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8/10/2019 Baxter Bplpc
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PRICE LIST & PRODUCT CATALOG
2012
8/10/2019 Baxter Bplpc
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C O N T E N T S
T 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
General Terms and Conditions of Sale . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Definitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Warranties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-6
Order/Delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-10
Billing/Payment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Returned Goods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
APD EQUIPMENT Rental Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-14
P E R I T O N E A L D I A LY S I SDIANEALPD Solution, ULTRABAGSystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PD1
DIANEALPD Solution, Single Bag . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PD2 PD3
EXTRANEAL (icodextrin) PD Solution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PD4
HOMECHOICEPROAutomated Peritoneal Dialysis System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PD5 PD6
HOMECHOICEAutomated Peritoneal Dialysis System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PD5 PD6
APD Drain Supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PD6
APD Miscellaneous Supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PD6
Disconnect Y-Sets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PD7
Miscellaneous CAPD Supplies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PD7
Assist 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 SHEMAVISIONDisposable Blood Chamber . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HD1
Dialyzers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HD2 HD3
Blood Tubing Sets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HD4
Fistula Needles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HD5 HD6
Disposable Supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HD7
Concentrates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HD8Trademarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HDTM
S O F T W A R E . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . SO1Trademarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . SOTM
A N C I L L A R I E SSponges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . AN1
Dressings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . AN1
Tape . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . AN2
Antiseptics/Chemicals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . AN3
Gloves . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . AN3
Blood Pressure Units . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . AN4
Scales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . AN4
Permanent Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . AN4
Miscellaneous Ancillary Supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . AN5Trademarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ANTM
P R E S C R I P T I O N F O R M S . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PF1 PF4
Trademarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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 R Y 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 SupportHours: 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
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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 ExportCUSTOMER 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 forany terrorist activities.
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I I . D E F I N I T I O N S
The following definitions apply to these Terms and Conditions:
CUSTOMERshall 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) andother licensed, outpatient dialysis centers (Centers).
DIRECTACCESSis 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.
DISPOSABLEshall mean any PRODUCT manufactured or sold by Baxter, other than EQUIPMENT or PARTS.
EQUIPMENTshall mean durable medical devices, hardware, instruments and instrumentation used primarily
for dialysis which is manufactured or sold by Baxter for its intended use.
EXPEDITED ORDERshall mean any order placed for delivery with less lead time than outlined in the Lead
Time section of these Terms and Conditions.
FORCE MAJEUREshall 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 PATIENTshall mean an individual for which CUSTOMER holds an active prescription and is providing
CAPD, APD or HD therapy in the patients home.
PARTshall mean a component manufactured or sold by Baxter for EQUIPMENT.
PRODUCTshall mean DISPOSABLE, EQUIPMENT, PART or any combination thereof.
RE-DELIVERYshall 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 DELIVERYshall mean an order placed for delivery to an established address on an established
date per the established delivery schedule.
OFF-SCHEDULE DELIVERYshall mean an order placed for delivery to an established address on a date that
varies from the established delivery date.
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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 OFMERCHANTABILITY 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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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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I V . O R D E R / D E L I V E R Y
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-performanceor 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 TimePeritoneal 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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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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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 isapplied.
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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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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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 orrights are waived unless the CUSTOMERS complaint has been received by Baxter within such thirty (30) day
period.
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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 eligiblefor 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 lut 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 $156.37
5B9758 2.5% 3000 5000 4/case $159.84
5B9759 4.25% 3000 5000 4/case $164.72
DIANEAL PD-2 PD So lut 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 $185.64
5B9857 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 Lactate
DIANEALLow Calcium PD Solution (mEq/L) 132 2.5 0.5 95 40
DIANEAL PD-2 PD Solution (mEq/L) 132 3.5 0.5 96 40
DIANEALPD-2 and Low Calciumperitoneal dialysis solutions in
ULTRABAGcontainers are indicated for use in chronic renalfailure patients being maintained on continuous ambulatory peritonealdialysis when nondialytic medical therapy is judged to be inadequate.
