baxter us price list
DESCRIPTION
Baxter US Price ListTRANSCRIPT
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PRICE LIST & PRODUCT CATALOG
2012
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C O N T E N T ST E R M S A N D C O N D I T I O N S O F S A L E
Baxters Renal Business Unit develops, manufactures and markets a comprehensive selection of PRODUCTS and services used in the treatment of kidney disease.
Directory of Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2General Terms and Conditions of Sale . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Definitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4Warranties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-6Order/Delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-10Billing/Payment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11Returned Goods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12APD EQUIPMENT Rental Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-14
P E R I T O N E A L D I A LY S I SDIANEAL PD Solution, ULTRABAG System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PD1DIANEAL PD Solution, Single Bag . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PD2 PD3EXTRANEAL (icodextrin) PD Solution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PD4HOMECHOICE PRO Automated Peritoneal Dialysis System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PD5 PD6HOMECHOICE Automated Peritoneal Dialysis System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PD5 PD6APD Drain Supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PD6APD Miscellaneous Supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PD6Disconnect Y-Sets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PD7Miscellaneous CAPD Supplies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PD7Assist Devices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PD7Transfer Sets, Catheter Supplies, Disconnect Caps, and Clamps . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PD8 Trademarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PDTM
A C U T E D I A LY S I SDialysis Solutions for CRRT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . AC1 Acute PD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . AC1 Trademarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ACTM
H E M O D I A LY S I S HEMAVISION Disposable Blood Chamber . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HD1Dialyzers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HD2 HD3Blood Tubing Sets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HD4Fistula Needles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HD5 HD6Disposable Supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HD7Concentrates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HD8 Trademarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HDTM
S O F T W A R E . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . SO1Trademarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . SOTM
A N C I L L A R I E SSponges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . AN1Dressings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . AN1Tape . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . AN2Antiseptics/Chemicals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . AN3Gloves . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . AN3Blood Pressure Units . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . AN4Scales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . AN4Permanent Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . AN4Miscellaneous Ancillary Supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . AN5 Trademarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANTM
P R E S C R I P T I O N F O R M S . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PF1 PF4Trademarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PFTM
N U M E R I C A L I N D E X . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IN1 IN2
Prices stated here are applicable to the U.S. only.Baxter may, at its sole discretion, revise or amend this price list and product catalog without prior notice to the customer.
Effective April 1, 2012
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D I R E C T O RY O F S E R V I C E S
HomeCare Services / Order Entry (HOME PATIENTS) 1-800-284-4060
Hours: 7:00 am - 6:00 pm CST Fax: 1-800-666-8457
Customer Service / Order Entry (Hospitals & Centers) 1-888-229-0001
Hours: 7:00 am - 6:00 pm CST Fax: 1-888-229-0020
NOTE: Hospital and Center orders are required to be placed electronically.
Electronic Commerce 1-877-334-2298
http://ecomm.baxter.com
Sales Inquiries 1-888-736-2543
PARTS and EQUIPMENT Service 1-800-553-6898
Hemodialysis On-site Service
Hours: 8:00 am - 5:00 pm local time
Emergency On-site Service (7 days a week)
Hours: 8:00 am -10:00 pm EST
Global Technical Services 1-800-553-6898
Peritoneal Dialysis Operational Support (24/7/365 days a year)
Hemodialysis Technical Support
Hours: 8:30 am - 5:00 pm EST
Clinical Support 1-888-736-2543
PRODUCT Surveillance 1-888-736-2543
Hardware Billing 1-800-553-6898
Credit and Collections 1-888-270-3189
Hours: 7:00 am - 5:00 pm CST
DIRECTACCESS 1-800-284-4060
https://homecareservices.baxter.com/
Pharmacy Services 1-888-736-2543
2 Effective Date 4/1/12
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Effective Date 4/1/12 3
I . G E N E R A L T E R M S A N D C O N D I T I O N S O F S A L E
ALL SALES ARE SUBJECT TO AND EXPRESSLY CONDITIONED UPON THE TERMS AND CONDITIONS CONTAINED HEREIN, WHICH ARE ACCEPTED BY THE CUSTOMER UPON PLACING OF AN ORDER FOR PRODUCT WITH BAXTER WHICH ORDER IS CONFIRMED BY BAXTER. NO VARIATION OF THESE TERMS AND CONDITIONS WILL BE BINDING UPON BAXTER UNLESS AGREED TO IN WRITING AND SIGNED BY AN AUTHORIZED EMPLOYEE OF BAXTER, OR UNLESS A SEPARATE DIALYSIS PRODUCT PURCHASE AGREEMENT OR OTHER APPLICABLE SALES DOCUMENT HAS BEEN SIGNED, IN WHICH CASE, SUCH SALES DOCUMENT SHALL GOVERN IN THE EVENT OF AN EXPRESS CONFLICT WITH THESE TERMS AND CONDITIONS. THESE TERMS AND CONDITIONS CAN ALSO BE FOUND AT:
http://www.baxter.com/downloads/patients_and_caregivers/therapies/renal/bplpc.pdf
Baxter reserves the right at any time to amend these Terms and Conditions. It is CUSTOMERS responsibility to review these Terms and Conditions prior to submitting each order. Baxter has no responsibility to notify CUSTOMER of any changes prior to the effective date of the changes. CUSTOMER shall be deemed to accept such amended Terms and Conditions by ordering PRODUCT after the date of such amendment.
No Reselling, Transfer or Export CUSTOMER agrees that PRODUCT purchased from Baxter is not for: a) resale, transfer, barter or trade to any entity or person, b) use in the further processing, packaging or filling of other drugs, therapies or devices, or c) export. Neither CUSTOMER nor HOME PATIENT shall transfer any PRODUCT to any other person or entity except to the person for whom the prescription is written. Any unused PRODUCT, once dispensed or delivered to HOME PATIENT or CUSTOMER, cannot be transferred to any other patients and must be destroyed in accordance with applicable state or local regulations or returned to Baxter per the guidelines outlined in the Returned Goods section of these Terms and Conditions.
Drug and Service State Licensing Requirements CUSTOMER agrees to maintain all state-mandated licenses and/or permits required to purchase, use, and dispense Baxter PRODUCT. CUSTOMER shall provide all applicable license and permit information to Baxter promptly upon request.
Tax, Tax-Exempt Status and Other Fees CUSTOMER agrees to pay all applicable federal, state, and local taxes (including property taxes); license and registration fees; and all other fees and costs based on CUSTOMERS lease, rental, purchase, possession or use of PRODUCT. A CUSTOMER that is exempt from taxation is required to provide valid certification of its exempt status to Master Data Center of Excellence
(1-877-329-0003; Fax 1-847-948-2540).
No Prohibited Use of PRODUCT CUSTOMER will not knowingly use, resell, transfer or distribute any PRODUCT directly or indirectly for the development, production or proliferation of weapons of mass destruction, or missile delivery systems and/or for any terrorist activities.
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4 Effective Date 4/1/12
I I . D E F I N I T I O N S
The following definitions apply to these Terms and Conditions:
CUSTOMER shall mean the legal entity purchasing PRODUCT, for the provision of Automated Peritoneal Dialysis (APD), Continuous Ambulatory Peritoneal Dialysis (CAPD), or Hemodialysis (HD) therapy. Such entities include, but are not limited to: hospitals and their affiliated outpatient dialysis clinics (Hospitals) and other licensed, outpatient dialysis centers (Centers).
DIRECTACCESS is an on-line tool to allow Hospitals and Centers to manage HOME PATIENT transactions. Key functions include: new patient set-up, status change, and prescription management. This is the preferred vehicle for CUSTOMER to manage HOME PATIENT transactions with Baxter.
DISPOSABLE shall mean any PRODUCT manufactured or sold by Baxter, other than EQUIPMENT or PARTS.
EQUIPMENT shall mean durable medical devices, hardware, instruments and instrumentation used primarily for dialysis which is manufactured or sold by Baxter for its intended use.
EXPEDITED ORDER shall mean any order placed for delivery with less lead time than outlined in the Lead Time section of these Terms and Conditions.
FORCE MAJEURE shall mean supply shortage of raw materials, manufacturing problems, delivery or labor problems, discontinuation of PRODUCT line, acts of regulatory or other governmental or quasi-governmental entities, terrorist activities, acts of hostility by foreign or domestic parties, acts of nature (including fire, flood, earthquake, storm, hurricane or other natural disaster), or unforeseen events or causes beyond Baxters control.
HOME PATIENT shall mean an individual for which CUSTOMER holds an active prescription and is providing CAPD, APD or HD therapy in the patients home.
PART shall mean a component manufactured or sold by Baxter for EQUIPMENT.
PRODUCT shall mean DISPOSABLE, EQUIPMENT, PART or any combination thereof.
RE-DELIVERY shall mean a situation in which previous delivery arrangements have been made and agreed to by HOME PATIENT and a second delivery is made after an unsuccessful first attempt to deliver has been made.
SCHEDULED DELIVERY shall mean an order placed for delivery to an established address on an established date per the established delivery schedule.
OFF-SCHEDULE DELIVERY shall mean an order placed for delivery to an established address on a date that varies from the established delivery date.
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Effective Date 4/1/12 5
I I I . WA R R A N T I E S
General Warranty Baxter warrants that PRODUCT manufactured by Baxter, when used in accordance with the directions on the labeling, is fit for the purposes and indications described on the labeling. The applicable manufacturer under the manufacturers warranty will cover PRODUCT not manufactured by Baxter, and Baxter provides no warranty for PRODUCT not manufactured by Baxter.
The warranty does not apply to any PRODUCT that is misused, abused, neglected, tampered with or damaged intentionally, by accident, flood, water, fire or other hazard. If PRODUCT is not used in accordance with manufacturers instructions, PRODUCT warranties are void and of no effect. There are no other express or implied warranties, including any warranty of merchantability or fitness for a particular purpose. Baxter shall not be liable for proximate, incidental, or special damages.
All warranties in these Terms and Conditions shall be construed to comply with the warranty Safe Harbor found at 42 C.F.R. 1001.952(g).
