1.8g
DV022 Eyetec DCR Tubes Stainless steel, silicone tubing, 30cm $135.00
Bodkin lacrimal intubation set
DV241 Eyetec DCR Tubes Crawford and Cannaliculus N/A $135.00
Intubation Sets
Prostheses List by Category, Groups and Sponsor Page 28 of 1059
DV256 LIS 052 "StenTube" Large Diameter Lachrymal Intubation 1.32mm Tube diameter $135.00
Set
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 1. Probes 0.90mm x 4.5cm, $135.00
silicone rods or silicone tubing - rod 40cm x 0.80mm. 2.
packaged sterile 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 PVP Bika: 0.64mm O.D. $135.00
Coated Silicone Plug/Metal Tube/80 x 0.8mm probes,
Probes/Polypropylene Thread PVP 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 Silicone tubing swaged, imbedded Probes: 40mm to 120mm x $135.00
Intubation Set into or around malleable and flexible 0.7mm to 1.2mm. Tube:
stainless steel probes. PEEK thread. 0.64mm to 1.18mm x 25mm
PEEK Thread:
0.2mm to 0.4mm x 500mm.
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 0.64mm to 1.18mm x 30mm
guides. PEEK thread. Introducer. to 350mm. PEEK Thread:
Plug Collar: 2mm to 4mm.
Prostheses List by Category, Groups and Sponsor Page 29 of 1059
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
DV258 Lacricath Lachrymal Duct Balloon Unilateral Lachrymal Duct Balloon 2mm, 3mm & 5mm $485.00
Catheter Catheter system including inflation
device
DV257 Lacricath Lachrymal Duct Balloon Bilateral Lachrymal Duct Balloon 2mm, 3mm and 5mm $879.00
Catheter Catheter System including inflation
device.
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 Bioceramic diameter, 12, 14, $1,200.00
(Aluminium Oxide)/Hydroxyapatite 16, 18, 20, 21, 22mm;
(Synthetic) Synthetic Diameter, 10, 12,
14, 16, 18, 20, 22mm
Prostheses List by Category, Groups and Sponsor Page 30 of 1059
SK521 Sphere Orbital Sphere Models 6316, 6326, Orbital Sphere Models $785.00
6327, 6317 and 6322 8702-8704. 6316: 14mm, 6326: 16mm,
COI implant, models 7222, 7223 & 6327: 18mm, 6317: 20mm,
80026. MCOI implant, models 7207 - 6322: 22mm, 8702: 19mm,
7209 Quad Motility Implants 9866 - 8703: 21mm, 8704: 23mm,
9868 & 80022 COI Implants 7222: Approx
4ml, 7223: Approx 5ml,
80026: Approx 6ml, MCOI
7207: Approx 3ml, 7208:
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 20, 22mm; Synthetic
oxide), mesh wrapped hydroxyapatite Hydroxyapatite diameter:
(synthetic), mesh wrap (polyglycolic 16, 18, 20, 22mm
acid)
MW002 Biopore Sphere An implantable device made of high- 14mm, 16mm, 18mm, 20mm, $1,930.00
density polyethylene material with an 22mm, 24mm (diameter)
interconnecting pore structure that
supports tissue ingrowth. The device
is available in sizes to meet the
Used for
orbital reconstruction following
enucleation and evisceration
procedure.
Prostheses List by Category, Groups and Sponsor Page 31 of 1059
SO019 FCI Orbital Implants Peg & Sleeve Standard Large $863.00
DE277 Frontalis Suspension Set Stainless steel needles with solid needles 0.90mm x 6.5cm, rod $315.00
silicone rods and silicone tubing - 40cm - 0.80mm, sleeve 10 x
packaged sterile 2mm
SO045 FCI Ptosis Probes Stainless steel needle probes swaged 80mm x 0.8mm needle $315.00
with silicone tubing. probes, 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 7mm, Mira 287WG Murray
Copolymer) 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 Sleeves-Mira 70 Sleeve 1mm $45.00
used in Scleral Buckling I.D., Mira 71 Sleeve 1mm
(Dimethylmethylvinyl Siloxane I.D., Mira 72 McNutt Sleeve
Copolymer) 1.57mm I.D., Mira 270
Sleeve 0.76mm I.D.