Important Risk Information for DIANEALSolutionsn 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 ofcontamination of equipment.
n Solution-related adverse reactions may include peritonitis,electrolyte and fluid imbalances, hypovolemia, hypervolemia,
hypotension, hypertension, disequilibrium syndrome, allergicsymptoms, and muscle cramping.
n Please see enclosed package inserts for DIANEALsolution fullprescribing information.
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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 lut 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 $120.90
L5B9727 2.5% 2000 3000 6/case $144.92
L5B9747 4.25% 2000 3000 6/case $146.73
L5B9901 1.5% 3000 3000 4/case $138.36
L5B9902 2.5% 3000 3000 4/case $140.30
L5B9903 4.25% 3000 3000 4/case $143.31
L5B4826 1.5% 5000 6000 2/case $74.15
L5B5202 2.5% 5000 6000 2/case $75.88
L5B5203 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 $365.35
L5B5183 4.25% 1000 1000 12/case $376.59
L5B5166 1.5% 2000 3000 6/case $121.75
L5B5177 2.5% 2000 3000 6/case $145.60
L5B5187 4.25% 2000 3000 6/case $148.04L5B5169 1.5% 3000 3000 4/case $136.97
L5B5179 2.5% 3000 3000 4/case $139.92
L5B5189 4.25% 3000 3000 4/case $143.78
L5B5193 1.5% 5000 6000 2/case $74.15
L5B5194 2.5% 5000 6000 2/case $75.87
L5B5195 4.25% 5000 6000 2/case $77.54
L5B9710 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 Lactate
DIANEAL Low Calcium PD Solution (mEq/L) 132 2.5 0.5 95 40
DIANEAL 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 DIANEALsolution full prescribing information.
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EXTRANEAL PD So lut ion , ULTRABAG Sys tem
Product Icodextrin Fill Volume (mL) Container Size (mL) Pack Factor Price/Case
5B4984 7.5% 2000 2000 6/case per contract
5B4986 7.5% 2500 3000 5/case per contract
EXTRANEAL PD So lut 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 contract
L5B4976 7.5% 2500 3000 5/case per contract
Na Ca Mg Cl Lactate
Extraneal(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). Extranealis 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 PeritonealEquilibration Test (PET).
Important Risk Information
Dangerous Drug-Device InteractionOnly use glucose-specific monitors and test strips to measure blood glucose levels in patients using Extraneal(icodextrin) Peritoneal Dialysis Solution. Blood glucosemonitoring 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, andGDH-FAD-based glucose monitors and test strips has resulted in falsely elevated glucose readings (due to the presence of maltose, see PRECAUTIONS/Drug/LaboratoryTest 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. Plasmalevels of Extraneal(icodextrin) and its metabolites return to baseline within approximately 14 days following cessation of Extraneal(icodextrin) administration. Thereforefalsely elevated glucose levels may be measured up to two weeks following cessation of Extraneal(icodextrin) therapy when GDH-PQQ, GDO, and GDH-FAD-based bloodglucose 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 dialysispatients using Extraneal(icodextrin) carefully review the product information of the blood glucose testing system, including that of test strips, to determine if the system isappropriate 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 listof 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 Extranealis contraindicated in patients with a known allergy to cornstarch or icodextrin, in patients with maltose or isomaltose intolerance, in patients with glycogen storagedisease, and in patients with pre-existing severe lactic acidosis
n ExtranealPD solution is intended for intraperitoneal administration only. Not for intravenous injectionn Rarely, serious hypersensitivity reactions to Extranealhave been reported, such as toxic epidermal necrolysis, angioedema, serum sickness, erythema multiforme and
leukocytoclastic vasculitis. If a serious reaction is suspected, discontinue Extranealand 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 ExtranealPD solution patients than in control patients,
were peritonitis, upper respiratory infection, hypertension, and rash. The most common treatment-related adverse event for ExtranealPD 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 ExtranealPD 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 peritonitis
n Fluid status, hematologic indices, blood chemistry, and electrolyte concentrations, including calcium, potassium, sodium, magnesium and bicarbonate, should be monitoredperiodically. Abnormalities in any of these parameters should be treated promptly under the care of a physician
n 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 cavity
n 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. ExtranealProduct Insert and ExtranealMedication Guide.