THE WARRANTY IN THIS SECTION SHALL BE IN LIEU OF ANY OTHER WARRANTY EXPRESSED, OR IMPLIED OR STATUTORY, RESPECTING PRODUCT, AND BAXTER MAKES NO IMPLIED WARRANTY OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. CUSTOMERS SOLE AND EXCLUSIVE REMEDY IN CONTRACT, TORT OR UNDER ANY OTHER THEORY AGAINST BAXTER WITH RESPECT TO PRODUCT AND ITS USE SHALL BE THE REPLACEMENT OR REPAIR OF THE PRODUCT AND NO OTHER REMEDY (INCLUDING, WITHOUT LIMITATION, CONSEQUENTIAL DAMAGES) SHALL BE AVAILABLE TO CUSTOMER. BAXTER SHALL HAVE NO FURTHER OBLIGATION OR LIABILITY WITH RESPECT TO PRODUCT, OR ITS SALE, OPERATION AND USE, AND BAXTER NEITHER ASSUMES, NOR AUTHORIZES THE ASSUMPTION OF, ANY OBLIGATION OR LIABILITY IN CONNECTION WITH SUCH PRODUCT.
EQUIPMENT Warranty Baxter warrants to CUSTOMER that EQUIPMENT delivered is free from defects in material or workmanship for the periods specified in the appropriate Operators and Technicians manual (which outlines the complete warranty), provided EQUIPMENT is used and maintained in accordance with the manufacturers operating instructions. PARTS installed which have been purchased from vendors other than Baxter shall void all applicable warranties.
Warranty for EQUIPMENT Service Repair Service is subject to a thirty (30) day conditional warranty.
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6 Effective Date 4/1/12
Limitation to Warranty for EQUIPMENT and Service The warranty does not apply to any EQUIPMENT or PART that is subjected to abnormal or unusual electrical or fluid stress, improperly installed or operated, serviced by anyone other than a Baxter authorized representative or not maintained in accordance with the routine maintenance schedule set forth in the Operators and Technicians manual for EQUIPMENT. Periodic preventative maintenance required to maintain proper EQUIPMENT operation is not covered under the warranty. These services can be purchased by calling 1-800-553-6898 and selecting the prompt for PARTS or on-site Service. Requests for service or replacement outside of Baxters normal working hours will be subject to additional charges. Warranty does not provide replacement DISPOSABLE or any other compensation during the period that CUSTOMERS EQUIPMENT is inoperative. Baxters sole obligation and CUSTOMERS exclusive remedy shall be limited to repair or replacement, at Baxters option and expense of the defective PART or EQUIPMENT, using new or reconditioned PARTS and/or subassemblies for a period of one hundred eighty (180) days, except for the HomeChoice or the HomeChoice Pro system which shall be for a period of ninety (90) days, following the date of initial delivery. Such repair or replacement shall be made without cost to CUSTOMER and Baxter reserves the right to determine the location at which the repair or replacement will be accomplished.
Indemnification CUSTOMER agrees to indemnify, defend and hold harmless Baxter, its affiliates and subsidiaries, and the officers, directors, employees, agents and insurers of each of them, from and against any and all third party claims, demands, actions, damages, expenses, costs, claims, judgments and liabilities (including, without limitation, interest, penalties and reasonable attorneys fees and investigative costs) incurred by Baxter, arising from, in connection with or as a consequence of a) any negligent, or wrongful act or omission by CUSTOMER; and/or b) CUSTOMERS transfer, use or sale of PRODUCT, except to the extent that such suit or demand arises out of the failure of PRODUCT to meet Baxters express warranty(ies); and/or c) CUSTOMERS possession, operation, maintenance, delivery or return of PRODUCT. Such protection shall include, without limitation, claims for personal injury or death or property damage arising out of any act or omission of CUSTOMER or its patients.
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Effective Date 4/1/12 7
I V. O R D E R / D E L I V E RY
Orders All orders shall be subject to these Terms and Conditions and shall not be subject to the terms, conditions, or provisions of any order confirmation, except to the extent that such confirmation specifies quantities.
Baxter will use commercially reasonable efforts to fill orders, but Baxter shall not be liable for non-performance or delays caused by a FORCE MAJEURE event. CUSTOMER agrees that in any and all such events, Baxter may allocate PRODUCT among CUSTOMERS without liability or other negative outcome with CUSTOMER.
All orders, with the exception of warranty orders or EQUIPMENT service orders covered under a service agreement, require a purchase order, supply contract or credit card authorization.
When using a purchase order form, any modification by CUSTOMER regarding pricing, terms of sale or any other terms or conditions shall not be effective unless accepted in advance and in writing by an authorized representative of Baxter. Only the list and quantity of PRODUCT and any specific shipping instructions shall be applicable to said sale.
Selling Unit of Measure Order quantities must be in the selling unit of measure indicated. Pack factors are noted for ease of ordering.
Prescription Requirement BAXTER WILL NOT ACCEPT ANY ORDER FOR HOME PATIENT WITHOUT A PRESCRIPTION SIGNED AND DATED BY A PHYSICIAN, which lists PRODUCT codes, quantities and the allowable refill period, not to exceed one (1) year. All new APD HOME PATIENT prescriptions must also include either a HomeChoice or HomeChoice Pro rental. HOMECHOICE devices cannot be shipped until a signed prescription is on file. Prescriptions should be managed and e-signed through DIRECTACCESS.
CUSTOMER may obtain copies of prescriptions at no charge through DIRECTACCESS. All other manner of requests shall be subject to a forty dollar ($40.00) processing fee.
Lead Time Peritoneal dialysis PRODUCT and HD DISPOSABLE orders require a five (5) business day lead time. HD EQUIPMENT orders require a sixty (60) business day lead time. EQUIPMENT and PART orders requiring expedited delivery at CUSTOMERS request are subject to an expedited processing and delivery charge quoted at the time of the order placement. Orders must be placed no later than 12:00 pm local time in the time zone of CUSTOMERS local Baxter distribution center to be deemed placed on that business day. Orders placed after 12:00 pm local time will be deemed placed on the following business day.
Freight and Distribution Published prices for DISPOSABLES include regular processing and distribution charges provided the order is placed five (5) business days prior to the SCHEDULED DELIVERY date. Inside delivery is standard for HOME PATIENT. Delivery to a Hospital or Center receiving or loading dock is standard while inside delivery is an additional service and may result in additional charges.
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8 Effective Date 4/1/12
Published prices for EQUIPMENT and PARTS do not include delivery, handling and installation. These charges will be arranged and billed separately, if applicable.
CUSTOMER is responsible for all freight and distribution charges for all PRODUCT when expedited order processing and delivery is required, unless specifically provided in these Terms and Conditions.
All shipments are considered contiguous USA only unless otherwise mutually agreed to in writing by CUSTOMER and Baxter. EQUIPMENT shall be sold FOB Origin. All other PRODUCT shall be sold FOB Destination; provided that PRODUCT is delivered in accordance with these Terms and Conditions.
Minimum Order Charge All orders that are less than two hundred fifty dollars ($250.00) will be subject to a charge of forty dollars ($40.00). Exemptions will be permitted only for:
deliveries required to correct Baxter error
new HOME PATIENT orders
SCHEDULED DELIVERY Hospitals and Centers: Recognizing that Hospitals and Centers have unique delivery and service requirements, Baxter and CUSTOMER may negotiate a mutually agreeable delivery, which in no event shall be more frequent than once weekly.
HOME PATIENT: Upon initiation of a new HOME PATIENT account, Baxter will establish a delivery schedule. HOME PATIENT delivery days shall be set according to this schedule. SCHEDULED DELIVERY will occur approximately once every four (4) weeks or thirteen (13) times per year.
Delivery frequency and scheduling will be maintained in Baxters transaction management system and will be used to determine if an order represents a SCHEDULED DELIVERY or OFF-SCHEDULE DELIVERY. HOME PATIENTS will receive a calendar indicating their ordering days and SCHEDULED DELIVERY days. Effective July 1, 2011, clinicians requiring a copy of HOME PATIENTS order and delivery schedule must utilize DIRECTACCESS to obtain a copy. Please contact HomeCare Services at 1-800-284-4060 for details or to set-up a DIRECTACCESS account.
HOME PATIENT orders must be placed no later than 12:00 pm local time, five (5) business days prior to the SCHEDULED DELIVERY date established on the routing calendar. Orders may be placed by telephone or by fax. Any order received less than five (5) business days prior to the SCHEDULED DELIVERY date will be considered an EXPEDITED ORDER and will be subject to expediting fees.
Should Baxter initiate a modification in delivery schedules due to route realignment, holiday shipping schedules, or pre-negotiated accelerated orders or special orders, CUSTOMER shall not incur freight charges for the shipment of these items.
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Effective Date 4/1/12 9
OFF-SCHEDULE DELIVERY All OFF-SCHEDULE DELIVERY will be assessed a one hundred fifty dollar ($150.00) service fee. Exemptions will be permitted only for: a) prescription changes authorized and documented by the physician; b) usage changes called in by the clinician; c) deliveries required to correct Baxter error; d) domestic travel orders subject to the Vacation Supply Deliveries section; and e) New HOME PATIENT Orders.
HOME PATIENT RE-DELIVERY Orders requiring RE-DELIVERY are subject to a charge of seventy-five dollar ($75.00).
EXPEDITED ORDERS EXPEDITED ORDERS at CUSTOMERS request are subject to an expedited processing charge.
The expedited processing charge for Hospitals or Center orders is one hundred fifty dollars ($150.00) if placed during normal business hours and two hundred fifty dollars ($250.00) if placed outside of normal business hours plus actual freight charges.
If an extra delivery is required that can ship ground a fifty dollar ($50.00) extra delivery fee is applied. If order placed after cut-off but can meet CUSTOMERS SCHEDULED DELIVERY a fifty dollar ($50.00) late fee is applied.
All Will Call (customer pickup) orders will be assessed a one hundred fifty dollar ($150.00) EXPEDITED ORDER charge regardless of time of request.