Prostheses List by Category, Groups and Sponsor Page 32 of 1059
AP006 Mira: Scleral Implants Solid Silicone-Band/Strip/Boat/Clip. Bands-Mira 40 Circling $45.00
Retinal Implant used in Scleral Band 2mm, Mira 240
Buckling (Dimethylmethylvinyl Circling Band 2.5mm.
Siloxane Copolymer) 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
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 $45.00
40, 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 0.6mmStrip - 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 $45.00
Groove, 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
Prostheses List by Category, Groups and Sponsor Page 33 of 1059
AP002 Mira: Scleral Implants Silicone Sponge- Retinal Implant Sponge- Mira 502 Cylinder $90.00
Used in Scleral Buckling (Silicone 2mm, Mira 5025 Cylinder
Elastomer 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
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 Sponge: 3 to 5mm
12mm; Gain Sponge:
6 x
Prostheses List by Category, Groups and Sponsor Page 34 of 1059
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, $25.00
Length 30mm
AL035 ISPAN Retinal Gases for Tamponade gases for retinal surgery 125g cylinder, dispensed in $75.00
Constellation® Vision System C3F8 and SF6 single dose syringe
AL036 ISPAN retinal gases Tamponade gases for retinal surgery 125 g cylinder, dispensed $75.00
C3F8 and SF6 in single dose syringe
DE284 Single Dose Ophthalmic Gases Single dose tamponading gas for 30ml $75.00
retinal surgery
IQ012 EasyGas Endotamponade Gases for Retinal 60ml dispensed in a single $75.00
Surgery, EasyGas SF6, C2F6 or C3F8, dose, sterile syringe
each supplied in a 60ml syringe,
Prostheses List by Category, Groups and Sponsor Page 35 of 1059
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- Perfluorocarbon Liquid for use as a 5mL $240.00
retinal surgery additive
BL018 DK Line 100% purified Perfluorodecalin 7ml $240.00
perfluorodecalin
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.
DE205 Arcotane (Perfloro-N-Octane) Liquid perfluoro-N-Octane aid for 5ml, 7ml $240.00
retinal 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 5ml $240.00
perfluorodecalin, FCI - OCTA:
Purified perfluoro-N-octane
Prostheses List by Category, Groups and Sponsor Page 36 of 1059
SO024 FCI - DECA, FCI - OCTA FCI - DECA: Purified 7ml $240.00
perfluorodecalin, FCI - OCTA:
Purified perfluoro-N-Octane
BL016 Oxane LMWC Fractioned Silicone Purified fractioned silicone oil 10mL $195.00
Oil
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 Viscosity: 1000 cst/5000 cst: solvent 10ml $195.00
Free) free purified silicone oil
Prostheses List by Category, Groups and Sponsor Page 37 of 1059
BD006 Harmony ™ HiResolution® Bionic The HiRes 90K with HiFocus 1j Straight array (1j). 56.0mm $13,570.00
Ear System - HiRes 90K Implant Electrode is the implanted component (L) x 28.0mm (W) x 3.0mm
Cochlear Stimulator with HiFocus of the HiResolution Bionic Ear (D)
1j Electrode System. It receives information
through an RF transmission coil,
processes the information and then
sends the resulting signal to an
electrode array implanted in the
cochlea. It consists of
receiving/transmitting coil,
Stimulator electrodes and HiFocus 1j
Electrode array.
BD007 Harmony ™ HiResolution® Bionic The HiRes 90K with HiFocus Helix Helix (coiled) electrode $13,570.00
Ear - HiRes 90K Implant Cochlear Electrode is the implanted component array - 56.0mm (L) x 28.0mm
Stimulator with HiFocus Helix of the HiResoulution Bionic Ear (W) x 3.0mm (D)
Electrode System. It receives information
through an RF tranmission coil,
precesses the information and then
sends the resulting signal to an
electrode array implanted in the
cochlea. It consists of
receiving/transmitting coil,
Stimulator electronics and HiFocus
Helix Electrode array
CO043 Nucleus Hybrid L 24 Implant A Nucleus Freedom cochlear implant One size $13,570.00
featuring a special 16mm, 22 contact
point electrode array
CO046 Cochlear™ Nucleus® CI512 Model CI512, 5th generation cochlear One Size $13,570.00
Cochlear Implants with Contour implant with perimodiloar electrode
Advance Electrode array. Titanium casing, removable
magnet, 22 half-banded platinum
electrodes, moulded in a durable
silicone seal.