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P E R I T O N E A L D I A L Y S I S S Y S T E M S
Automated Peritoneal Dialysis
HOMECHOICE PRO and HOMECHOICE Automated Peritoneal Systems
Product Description Pack Factor Price
De v i c e s
5C4471 HOMECHOICEAutomated PD System 1/each $17,719.67
5C8310 HOMECHOICE PROAutomated PD System 1/each $20,251.06
HOMECHOICE PROSystem HOMECHOICE System
Lu e r D i s p o s ab l e Se t s
R5C4479C Automated PD Set with Cassette - 4 Prong 30/case $966.63
L5C4531 Integrated APD Set 30/case $1,303.78
N5C8305C Low Recirculation Volume APD Set with cassette 30/case $2,786.84
n Integrated APD Set has 3 supply lines, and 22 patient and drain lines.n Low 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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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 S
Automated Peritoneal Dialysis
HOMECHOICE PRO and HOMECHOICE Automated Peritoneal Systems (Cont.)
Product Description Pack Factor Price
Da t a C ar d s
R5C4522 HOMECHOICE PROCard 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 en s i o n L i n e s
5C4480C 12 Foot Patient Extension Line with EASY-LOCKConnector 30/case $246.60
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P E R I T O N E A L D I A L Y S I S S Y S T E M S
CAPD
Product Description Pack Factor Price
D i s c on n e c t Y- S et s
5C4366P ULTRASETDisposable Disconnect Y-Set (Spike) 60/case $552.61L5C4366 ULTRASETDisposable Disconnect Y-Set (Luer) 30/case $315.07
M i s c e l l a n eo u s C AP D Su p p l i es
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 ev 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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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-LOCKTransfer Set (6) 6/case $377.56
5C4449 MINICAPExtended Life PD Transfer Set (6) with Roller Clamp 6/case $377.56
5C4482 MINICAPExtended Life PD Transfer Set (6) with Twist Clamp 6/case $344.00
5C4483 MINICAPExtended 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-LOCKAdapter 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 IMMOBILIZERcatheter stabilizing device 30/case $476.98
Disconnect Caps
5C4212P Disconnect Cap (Walnut Cap) 60/case $376.16
5C4456 FLEXICAPDisconnect Cap for High Dose Therapy 30/case $94.52
5C4466P MINICAPDisconnect Cap 60/case $313.44
Clamps
5C4527 Outlet Port Clamp with Short Nose 12/case $78.88
5C4957 ULTRACLAMPClamp (not for use as outlet port clamp) 12/case $78.88
Locking Titanium Adapter
FLEXICAPDisconnect Cap
MINICAPDisconnect 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 S
For 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 $1,799.77
5M3134 MINIFILTERPlus Hemofilter 700cm2 4/case $918.65
Dialysis Solutions for CRRT
Bicarbonate Buffer Solution
Product Description Pack Factor Price/Case
5B9248 ACCUSOLDialysis Solution 2.5L 35 Bicarbonate K4 4/case $101.72
5B9249 ACCUSOLDialysis Solution 2.5L 35 Bicarbonate K2 4/case $101.72
5B9250 ACCUSOLDialysis Solution 2.5L 35 Bicarbonate K0 0 Dextrose 4/case $101.72
5B9251 ACCUSOLDialysis Solution 2.5L 30 Bicarbonate K2 4/case $101.72
5B9252 ACCUSOLDialysis 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 INTERLINKSystem 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 S
For 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 HEMAVISIONDisposable 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 DICEA90 dialyzer (for single-use only) 24/case $1,084.95
5M2592 DICEA110 dialyzer (for single-use only) 24/case $1,200.89
5M2593 DICEA130 dialyzer (for single-use only) 24/case $1,245.92