Expedited processing charges for HOME PATIENTS are:
*When and where available
EXPEDITED ORDERS to Alaska and Hawaii residents are subject to the expedited processing charge PLUS an additional charge to be quoted at the time of the order
Orders placed after normal business hours or on weekends are subject to the expedited processing charge PLUS an additional charge of one hundred twenty-five dollars ($125.00), PLUS any applicable OFF-SCHEDULE DELIVERY and Minimum Order Charges
Same Business Day*
Next Business Day*
Second Business Day*
Third Business Day*
Fourth Business Day*
$95.00 $65.00 $45.00 $35.00 $25.00
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10 Effective Date 4/1/12
Vacation Supply Deliveries Travel orders for destinations within the continental U.S. (excluding all cruises regardless of departure port) require a lead time of fourteen (14) business days. Less lead time will result in EXPEDITED ORDER charges of one hundred dollars ($100.00) as outlined in the previous section.
Through the Global Destinations Program, peritoneal dialysis HOME PATIENTS can successfully continue their therapy while travelling outside of the continental U.S., including Alaska and Hawaii and cruises from any port, domestic or international. Customer is responsible for the shipping and handling costs associated with the order delivery. The handling cost for a standard order (>30 days notice) is one hundred dollars ($100.00) while an EXPEDITED ORDER (
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Effective Date 4/1/12 11
V. B I L L I N G / PAY M E N T
Terms of Sale All orders are subject to credit approval and acceptance at Baxters home office. Standard payment terms are net thirty (30) from the date of invoice. Payment terms are in effect as of the date of the order. Payment is made to the remit to address indicated on the invoice. Credit card payments are subject to approval by Credit and Collections.
Invoices that are not paid according to the payment terms of each sale shall bear interest at the lesser of 18% per annum or the highest rate allowed by applicable law. Additionally, Baxter reserves the right to require payment in advance of shipment.
Prices PRODUCT is priced at the amount indicated for the selling unit of measure ordered. Prices and specifications are subject to change without notice. All shipments are billed at the price in effect on the date of the order. PRODUCT is billed upon shipment.
Published PRODUCT prices are exclusive of all taxes.
EQUIPMENT service and separately billable PRODUCT processing and delivery charges are priced as described in these Terms and Conditions.
Discount Disclosure Statement CUSTOMER and Baxter intend that all purchases of PRODUCT and services made by CUSTOMER shall be administered in accordance with the provisions of the federal Anti-Kickback Statute (42, U.S.C. 1320a-7b(b)). Any discounts and rebates received by CUSTOMER with respect to PRODUCT may be considered discounts or other reductions in price under the Anti-Kickback Statute, Section 1128B(b)(3)(A) of the Social Security Act [42 U.S.C. 1320a-7b(b)(3)(A)].
To the extent required by the Anti-Kickback Statute or the Discount Safe Harbor regulations, 42 C.F.R 1001.952(h) et seq., CUSTOMER shall fully and accurately disclose such discounts and other reductions in price in accordance with the applicable state or federal cost reporting requirements, including, without limitation, disclosing and accurately reflecting where appropriate, and as appropriate, to the applicable reimbursement methodology. Baxter will provide CUSTOMER with sales and discount information to allow CUSTOMER to comply with this Section and the Discount Safe Harbor regulation, including sufficient rebate and pricing information to enable CUSTOMER to accurately report its actual costs for all purchases of PRODUCT and services. The total charges for PRODUCT and services purchased by CUSTOMER shall be the contract price less any such discounts, including rebates.
Credit and Disputes Only amounts which are disputed in good faith may be withheld from payment pending resolution. Any portion of an invoice not in dispute must be remitted within the payment terms of each sale. All disputes must be submitted in writing to Credit and Collections within thirty (30) days from the date of invoice. All disputes or rights are waived unless the CUSTOMERS complaint has been received by Baxter within such thirty (30) day period.
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12 Effective Date 4/1/12
V I . R E T U R N E D G O O D S
DISPOSABLES and PARTS DISPOSABLES and PARTS that have not been stored in a sanitary manner and in accordance with the package insert cannot be returned or credited. Verification of proper storage may be required for credit. DISPOSABLES and PARTS must be returned in the original, unopened and undamaged carton or package to be eligible for credit.
CUSTOMER must notify Baxter and obtain a return goods authorization (RGA) number prior to returning DISPOSABLES and PARTS. DISPOSABLES and PARTS will not be eligible for credit without prior approval of the return and unless returned in accordance with this Returned Goods section. Approval to return DISPOSABLES and PARTS does not guarantee credit. Baxter does not assume liability for DISPOSABLES and PARTS returned without prior approval. Credit will be issued to the original purchaser only. DISPOSABLE and PARTS provided at no charge are not eligible for credit but remain subject to the terms of this Returned Goods section.
A ninety-five dollar ($95.00) pick-up charge will be applied against any credit due on DISPOSABLE returns, excluding Baxter order/delivery errors. Any portion of the charge that exceeds the credit will be invoiced separately.
Baxter order/delivery errors must be reported within two (2) business days of receipt and, when applicable, returned within thirty (30) days of receipt to be eligible for one hundred percent (100%) credit. Examples include shortages, damages, order entry errors and delivery errors. DISPOSABLES and PARTS returned after thirty (30) days but within ninety (90) days of receipt may be eligible for credit as excess stock.
CUSTOMER or HOME PATIENT order errors must be reported within two (2) business days of receipt and returned within thirty (30) days of receipt to be eligible for fifty percent (50%) credit. Peritoneal dialysis solutions returned from HOME PATIENT are not eligible for credit. DISPOSABLES with a 5K or 5Q prefix are not returnable.
DISPOSABLES and PARTS returned after thirty (30) days but within ninety (90) days of receipt may be eligible for credit as excess stock. Excess stock must be returned within ninety (90) days of receipt to be eligible for fifty percent (50%) credit. Excess stock shall not be eligible for credit under the following circumstances:
returned after ninety (90) days from receipt returned with less than three (3) months remaining to expiration returned from HOME PATIENT returns with a 5K or 5Q prefix returns sold on a no return basis
EQUIPMENT Purchased EQUIPMENT is not returnable unless shipped in error by Baxter. Leased, rental, trade-in, and/or evaluation EQUIPMENT may be returned as governed by the terms of this section.
EQUIPMENT returns are at CUSTOMERS expense, and EQUIPMENT must be in the same condition as when delivered to CUSTOMER, normal wear and tear expected. CUSTOMER shall deliver the EQUIPMENT to such place or on board such carrier, packed for shipping, as Baxter may specify. CUSTOMER is responsible for return of EQUIPMENT including all associated charges with the exception of return due to EQUIPMENT shipped in error by Baxter. CUSTOMER shall give Baxter prior written notice that it is returning EQUIPMENT.
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V I I . A P D E Q U I P M E N T R E N TA L P R O G R A M
Commencement and Monthly Fee The rental program shall begin on the date that is five (5) days after the date of shipment (EQUIPMENT Effective Date) and shall continue until EQUIPMENT is returned to Baxter. CUSTOMER may terminate the rental program at any time by giving notice to Baxter and returning EQUIPMENT to Baxter. Rental fees will be billed monthly. If EQUIPMENT Effective Date is any day other than the first of the month, the first monthly rental fee shall be prorated. Thereafter, full monthly rental fees shall be due for each month through the month in which the rental program terminates. CUSTOMER is responsible for all rental fees until such time as the EQUIPMENT is returned to Baxter.
The rental program for EQUIPMENT delivered to CUSTOMER for evaluation purposes only (Evaluator EQUIPMENT) is governed by these Terms and Conditions except that the rental program shall begin on the forty-fifth (45th) day after Baxter provides the first in-service for the Evaluator EQUIPMENT (Evaluator Rental Commencement Date).
Warranties All applicable warranties in the Warranties section extend to EQUIPMENT.
Customer Obligation CUSTOMER shall use EQUIPMENT only for the purposes and according to the instructions indicated in the labeling as well as those included with EQUIPMENT. CUSTOMER shall not make modifications, alterations, or additions to EQUIPMENT without prior written consent of Baxter. EQUIPMENT shall remain personal property at all times regardless of how it is attached or installed. Baxter shall have the right, during normal business hours, to enter CUSTOMERS premises or any EQUIPMENT site to inspect EQUIPMENT. Title to EQUIPMENT remains with Baxter. CUSTOMER assumes the risk of loss of, and has responsibility for, damage to EQUIPMENT from any cause.
Effective Date 4/1/12 13
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Default The following shall constitute events of default:
CUSTOMER fails to pay monthly rental fee according to the terms stated on the invoice
CUSTOMER fails to perform any of its other obligations under the rental program and such failure continues for thirty (30) calendar days after Baxter gives CUSTOMER written notice of such failure
A petition in bankruptcy is filed by CUSTOMER or CUSTOMER makes an assignment for the benefit of creditors, or consents to the appointment of a trustee or receiver, or a trustee or receiver is appointed by CUSTOMER for any parts of EQUIPMENT or for a substantial part of CUSTOMERS assets without its consent and is not dismissed within a period of thirty (30) calendar days, or bankruptcy, reorganization, or insolvency proceedings are instituted against CUSTOMER and are not dismissed within thirty (30) calendar days thereafter
Upon the happening of any event of CUSTOMER default, Baxter may, at its sole option: a) take immediate possession of any or all of EQUIPMENT, and, for such purposes, enter upon CUSTOMERS premises or site where EQUIPMENT is located and remove it, without liability for so doing, or b) require CUSTOMER, at its expense, to return EQUIPMENT to Baxter as provided in the Returned Goods section.
EQUIPMENT Services and Charges Global Technical Services provides the scheduling and replacement of APD EQUIPMENT. Replacement of APD EQUIPMENT will be performed on a next day basis, subject to availability. Expedited replacements are those requiring same day delivery. Expedited replacements are subject to an additional processing and delivery charge quoted at the time service is requested.
