national diabetes services scheme (ndss) insulin · pdf filenational diabetes services scheme...

National Diabetes Services Scheme (NDSS)INSULIN PUMP CONSUMABLES

ORDER FORM

NDSS IPC Order Form

115 Soft Release O (6mm, 26G, 60cm) Manage S6051 Dana Proprietary sT 10 sets 16.20




507 Cleo 90 (6mm, 28G, 61cm) MSA 21-7220-24 Generic Luer lock aT 10 sets 16.20






513 Accu-Chek FlexLink (8mm, 30cm) Roche 4626427001 Spirit/Spirit Combo/Generic Luer lock sT 10 sets 16.20






519 Accu-Chek FlexLink Cannula (8mm) Roche 4626567001 Spirit/Spirit Combo/Generic Luer lock sT 10 Cannula 11.30

520 Accu-Chek FlexLink Cannula (10mm) Roche 4626575001 Spirit/Spirit Combo/Generic Luer lock sT 10 Cannula 11.30

537 Inset 30 Infusion set (13mm, 110cm) grey AMSL 100-396-03 Generic Luer lock aT 10 sets 16.20

538 Inset 30 Infusion Set (13mm, 60cm) blue AMSL 100-396-01 Generic Luer lock aT 10 sets 16.20

539 Inset 30 Infusion set (13mm, 60cm) pink AMSL 100-396-02 Generic Luer lock aT 10 sets 16.20

540 Inset 30 Infusion set (13mm, 60cm) grey AMSL 100-396-00 Generic Luer lock aT 10 sets 16.20

541 Animas Comfort (17mm, 27G, 60cm) AMSL 100-006-51 Generic Luer lock aT 10 sets 16.20

542 Animas Comfort (17mm, 27G, 60cm) AMSL 100-006-03 Generic Luer lock aT 10 cannulae + 5 lines 13.50

543 Animas Comfort (17mm, 27G, 110cm) AMSL 100-006-50 Generic Luer lock aT 10 sets 16.20

544 Animas Comfort (17mm, 27G, 110cm) AMSL 100-006-02 Generic Luer lock aT 10 cannulae + 5 lines 13.50

545 Inset II - includes insertion device (6mm, 27G, 60cm) grey AMSL 100-410-00 Generic Luer lock sT 10 sets 16.20

545.1 Inset II - includes insertion device (6mm, 27G, 60cm) blue AMSL 100-410-01 Generic Luer lock sT 10 sets 16.20

545.2 Inset II - includes insertion device (6mm, 27G, 60cm) pink AMSL 100-410-02 Generic Luer lock sT 10 sets 16.20


546.1 Inset II - includes insertion device (9mm, 27G, 60cm) blue AMSL 100-411-01 Generic Luer lock sT 10 sets 16.20

546.2 Inset II - includes insertion device (9mm, 27G, 60cm) pink AMSL 100-411-02 Generic Luer lock sT 10 sets 16.20



549 Animas Comfort (60cm, 27G, 13mm) AMSL 100-240-01 Generic Luer lock aT 10 sets 16.20

551 Animas Comfort (110cm, 27G, 13mm) AMSL 100-240-03 Generic Luer lock aT 10 sets 16.20

552 Animas Comfort (60cm, 27G, 13mm) AMSL 100-240-04 Generic Luer lock aT 10 cannulae + 5 lines 13.50

553 Animas Comfort (110cm, 27G, 13mm) AMSL 100-240-05 Generic Luer lock aT 10 cannulae + 5 lines 13.50

561 Medtronic Paradigm Quickset (9mm, 25G, 110cm) Medtronic MMT-396 Paradigm Paradigm only sT 10 sets 16.20




568 Medtronic Paradigm Silhouette (17mm, 25G, 110cm) Medtronic MMT-377 Paradigm Paradigm only aT 10 sets 16.20


576 Medtronic Quick Sets (9mm, 25G, 110cm) Medtronic MMT-390 507/507c/508 Luer lock sT 10 sets 16.20




582 Medtronic Silhouette (17mm, 25G, 110cm) Medtronic MMT-371 507/507c/508 Luer lock aT 10 sets 16.20

583 Medtronic Silhouette (17mm, 25G, 60cm) Medtronic MMT-373 507/507c/508 Luer lock aT 10 sets 16.20



590 Accu-Chek TenderLink Cannula (13mm) Roche 5015260001 Spirit/Spirit Combo/Generic Luer lock aT 10 cannula 11.30

591 Accu-Chek TenderLink Cannula (17mm) Roche 5015251001 Spirit/Spirit Combo/Generic Luer lock aT 10 cannula 11.30

592 Accu-Chek TenderLink 1 (13mm, 30cm) Roche 4541596001 Spirit/Spirit Combo/Generic Luer lock aT 10 sets 16.20




No. Per box3

Price

per box4

$

No.