5M2594 DICEA150 dialyzer (for single-use only) 24/case $1,287.95
5M2595 DICEA170 dialyzer (for single-use only) 24/case $1,360.92
5M2596 DICEA210 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 EXELTRA150 dialyzer (for single-use only) 24/case $1,365.61
5M2120 EXELTRA170 dialyzer (for single-use only) 24/case $1,405.23
5M2121 EXELTRA190 dialyzer (for single-use only) 24/case $1,450.22
5M2132 EXELTRAPlus 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 XENIUM130 dialyzer (for single-use only) 24/case $793.56
5M6402 XENIUM150 dialyzer (for single-use only) 24/case $888.46
5M6403 XENIUM170 dialyzer (for single-use only) 24/case $943.00
5M6404 XENIUM 190 dialyzer (for single-use only) 24/case $1,006.96
5M6405 XENIUM 210 dialyzer (for single-use only) 24/case $1,085.00
Product Description Pack Factor Price/Case
H25601A XENIUMXPH110 dialyzer (for single-use only) 24/case $748.22H25602A XENIUMXPH 130 dialyzer (for single-use only) 24/case $793.56
H25603A XENIUMXPH 150 dialyzer (for single-use only) 24/case $888.46
H25604A XENIUMXPH 170 dialyzer (for single-use only) 24/case $943.00
H25605A XENIUMXPH 190 dialyzer (for single-use only) 24/case $1,006.96
H25606A XENIUMXPH 210 dialyzer (for single-use only) 24/case $1,085.00
XENIUM Dialyzers, High Flux, Synthetic
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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-HP90 dialyzer 24/case $1,084.95
5M2732 CA-HP110 dialyzer 24/case $1,200.89
5M2733 CA-HP130 dialyzer 24/case $1,245.92
5M2734 CA-HP150 dialyzer 24/case $1,287.95
5M2735 CA-HP170 dialyzer 24/case $1,360.92
5M2736 CA-HP210 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
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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 $207.77
A209YV803 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
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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 $876.52
FS1525BC Safety Fistula 15G x 1, fixed hub 500/case $876.52
FS1525BCR 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 $876.52
FS1625BCR 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 $904.65
FS152530TP Safety Fistula 15G x 1, fixed hub 250 pair/case $876.52
FS152530TPR Safety Fistula 15G x 1, rotating hub 250 pair/case $904.65
FS162530TP 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 TULIP15G x 1 Fixed Hub w/Backeye 300/case $525.91FT153230BC TULIP15G x 11/4 Fixed Hub w/Backeye 300/case $525.91
FT162530BC TULIP16G x 1 Fixed Hub w/Backeye 300/case $525.91
FT152530BCR TULIP15G x 1 Rotating Hub w/Backeye 300/case $543.22
FT162530BCR TULIP16G x 1 Rotating Hub w/Backeye 300/case $543.22
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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 TULIP14G x 1 Fixed Hub Twin Pack 120 pair + 10 singles/case $438.25
FT152530TP TULIP15G x 1 Fixed Hub Twin Pack 120 pair + 10 singles/case $438.25
FT162530TP TULIP16G x 1 Fixed Hub Twin Pack 120 pair + 10 singles/case $438.25
FT172530TP TULIP17G x 1 Fixed Hub Twin Pack 120 pair + 10 singles/case $438.25
HD6 Effective Date 4/1/12
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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 S
Nipros Disposable DOSE-SAVER Syringes
Miscellaneous Nipro Supplies
Product Description Pack Factor Price/Case
JD01D2238 Disposable DOSE-SAVERSyringe 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-SAVERSyringe 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 $193.32
2B1322Q 0.9% Sodium Chloride Injection, USP 250 36/case $193.32
