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2012

PRICE LIST & PRODUCT CATALOG

CONTENTS
TERMS AND CONDITIONS OF SALE
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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
General Terms and Conditions of Sale . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Definitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Warranties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Order/Delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Billing/Payment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Returned Goods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
APD EQUIPMENT Rental Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2
3
4
5-6
7-10
11
12
13-14

P E R I T O N E A L D I A LY S I S
DIANEAL PD Solution, ULTRABAG System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PD1
DIANEAL PD Solution, Single Bag . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
EXTRANEAL (icodextrin) PDSolution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
HOMECHOICE PRO Automated Peritoneal Dialysis System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
HOMECHOICE Automated Peritoneal Dialysis System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
APD Drain Supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
APD Miscellaneous Supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Disconnect Y-Sets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Miscellaneous CAPD Supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Assist Devices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Transfer Sets, Catheter Supplies, Disconnect Caps, and Clamps . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Trademarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

PD2 PD3
PD4
PD5 PD6
PD5 PD6
PD6
PD6
PD7
PD7
PD7
PD8
PDTM

A C U T E D I A LY S I S
Dialysis Solutions for CRRT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . AC1
Acute PD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . AC1
Trademarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ACTM

H E M O D I A LY S I S

HEMAVISION Disposable Blood Chamber . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


Dialyzers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Blood Tubing Sets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Fistula Needles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Disposable Supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Concentrates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Trademarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

HD1
HD2 HD3
HD4
HD5 HD6
HD7
HD8
HDTM

S O F T W A R E . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . SO1
Trademarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . SOTM

ANCILLARIES
Sponges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Dressings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Tape . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Antiseptics/Chemicals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Gloves . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Blood Pressure Units . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Scales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Permanent Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Miscellaneous Ancillary Supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Trademarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

AN1
AN1
AN2
AN3
AN3
AN4
AN4
AN4
AN5
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

DIRECTORY OF SERVICES
HomeCare Services / Order Entry (HOME PATIENTS)
Hours: 7:00 am - 6:00 pm CST

1-800-284-4060
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
http://ecomm.baxter.com

1-877-334-2298

Sales Inquiries

1-888-736-2543

PARTS and EQUIPMENT Service


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

1-800-553-6898

Global Technical Services


Peritoneal Dialysis Operational Support (24/7/365 days a year)
Hemodialysis Technical Support
Hours: 8:30 am - 5:00 pm EST

1-800-553-6898

Clinical Support

1-888-736-2543

PRODUCT Surveillance

1-888-736-2543

Hardware Billing

1-800-553-6898

Credit and Collections


Hours: 7:00 am - 5:00 pm CST

1-888-270-3189

DIRECTACCESS
https://homecareservices.baxter.com/

1-800-284-4060

Pharmacy Services

1-888-736-2543

Effective Date 4/1/12

I.

GENERAL TERMS AND CONDITIONS OF SALE

ALL SALES ARE SUBJECT TO AND EXPRESSLY CONDITIONED UPON THE TERMS AND CONDITIONS
CONTAINED HEREIN, WHICH ARE ACCEPTED BY THE CUSTOMER UPON PLACING OF AN ORDER FOR
PRODUCT WITH BAXTER WHICH ORDER IS CONFIRMED BY BAXTER. NO VARIATION OF THESE TERMS
AND CONDITIONS WILL BE BINDING UPON BAXTER UNLESS AGREED TO IN WRITING AND SIGNED BY
AN AUTHORIZED EMPLOYEE OF BAXTER, OR UNLESS A SEPARATE DIALYSIS PRODUCT PURCHASE
AGREEMENT OR OTHER APPLICABLE SALES DOCUMENT HAS BEEN SIGNED, IN WHICH CASE, SUCH
SALES DOCUMENT SHALL GOVERN IN THE EVENT OF AN EXPRESS CONFLICT WITH THESE TERMS AND
CONDITIONS. THESE TERMS AND CONDITIONS CAN ALSO BE FOUND AT:
http://www.baxter.com/downloads/patients_and_caregivers/therapies/renal/bplpc.pdf
Baxter reserves the right at any time to amend these Terms and Conditions. It is CUSTOMERS responsibility
to review these Terms and Conditions prior to submitting each order. Baxter has no responsibility to notify
CUSTOMER of any changes prior to the effective date of the changes. CUSTOMER shall be deemed to accept
such amended Terms and Conditions by ordering PRODUCT after the date of such amendment.
No Reselling, Transfer or Export
CUSTOMER agrees that PRODUCT purchased from Baxter is not for: a) resale, transfer, barter or trade to any
entity or person, b) use in the further processing, packaging or filling of other drugs, therapies or devices, or
c) export. Neither CUSTOMER nor HOME PATIENT shall transfer any PRODUCT to any other person or entity
except to the person for whom the prescription is written. Any unused PRODUCT, once dispensed or delivered
to HOME PATIENT or CUSTOMER, cannot be transferred to any other patients and must be destroyed in
accordance with applicable state or local regulations or returned to Baxter per the guidelines outlined in the
Returned Goods section of these Terms and Conditions.
Drug and Service State Licensing Requirements
CUSTOMER agrees to maintain all state-mandated licenses and/or permits required to purchase, use, and
dispense Baxter PRODUCT. CUSTOMER shall provide all applicable license and permit information to Baxter
promptly upon request.
Tax, Tax-Exempt Status and Other Fees
CUSTOMER agrees to pay all applicable federal, state, and local taxes (including property taxes); license and
registration fees; and all other fees and costs based on CUSTOMERS lease, rental, purchase, possession or
use of PRODUCT. A CUSTOMER that is exempt from taxation is required to provide valid certification of its
exempt status to Master Data Center of Excellence
(1-877-329-0003; Fax 1-847-948-2540).
No Prohibited Use of PRODUCT
CUSTOMER will not knowingly use, resell, transfer or distribute any PRODUCT directly or indirectly for the
development, production or proliferation of weapons of mass destruction, or missile delivery systems and/or for
any terrorist activities.