Prostheses List by Category, Groups and Sponsor Page 38 of 1059
US008 Mi1000 CONCERTO/ Mi1000 Ultra small minimally invasive Stimulator Housing: L 17.3 $13,570.00
Concerto PIN titanium cochlear implant with six mm, W 25.4 mm, Thin 4.5 mm
(Weight 7.6g)
Includes sequential and parallel Electrode: Standard (26.4
stimulation, comprehensive mm), FLEXsoft (26.4 mm),
diagnostic toolkit and safety features Medium (20.9mm), FLEX24
such as unique implant ID and output (20.9mm), Compressed
capacitors for each channel (12.1mm), FLEX28
(23.1mm)
CO021 Nucleus Freedom Implant with Model C124RE (CA), Generation 4 one size only $13,570.00
Contour Advance Electrode Cochlear implant with perimodiolar
Titanium casing,
removable magnet, 22 half-banded
platinum electrodes, moulded in a
durable silicone seal
CO024 Nucleus Freedom Implant with Speech processor and accessories - One size only $13,570.00
Straight Electrode Initial
CO057 Cochlear™ Nucleus® CI422 Model CI422, 4th generation cochlear One size $13,570.00
cochlear implant with Straight implant with straight array. Titanium
22 half
banded platinum intracochlear
electrodes moulded with a silicone
elastomer carrier and spaced over a
The electrode
diameter is 0.6mm at the badal end,
tapering to 0.3mm at the apical
electrode band.
Prostheses List by Category, Groups and Sponsor Page 39 of 1059
BD008 Harmony™ HiResolution® Bionic The Auria Harmony Processor is an Sound Processor Size 54 $11,500.00
Ear System - Behind The Ear Sound external component of the HiRes mm (H) x 13mm (TH) x 21
Processor - Auria Harmony Sound Bionic Ear System. This processor is mm (w). Headpiece
Processor (INITIAL Order) intended to deliver HiResolution Diameter: 28.1 mm
sound to a cochlear implant by
converting sound waves (received via
a microphone) into an electrical
signal which is then transmitted to
the implant via a headpiece. This
listing includes sound processor,
headpiece, earhooks, powercels,
rechargers, cables and essential
accessories.
BD011 Harmony™ HiResolution® Bionic The Platinum Sound Processor is a PSP only one size; 2.69' x $11,500.00
Ear System -Body worn sound body worn component of the HiRes 2.19" x 0.81"
processor - Platinum Series Bionic Ear System. This processor is Headpiece cable: options
Processor (PSP) INITIAL Order intended to deliver HiResolution 18, 24, 32, 42 and 48 inches
sount to a cochlear implant by
converting soundwaves (received via
a microphone in the Platinum
Headpiece) into an electrical signal
that is then transmitted to the implant
via the headpiece. This listing
consists of the sound processor,
headpiece, connecting cables, and
essential accessory kit.
BD014 Neptune Sound Processor and The Neptune Processor is an external One size only and varying $11,500.00
Headpiece (UHP) initial order component of the HiRes Bionic Ear cable lengths.
includes Neptune Accessory Kit, System. This processor is intended to
these devices are the external part of deliver HiResolution sound to a
a cochlear implant system. cochlear implant.
System Composed of: Processor and
Universal Headpiece and Cable
(UHP) with Neptune Accessory kit
comprising: Neptune Connect,
Neptune Cover, Neptune cable for
AquaMic, Thin magnet, Foam
Spacer, Aquamic Color caps.
Prostheses List by Category, Groups and Sponsor Page 40 of 1059
BD017 Naida CI Q70 Sound Processor The Naida CI sound processor is one Measurements Size H x W x $11,500.00
part of a cochlear implant system that D in mm:
enables hearing. The other necessary Processor Only 26 x 9 x19
parts of the system are the Implantable - with Off-the-Ear Adaptor
Cochlear Stimulator (ICS), headpiece 40 x 9 x 19
and headpiece cable. The sound - with 110 mAh 49 x 9 x 19
processor consists of two parts: the
sound processor and battery power - with 170 mAh 55x 9 x 19
source. There are five battery options, - with 230 mAh 59 x 9 x 19
including three sizes of Lithium Ion
rechargeable PowerCel™ batteries - with Zn-Air Battery Pak
and a Zn-Air Battery Pak
CO022 Nucleus Freedom Speech Processor Speech processor (modular) and One size only $11,500.00
- Initial accessories
CO048 Cochlear™ Nucleus® CP810 The ear level sound processor of the One size $11,500.00
Sound Processor - INITIAL Nucleus 5 cochlear implant system
with multiple wearing options and a
remote control.