14 Effective Date 4/1/12
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Effective Date 4/1/12 PD1
P E R I T O N E A L D I A L Y S I S DIANEAL PD Solution, ULTRABAG System
DIANEAL Low Ca lc ium PD So lu t ion
Product Dextrose Fill Volume (mL) Container Size (mL) Pack Factor Price/Case
5B9765P 1.5% 1500 2000 8/case $272.57 5B9775P 2.5% 1500 2000 8/case $280.10 5B9795P 4.25% 1500 2000 8/case $282.22 5B9766 1.5% 2000 2000 6/case $191.07 5B9776 2.5% 2000 2000 6/case $213.18 5B9796 4.25% 2000 2000 6/case $215.13 5B9768P 1.5% 2500 3000 5/case $176.73 5B9778P 2.5% 2500 3000 5/case $181.74 5B9798P 4.25% 2500 3000 5/case $185.64 5B9757 1.5% 3000 5000 4/case $156.375B9758 2.5% 3000 5000 4/case $159.84 5B9759 4.25% 3000 5000 4/case $164.72
DIANEAL PD-2 PD So lu t ion
5B9866 1.5% 2000 2000 6/case $191.07 5B9876 2.5% 2000 2000 6/case $213.18 5B9896 4.25% 2000 2000 6/case $215.13 5B9868P 1.5% 2500 3000 5/case $176.73 5B9878P 2.5% 2500 3000 5/case $181.74 5B9898P 4.25% 2500 3000 5/case $185.645B9857 1.5% 3000 5000 4/case $156.37 5B9858 2.5% 3000 5000 4/case $159.84 5B9859 4.25% 3000 5000 4/case $164.72
Na Ca Mg Cl LactateDIANEAL Low Calcium PD Solution (mEq/L) 132 2.5 0.5 95 40DIANEAL PD-2 PD Solution (mEq/L) 132 3.5 0.5 96 40
DIANEAL PD-2 and Low Calcium peritoneal dialysis solutions in ULTRABAG containers are indicated for use in chronic renal failure patients being maintained on continuous ambulatory peritoneal dialysis when nondialytic medical therapy is judged to be inadequate.
Important Risk Information for DIANEAL Solutionsn Not for Intravenous Injection.n Use aseptic technique. Contamination of connector may result in
peritonitis.n Adverse reactions to peritoneal dialysis include mechanical and
solution related problems as well as the results of contamination of equipment.
n Solution-related adverse reactions may include peritonitis, electrolyte and fluid imbalances, hypovolemia, hypervolemia, hypotension, hypertension, disequilibrium syndrome, allergic symptoms, and muscle cramping.
n Please see enclosed package inserts for DIANEAL solution full prescribing information.
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PD2 Effective Date 4/1/12
P E R I T O N E A L D I A L Y S I S DIANEAL PD Solution, Single Bag (AMBU-FLEX Container)
D IANEAL Low Ca lc ium PD So lu t ion , Luer (AMBU-FLEX I I Conta iner )
Product Dextrose Fill Volume (mL) Container Size (mL) Pack Factor Price/Case
L5B4825 1.5% 2000 3000 6/case $120.90L5B9727 2.5% 2000 3000 6/case $144.92 L5B9747 4.25% 2000 3000 6/case $146.73 L5B9901 1.5% 3000 3000 4/case $138.36L5B9902 2.5% 3000 3000 4/case $140.30L5B9903 4.25% 3000 3000 4/case $143.31L5B4826 1.5% 5000 6000 2/case $74.15 L5B5202 2.5% 5000 6000 2/case $75.88L5B5203 4.25% 5000 6000 2/case $77.72 L5B9770 1.5% 6000 6000 2/case $88.61 L5B9771 2.5% 6000 6000 2/case $90.54 L5B9772 4.25% 6000 6000 2/case $93.04
DIANEAL P D - 2 P D S o l u t i o n , L u e r (AMBU-FLEX I I C o n t a i n e r )
Product Dextrose Fill Volume (mL) Container Size (mL) Pack Factor Price/Case
L5B5163 1.5% 1000 1000 12/case $350.18 L5B5173 2.5% 1000 1000 12/case $365.35L5B5183 4.25% 1000 1000 12/case $376.59 L5B5166 1.5% 2000 3000 6/case $121.75L5B5177 2.5% 2000 3000 6/case $145.60 L5B5187 4.25% 2000 3000 6/case $148.04 L5B5169 1.5% 3000 3000 4/case $136.97 L5B5179 2.5% 3000 3000 4/case $139.92L5B5189 4.25% 3000 3000 4/case $143.78L5B5193 1.5% 5000 6000 2/case $74.15 L5B5194 2.5% 5000 6000 2/case $75.87 L5B5195 4.25% 5000 6000 2/case $77.54L5B9710 1.5% 6000 6000 2/case $87.93 L5B9711 2.5% 6000 6000 2/case $90.24 L5B9712 4.25% 6000 6000 2/case $92.56
Na Ca Mg Cl LactateDIANEAL Low Calcium PD Solution (mEq/L) 132 2.5 0.5 95 40DIANEAL PD-2 PD Solution (mEq/L) 132 3.5 0.5 96 40
n Please see important safety information on page PD1.n Please see enclosed package inserts for DIANEAL solution full prescribing information.
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Effective Date 4/1/12 PD3
EXTRANEAL PD So lu t ion , ULTRABAG Sys tem
Product Icodextrin Fill Volume (mL) Container Size (mL) Pack Factor Price/Case
5B4984 7.5% 2000 2000 6/case per contract5B4986 7.5% 2500 3000 5/case per contract
EXTRANEAL PD So lu t ion , S ing le Bag , Luer (AMBU-FLEX I I ) Conta iner
Product Icodextrin Fill Volume (mL) Container Size (mL) Pack Factor Price/Case
L5B4974 7.5% 2000 2000 6/case per contractL5B4976 7.5% 2500 3000 5/case per contract
Na Ca Mg Cl LactateExtraneal (icodextrin) PD Solution (mEq/L) 132 3.5 0.5 96 40
P E R I T O N E A L D I A L Y S I S EXTRANEAL (icodextrin) PD Solution
Extraneal (icodextrin) Peritoneal Dialysis (PD) solution is indicated for a single daily exchange for the long (8 to16 hour) dwell during Continuous Ambulatory Peritoneal Dialysis (CAPD) or Automated Peritoneal Dialysis (APD) for the management of End-Stage Renal Disease (ESRD). Extraneal is also indicated to improve (compared to 4.25% dextrose) long-dwell ultrafiltration and clearance of creatinine and urea nitrogen in patients with high-average or greater transport characteristics, as defined using the Peritoneal Equilibration Test (PET).Important Risk Information
Dangerous Drug-Device Interaction Only use glucose-specific monitors and test strips to measure blood glucose levels in patients using Extraneal (icodextrin) Peritoneal Dialysis Solution. Blood glucose monitoring devices using glucose dehydrogenase pyrroloquinolinequinone (GDH-PQQ) or glucose-dye-oxidoreductase (GDO)-based methods must not be used. In addition, some blood glucose monitoring systems using glucose dehydrogenase flavin-adenine dinucleotide (GDH-FAD)-based methods must not be used. Use of GDH-PQQ, GDO, and GDH-FAD-based glucose monitors and test strips has resulted in falsely elevated glucose readings (due to the presence of maltose, see PRECAUTIONS/Drug/Laboratory Test Interactions). Falsely elevated glucose readings have led patients or health care providers to withhold treatment of hypoglycemia or to administer insulin inappropriately. Both of these situations have resulted in unrecognized hypoglycemia, which has led to loss of consciousness, coma, permanent neurological damage, and death. Plasma levels of Extraneal (icodextrin) and its metabolites return to baseline within approximately 14 days following cessation of Extraneal (icodextrin) administration. Therefore falsely elevated glucose levels may be measured up to two weeks following cessation of Extraneal (icodextrin) therapy when GDH-PQQ, GDO, and GDH-FAD-based blood glucose monitors and test strips are used.
Because GDH-PQQ, GDO, and GDH-FAD-based blood glucose monitors may be used in hospital settings, it is important that the health care providers of peritoneal dialysis patients using Extraneal (icodextrin) carefully review the product information of the blood glucose testing system, including that of test strips, to determine if the system is appropriate for use with Extraneal (icodextrin).
To avoid improper insulin administration, educate patients to alert health care providers of this interaction whenever they are admitted to the hospital.
The manufacturer(s) of the monitor and test strips should be contacted to determine if icodextrin or maltose causes interference or falsely elevated glucose readings. For a list of toll free numbers for glucose monitor and test strip manufacturers, please contact the Baxter Renal Clinical Help Line 1-888-RENAL-HELP or visit www.glucosesafety.com.
n Extraneal is contraindicated in patients with a known allergy to cornstarch or icodextrin, in patients with maltose or isomaltose intolerance, in patients with glycogen storage disease, and in patients with pre-existing severe lactic acidosis
n Extraneal PD solution is intended for intraperitoneal administration only. Not for intravenous injectionn Rarely, serious hypersensitivity reactions to Extraneal have been reported, such as toxic epidermal necrolysis, angioedema, serum sickness, erythema multiforme and
leukocytoclastic vasculitis. If a serious reaction is suspected, discontinue Extraneal and institute appropriate treatment as clinically indicatedn Patients with insulin-dependent diabetes may require modification of insulin dosage following initiation of treatmentn A patients volume status should be carefully monitored to avoid hyper- or hypovolemia and potentially severe consequences including congestive heart failure, volume
depletion and hypovolemic shock. An accurate fluid balance record must be kept and the patients body weight monitoredn In clinical trials, the most frequently reported adverse events occurring in 10% of patients, and more common in Extraneal PD solution patients than in control patients,
were peritonitis, upper respiratory infection, hypertension, and rash. The most common treatment-related adverse event for Extraneal PD solution patients was skin rash. Additional adverse reactions have been reported in the post-marketing setting and are detailed in the full prescribing information
General Peritoneal Dialysis-Relatedn Encapsulating peritoneal sclerosis (EPS) is a known, rare complication of peritoneal dialysis therapy. EPS has been reported in patients using peritoneal dialysis solutions
including Extraneal PD solution. Infrequent but fatal outcomes have been reportedn Aseptic technique should be used throughout the peritoneal dialysis procedure to reduce the possibility of infection, such as peritonitisn Fluid status, hematologic indices, blood chemistry, and electrolyte concentrations, including calcium, potassium, sodium, magnesium and bicarbonate, should be monitored
periodically. Abnormalities in any of these parameters should be treated promptly under the care of a physiciann Overinfusion of peritoneal dialysis solution volume into the peritoneal cavity may be characterized by abdominal distention, feeling of fullness and/or shortness of breath.
Treatment of overinfusion is to drain the peritoneal dialysis solution from the peritoneal cavityn Treatment should be initiated and monitored under the supervision of a physician knowledgeable in the management of patients with renal failuren Please see full prescribing information. Extraneal Product Insert and Extraneal Medication Guide.