Effective Date 4/1/12 3

II. DEFINITIONS

The following definitions apply to these Terms and Conditions:


CUSTOMER shall mean the legal entity purchasing PRODUCT, for the provision of Automated Peritoneal
Dialysis (APD), Continuous Ambulatory Peritoneal Dialysis (CAPD), or Hemodialysis (HD) therapy. Such
entities include, but are not limited to: hospitals and their affiliated outpatient dialysis clinics (Hospitals) and
other licensed, outpatient dialysis centers (Centers).
DIRECTACCESS is an on-line tool to allow Hospitals and Centers to manage HOME PATIENT transactions.
Key functions include: new patient set-up, status change, and prescription management. This is the preferred
vehicle for CUSTOMER to manage HOME PATIENT transactions with Baxter.
DISPOSABLE shall mean any PRODUCT manufactured or sold by Baxter, other than EQUIPMENT or PARTS.
EQUIPMENT shall mean durable medical devices, hardware, instruments and instrumentation used primarily
for dialysis which is manufactured or sold by Baxter for its intended use.
EXPEDITED ORDER shall mean any order placed for delivery with less lead time than outlined in the Lead
Time section of these Terms and Conditions.
FORCE MAJEURE shall mean supply shortage of raw materials, manufacturing problems, delivery or labor
problems, discontinuation of PRODUCT line, acts of regulatory or other governmental or quasi-governmental
entities, terrorist activities, acts of hostility by foreign or domestic parties, acts of nature (including fire, flood,
earthquake, storm, hurricane or other natural disaster), or unforeseen events or causes beyond Baxters control.
HOME PATIENT shall mean an individual for which CUSTOMER holds an active prescription and is providing
CAPD, APD or HD therapy in the patients home.
PART shall mean a component manufactured or sold by Baxter for EQUIPMENT.
PRODUCT shall mean DISPOSABLE, EQUIPMENT, PART or any combination thereof.
RE-DELIVERY shall mean a situation in which previous delivery arrangements have been made and agreed to
by HOME PATIENT and a second delivery is made after an unsuccessful first attempt to deliver has been made.
SCHEDULED DELIVERY shall mean an order placed for delivery to an established address on an established
date per the established delivery schedule.
OFF-SCHEDULE DELIVERY shall mean an order placed for delivery to an established address on a date that
varies from the established delivery date.

