St Jude Medical Unify Quadra CRT Cardiac Resynchronisation 52,750.00 Australia Pty Ltd CD 3251-40Q Therapy Defibrillator with 40J delivered energy with quadripole pacing and SJ4 connector Appendix 4 ICD leads on the Prosthesis list Sponsor Product name Description Min Max benefit benefit ($) ($) Transvenous/steroid/passive leads Boston Scientific Endotak Reliance S Passive fixation single coil 9,000.00 Australia Pty Ltd 4-SITE defibrillation leads & 4-SITE connector Boston Scientific Endotak Reliance G Passive fixation dual coil 9,000.00 Australia Pty Ltd 4-SITE defibrillation leads with ePTFE covered coils & 4-SITE connector Boston Scientific Endotak Reliance Passive fixation single coil 9,000.00 Australia Pty Ltd SG 4-SITE defibrillation leads with ePTFE covered coil & 4-SITE connector Boston Scientific Endotak Reliance Passive fixation dual coil 9,000.00 Australia Pty Ltd 4-SITE defibrillation leads with 4-SITE connector Biotronik Australia Linox TD Fractal and steroid coated 9,000.00 Pty Ltd passive fixation quadripolar ICD lead Biotronik Australia Linox T Single-shock coil ICD lead with 9,000.00 Pty Ltd passive fixation Biotronik Australia Linox SMART TD Dual-shock coil ICD lead with 9,000.00 Pty Ltd passive fixation and hydrophilic coating on lead body Guidant Australia Endotak Reliance Passive Dual Coil 9,000.00 Pty Ltd Lead Guidant Australia Endotak Reliance Passive Single Coil with GORE 9,000.00 Pty Ltd SG Passive ePTFE covered coil Guidant Australia Endotak Reliance G Passive Dual Coil with GORE 9,000.00 Pty Ltd Passive ePTFE covered coil
St Jude Medical Australia Pty Ltd Unify Quadra CRT CD 3251-40Q Cardiac Resynchronisation Therapy Defibrillator with 40J delivered energy with quadripole pacing and SJ4 connector 52,750.00 Appendix 4 ICD leads on the Prosthesis list Sponsor Product name Description Min benefit ($) Max benefit ($) Transvenous/steroid/passive leads Boston Scientific Australia Pty Ltd Endotak Reliance S 4-SITE Passive fixation single coil defibrillation leads & 4-SITE connector 9,000.00 Boston Scientific Australia Pty Ltd Endotak Reliance G 4-SITE Passive fixation dual coil defibrillation leads with ePTFE covered coils & 4-SITE connector 9,000.00 Boston Scientific Australia Pty Ltd Endotak Reliance SG 4-SITE Passive fixation single coil defibrillation leads with ePTFE covered coil & 4-SITE connector 9,000.00 Boston Scientific Australia Pty Ltd Endotak Reliance 4-SITE Passive fixation dual coil defibrillation leads with 4-SITE connector 9,000.00 Biotronik Australia Pty Ltd Linox TD Fractal and steroid coated passive fixation quadripolar ICD lead 9,000.00 Biotronik Australia Pty Ltd Linox T Single-shock coil ICD lead with passive fixation 9,000.00 Biotronik Australia Pty Ltd Linox SMART TD Dual-shock coil ICD lead with passive fixation and hydrophilic coating on lead body 9,000.00 Guidant Australia Pty Ltd Endotak Reliance Lead Passive Dual Coil 9,000.00 Guidant Australia Pty Ltd Endotak Reliance SG Passive Passive Single Coil with GORE ePTFE covered coil 9,000.00 Guidant Australia Pty Ltd Endotak Reliance G Passive Passive Dual Coil with GORE ePTFE covered coil 9,000.00