2B1323Q 0.9% Sodium Chloride Injection, USP 500 24/case $128.88
2B1324X 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 $87.93
2F7122 0.9% Sodium Chloride Irrigation, USP 250 24/case $153.12
2F7124 0.9% Sodium Chloride Irrigation, USP 1000 12/case $89.88
2F7125 0.9% Sodium Chloride Irrigation, USP 1500 9/case $91.80
Effective Date 4/1/12 HD7
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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 COBEProportioning 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 $45.45
5M7823 140 0.00 2.50 1.00 104.50 4.0 200 35.0 4/case $45.45
5M7824 139 2.00 2.50 1.00 105.50 4.0 200 35.0 4/case $45.45
5M7825 139 3.00 3.00 1.00 107.00 4.0 200 35.0 4/case $45.45
5M7856 139 0.00 0.00 1.00 101.00 4.0 200 35.0 4/case $45.45
5M7857 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 $49.78
5M7904 137 2.00 3.00 0.75 105.75 4.0 200 33.0 4/case $49.78
5M7909 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
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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 S
For hemodialysis products listed on pages HD1-HD8
Effective Date 4/1/12 HDTM
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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/each
5M5730U Renal Software Suite, PD Link User License Upgrade 1/each
RENALSOFT Clinical Software - Medical Record, CKD, PD, HD modules
RENLSFT RENALSOFTClinical Software 1/each
Contact your Baxter representative for more information
SO1
Effective Date 4/1/12
RENALSOFT Software Interface
5M5720 RENALSOFTSoftware Interface CD 1/each
Contact your Baxter representative for more information
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The following is a listing of trademarks of Baxter International Inc:
Baxter
HomeChoice PRO
RenalSoft
T R A D E M A R K S
For software products listed on page SO1
Effective Date 4/1/12 SOTM
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Sponges
Product Description Pack Factor Price/Box
5K7458P SORB-IT IV Sponge (split) 2 x 2 6-ply Sterile 35/box $17.48
5K7407P EXCILONDrain Sponge (split) 4 x 4 6-ply Sterile 25/box $38.71
5K7424P CURITYGauze Sponge 2 x 2 8-ply Sterile 50/box $9.23
5K7505P CURITYGauze Sponge 4 x 4 8-ply Sterile 25/box $10.41
5K7416P CURITY Gauze Sponge 4 x 4 12-ply Sterile 25/box $11.45
5K7426P CURITYGauze Sponge 2 x 2 12-ply Non-Sterile 200/box $11.77
5K7425P CURITYGauze Pad 2 x 2 12-ply Sterile 100/box $28.36
5K7567P VERSALONAll Purpose Sponge 2 x 2 4-ply Sterile 25/box $4.44
5K7559P VERSALONAll Purpose Sponge 3 x 3 4-ply Sterile 25/box $8.22
5K7589P VERSALONAll Purpose Sponge 4 x 4 4-ply Sterile 25/box $10.75
5K7428P CURITYCover Sponge 4 x 3 Sterile 25/box $11.93
5K7543P CURITYCover Sponge 4 x 4 Sterile 25/box $13.35
5K7427P CURITYCover Sponge 3 x 3 Non-Sterile 100/box $10.35
5K7525P CURITYCover Sponge 4 x 3 Non-Sterile 100/box $14.35
5K7430P CURITYCover 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/Box
5K7401P COVERLETAdhesive Bandage, Flexible 1 x 3 100/box $24.49
5K7479P BIOPATCHAntimicrobial Dressing - 1 disk w/7.0 mm center hole 10/box $180.73
5K7538P PRIMAPOREAdhesive Dressing 4 x 31/8 Sterile 20/box $47.53
5K7548P PRIMAPOREAdhesive Dressing 6 x 31/8 Sterile 20/box $51.88
5K7568P PRIMAPOREAdhesive Dressing 8 x 4 Sterile 20/box $66.36
5K7532P TELFAAdhesive Island Dressing 2 x 31/2 Sterile 50/box $21.70
5K7588P TELFAAdhesive Island Dressing 4 x 5 Sterile 25/box $83.00
5K7522P VIASORBWound Dressing 2 x 3 Sterile 20/box $109.27
5K7523P VIASORBWound Dressing 4 x 6 Sterile 20/box $151.23