CO069 Cochlear ™ Nucleus® CP910 The Cochlear Nucleus CP910 Sound There is only one size of the $11,500.00
Sound Processor (Initial) Processor is a behind-the-ear sound processing unit and coil.
processor two built-in directional There are two sizes for
microphones battery holder and cover.
CO071 Cochlear ™ Nucleus® CP920 The Cochlear Nucleus CP920 Sound There is only one size of the $11,500.00
Sound Processor (Initial) Processor is a behind-the-ear sound processing unit and coil.
processor with two built-in There are two sizes for
directional micophones. battery holder and cover.
US004 OPUS 2 Speech Processor Cochlear implant speech processor, 54.0mm x 35.1mm x 8.7mm $11,500.00
16mm (2mm increments) X 0-
2.5 degrees
DY087 Surgical Titanium Mesh System End Plate or Screws or End Cap 10-33mm $1,325.00
(Round / Oblong / Trapezoidal)
DY088 Surgical Titanium Mesh System Rings (Standard and Angled) 17-26mm x 22-33mm $1,325.00
BF003 A-Mesh Spinal Titanium Mesh Plate A-Mesh® Spinal Titanium Mesh is Diameter: 14, 20 or 25mm $1,325.00
designed to restore biomechanical
integrity throughout the thoracic and
lumbar spine following vertebrectomy
or corpectomy for patients with spine
tumors or fractures
MC539 Pyramesh End ring/cap 10 - 25mm $1,325.00
Prostheses List by Category, Groups and Sponsor Page 1055 of 1059
MC821 T2 End Cap 13-31 mm, 0, 4, 8, 15 degree $1,325.00
lordosis
SK424 VBOSS End cap Sizes 10 to 25mm $1,325.00
SY295 Synmesh End rings round/oblong $1,325.00
ER138 Santorini Solid Corpectomy Cage Cage, fixed height, Peek (12x14) or (16x20) mm $3,605.00
System footprint x (18-62) mm
LH483 Coflex-F Interspinous fusion device 8, 10, 12, 14, 16mm $1,425.00
MC637 CD Horizon Spire Plate 35-41mm $1,425.00
NK027 Axle Interspinous fusion System Interspinous fusion plate system Plates: 36mm to 40 mm $1,425.00
Inserts: 8mm-18mm
NV064 Affix Plate Spinous process plate with an 25mm - 55mm $1,425.00
integrated canted-coil locking
mechanism.
Prostheses List by Category, Groups and Sponsor Page 1056 of 1059
BX308 Actifuse ABX MIS Actifuse ABX MIS, Refill Cartridge, 7.5ml $1,560.00
7.5ml
BX309 Actifuse ABX MIS Actifuse ABX MIS, Applicator and 7.5ml $2,300.00
Cartridge, 7.5ml
GO183 Actifuse ABX MIS Actifuse ABX MIS, Applicator and 7.5ml $2,300.00
Cartridge, 7.5ml
GO184 Actifuse ABX MIS Actifuse ABX MIS, Refill Cartridge, 7.5ml $1,560.00
7.5ml
BX313 Actifuse ABX Easyfill Putty Actifuse ABX Easyfill Putty - A 5ml $1,300.00 $1,540.00
silicate substituted synthetic bone
GO162 Actifuse ABX Easyfill Putty Actifuse ABX Easyfill Putty - A 5ml $1,300.00 $1,540.00
silicate substituted synthetic bone
BX310 Actifuse ABX Easyfill Actifuse ABX Easyfill - A silicate 1.5mL to 4mL $1,080.00 $1,200.00
substituted synthetic bone graft
GO161 Actifuse ABX Easyfill Actifuse ABX Easyfill - A silicate 1.5mL to 4mL $1,080.00 $1,200.00
substituted synthetic bone graft
BX312 Actifuse ABX Easyfill Putty Actifuse ABX Easyfill Putty - A 10ml $2,300.00
silicate substituted synthetic bone
Prostheses List by Category, Groups and Sponsor Page 1057 of 1059
GO163 Actifuse ABX Easyfill Putty Actifuse ABX Easyfill Putty - A 10ml $2,300.00
silicate substituted synthetic bone
DY187 Limb Preservation System Beaded, 'Porocoat' Standard & Neutral, 15deg Left & Right $6,990.00
Trochanter Replacement in both styles
BX311 ACTIFUSE ABX Putty Actifuse AVX Putty - A silicated 20ml $4,600.00
substituted synthetic bone graft.
