Baxter Bplpc

8/10/2019 Baxter Bplpc

1/50

PRICE LIST & PRODUCT CATALOG

2012


2/50

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


3/50

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

2 Effective Date 4/1/12


4/50

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 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.


5/50


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.


6/50


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.


7/50


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.


8/50


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.


9/50


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.


10/50


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


11/50


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 (


12/50


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.


13/50


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.


14/50

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.



15/50

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.



16/50

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.


17/50

PD2 Effective Date 4/1/12


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 )


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 )


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.


18/50


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


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.


19/50


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.


20/50


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


Automated Peritoneal Dialysis

HOMECHOICE PRO and HOMECHOICE Automated Peritoneal Systems (Cont.)


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


21/50



CAPD


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


5C4505 EZ-Aide Assist Device 1/each $200.91


22/50


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


23/50

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


24/50

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


RENAFLO II Hemofilters

5M3121 HF400 Hemofilter 0.30m2 12/case $1,570.86




5M3134 MINIFILTERPlus Hemofilter 700cm2 4/case $918.65

Dialysis Solutions for CRRT

Bicarbonate Buffer Solution


5B9248 ACCUSOLDialysis Solution 2.5L 35 Bicarbonate K4 4/case $101.72


5B9250 ACCUSOLDialysis Solution 2.5L 35 Bicarbonate K0 0 Dextrose 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


2C7565 INTERLINKSystem with Add-On BURETROL 48/case $529.92

Disposable Sets

5C4446 5-Prong Manifold Set (Spike) 15/case $228.70


25/50


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



26/50

Effective Date 4/1/12 HD1

HEMAVISION Disposable Blood Chamber


HCT1000B HEMAVISIONDisposable Blood Chamber 288/case $1,817.96

H E M O D I A L Y S I S


27/50

HD2 Effective Date 4/1/12

DICEA High Performance Dialyzers, Cellulose Diacetate, High Efficiency


5M2591 DICEA90 dialyzer (for single-use only) 24/case $1,084.95






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


5M2119 EXELTRA150 dialyzer (for single-use only) 24/case $1,365.61



5M2132 EXELTRAPlus 210 dialyzer (for single-use only) 24/case $1,485.52


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


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


28/50


CA-HP High Performance Cellulose Diacetate Hollow Fiber Dialyzers, High Efficiency


5M2731 CA-HP90 dialyzer 24/case $1,084.95






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


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


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


29/50

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


*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.



30/50

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


FS1425BC Safety Fistula 14G 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




Nipros SAFETOUCH II Safety Fistula Needle, Twin Pack Needle Set, Arterial Needle with

Back-Eye, Venous Needle without Back-Eye


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







Nipros BIOHOLE Dull Needles


FD152530BC 15G x 1 Fixed Hub w/Backeye 50/case $93.06


Nipros TULIP Safety Fistula Needle, Single Needle Set with Back-Eye


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


31/50

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


FT142530TP TULIP14G x 1 Fixed Hub Twin Pack 120 pair + 10 singles/case $438.25






32/50

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


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


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





33/50

Bicarbonate Concentrate (B-Side) by Minntech Renal Systems

T h r e e S t r e a m


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 )


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



34/50


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


35/50

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


RENALSOFT Software Interface

5M5720 RENALSOFTSoftware Interface CD 1/each

Contact your Baxter representative for more information


36/50


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


37/50

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



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



A N C I L L A R I E S

Gauze Sponge

IV Sponge

Dressings


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



38/50

Cloth Tape

Paper Tape

Plastic Tape


Tape


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


39/50

Antiseptics/Chemicals


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


Surgical Scrub

Gloves


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



40/50

Blood Pressure Units


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


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


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


Effective Date 4/1/12 AN4


41/50

Miscellaneous Ancillary Supplies


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


Face Mask

AN5



42/50

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


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


43/50


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


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


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



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


46/50

PF4


47/50

The following is a listing of trademarks of Baxter International Inc.:

Baxter

Dianeal

DirectAccess

Extraneal

HomeChoice

HomeChoice PRO

MiniCap

UltraBag

UltraClamp


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


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

Documents

Baxter Bplpc