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PD4 Effective Date 4/1/12
P E R I T O N E A L D I A L Y S I S S Y S T E M SAutomated Peritoneal Dialysis
HOMECHOICE PRO and HOMECHOICE Automated Peritoneal Systems
Product Description Pack Factor Price
D e v i c e s
5C4471 HOMECHOICE Automated PD System 1/each $17,719.67 5C8310 HOMECHOICE PRO Automated PD System 1/each $20,251.06
HOMECHOICE PRO System HOMECHOICE System
L u e r D i s p o s a b l e S e t s
R5C4479C Automated PD Set with Cassette - 4 Prong 30/case $966.63 L5C4531 Integrated APD Set 30/case $1,303.78N5C8305C Low Recirculation Volume APD Set with cassette 30/case $2,786.84
nIntegrated APD Set has 3 supply lines, and 22 patient and drain lines.nLow Recirculation Volume APD Set has in-line medication port, a shrouded patient connector, and a smaller internal
diameter and shorter patient line length. Recirculation volume 17mL.
Rx Only. For safe and proper use refer to Operators Manual.
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Effective Date 4/1/12 PD5
APD Drain Supplies
5C4145P 15 Liter Drainage Bag 30/case $303.44 5C4464P Sterile Drain Extension Line, 12 feet 30/case $170.97 5C4476 Effluent Sample Bag, 150mL 6/case $58.01 5C4512 APD Drain Manifold (Connects two 15 liter drain bags) 30/case $219.79
APD Miscellaneous Supplies
5C4462 Empty Sterile Bag, 3 Liter 48/case $610.13 5C4426 5 Prong Manifold Set with Connector Tube 30/case $417.61 5C4446 5-Prong Manifold Set (Spike) 15/case $228.70 L5C4446 5-Prong Manifold Set (Luer) 15/case $268.83 5C4971 QUIETCOIL Device 1/each $48.18
P E R I T O N E A L D I A L Y S I S S Y S T E M SAutomated Peritoneal Dialysis
HOMECHOICE PRO and HOMECHOICE Automated Peritoneal Systems (Cont.)
Product Description Pack Factor Price
D a t a C a r d s
R5C4522 HOMECHOICE PRO Card 6/case $327.824994000449 USB Smart Media Card Reader* 1/each
*Order this part by calling Baxter Technical Services 1-800-553-6898, parts and hardware option 2.
C a r r y i n g C a s e s
5C4406 Carrying Case 1/each $153.49 5C8346 Hard Carrying Case with Wheels 1/each $453.51 E x t e n s i o n L i n e s
5C4480C 12 Foot Patient Extension Line with EASY-LOCK Connector 30/case $246.60
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PD6 Effective Date 4/1/12
P E R I T O N E A L D I A L Y S I S S Y S T E M SCAPD
Product Description Pack Factor Price
D i s c o n n e c t Y- S e t s
5C4366P ULTRASET Disposable Disconnect Y-Set (Spike) 60/case $552.61 L5C4366 ULTRASET Disposable Disconnect Y-Set (Luer) 30/case $315.07 M i s c e l l a n e o u s C A P D S u p p l i e s
5C4530 Spike Protector II (protective cover for aseptic transfer set spikes) 48/case $586.86 5C4190 CAPD Drainage Bracket 1/each $109.81
Assist Devices
CXD II Compact Exchange Device for APD Patients
Product Description Pack Factor Price/Each
D e v i c e
5C4275 Compact Exchange Device (CXD II) 1/each $660.12 C a r r y i n g C a s e
5C4942 Compact Exchange Device Carrying Case 1/each $86.10
Product Description Pack Factor Price/Each
5C4505 EZ-Aide Assist Device 1/each $200.91
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Effective Date 4/1/12 PD7
P E R I T O N E A L D I A L Y S I S P A T I E N T C O N N E C T O L O G Y
Product Description Pack Factor Price/Case
Transfer Sets 5C4442 Extended Life EASY-LOCK Transfer Set (6) 6/case $377.56 5C4449 MINICAP Extended Life PD Transfer Set (6) with Roller Clamp 6/case $377.56 5C4482 MINICAP Extended Life PD Transfer Set (6) with Twist Clamp 6/case $344.00 5C4483 MINICAP Extended Life PD Transfer Set Extra Short (4) 6/case $360.39 with Twist Clamp 5C4160 Transfer Set with Spike Connector (48) 12/case $248.57 Transfer Set Adapters 5C4136 EASY-LOCK-to-Spike Adapter Set 12/case $109.89 5C4137 PD Spike-to-EASY-LOCK Adapter Set 12/case $109.89 5C4413 Spike/Syringe Adapter (connects spike on patient transfer set to luer-type syringe) 10/case $53.12 Transfer Sets For Straight Line CAPD 5C4213P Connection Shield II-K with Povidone-Iodine Solution 60/case $285.13 5C4215P Locking Connection Shield 60/case $458.95 Catheter Supplies 5C4129 Locking Titanium Adapter (2 piece) 5/case $1,172.16 5C4169 Locking cap for Baxter PD Catheter Adapter 25/case $124.00 5C4319 Immobile catheter and transfer set stabilizing device 30/case $153.84 5C4381 IMMOBILIZER catheter stabilizing device 30/case $476.98 Disconnect Caps5C4212P Disconnect Cap (Walnut Cap) 60/case $376.16 5C4456 FLEXICAP Disconnect Cap for High Dose Therapy 30/case $94.52 5C4466P MINICAP Disconnect Cap 60/case $313.44 Clamps 5C4527 Outlet Port Clamp with Short Nose 12/case $78.88 5C4957 ULTRACLAMP Clamp (not for use as outlet port clamp) 12/case $78.88
Locking Titanium Adapter
FLEXICAP Disconnect Cap
MINICAP Disconnect Cap
Outlet Port Clamp
ULTRACLAMP Clamp
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PDTM Effective Date 4/1/12
The following is a listing of trademarks of Baxter International Inc:
Ambu-Flex
Baxter
Dianeal
Easy-Lock
Extraneal
FlexiCap
HomeChoice
HomeChoice PRO
Immobilizer
MiniCap
QuietCoil
UltraBag
UltraClamp
UltraSet
T R A D E M A R K SFor peritoneal dialysis products listed on pages PD1-PD7
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Effective Date 4/1/12 AC1
CRRT - Continuous Renal Replacement Therapy - Critical Care Nephrology
A C U T E D I A L Y S I S
Product Description Pack Factor Price
RENAFLO II Hemofilters 5M3121 HF400 Hemofilter 0.30m2 12/case $1,570.86 5M3122 HF700 Hemofilter 0.71m2 12/case $1,653.55 5M3123 HF1200 Hemofilter 1.25m2 12/case $1,736.23 5M3074 HF2000 Hemofilter 1.98m2 12/case $1,799.775M3134 MINIFILTER Plus Hemofilter 700cm2 4/case $918.65
Dialysis Solutions for CRRT
Bicarbonate Buffer SolutionProduct Description Pack Factor Price/Case5B9248 ACCUSOL Dialysis Solution 2.5L 35 Bicarbonate K4 4/case $101.72 5B9249 ACCUSOL Dialysis Solution 2.5L 35 Bicarbonate K2 4/case $101.725B9250 ACCUSOL Dialysis Solution 2.5L 35 Bicarbonate K0 0 Dextrose 4/case $101.725B9251 ACCUSOL Dialysis Solution 2.5L 30 Bicarbonate K2 4/case $101.725B9252 ACCUSOL Dialysis Solution 2.5L 30 Bicarbonate K2 0 Calcium 4/case $101.72
Lactate Buffer Solution
5B7860 Premixed Dialysate for Hemodiafiltration-5 liter bag 2/case $80.12
Catheter Supplies
Acute PD
Product Description Pack Factor Price/Case
2C7565 INTERLINK System with Add-On BURETROL 48/case $529.92
Disposable Sets
5C4446 5-Prong Manifold Set (Spike) 15/case $228.70
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The following is a listing of trademarks of Baxter International Inc:
Accusol
Baxter
Buretrol
InterLink
The following is a listing of trademarks of Minntech Corporation:
Minifilter
Renaflo
T R A D E M A R K SFor acute dialysis products listed on page AC1
ACTM Effective Date 4/1/12
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Effective Date 4/1/12 HD1
HEMAVISION Disposable Blood Chamber
Product Description Pack Factor Price
HCT1000B HEMAVISION Disposable Blood Chamber 288/case $1,817.96
H E M O D I A L Y S I S
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HD2 Effective Date 4/1/12
DICEA High Performance Dialyzers, Cellulose Diacetate, High Efficiency
Product Description Pack Factor Price/Case
5M2591 DICEA 90 dialyzer (for single-use only) 24/case $1,084.955M2592 DICEA 110 dialyzer (for single-use only) 24/case $1,200.895M2593 DICEA 130 dialyzer (for single-use only) 24/case $1,245.925M2594 DICEA 150 dialyzer (for single-use only) 24/case $1,287.955M2595 DICEA 170 dialyzer (for single-use only) 24/case $1,360.925M2596 DICEA 210 dialyzer (for single-use only) 24/case $1,466.75
Rx Only. For safe and proper use refer to Operators Manual.