5K7459P OPSITEPost Op Dressing 61/8 x 33/8 Sterile 20/box $87.89
5K7580P TEGADERMTransparent 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
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Cloth Tape
Paper Tape
Plastic Tape
A N C I L L A R I E S
Tape
Product Description Pack Factor Price/Box
5K7624 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
8/10/2019 Baxter Bplpc
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Antiseptics/Chemicals
Product Description Pack Factor Price
5K4075 MANUGEL85 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 PLUSSkin Antiseptic 500 mL 1 ea $30.965K4054P SHUR-CLENSSkin Wound Cleanser - 20 mL 25/box $96.43
5K4005 ALCAVIS50 - 500 mL 1 ea $20.53
5K4027 BETASEPTSurgical 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-PREPProtective Dressing 50/box $25.06
5K8058P Adhesive Remover Pad 100/box $29.78
5K4033P HEMASTIXReagent Strips 50/box $77.58
5K4265P SERIMCholorine Residual Test Kit 1 ea $156.185K4291P Bleach Wipes 50/box $63.58
5K4226 ACTRILCold Sterilant for Machine and Surface Disinfectant - Gallon 1 ea $47.43
5K4225P ACTRILResidual Test Strips 100/bottle $71.41
5K4285 MINNCARECold Sterilant for use on RO Membranes - Quart 1 ea $86.99
5K4286P MINNCAREResidual 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 $26.79
5K7778P Latex Free. Non-sterile. Powder Free. Nitrile. Medium 100/box $26.79
5K7779P Latex Free. Non-sterile. Powder Free. Nitrile. Large 100/box $26.79
AN3
Effective Date 4/1/12
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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
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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-CAPClamp 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
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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 S
For ancillary products listed on pages AN1-AN5
Effective Date 4/1/12 ANTM
8/10/2019 Baxter Bplpc
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8/10/2019 Baxter Bplpc
44/50Pat
ientName
Phone
AlternateContact
Phone
DeliveryAddress
City
State
Zip
Ma
ilingAddress(ifdifferent)
City
State
Zip
Gender:
Male
Female
DOB
/
/
Clinic/Hospital
Phone
Address
City
State
Zip
Contact
PO#
Daysreserve:_______
____________________
Litersperda
y:_______________________
SolutionMaximum
Qua
ntityperdeliverycycle:_______________________________________
ONEYEARREFILLunlessotherwisenoted
_________________________________________
CAPD
Prescription
Form
USEASDIRECTED
Fo
rNew
YorkStatePrescriptionsOnly:
PRESC
RIPITONSWILLBEFILLEDGENERICALLY
UNLE
SSPRESCRIBERWRITESdawINTHE
BOXBELOW
ThisESRDpatienthasbeentrainedinHomePeritonealDialysisandwillrequire
thesupplieslistedbelow.
Physician:
S i
t
( S b t i t t i P i t t d )
D t
( D i W i t t )
P h i i N P i t d
Dia
betictype:
Non-Diabetic
Type1InsulinDependent
Type2InsulinDependent
Type2Non-InsulinDependent
Pro
duct
Code
%D
extrose
FillVol
Pack
Factor
OrdQty
Max
Qty
DIANEALPDSolutionULTRABAG:
LowCal
PD2
5B
1.5%
L
5B
2.5%
L
5B
4.25%
L
5B
L
5B
L
5B
L
EX
TRANEAL(Icodextrin)PDSolution:
5B
EXTRANEAL
L
Disposables:
5C
4466P
MINICAPDisconnectCap
60
5C
4527
BlueOutletPortClamp
12
5C
4957
RedULTRACLAMPClamp
12
L5C4366
DisconnectY-Set
30
5C
4319
Immobile(Velcro)
30
5C
4381
IMMOBILIZER
30
Product
Code
Description
Pack
Factor
OrdQty
Max
Qty
Ancillaries:
5K7416P
Gau
zeSponge4x412-ply
25
5K7458P
IVS
ponge2x26-ply
35
5K7424P
Gau
zeSponge2x28-ply
50
5K7615
PaperTape1
1roll
5K7619
Plas
ticTape1
1roll
5K7624
ClothTape1
1roll
5K8070P
FaceMask,Yellow
50
5K8123P
FaceMask,White
50
5K4070
AntimicrobialSoap16oz.