GO177 ACTIFUSE ABX Putty Actifuse AVX Putty - A silicated 20ml $4,600.00
substituted synthetic bone graft.
ZI265 Continuum hip system Hedrocel AVN Rod 3mm - 12mm block $3,208.00
Prostheses List by Category, Groups and Sponsor Page 1058 of 1059
BI487 Mimix Calcium Phosphate Bone Calcium Phosphate 5 grams $1,004.00
Void Filler
BI488 Mimix Calcium Phosphate Bone Calcium Phosphate 10 grams $1,900.00
Void Filler
BI489 Mimix Calcium Phosphate Bone Calcium Phosphate 20 grams $2,300.00
Void Filler
Prostheses List by Category, Groups and Sponsor Page 1059 of 1059
Schedule - Part B - Human Tissue List February 2014
TBV56 Donor Tissue Bank of Victoria $1,117.00
QHV09 The Prince Charles Hospital - Queensland Heart Valve Bank $6,300.00
SHV03 Sydney Heart Valve Bank, St. Vincent's Hospital $1,263.00
TBV03 Donor Tissue Bank of Victoria $1,116.00
QHV08 The Prince Charles Hospital - Queensland Heart Valve Bank $6,600.00
QHV07 The Prince Charles Hospital - Queensland Heart Valve Bank $1,915.00
QHV03 The Prince Charles Hospital - Queensland Heart Valve Bank $1,743.00
QHV05 The Prince Charles Hospital - Queensland Heart Valve Bank $1,915.00
QHV04 The Prince Charles Hospital - Queensland Heart Valve Bank $1,743.00
TBV50 Donor Tissue Bank of Victoria $540.00
QHV11 The Prince Charles Hospital - Queensland Heart Valve Bank $1,915.00
QHV01 The Prince Charles Hospital - Queensland Heart Valve Bank $6,600.00
RPH01 Royal Perth Hospital T/A Heart Valve Bank $6,406.00
SHV01 Sydney Heart Valve Bank, St. Vincent's Hospital $6,842.00
TBV01 Donor Tissue Bank of Victoria $7,278.00
Page 1 of 15
QHV10 The Prince Charles Hospital - Queensland Heart Valve Bank $6,300.00
QHV02 The Prince Charles Hospital - Queensland Heart Valve Bank $6,600.00
RPH02 Royal Perth Hospital T/A Heart Valve Bank $6,406.00
SHV02 Sydney Heart Valve Bank, St. Vincent's Hospital $6,842.00
TBV02 Donor Tissue Bank of Victoria $7,278.00
SYN03 Synthes Australia Pty Ltd $2,200.00
SYN07 Synthes Australia Pty Ltd $27,000.00
QBB72 The Queensland Bone Bank $477.00
SYN06 Synthes Australia Pty Ltd $14,000.00
QBB73 The Queensland Bone Bank $705.00
SYN04 Synthes Australia Pty Ltd $3,500.00
QBB71 The Queensland Bone Bank $248.00
SYN05 Synthes Australia Pty Ltd $5,700.00
LEM03 Lions Eye Donation Service $770.00
LEM01 Lions Eye Donation Service $2,000.00
LEN01 Lions NSW Eye Bank $2,026.00
LEW01 Lions Eye Bank of Western Australia $2,500.00
QEB01 Queensland Eye Bank $2,100.00
SAE01 The Eye Bank of South Australia $1,890.00
Page 2 of 15
LEW03 Lions Eye Bank of Western Australia $3,000.00
SAE03 The Eye Bank of South Australia $2,849.00
LEM04 Lions Eye Donation Service $2,660.00
LEN03 Lions NSW Eye Bank $1,216.00
LEM02 Lions Eye Donation Service $150.00
LEN02 Lions NSW Eye Bank $304.00
LEW02 Lions Eye Bank of Western Australia $250.00
QEB02 Queensland Eye Bank $298.00
SAE02 The Eye Bank of South Australia $230.00
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
TBV52 Victorian Institute of Forensic Medicine $683.00
TBV53 Victorian Institute of Forensic Medicine $1,364.00
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
Page 3 of 15
QBB10 The Queensland Bone Bank $680.00
TBV09 Donor Tissue Bank of Victoria $1,073.00
TBV10 Donor Tissue Bank of Victoria $2,044.00
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
SYN02 Synthes Australia Pty Ltd $3,400.00
SYN01 Synthes Australia Pty Ltd $2,650.00
TBV55 Donor Tissue Bank of Victoria $1,157.00
TBV54 Donor Tissue Bank of Victoria $578.00
PBT37 Perth Bone and Tissue Bank $750.00
PBT62 Perth Bone and Tissue Bank $550.00