H E M O D I A L Y S I S D I A L Y Z E R S
SINGLE-USE
XENIUM XPH Dialyzers, High Flux, Synthetic
EXELTRA High Flux Dialyzers, Cellulose Triacetate
Product Description Pack Factor Price/Case
5M2119 EXELTRA 150 dialyzer (for single-use only) 24/case $1,365.61 5M2120 EXELTRA 170 dialyzer (for single-use only) 24/case $1,405.235M2121 EXELTRA 190 dialyzer (for single-use only) 24/case $1,450.225M2132 EXELTRA Plus 210 dialyzer (for single-use only) 24/case $1,485.52
Product Description Pack Factor Price/Case
5M6400 XENIUM 110 dialyzer (for single-use only) 24/case $748.225M6401 XENIUM 130 dialyzer (for single-use only) 24/case $793.565M6402 XENIUM 150 dialyzer (for single-use only) 24/case $888.465M6403 XENIUM 170 dialyzer (for single-use only) 24/case $943.005M6404 XENIUM 190 dialyzer (for single-use only) 24/case $1,006.965M6405 XENIUM 210 dialyzer (for single-use only) 24/case $1,085.00
Product Description Pack Factor Price/Case
H25601A XENIUM XPH 110 dialyzer (for single-use only) 24/case $748.22 H25602A XENIUM XPH 130 dialyzer (for single-use only) 24/case $793.56H25603A XENIUM XPH 150 dialyzer (for single-use only) 24/case $888.46H25604A XENIUM XPH 170 dialyzer (for single-use only) 24/case $943.00H25605A XENIUM XPH 190 dialyzer (for single-use only) 24/case $1,006.96H25606A XENIUM XPH 210 dialyzer (for single-use only) 24/case $1,085.00
XENIUM Dialyzers, High Flux, Synthetic
-
Effective Date 4/1/12 HD3
CA-HP High Performance Cellulose Diacetate Hollow Fiber Dialyzers, High Efficiency
Product Description Pack Factor Price/Case
5M2731 CA-HP 90 dialyzer 24/case $1,084.95 5M2732 CA-HP 110 dialyzer 24/case $1,200.89 5M2733 CA-HP 130 dialyzer 24/case $1,245.92 5M2734 CA-HP 150 dialyzer 24/case $1,287.95 5M2735 CA-HP 170 dialyzer 24/case $1,360.925M2736 CA-HP 210 dialyzer 24/case $1,466.75
H E M O D I A L Y S I S D I A L Y Z E R S
REUSE
CT Cellulose Triacetate Hollow Fiber Dialyzers, High Flux
Product Description Pack Factor Price/Case
5M1542 CT 110G dialyzer 24/case $1,395.68 5M1546 CT 190G dialyzer 24/case $1,504.45
CA Cellulose Acetate Hollow Fiber Dialyzers, Conventional
Product Description Pack Factor Price/Case
5M1729 CA 50 dialyzer (for single-use only) 24/case $834.39 5M1730 CA 70 dialyzer (for single-use only) 24/case $834.39
SINGLE-USE
-
H E M O D I A L Y S I S B L O O D T U B I N G S E T S
Blood tubing with pre-attached transducer protectors and priming set with needleless access port
Product Description Pack Factor Price/Case
*5M9634 8 mm pump segment, pre-pump pillow, post-pump arterial chamber 24/case $207.77*A201V801 1/4 pump segment, pre-pump arterial chamber 24/case $207.77*A203V801 8 mm pump segment, pre-pump arterial chamber 24/case $207.77*A204V801 8 mm pump segment, post-pump arterial chamber 24/case $207.77A209YV803 8 mm pump segment, pre-pump arterial chamber, Y-port saline set 24/case $207.77 A210V803 8 mm pump segment, post-pump arterial chamber 24/case $207.77 A217YV806 8 mm pump segment, post-pump arterial chamber, Y-port saline set 24/case $207.77
NIPRO SET Blood Tubing Sets by Nipro Corporation
*These tubing sets are compatible with selected Baxter Hemodialysis Instruments.
Please refer to the Recommended Blood Tubing Set Matrix for Baxter Hemodialysis Instruments. Baxter cannot recommend using sets outside the sets listed in the matrix. Please also refer to the Blood Tubing Set-up Guide for proper set-up for each recommended blood tubing set. For a copy of either the Blood Tubing Set Matrix or the Blood Tubing Set-up Guide please contact Renal Technical Support at 1-800-553-6898, Select 1 for English, Prompt 4, Option 1.
HD4 Effective Date 4/1/12
-
H E M O D I A L Y S I S F I S T U L A N E E D L E S
Nipros SAFETOUCH II Safety Fistula Needle, Single Needle Set with Back-Eye
Product Description Pack Factor Price/Case
FS1425BC Safety Fistula 14G x 1, fixed hub 500/case $876.52FS1525BC Safety Fistula 15G x 1, fixed hub 500/case $876.52FS1525BCR Safety Fistula 15G x 1, rotating hub 500/case $904.65 FS1532BC Safety Fistula 15G x 114, fixed hub 500/case $876.52FS1625BC Safety Fistula 16G x 1, fixed hub 500/case $876.52FS1625BCR Safety Fistula 16G x 1, rotating hub 500/case $904.65 FS163230BC Safety Fistula 16G x 114, fixed hub 500/case $876.52 FS1725BC Safety Fistula 17G x 1, fixed hub 500/case $876.52 FS173230BC Safety Fistula 17G x 114, fixed hub 500/case $876.52
Nipros SAFETOUCH II Safety Fistula Needle, Twin Pack Needle Set, Arterial Needle with Back-Eye, Venous Needle without Back-Eye
Product Description Pack Factor Price/Case
FS142530TP Safety Fistula 14G x 1, fixed hub 250 pair/case $876.52 FS142530TPR Safety Fistula 14G x 1, rotating hub 250 pair/case $904.65FS152530TP Safety Fistula 15G x 1, fixed hub 250 pair/case $876.52FS152530TPR Safety Fistula 15G x 1, rotating hub 250 pair/case $904.65FS162530TP Safety Fistula 16G x 1, fixed hub 250 pair/case $876.52 FS162530TPR Safety Fistula 16G x 1, rotating hub 250 pair/case $904.65 FS172530TP Safety Fistula 17G x 1, fixed hub 250 pair/case $876.52 FS172530TPR Safety Fistula 17G x 1, rotating hub 250 pair/case $904.65
Nipros BIOHOLE Dull Needles
Product Description Pack Factor Price/Case
FD152530BC 15G x 1 Fixed Hub w/Backeye 50/case $93.06
Effective Date 4/1/12 HD5
Nipros TULIP Safety Fistula Needle, Single Needle Set with Back-Eye
Product Description Pack Factor Price/Case
FT152530BC TULIP 15G x 1 Fixed Hub w/Backeye 300/case $525.91 FT153230BC TULIP 15G x 11/4 Fixed Hub w/Backeye 300/case $525.91 FT162530BC TULIP 16G x 1 Fixed Hub w/Backeye 300/case $525.91 FT152530BCR TULIP 15G x 1 Rotating Hub w/Backeye 300/case $543.22 FT162530BCR TULIP 16G x 1 Rotating Hub w/Backeye 300/case $543.22
-
H E M O D I A L Y S I S F I S T U L A N E E D L E S
Nipros TULIP Safety Fistula Needle, Twin Pack Needle Set, Arterial Needle with Back-Eye, Venous Needle without Back-Eye
Product Description Pack Factor Price/Case
FT142530TP TULIP 14G x 1 Fixed Hub Twin Pack 120 pair + 10 singles/case $438.25 FT152530TP TULIP 15G x 1 Fixed Hub Twin Pack 120 pair + 10 singles/case $438.25FT162530TP TULIP 16G x 1 Fixed Hub Twin Pack 120 pair + 10 singles/case $438.25 FT172530TP TULIP 17G x 1 Fixed Hub Twin Pack 120 pair + 10 singles/case $438.25
HD6 Effective Date 4/1/12
-
H E M O D I A L Y S I S D I S P O S A B L E S U P P L I E SNipros Disposable DOSE-SAVER Syringes
Miscellaneous Nipro Supplies
Product Description Pack Factor Price/Case
JD01D2238 Disposable DOSE-SAVER Syringe 1cc 22G x 1 1/2 1000/case $541.06 JD01D2516 Disposable DOSE-SAVER Syringe 1cc 25G x 5/8 1000/case $557.29 JD03D2238 Disposable DOSE-SAVER Syringe 3cc 22G x 1 1/2 1000/case $546.47
Product Description Pack Factor Price/Case
TPSURE1 Transducer Protector 1000/case $1,113.95 PS01 Priming Set 200/case $200.19
Intravenous Injections In VIAFLEX Plastic Containers (Saline) Sodium Chloride Injections
Product Description Container Size (mL) Pack Factor Price/Case
2B1321 0.9% Sodium Chloride Injection, USP 150 36/case $193.322B1322Q 0.9% Sodium Chloride Injection, USP 250 36/case $193.322B1323Q 0.9% Sodium Chloride Injection, USP 500 24/case $128.882B1324X 0.9% Sodium Chloride Injection, USP 1000 14/case $81.34
Irrigation Solutions in Plastic Containers
Product Description Container Size (mL) Pack Factor Price/Case
