Document ID: chunk:federal_register_of_legislation:F2024L01386:schedule:1:p390
Version: federal_register_of_legislation:F2024L01386
Segment Type: schedule
Provision Reference: sch 1 (pt 390/696)
Character Range: 13736052–13779631

Chamber MRI Conditional Pacemaker                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   Weight - 20g   Volume - 8cc                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    $5,980.00
RF042                                                                                                                                                               Alizea™ DR                                                                                                                                             Dual chamber MRI conditional pacemaker                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   Volume - 10.95cc  Weight - 24.2g                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               $5,980.00
RF029                                                                                                                                                               OTO DR                                                                                                                                                 Dual Chamber MRI Conditional  Pacemaker                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  Weight - 20g  Volume - 8cc                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     $5,980.00
RF016                                                                                                                                                               KORA 100 DR                                                                                                                                            KORA 100 DR is a Dual Chamber MRI conditional, Rate Responsive Pacemaker                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 41.2 x 41.5 x 6.1mm                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            $5,980.00
RF026                                                                                                                                                               ENO DR                                                                                                                                                 Dual Chamber MRI Conditional Pacemaker                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   Weight 20g  Volume 8cc                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         $5,980.00

  g
     BIOTRONIK AUSTRALIA PTY LIMITED
QQ135                                                                                                                                                               Solvia Rise DR-T                                                                                                                                       Dual Chamber Pacemaker, ventricular capture control, physiological rate adaption,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        48 x 44  x 6.5 mm,  11cm3   23.2g                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              $6,870.00
                                                                                                                                                                                                                                                                                                                           EarlyCheck, automatic event (IEGM) & trend triggered transmission. Wandless telemetry,
                                                                                                                                                                                                                                                                                                                           Home Monitoring, MRI Guard 24/7, Closed Loop Stimulation, IS-1 connector
BT242                                                                                                                                                               Enitra 8 DR-T                                                                                                                                          Dual Chamber Pacemaker, ventricular capture control, physiological rate adaption,automatic event (IEGM) & trend triggered transmission. Wandless telemetry, Home Monitoring, MRI AutoDetect, MRI conditional, IS-1 connector                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             11 cm3/ 23.2 g        48 mm × 44 mm × 6.5 mm                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   $6,870.00
QQ151                                                                                                                                                               Amvia Sky DR-T                                                                                                                                         Dual Chamber Pacemaker, ventricular capture control, physiological rate adaption, atrial anti-tachycardia pacing,  Quick/Early Check, automatic event (IEGM) & trend triggered transmission. Wandless telemetry, Home Monitoring, MRI Guard 24/7, Closed Loop Stimulation, IS-1 connector                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                48 x 44 x 6.5 mm, 11 cm3,  23.2 grams                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          $6,870.00
BT214                                                                                                                                                               Evity 8 DR-T                                                                                                                                           Dual Chamber Pacemaker, ventricular capture control, physiological rate adaption, automatic event (IEGM) & trend triggered transmission. Wandless telemetry, Home Monitoring, MRI AutoDetect, MRI conditional, IS-1 connector                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            IS-1 (2x) 11 cm3/ 23.2 g     48 mm × 44 mm × 6.5 mm                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            $6,870.00
BT193                                                                                                                                                               Edora 8 DR-T                                                                                                                                           Dual Chamber Pacemaker, ventricular capture control, physiological rate adaption, automatic event (IEGM) & trend triggered transmission. Wandless telemetry, Home Monitoring, MRI AutoDetect, MRI conditional, IS-1 connector                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            48 x 44 x 6.5 mm, 11 cm3,  23.2 grams                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          $6,870.00

     MEDTRONIC AUSTRALASIA PTY LTD
MI237                                                                                                                                                               Azure XT DR MRI SureScan                                                                                                                               MR Conditional dual chamber pacemaker with SureScan™ technology and Bluetooth® wireless telemetry                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        12.75 cm3 22.5g                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                $6,870.00
MC933                                                                                                                                                               Advisa DR MRI SureScan                                                                                                                                 Advisa DR MRI SureScan A3DR01 - Dual-chamber pacemaker                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   12.7cc, 22g                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    $6,870.00
MI243                                                                                                                                                               Azure S DR MRI SureScan                                                                                                                                MR Conditional dual chamber pacemaker with SureScan™ technology and Bluetooth® wireless telemetry (OOE-DDDR)                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             12.75cm3 22.5g                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 $6,870.00

  g, Remote Monitoring Service
     MEDTRONIC AUSTRALASIA PTY LTD
MI448                                                                                                                                                               Azure XT DR MRI SureScan with BlueSync mobile remote monitoring                                                                                        MR Conditional dual chamber pacemaker with SureScan™ technology and Bluetooth® wireless telemetry with BlueSync mobile remote monitoring                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 12.75 cm3 22.5g                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                $8,320.00        The benefit includes a component for remote monitoring services provided via a remote monitoring system or a smart device application. A separate benefit cannot be claimed in respect of a remote monitoring system listed on Part C of the Schedule.
MI449                                                                                                                                                               Azure S DR MRI SureScan with