PBT10 Perth Bone and Tissue Bank $3,745.00
PBT64 Perth Bone and Tissue Bank $1,850.00
Page 4 of 15
PBT08 Perth Bone and Tissue Bank $2,709.00
QBB45 The Queensland Bone Bank $1,993.00
QBB03 The Queensland Bone Bank $2,524.00
PBT09 Perth Bone and Tissue Bank $3,330.00
PBT38 Perth Bone and Tissue Bank $900.00
TBV11 Donor Tissue Bank of Victoria $1,285.00
PBT63 Perth Bone and Tissue Bank $950.00
TBV12 Donor Tissue Bank of Victoria $2,299.00
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 $762.00
TBV08 Donor Tissue Bank of Victoria $827.00
PBT11 Perth Bone and Tissue Bank $300.00
QBB12 The Queensland Bone Bank $210.00
TBV17 Donor Tissue Bank of Victoria $430.00
Page 5 of 15
AUB05 Australian Biotechnologies $2,451.00
QBB52 The Queensland Bone Bank $441.00
TBV14 Donor Tissue Bank of Victoria $842.00
PBT07 Perth Bone and Tissue Bank $2,664.00
PBT48 Perth Bone and Tissue Bank $3,032.00
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 $5,787.00
NBB09 New South Wales Bone Bank $922.00
TBV21 Donor Tissue Bank of Victoria $889.00
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
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
Page 6 of 15
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 $2,932.00
QBB27 The Queensland Bone Bank $2,163.00
RNB01 Hunter New England Bone Bank $2,250.00
SVN01 Mater Hospital $731.00
TBV26 Donor Tissue Bank of Victoria $2,596.00
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 $1,330.00
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
NBB57 New South Wales Bone Bank $2,778.00
NBB13 New South Wales Bone Bank $2,507.00
TBV24 Donor Tissue Bank of Victoria $2,357.00
NBB56 New South Wales Bone Bank $1,687.00
Page 7 of 15
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 $3,771.00
TBV22 Donor Tissue Bank of Victoria $4,251.00
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 $7,120.00
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 $3,771.00
TBV25 Donor Tissue Bank of Victoria $4,220.00
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 $4,095.00
MVS07 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
NBB18 New South Wales Bone Bank $6,041.00
Page 8 of 15
PBT25 Perth Bone and Tissue Bank $2,967.00
QBB32 The Queensland Bone Bank $2,651.00
TBV27 Donor Tissue Bank of Victoria $6,863.00
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 $1,164.00
MVS13 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
TBV28 Donor Tissue Bank of Victoria $762.00
TBV30 Donor Tissue Bank of Victoria $2,419.00
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 $3,300.00
MVS08 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
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 $7,487.00
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 $2,984.00
NBB23 New South Wales Bone Bank $1,195.00
PBT32 Perth Bone and Tissue Bank $1,067.00
Page 9 of 15
QBB35 The Queensland Bone Bank $1,195.00
TBV34 Donor Tissue Bank of Victoria $1,149.00
QBB36 The Queensland Bone Bank $735.00
TBV37 Donor Tissue Bank of Victoria $1,823.00
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 $2,472.00
MVS20 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
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 $3,054.00
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
Page 10 of 15
TBV35 Donor Tissue Bank of Victoria $2,919.00
NBB53 New South Wales Bone Bank $1,448.00
NBB31 New South Wales Bone Bank $1,781.00
TBV38 Donor Tissue Bank of Victoria $1,964.00
PBT47 Perth Bone and Tissue Bank $1,921.00
QBB05 The Queensland Bone Bank $1,400.00