1
5K4075
MANUGEL85Antiseptic
1
5K4066
EXS
EPTPLUSAntiseptic
1
5K4005
ALC
AVIS50(500ml)
1
Product
Code
Description
Pack
Factor
OrdQty
Max
Qty
AdditionalItems:
Valkits/PermanentEquipment:
OrdQty
To
Clinic
To
Patient
VALKITA
NoIVPole,RegBP
Cuff
VALKITAL
NoIVPole,LgBPCuff
VALKITC
w/IVPole,RegBPCuff
VALKITCL
w/IVPole,LgBPCuff
VALKITP
NoScale,
Sm
BPC
uff
5K3961
HeatingPad,KingSize
5Q3810
IVPole
5K3582
ScaleSpring
5K3966
BPUnit,Digital(Me
dium
Cuff)
5K3575
Scale,Digital
5K3572
Thermometer,Digital
8/10/2019 Baxter Bplpc
45/50Pat
ientName
Phone
AlternateContact
Phone
DeliveryAddress
City
State
Zip
Ma
ilingAddress(ifdifferent)
City
State
Zip
Gender:
Male
Female
DOB
/
/
Clinic/Hospital
Phone
Address
City
State
Zip
Contact
PO#
Treatmentsperweek:________________________________
_________________________
ONEYEARREFILLunlessotherwisenoted
_________________________________________
HD
Prescription
Form
USEASDIRECTED
Fo
rNew
YorkStatePrescriptionsOnly:
PRESC
RIPITONSWILLBEFILLEDGENERICALLY
UNLE
SSPRESCRIBERWRITESdawINTHE
BOXBELOW
Phys
ician:
Sig
nature
(SubstitutionPermitted)
Date
(DispenseasWritten)
PhysicianNamePrinted
Dia
betictype:
Non-Diabetic
Type1InsulinDependent
Type2InsulinDependent
Type2Non-InsulinDependent
Pro
duct
Code
Description
Pack
F
actor
OrdQty
Max
Qty
2B1324X
0.9%S
alineInj.,USP1000mL
14
5M
AcidConcentrate
5M
BicarbonateConcentrate,Liquid
5M
BicarbonateConcentrate,
Powder
5M
Dialyzer
Fistula___
Gx____
BloodTubingSet
TPSURE1
TransducerProtector
1000
5K4033P
HEMA
STIXReagentStrips
50
5K4225P
ACTRILResidualTestStrips
100
5K4077
ConductivitySol14.0M/HHOS
1
5K4226
ACTRILMachineDisinfectant
1
Product
Code
Description
Pack
Factor
OrdQty
Max
Qty
Anc
illaries:
5K7416P
Gauze
Sponge4x412-ply
25
5K7458P
IVSpo
nge2x26-ply
35
5K7615
Paper
Tape1
1roll
5K7619
Plastic
Tape1
1roll
5K7624
ClothTape1
1roll
5K8070P
FaceM
ask,Yellow
50
5K8123P
FaceM
ask,White
50
5K4070
AntimicrobialSoap16oz.
1
5K4075
MANU
GEL85Antiseptic
1
5K4001
Alcoho
lIsopropyl70%1
6oz.
