St Jude Medical St Jude Medical Tendril ST Model 1882TC Lead 143300 Australia Pty Ltd Cardiac Rhythm Management Division USA St Jude Medical St Jude Medical Tendril ST Model 1888TC Lead 143301 Australia Pty Ltd Cardiac Rhythm Management Division USA St Jude Medical St Jude Medical Tendril STS Lead Model 1988TC 170585 Australia Pty Ltd Cardiac Rhythm Management Division USA St Jude Medical St Jude Medical Tendril STS Lead Model 2088TC 170587 Australia Pty Ltd Cardiac Rhythm Management Division USA Appendix 3 CRT-D devices on the Prosthesis list Sponsor Product name Description Min Max benefit benefit ($) ($) Biotronik Australia Lumax 540 HF-T High Energy, Three Chamber 47,840.00 Pty Ltd ICD (Implantable Cardiac Defibrillator) with Advanced Patient Management Via unique Home Monitoring Technology incorporating Automatic RV/LV Threshold Monitoring and Extended Longevity. Boston Scientific COGNIS 100 HE CRT-D high energy with RF 47,840.00 Australia Pty Ltd (DF-1/IS-1 & Boston Scientific COGNIS 100 HE CRT-D high energy with RF 48,590.00 Australia Pty Ltd IS4 Boston Scientific ENERGEN CRT-D High energy CRT-D with DF-1 47,840.00 Australia Pty Ltd RV connector and IS-1 LV connector
St Jude Medical Australia Pty Ltd St Jude Medical Cardiac Rhythm Management Division USA Tendril ST Model 1882TC Lead 143300 St Jude Medical Australia Pty Ltd St Jude Medical Cardiac Rhythm Management Division USA Tendril ST Model 1888TC Lead 143301 St Jude Medical Australia Pty Ltd St Jude Medical Cardiac Rhythm Management Division USA Tendril STS Lead Model 1988TC 170585 St Jude Medical Australia Pty Ltd St Jude Medical Cardiac Rhythm Management Division USA Tendril STS Lead Model 2088TC 170587 Appendix 3 CRT-D devices on the Prosthesis list Sponsor Product name Description Min benefit ($) Max benefit ($) Biotronik Australia Pty Ltd Lumax 540 HF-T High Energy, Three Chamber ICD (Implantable Cardiac Defibrillator) with Advanced Patient Management Via unique Home Monitoring Technology incorporating Automatic RV/LV Threshold Monitoring and Extended Longevity. 47,840.00 Boston Scientific Australia Pty Ltd COGNIS 100 HE (DF-1/IS-1 & CRT-D high energy with RF 47,840.00 Boston Scientific Australia Pty Ltd COGNIS 100 HE CRT-D high energy with RF IS4 48,590.00 Boston Scientific Australia Pty Ltd ENERGEN CRT-D High energy CRT-D with DF-1 RV connector and IS-1 LV connector 47,840.00
1223-Final-Protocol.docx