Document ID: chunk:federal_register_of_legislation:F2024L01386:schedule:1:p389
Version: federal_register_of_legislation:F2024L01386
Segment Type: schedule
Provision Reference: sch 1 (pt 389/696)
Character Range: 13699330–13743548

cm3/ 20.8g     48 mm × 40 mm × 6.5 mm                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           $3,662.00

     BOSTON SCIENTIFIC PTY LTD
BS271                                                                                                                                                               VITALIO MRI SR                                                                                                                                         Single Chamber Pacemaker, MRI Compatible                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 11.5cc                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         $3,662.00
BS320                                                                                                                                                               ACCOLADE MRI SR                                                                                                                                        Single Chamber Pacemaker, MRI Conditional                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                ACCOLADE MRI SR 4.45 x 4.81 x 0.75cm                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           $3,662.00

  Remote Monitoring Service
     MEDTRONIC AUSTRALASIA PTY LTD
MI446                                                                                                                                                               Azure XT SR MRI SureScan  with BlueSync mobile remote monitoring                                                                                       MR Conditional single chamber pacemaker with SureScan™ technology and Bluetooth® wireless telemetry (OOE-VVIR) with BlueSync mobile remote monitoring                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    12.25cm3 22.5g                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 $5,112.00        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.
MI447                                                                                                                                                               Azure S SR MRI SureScanTM with BlueSync mobile remote monitoring                                                                                       MR Conditional single chamber pacemaker with SureScan™ technology and Bluetooth® wireless telemetry (OOE-VVIR) with BlueSync mobile remote monitoring                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    12.25cm3 22.5g                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 $5,112.00        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.

08.04.04 - Leadless pacemaker
     ABBOTT MEDICAL AUSTRALIA PTY LTD.
QQ547                                                                                                                                                               Aveir VR Transcatheter Leadless Pacemaker Model LSP112V                                                                                                Single chamber transcatheter leadless pacemaker, MRI-ready, 243 mAh battery capacity, chronically retrievable,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           3.8cm length, 0.65 outer diameter and 2.4 grams weight                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         $10,083.00
                                                                                                                                                                                                                                                                                                                           active helix fixation, expandable to dual chamber.

     MEDTRONIC AUSTRALASIA PTY LTD
MI516                                                                                                                                                               Micra VR Transcatheter Pacemaker                                                                                                                       Single chamber transcatheter leadless pacemaker with SureScan™ technology including a delivery catheter (MC1VR01).                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       2.59cm length, 0.67cm outer diameter and 1.75 grams weight                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     $10,083.00
QQ601                                                                                                                                                               Micra VR2 Transcatheter Pacemaker                                                                                                                      Single chamber transcatheter leadless pacemaker with SureScan technology including a delivery catheter (MC2VR01).                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        2.59cm length, 0.67cm outer diameter and 1.75 grams weight                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     $10,083.00

08.05 - Dual Chamber Pacemakers
08.05.04 - DDDR with continuous threshold monitoring in atrium + ventricle with ability to adapt pacing outputs accordingly, & with four or more advanced features
     MEDTRONIC AUSTRALASIA PTY LTD
MI222                                                                                                                                                               Attesta DR MRI SureScan pacemaker                                                                                                                      MRI safe, dual chamber rate responsive pacemaker (DDDR)                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  12.1cm3 23.6g                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  $5,980.00
MI233                                                                                                                                                               Attesta S DR MRI SureScan pacemaker                                                                                                                    MRI, dual chamber rate responsive pacemaker (DDDR)                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       11.1cm3 23.6g                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  $5,980.00
MC726                                                                                                                                                               Adapta Pacemaker                                                                                                                                       DR Pacemaker                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             11.1 - 13cc 23.6g - 28.1g                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      $5,980.00
                                                                                                                                                                                                                                                                                                                           Models ADDR01, ADDRS1, ADDR03
MI226                                                                                                                                                               Attesta L DR MRI SureScan pacemaker                                                                                                                    MRI, dual chamber rate responsible pacemaker (DDDR)                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      13.1cm3 31.3g                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  $5,980.00

     MICROPORT CRM PTY LIMITED
RF030                                                                                                                                                               TEO DR                                                                                                                                                 Dual 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