2F7112 Sterile Water For Irrigation, USP 250 24/case $146.642F7115 Sterile Water For Irrigation, USP 1500 9/case $87.932F7122 0.9% Sodium Chloride Irrigation, USP 250 24/case $153.122F7124 0.9% Sodium Chloride Irrigation, USP 1000 12/case $89.882F7125 0.9% Sodium Chloride Irrigation, USP 1500 9/case $91.80
Effective Date 4/1/12 HD7
-
Bicarbonate Concentrate (B-Side) by Minntech Renal Systems
T h r e e S t r e a m
Product Description Pack Factor Price/Case
5M7828 Bicarbonate Concentrate Powder for Conventional Proportioning Systems - 2.5 gal 20 packets/case $104.97 5M7829 Liquid Bicarbonate Concentrate for use with Conventional Proportioning Systems 4/case $58.43 (1 gal; 3.78 liters) C O B E ( B - S i d e )
Product Description Pack Factor Price/Case
5M7905 Bicarbonate Concentrate Powder for COBE Proportioning Systems (2.1 gal: 8 liters) 20 packets/case $104.97 5M7906 Liquid Bicarbonate Concentrate for use with COBE (45x) Proportioning Systems 4/case $58.43 (1 gal; 3.78 liters)
H E M O D I A L Y S I S C O N C E N T R A T E S
Acid Concentrate (A-Side) by Minntech Renal Systems
T h r e e S t r e a m ( C o n v e n t i o n a l ) P r o p o r t i o n i n g S y s t e m s ( 3 6 . 8 3 x d i l u t i o n ) Final dialysate composition approximates mEq/L when diluted with purified water and any B-side Bicarbonate product listed below
Product Na K Ca Mg Cl Acetate Dextrose Bicarbonate Pack Price/Case Factor
5M7818 140 1.00 2.50 1.00 105.50 4.0 200 35.0 4/case $45.45 5M7820 139 2.00 3.50 1.00 106.50 4.0 200 35.0 4/case $45.45 5M7821 139 1.00 3.50 1.00 105.50 4.0 200 35.0 4/case $45.45 5M7822 143 2.00 3.00 1.00 110.00 4.5 200 35.5 4/case $45.455M7823 140 0.00 2.50 1.00 104.50 4.0 200 35.0 4/case $45.455M7824 139 2.00 2.50 1.00 105.50 4.0 200 35.0 4/case $45.455M7825 139 3.00 3.00 1.00 107.00 4.0 200 35.0 4/case $45.455M7856 139 0.00 0.00 1.00 101.00 4.0 200 35.0 4/case $45.455M7857 139 3.00 2.50 0.75 106.25 4.0 200 35.0 4/case $45.45 COBE P r o p o r t i o n i n g S y s t e m s ( 4 5 x d i l u t i o n )
Product Na K Ca Mg Cl Acetate Dextrose Bicarbonate Pack Price/Case Factor
5M7901 137 0.00 2.25 0.75 103.00 5.0 200 32.0 4/case $49.78 5M7902 137 2.00 2.50 0.75 105.25 4.0 200 33.0 4/case $49.78 5M7903 137 1.00 3.00 0.75 104.75 4.0 200 33.0 4/case $49.785M7904 137 2.00 3.00 0.75 105.75 4.0 200 33.0 4/case $49.785M7909 137 1.00 2.25 0.75 104.00 5.0 200 32.0 4/case $49.78 5M7911 137 3.00 3.00 0.75 106.75 4.0 200 33.0 4/case $49.78
HD8 Effective Date 4/1/12
-
The following is a listing of trademarks of Baxter International Inc:
Baxter
CA
CA-HP
CT
Dicea
Exeltra
Hemavision
Viaflex
Xenium
The following is a listing of trademarks of VascA, Inc:
LifeSite
The following is a listing of trademarks of Cardian NBCT, Inc:
COBE
The following is a listing of trademarks of Nipro Corporation:
Dose-Saver
SafeTouch II
Tulip
T R A D E M A R K SFor hemodialysis products listed on pages HD1-HD8
Effective Date 4/1/12 HDTM
-
S O F T W A R E
Renal Software Suite (for use with HOMECHOICE PRO Automated PD System)
Product Description Pack Factor
5M5730 Renal Software Suite, PD Link Single User License 1/each5M5730U Renal Software Suite, PD Link User License Upgrade 1/each
RENALSOFT Clinical Software - Medical Record, CKD, PD, HD modules
RENLSFT RENALSOFT Clinical Software 1/each Contact your Baxter representative for more information
SO1 Effective Date 4/1/12
RENALSOFT Software Interface
5M5720 RENALSOFT Software Interface CD 1/each Contact your Baxter representative for more information
-
The following is a listing of trademarks of Baxter International Inc:
Baxter
HomeChoice PRO
RenalSoft
T R A D E M A R K SFor software products listed on page SO1
Effective Date 4/1/12 SOTM
-
Sponges
Product Description Pack Factor Price/Box5K7458P SORB-IT IV Sponge (split) 2 x 2 6-ply Sterile 35/box $17.48 5K7407P EXCILON Drain Sponge (split) 4 x 4 6-ply Sterile 25/box $38.71 5K7424P CURITY Gauze Sponge 2 x 2 8-ply Sterile 50/box $9.235K7505P CURITY Gauze Sponge 4 x 4 8-ply Sterile 25/box $10.41 5K7416P CURITY Gauze Sponge 4 x 4 12-ply Sterile 25/box $11.455K7426P CURITY Gauze Sponge 2 x 2 12-ply Non-Sterile 200/box $11.77 5K7425P CURITY Gauze Pad 2 x 2 12-ply Sterile 100/box $28.36 5K7567P VERSALON All Purpose Sponge 2 x 2 4-ply Sterile 25/box $4.44 5K7559P VERSALON All Purpose Sponge 3 x 3 4-ply Sterile 25/box $8.22 5K7589P VERSALON All Purpose Sponge 4 x 4 4-ply Sterile 25/box $10.75 5K7428P CURITY Cover Sponge 4 x 3 Sterile 25/box $11.93 5K7543P CURITY Cover Sponge 4 x 4 Sterile 25/box $13.35 5K7427P CURITY Cover Sponge 3 x 3 Non-Sterile 100/box $10.35 5K7525P CURITY Cover Sponge 4 x 3 Non-Sterile 100/box $14.35 5K7430P CURITY Cover Sponge 4 x 4 Non-Sterile 100/box $19.79
A N C I L L A R I E S
Gauze Sponge
IV Sponge
Dressings
Product Description Pack Factor Price/Box5K7401P COVERLET Adhesive Bandage, Flexible 1 x 3 100/box $24.495K7479P BIOPATCH Antimicrobial Dressing - 1 disk w/7.0 mm center hole 10/box $180.73 5K7538P PRIMAPORE Adhesive Dressing 4 x 31/8 Sterile 20/box $47.53 5K7548P PRIMAPORE Adhesive Dressing 6 x 31/8 Sterile 20/box $51.88 5K7568P PRIMAPORE Adhesive Dressing 8 x 4 Sterile 20/box $66.36 5K7532P TELFA Adhesive Island Dressing 2 x 31/2 Sterile 50/box $21.70 5K7588P TELFA Adhesive Island Dressing 4 x 5 Sterile 25/box $83.00 5K7522P VIASORB Wound Dressing 2 x 3 Sterile 20/box $109.275K7523P VIASORB Wound Dressing 4 x 6 Sterile 20/box $151.23 5K7459P OPSITE Post Op Dressing 61/8 x 33/8 Sterile 20/box $87.89 5K7580P TEGADERM Transparent Dressing 23/8 x 23/4 Sterile 100/box $124.97 5K7579P TEGADERM Transparent Dressing 4 x 43/4 Sterile 50/box $195.31 5K7578P TEGADERM Transparent Dressing 6 x 8 Sterile 10/box $88.98
AN1 Effective Date 4/1/12
-
Cloth Tape
Paper Tape
Plastic Tape
A N C I L L A R I E S
Tape
Product Description Pack Factor Price/Box5K7624 Cloth Tape 1 x 10 yds 1/ea $2.24 5K7630 Cloth Tape 2 x 10 yds 1/ea $4.93 5K7639 Soft Cloth Tape 2 x 10 yds 1/ea $20.91 5K7615 Paper Tape 1 x 10 yds 1/ea $1.90 5K7617 Paper Tape 2 x 10 yds 1/ea $3.63 5K7660 Paper Tape 1 x 10 yds w/Dispenser 1/ea $1.87 5K7667 Paper Tape 2 x 10 yds w/Dispenser 1/ea $3.77 5K7619 Plastic Tape 1 x 10 yds 1/ea $3.07 5K7627 Plastic Tape 2 x 10 yds 1/ea $6.97
Effective Date 4/1/12 AN2
-
Antiseptics/Chemicals
Product Description Pack Factor Price
5K4075 MANUGEL 85 Antiseptic Hydroalcoholic Gel, 500 mL with Pump 1 ea $22.27 5K4227 CAL STAT PLUS Hand Rub No Rinse - 4 oz. 1 ea $11.17 5K4070 Liquid Soap Antimicrobial - 16 oz. w/pump 1 ea $9.36 5K4066 EXSEPT PLUS Skin Antiseptic 500 mL 1 ea $30.96 5K4054P SHUR-CLENS Skin Wound Cleanser - 20 mL 25/box $96.43 5K4005 ALCAVIS 50 - 500 mL 1 ea $20.53 5K4027 BETASEPT Surgical Scrub 4% - 32oz. with Pump 1 ea $25.52 5K4001 Alcohol Isopropyl 70% - 16oz. 1 ea $3.69 5K4172P Alcohol Prep Medium 21/4 x 11/4 2-ply 200/box $7.97 5K4012P Povidone-Iodine Swab-aid 13/4 x 11/4 100/box $22.44 5K4013P Povidone-Iodine Swabstick 3/pk 25/box $22.68 5K8148P SKIN-PREP Protective Dressing 50/box $25.06 5K8058P Adhesive Remover Pad 100/box $29.78 5K4033P HEMASTIX Reagent Strips 50/box $77.58 5K4265P SERIM Cholorine Residual Test Kit 1 ea $156.18 5K4291P Bleach Wipes 50/box $63.585K4226 ACTRIL Cold Sterilant for Machine and Surface Disinfectant - Gallon 1 ea $47.43 5K4225P ACTRIL Residual Test Strips 100/bottle $71.41 5K4285 MINNCARE Cold Sterilant for use on RO Membranes - Quart 1 ea $86.99 5K4286P MINNCARE Residual Test Strip 100/box $88.70 5K4077 Conductivity Standard Solution 14.0 M/HHOS - 32oz. 1 ea $53.62