TBV40 Donor Tissue Bank of Victoria $1,306.00
TBV39 Donor Tissue Bank of Victoria $2,368.00
PBT60 Perth Bone and Tissue Bank $1,567.00
QBB47 The Queensland Bone Bank $788.00
TBV41 Donor Tissue Bank of Victoria $1,125.00
PBT40 Perth Bone and Tissue Bank $2,954.00
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 $3,436.00
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
Page 11 of 15
PBT41 Perth Bone and Tissue Bank $300.00
TBV43 Donor Tissue Bank of Victoria $537.00
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 $1,129.00
QBB65 The Queensland Bone Bank $1,433.00
NBB02 New South Wales Bone Bank $2,228.00
PBT01 Perth Bone and Tissue Bank $2,601.00
QBB01 The Queensland Bone Bank $1,922.00
TBV06 Donor Tissue Bank of Victoria $2,300.00
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
Page 12 of 15
NBB33 New South Wales Bone Bank $2,147.00
TBV42 Donor Tissue Bank of Victoria $2,368.00
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 $2,698.00
NBB67 New South Wales Bone Bank $2,184.00
QBB58 The Queensland Bone Bank $1,922.00
TBV57 Donor Tissue Bank of Victoria $2,300.00
NBB71 New South Wales Bone Bank $2,184.00
QBB57 The Queensland Bone Bank $1,922.00
TBV47 Donor Tissue Bank of Victoria $1,832.00
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 $2,401.00
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
Page 13 of 15
QBB54 The Queensland Bone Bank $2,365.00
TBV45 Donor Tissue Bank of Victoria $2,722.00
TBV44 Donor Tissue Bank of Victoria $2,826.00
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
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
Page 14 of 15
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 $3,167.00
NBB40 New South Wales Bone Bank $1,854.00
NBB38 New South Wales Bone Bank $2,450.00
Page 15 of 15
Schedule - Part C - Other Prostheses February 2014
DF001 DANAIIS Insulin Pump Continuous insulin infusion pump 75mm x 45mm x 19mm $4,000.00
AN011 Animas Vibe Insulin Pump & CGM Ambulatory insulin infusion pump Pump/Monitor: 8.26 x 5.08 $8,950.00
System with real-time continuous glucose x 2.18cm
monitoring (CGM) 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 $8,950.00
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.
RO044 Accu-Chek Combo System Insulin delivery device capable of The Accu-Chek Combo $8,950.00
remotely receiving and acting on System is only available in
information about blood glucose one size.
levels, performing bolus calculation
and bolus advice on additional
parameters than what is normally
AN005 Animas 2020 Insulin Pump. Ambulatory Insulin Infusion Pump 7.4cm x 5cm x 1.9cm $7,750.00
Page 1 of 3
MC839 Medtronic MiniMed Insulin Paradigm Veo Model MMT-554. 5.1 x 7.6 x 2.0cm $9,500.00
Infusion Pump 'Smart' Insulin Pump with REAL-
Time continuous glucose monitoring
capability, incorporating a low
glucose suspend and with remote
MC840 Medtronic MiniMed Insulin Paradigm Veo Model MMT-754. 5.1 x 9.4 x 2.0cm $9,500.00
Infusion Pump 'Smart' Insulin Pump with REAL-
Time continuous glucose monitoring
capability, incorporating a low
glucose suspend and with remote
Page 2 of 3
MC763 Reveal XT Reveal XT Insertable Cardiac Monitor 61 x 19 x 8 mm with a $3,900.00
volume of 9cc
MC768 Reveal DX Insertable Cardiac Monitor 61 x 19 x 8 mm with a $3,900.00
volume of 9cc
SJ152 SJM Confirm Model DM2102 Implantable cardiac monitor with 6.5cc, 12g $3,900.00
atrial fibrillation monitoring.
SJ159 SJM Confirm Model DM2100 Implantable cardiac monitor 6.5cc, 12g $3,900.00
Page 3 of 3
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