1
5K4172P
Alcoho
lSwabs
200
5K4012P
Povido
ne-IodineSwabs
100
5K4013P
Povido
ne-IodineSwabsticks3/pk
25
Product
Code
Description
Pack
Factor
OrdQty
Max
Qty
Anc
illaries(cont.):
5K7444P
Underpad,BluePlastic
100
5K77
Gloves
100
Add
itionalItems:
PermanentEqu
ipment:
5K3966
BPUnit,Digital(Me
dium
Cuff)
1
5K3575
Scale,Digital
1
5K3739
Forceps41/4
1
5K3826
DialysisBathConductivityMeter
1
8/10/2019 Baxter Bplpc
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PF4
8/10/2019 Baxter Bplpc
47/50
The following is a listing of trademarks of Baxter International Inc.:
Baxter
Dianeal
DirectAccess
Extraneal
HomeChoice
HomeChoice PRO
MiniCap
UltraBag
UltraClamp
The following is a listing of trademarks of Minntech Corporation:
Actril
The following is a listing of trademarks of Bayer Healthcare LLC:
Hemastix
The following is a listing of trademarks of Alcavis HDC,LLC:
Manugel
T R A D E M A R K S
For prescription forms listed on pages PF1-PF4
PFTM Effective Date 4/1/12
8/10/2019 Baxter Bplpc
48/50
N U M E R I C A L I N D E X
2B1321 HD7
2B1322Q HD7
2B1323Q HD7
2B1324X HD7
2C7565 AC1
2F7112 HD7
2F7115 HD7
2F7122 HD7
2F7124 HD7
2F7125 HD7
5B4984 PD3
5B4986 PD3
5B7860 AC1
5B9248 AC1
5B9249 AC1
5B9250 AC1
5B9251 AC1
5B9252 AC1
5B9757 PD1
5B9758 PD1
5B9759 PD1
5B9765P PD1
5B9766 PD1
5B9768P PD1
5B9775P PD1
5B9776 PD1
5B9778P PD1
5B9795P PD1
5B9796 PD1
5B9798P PD1
5B9857 PD1
5B9858 PD1
5B9859 PD1
5B9866 PD1
5B9868P PD1
5B9876 PD1
5B9878P PD1
5B9896 PD1
5B9898P PD1
5C4129 PD7
5C4136 PD7
5C4137 PD7
5C4145P PD5
5C4160 PD7
5C4169 PD7
5C4190 PD6
5C4212P PD7
5C4213P PD7
5C4215P PD7
5C4275 PD6
5C4319 PD7
5C4366P PD6
5C4381 PD7
5C4406 PD5
5C4413 PD7
5C4426 PD5
5C4442 PD7
5C4446 PD5, AC1
5C4449 PD7
5C4456 PD7
5C4462 PD5
5C4464P PD5
5C4471 PD4
5C4476 PD5
5C4480C PD5
5C4482 PD7
5C4483 PD7
5C4505 PD6
5C4512 PD5
5C4527 PD7
5C4530 PD6
5C4942 PD6
5C4957 PD7
5C4971 PD5
5C8310 PD4
5C8346 PD5
5K3517 AN4
5K3545 AN4
5K3572 AN4
5K3575 AN4
5K3582 AN4
5K3585 AN4
5K3739 AN5
5K3826 AN4
5K3961 AN4
5K3966 AN4
5K3967 AN4
5K3968 AN4
5K4001 AN3
5K4005 AN3
5K4012P AN3
5K4013P AN3
5K4027 AN3
5K4033P AN3
5K4054P AN3
5K4066 AN3
5K4070 AN3
5K4075 AN3
5K4077 AN3
5K4172P AN3
5K4225P AN3
5K4226 AN3
5K4227 AN3
5K4265P AN3
5K4285 AN3
5K4286P AN3
5K4291P AN3
5K4500 AN3
5K7401P AN1
5K7402P AN5
5K7406P AN5
5K7407P AN1
5K7416P AN1
5K7424P AN1
5K7425P AN1
5K7426P AN1
5K7427P AN1
5K7428P AN1
5K7430P AN1
5K7444P AN5
5K7458P AN1
5K7459P AN1
5K7479P AN1
5K7505P AN1
5K7522P AN1
5K7523P AN1
5K7525P AN1
5K7532P
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