Document ID: chunk:federal_register_of_legislation:F2025L00198:schedule:1:p662
Version: federal_register_of_legislation:F2025L00198
Segment Type: schedule
Provision Reference: sch 1 (pt 662/706)
Character Range: 2162193–2165691

Usable Length: 40 to 130 cm.    $1,245.00

QQ646  IN.PACT 018 Paclitaxel-coated PTA Balloon Catheter  The FreePac drug coating on the balloon of the IN.PACT 018 DCB consists of the drug paclitaxel and the excipient urea.   Balloon Diameter: 4 to 7 mm; Balloon Length: 40 to 150 mm; Catheter Usable Length: 80 to 130 cm  $1,245.00

Prescribed List -Part D

03 - General Miscellaneous
Billing Code  Product Name  Description  Size  Minimum Benefit  Condition

03.02 - DRUG DELIVERY DEVICES
03.02.02 - Infusion Pumps, Balloon Based
  03.02.02.01 - Fixed Flow Rate
     B BRAUN AUSTRALIA PTY LTD
BB349  Easypump  Disposable Elastomeric infusion pump system  LT: Filling Volume: 60ml - 400ml, Flow Rate: 0.5ml/h - 10ml/h  $28.00
                                                              ST: Filling Volume: 50ml - 500ml, Flow Rate: 50ml/h - 500ml/h

     EPIC MEDICAL PTY LTD
QQ832  SMARTeZ RS Rigid Shell Single Use Elastomeric Infusion Pump  DESCRIPTION                                                                                                                                                                                                                                                                                                                                                                                                Long Term Infusion: 60ml - 300ml, 0.5ml/hr to 11.5ml/hr flow rate.     Short Time Infusion: 50ml - 250ml, 50ml/hr to 250ml/hr flow rate.    $28.00
                                                                    The SMARTeZ RS Rigid Shell Elastomeric Infusion Pump (SINGLE USE for a Single patient),  elastomeric pump with rigid shell on the fluid reservoir. The device works independently of main power supplies or batteries, enabling patient to be treated in an ambulatory manner.
                                                                    Fluid is delivered to patient by positive pressure applied by the elastomeric membranes on the fluid reservoir. The flow rate is determined by the combination of the flow restrictor (capillary tube) and positive pressure of the elastomeric membrane. This pressure delivers the fluid against the back pressure of the catheters and  infusion site. Suitable for short term and long term infusion.

QQ825  SMARTeZ Soft Shell Elastomeric Infusion Pump  The SMARTeZ Soft Shell Elastomeric Infusion Pump pump has a specially designed multi-layered balloon-like reservoir to be filled with the drug or fluid intended for infusion. It exerts mechanical pressure to administer the contents at a predetermined flow rate. The entire unit is sterile and is intended for single use only.  Long Infusion: Filling Volume: 60ml - 400ml, Flow Rate: 0.5ml/h - 10ml/h  Short Infusion: Filling Volume: 50ml - 500ml, Flow Rate: 50ml/h - 500ml/h  $28.00

QQ831  SMARTeZ Rigid Shell Single Use Elastomeric Infusion Pump - Chemotherapy  SMARTeZ Rigid Shell Single use Elastomeric Infusion Pump - Chemotherapy-rated pumps are available with and without a bonded closed system transfer device attachment. (CSTD) providing a true closed system for the safety of both the patient and caregivers. Product is used for a single patient only.  Size, 60ml - 275ml. Flow rates: 0.5mL/hr to 100mL/hr  $28.00

QQ828  SMARTeZ Plus Painbloc Single Use Elastomeric Infusion pump - Fixed Flow rate - Single patient use  The SMARTeZ Plus PainBloc pump is a single use soft-shell elastomeric pump, for single patient use only. The Painbloc