A N C I L L A R I E S
Surgical Scrub
Gloves
Product Description Pack Factor Price/Box
5K7777P Latex Free. Non-sterile. Powder Free. Nitrile. Small 100/box $26.795K7778P Latex Free. Non-sterile. Powder Free. Nitrile. Medium 100/box $26.795K7779P Latex Free. Non-sterile. Powder Free. Nitrile. Large 100/box $26.79
AN3 Effective Date 4/1/12
-
Blood Pressure Units
Product Description Pack Factor Price/Each
5K3966 Digital Auto Inflate Blood Pressure Unit w/medium cuff (arm girth 9.4 - 14.2) 1/each $186.76 5K3967 Digital Auto Inflate Blood Pressure Unit w/small cuff (arm girth 6.3 - 9.4) 1/each $180.36 5K3968 Digital Auto Inflate Blood Pressure Unit w/large cuff (arm girth 14.2 - 17.7) 1/each $203.00
Scales
Product Description Pack Factor Price/Each
5K3517 Scale Pediatric Digital (Capacity: 44 lbs x 1/2 oz / 20 kg x 0.01 kg) 1/each $559.58 5K3545 Scale Digital w/detachable display (Capacity: 400 lbs x 0.2 lbs / 180 kg x 0.1 kg) 1/each $333.94 5K3575 Scale Digital 1-1/2 Display (Capacity: 400 lbs x 0.1 lbs / 180 kg x 0.05 kg) 1/each $116.10 5K3582 Scale Spring (5000 gm x 100 gm) 1/each $21.08 5K3585 Scale Spring Pediatric (250 gm x 10 gm) 1/each $20.65
Permanent Equipment
Product Description Pack Factor Price/Each
5K3961 Heating Pad - King Size 3 Heat Setting 1/each $83.61 5Q3810 I.V. Pole Double-Hook Free Standing 47 x 84 1/each $117.40 5K3572 Thermometer, Digital 1/each $13.86 5K3826 Dialysis Bath Conductivity Meter 1/each $408.91 5K8100 PD Simulator and Case Dummy Tummy 1/each $1,209.32
A N C I L L A R I E S
Effective Date 4/1/12 AN4
-
Miscellaneous Ancillary Supplies
Product Description Pack Factor Price/Each
5K7444P Underpad Plastic Lined 17 x 24 100/box $20.87 5K7402P Sterile Field 18 x 26 50/box $48.73 5K4500 BETA-CAP Clamp 1 ea $5.54 5K3739 Forcep 414 Blue Plastic Dravon A-Clamp Smooth Jaw 1 ea $6.04 5K7406P Cotton-Tipped Applicator Sterile 6 Long - 2/pkg 100/box $22.79 5K8123P Face Mask White Paper Pleated 50/box $8.03 5K8070P Face Mask - Yellow Pleated 50/box $15.42 5K8032P Face Mask - Blue Molded Fluid Resistant 50/box $27.58 5K8065P Can Liner, 33 Gal, Black 250/box $78.49
A N C I L L A R I E S
Face Mask
AN5 Effective Date 4/1/12
JonathanHighlight
JonathanHighlight
-
The following is a listing of trademarks of Alcavis HDC, LLC: Alcavis Exsept Plus Manugel
The following is a listing of trademarks of Bayer Healthcare LLC: Hemastix
The following is a listing of trademarks of BSN Medical gmbh Corporation: Coverlet
The following is a trademark of Covidien AG: Beta-Cap Viasorb
The following is a listing of trademarks of E-Med Corporation: IV Strip
The following is a trademark of E.R. Squibb & Sons, LLC: Shur-Clens
The following is a listing of trademarks of Johnson & Johnson Corporation: BioPatch
The following is a listing of trademarks of Minntech Corporation: Actril Minncare
The following is a trademark of Nitto Denko Corp.: Xtrata
The following is a listing of trademarks of Purdue Frederick Company: Betasept
The following is a listing of trademarks of Serim Research Corporation: Serim
The following is a listing of trademarks of Smith & Nephew Medical Limited: Opsite Primapore Skin-Prep
The following is a trademark of Steris Inc.: Cal-Stat
The following is a listing of trademarks of Tyco Healthcare Group LP Curity Excilon Sorb-It Telfa Versalon
The following is a trademark of 3M Company: Tegaderm
T R A D E M A R K SFor ancillary products listed on pages AN1-AN5
Effective Date 4/1/12 ANTM
-
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mP
Clam
p12
Anci
llarie
s:5K
7416
PGa
uze
Spon
ge 4
x
4 1
2-pl
y25
5K74
58P
IV S
pong
e 2
x 2
6-
ply
355K
7424
PGa
uze
Spon
ge 2
x
2 8
-ply
50
5K76
15Pa
per T
ape
11
roll
5K76
19Pl
astic
Tap
e 1
1 ro
ll5K
7624
Clot
h Ta
pe 1
1
roll
5K80
70P
Face
Mas
k, Y
ello
w50
5K81
23P
Face
Mas
k, W
hite
50
Prod
uct
Code
Desc
riptio
nPa
ck
Fact
orOr
d Qt
yM
ax
Qty
Anci
llarie
s (c
ont.)
: 5K
4070
Antim
icro
bial
Soa
p 16
oz.
15K
4075
mAN
UgEL
85
Antis
eptic
15K
4066
ExSE
PT P
LUS
Antis
eptic
15K
4005
ALcA
vIS
50 (5
00m
l)1
valk
its/P
erm
anen
t Equ
ipm
ent:
Ord
Qty
To
Clin
icTo
Pa
tient
VALK
ITA
No IV
Pol
e, R
eg B
P Cu
ff
VALK
ITAL
No IV
Pol
e, L
g BP
Cuf
f
VALK
ITC
w/IV
Pol
e, R
eg B
P Cu
ffVA
LKIT
CLw
/IV P
ole,
Lg
BP C
uff
VALK
ITP
No S
cale
, Sm
BP
Cuff
5K39
61He
atin
g Pa
d, K
ing
Size
5Q38
10IV
Pol
e5K
3582
Scal
e Sp
ring
5K39
66BP
Uni
t, Di
gita
l (M
ediu
m C
uff)
5K35
75Sc
ale,
Dig
ital
5K35
72Th
erm
omet
er, D
igita
l
Pres
crip
tion
Form
s
-
Patie
nt N
ame
Phon
e
Alte
rnat
e Co
ntac
t
Ph
one
Deliv
ery
Addr
ess
City
Stat
e
Zip
Mai
ling
Addr
ess
(if d
iffer
ent)
Ci
ty
St
ate
Zi
pGe
nder
: M
ale
F
emal
e
DOB
/
/
Clin
ic/H
ospi
tal
Ph
one
Addr
ess
City
St
ate
Zi
pCo
ntac
t
PO
#
Days
rese
rve:
____
____
____
____
____
____
___
Lite
rs p
er d
ay:
____
____
____
____
____
___
Solu
tion
Max
imum
Qua
ntity
per
del
ivery
cyc
le:
____
____
____
____
____
____
____
____
____
___
ON
E YE
AR R
EFIL
L un
less
oth
erw
ise
note
d _
____
____
____
____
____
____
____
____
____
____
C
AP
D P
resc
rip
tio
n F
orm PF2
USE
AS D
IREC
TED
For
New
Yor
k St
ate
Pres
crip
tions
Onl
y:PR
ESCR
IPIT
ON
S W
ILL
BE F
ILLE
D G
ENER
ICAL
LY
UNLE
SS P
RESC
RIBE
R W
RITE
S d
aw
IN T
HE
BOX
BELO
W
This
ESR
D pa
tient
has
bee
n tr
aine
d in
Hom
e Pe
riton
eal D
ialy
sis
and
will
req
uire
the
supp
lies
liste
d be
low
.
Phys
icia
n:
Sign
atur
e (S
ubst
itutio
n Pe
rmitt
ed)
Date
(D
ispe
nse
as W
ritte
n)
Phys
icia
n Na
me
Prin
ted
Diab
etic
type
: N
on-D
iabe
tic
Typ
e 1
Insu
lin D
epen
dent
T
ype
2 In
sulin
Dep
ende
nt
Typ
e 2
Non-
Insu
lin D
epen
dent
Prod
uct
Code
% D
extro
seFi
ll Vo
lPa
ck
Fact
orOr
d Qt
yM
ax
Qty
DIAN
EAL
PD S
olut
ion
ULTR
ABAg
: Lo
wCa
l PD
25B
1.5%
L5B
2.5%
L5B
4.25
%L
5BL
5BL
5BL
ExTR
ANEA
L (Ic
odex
trin
) PD
Solu
tion:
5BEx
TRAN
EAL
L
Disp
osab
les:
5C44
66P
mIN
IcAP
Dis
conn
ect C
ap60
5C45
27Bl
ue O
utle
t Por
t Cla
mp
125C
4957
Red
ULTR
AcLA
mP
Clam
p12
L5C4
366
Disc
onne
ct Y
-Set
30
5C43
19Im
mob
ile (V
elcr
o)30
5C43
81Im
mOB
ILIz
ER30
Prod
uct
Code
Desc
riptio
nPa
ck
Fact
orOr
d Qt
yM
ax
Qty
Anci
llarie
s:5K
7416
PGa
uze
Spon
ge 4
x
4 1
2-pl
y25
5K74
58P
IV S
pong
e 2
x 2
6-
ply
355K
7424
PGa
uze
Spon
ge 2
x
2 8
-ply
50
5K76
15Pa
per T
ape
11
roll
5K76
19Pl
astic
Tap
e 1
1 ro
ll5K
7624
Clot
h Ta
pe 1
1
roll
5K80
70P
Face
Mas
k, Y
ello
w50
5K81
23P
Face
Mas
k, W
hite
50
5K40
70An
timic
robi
al S
oap
16oz
.1
5K40
75m
ANUg
EL 8
5 An
tisep
tic1
5K40
66Ex
SEPT
PLU
S An
tisep
tic1
5K40
05AL
cAvI
S 50
(500
ml)
1
Prod
uct
Code
Desc
riptio
nPa
ck
Fact
orOr
d Qt
yM
ax
Qty
Addi
tiona
l Ite
ms:
valk
its/P
erm
anen
t Equ
ipm
ent:
Ord
Qty
To
Clin
icTo
Pa
tient
VALK
ITA
No IV
Pol
e, R
eg B
P Cu
ff
VALK
ITAL
No IV
Pol
e, L
g BP
Cuf
f
VALK
ITC
w/IV
Pol
e, R
eg B
P Cu
ffVA
LKIT
CLw
/IV P
ole,
Lg
BP C
uff
VALK
ITP
No S
cale
, Sm
BP
Cuff
5K39
61He
atin
g Pa
d, K
ing
Size
5Q38
10IV
Pol
e5K
3582
Scal
e Sp
ring
5K39
66BP
Uni
t, Di
gita
l (M
ediu
m C
uff)
5K35
75Sc
ale,
Dig
ital
5K35
72Th
erm
omet
er, D
igita
l
Pres
crip
tion
Form
s
-
Patie
nt N
ame
Phon
e
Alte
rnat
e Co
ntac
t
Ph
one
Deliv
ery
Addr
ess
City
Stat
e
Zip
Mai
ling
Addr
ess
(if d
iffer
ent)
Ci
ty
St
ate
Zi
pGe
nder
: M
ale
F
emal
e
DOB
/
/
Clin
ic/H
ospi
tal
Ph
one
Addr
ess
City
St
ate
Zi
pCo
ntac
t
PO
#
Trea
tmen
ts p
er w
eek:
____
____
____
____
____
____
____
____
____
____
____