Boxes

Amount

payable $

Version - March 2016

NDSS

CodeProduct Description

Supplier

Code

Supplier

Catalogue No.Pump

1Connection

Type2

Needle cannula

angle & type

Infusion Sets

Subtotal (A) $

NDSS IPC Order Form continued



603 Soft - Release ST (19mm, 26G, 70cm) Manage SR102 Dana Dana only aT 10 sets 16.20

611 Superline Easy Release II (7mm, 17G, 70cm) Manage SU401 Dana Dana only sm 10 sets 16.20

615 Accu-Chek Rapid-D Link Cannula (6mm, 10cm tail) Roche 4541006001 Spirit/Spirit Combo/Generic Luer lock sm 25 cannulae 28.40



618 Accu-Chek Rapid-D Transfer Set (28G, 20cm) Roche 4541057001 Spirit/Spirit Combo/Generic Luer lock sm 10 lines 4.90






643 Medtronic Paradigm Mio (6mm, 27G, 45cm) pink Medtronic MMT-921 Paradigm Paradigm only sT 10 sets 16.20

643.1 Medtronic Paradigm Mio (6mm, 27G, 45cm) blue Medtronic MMT-941 Paradigm Paradigm only sT 10 sets 16.20





645.2 Medtronic Paradigm Mio (6mm, 27G, 80cm) clear Medtronic MMT-965 Paradigm Paradigm only sT 10 sets 16.20

646 Medtronic Paradigm Mio (9mm, 27G, 80cm) clear Medtronic MMT-975 Paradigm Paradigm only sT 10 sets 16.20

647 Medtronic Paradigm Sure - T (6mm, 29G, 60cm) Medtronic MMT-864 Paradigm Paradigm only sm 10 sets 16.20






653 Medtronic Sure - T (6mm, 29G, 60cm) Medtronic MMT-863 507/507c/508 Luer lock sm 10 sets 16.20








673 Contact Detach Infusion Set (6mm, 29G, 60cm) AMSL 100-905-00 Generic Luer lock sm 10 sets 16.20







680 Accu-Chek Flexlink Cannula (6mm) Roche 6593941001 Spirit/Spirit Combo/Generic Luer lock sT 10 cannula 11.30

Subtotal (B) $

Supplier

Catalogue No.Pump

1Connection

Type2

Needle cannula

angle & typeNo. Per box

3

Price

per box4

$

No.

Boxes

Amount

payable $

NDSS

CodeProduct Description

Supplier

Code

NDSS IPC Order Form continued

702 Deltec Insulin Reservoir, 3mL MSA 21-1750-24 Cozmo na na 25 26.60

704 Minimed Reservoir, 3mL Medtronic MMT-103A 507/507 c/508 na na 10 10.80

705 Medtronic Paradigm Insulin Reservoir 1.8mL Medtronic MMT-326A 515/522/554 na na 10 10.80

706 Medtronic Paradigm Insulin Reservoir 3mL Medtronic MMT-332A 715/722/754 na na 10 10.80

709.1 Dana Reservoir 3mL Manage DAC00201 Dana only na na 10 10.80

710 Animas IR1200/2020 Pump Cartridge 2mL AMSL AN100-124-01 IR1200/2020/Vibe na na 10 10.80

713 Accu-Chek Spirit Cartridge 3.15mL Roche 5206073001 Spirit/Spirit Combo/Generic na na 25 26.60

714 Accu-Chek Spirit Cartridge 3.15mL Roche 4949935001 Spirit/Spirit Combo/Generic na na 5 5.40

AMSL - Australasian Medical & Scientific Limited

Medtronic - Medtronic Australasia

Manage - Managing Diabetes

Roche - Roche Diagnostics

The National Diabetes Services Scheme (NDSS) is an initiative of the Australian Government administered by Diabetes Australia

OPS.FM.RG.016 v1603

Pump Reservoirs/Cartridges

Subtotal (C) $

Total Amount Payable

(A+B+C)$

Office Use Only

Needle/cannula angle & type: straight, metal = sm straight, Teflon = sT angled, metal = am angled, Teflon = aT

NDSS ORDER FORM - UPDATED 01/03/2016

1 This column indicates manufacturer recommended pump for use with listed consumable.

2 If a 'Lure lock' connection type is indicated, the product may be compatible with other pumps. Please note that the pump manufacturer may decline to provide support (or honour warranties) in the event that problems arise while utilising a pump

3 'sets' indicates equal number of cannulae and lines, e.g. '10 sets' = 10 cannulae + 10 lines.

4 Please note that there are no additional concessions on subsidised insulin pump consumables.

# Inset products include an additional co-payment of $20.00 per box to fund the integrated inserter.

Supplier codes:

national diabetes services scheme (ndss) insulin · pdf filenational diabetes services scheme...

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