Effective Date 4/1/12

I I I . WA R R A N T I E S

General Warranty
Baxter warrants that PRODUCT manufactured by Baxter, when used in accordance with the directions on the
labeling, is fit for the purposes and indications described on the labeling. The applicable manufacturer under the
manufacturers warranty will cover PRODUCT not manufactured by Baxter, and Baxter provides no warranty for
PRODUCT not manufactured by Baxter.
The warranty does not apply to any PRODUCT that is misused, abused, neglected, tampered with or damaged
intentionally, by accident, flood, water, fire or other hazard. If PRODUCT is not used in accordance with
manufacturers instructions, PRODUCT warranties are void and of no effect. There are no other express or
implied warranties, including any warranty of merchantability or fitness for a particular purpose. Baxter shall not
be liable for proximate, incidental, or special damages.
All warranties in these Terms and Conditions shall be construed to comply with the warranty Safe Harbor found
at 42 C.F.R. 1001.952(g).
THE WARRANTY IN THIS SECTION SHALL BE IN LIEU OF ANY OTHER WARRANTY EXPRESSED, OR
IMPLIED OR STATUTORY, RESPECTING PRODUCT, AND BAXTER MAKES NO IMPLIED WARRANTY OF
MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. CUSTOMERS SOLE AND EXCLUSIVE
REMEDY IN CONTRACT, TORT OR UNDER ANY OTHER THEORY AGAINST BAXTER WITH RESPECT TO
PRODUCT AND ITS USE SHALL BE THE REPLACEMENT OR REPAIR OF THE PRODUCT AND NO OTHER
REMEDY (INCLUDING, WITHOUT LIMITATION, CONSEQUENTIAL DAMAGES) SHALL BE AVAILABLE
TO CUSTOMER. BAXTER SHALL HAVE NO FURTHER OBLIGATION OR LIABILITY WITH RESPECT TO
PRODUCT, OR ITS SALE, OPERATION AND USE, AND BAXTER NEITHER ASSUMES, NOR AUTHORIZES
THE ASSUMPTION OF, ANY OBLIGATION OR LIABILITY IN CONNECTION WITH SUCH PRODUCT.
EQUIPMENT Warranty
Baxter warrants to CUSTOMER that EQUIPMENT delivered is free from defects in material or workmanship
for the periods specified in the appropriate Operators and Technicians manual (which outlines the complete
warranty), provided EQUIPMENT is used and maintained in accordance with the manufacturers operating
instructions. PARTS installed which have been purchased from vendors other than Baxter shall void all
applicable warranties.
Warranty for EQUIPMENT Service Repair
Service is subject to a thirty (30) day conditional warranty.

Effective Date 4/1/12 5

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 1-800553-6898 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.

Effective Date 4/1/12

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-performance
or delays caused by a FORCE MAJEURE event. CUSTOMER agrees that in any and all such events, Baxter
may allocate PRODUCT among CUSTOMERS without liability or other negative outcome with CUSTOMER.
All orders, with the exception of warranty orders or EQUIPMENT service orders covered under a service
agreement, require a purchase order, supply contract or credit card authorization.
When using a purchase order form, any modification by CUSTOMER regarding pricing, terms of sale or any
other terms or conditions shall not be effective unless accepted in advance and in writing by an authorized
representative of Baxter. Only the list and quantity of PRODUCT and any specific shipping instructions shall be
applicable to said sale.
Selling Unit of Measure
Order quantities must be in the selling unit of measure indicated. Pack factors are noted for ease of ordering.
Prescription Requirement
BAXTER WILL NOT ACCEPT ANY ORDER FOR HOME PATIENT WITHOUT A PRESCRIPTION SIGNED AND
DATED BY A PHYSICIAN, which lists PRODUCT codes, quantities and the allowable refill period, not to exceed
one (1) year. All new APD HOME PATIENT prescriptions must also include either a HomeChoice or HomeChoice
Pro rental. HOMECHOICE devices cannot be shipped until a signed prescription is on file. Prescriptions should
be managed and e-signed through DIRECTACCESS.
CUSTOMER may obtain copies of prescriptions at no charge through DIRECTACCESS. All other manner of
requests shall be subject to a forty dollar ($40.00) processing fee.
Lead Time
Peritoneal dialysis PRODUCT and HD DISPOSABLE orders require a five (5) business day lead time. HD
EQUIPMENT orders require a sixty (60) business day lead time. EQUIPMENT and PART orders requiring
expedited delivery at CUSTOMERS request are subject to an expedited processing and delivery charge quoted
at the time of the order placement. Orders must be placed no later than 12:00 pm local time in the time zone of
CUSTOMERS local Baxter distribution center to be deemed placed on that business day. Orders placed after
12:00 pm local time will be deemed placed on the following business day.
Freight and Distribution
Published prices for DISPOSABLES include regular processing and distribution charges provided the order is
placed five (5) business days prior to the SCHEDULED DELIVERY date. Inside delivery is standard for HOME
PATIENT. Delivery to a Hospital or Center receiving or loading dock is standard while inside delivery is an
additional service and may result in additional charges.

Effective Date 4/1/12 7

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 setup 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.

Effective Date 4/1/12

OFF-SCHEDULE DELIVERY
All OFF-SCHEDULE DELIVERY will be assessed a one hundred fifty dollar ($150.00) service fee. Exemptions will
be permitted only for: a) prescription changes authorized and documented by the physician; b) usage changes
called in by the clinician; c) deliveries required to correct Baxter error; d) domestic travel orders subject to the
Vacation Supply Deliveries section; and e) New HOME PATIENT Orders.
HOME PATIENT RE-DELIVERY
Orders requiring RE-DELIVERY are subject to a charge of seventy-five dollar ($75.00).
EXPEDITED ORDERS
EXPEDITED ORDERS at CUSTOMERS request are subject to an expedited processing charge.
The expedited processing charge for Hospitals or Center orders is one hundred fifty dollars ($150.00) if placed
during normal business hours and two hundred fifty dollars ($250.00) if placed outside of normal business hours
plus actual freight charges.
If an extra delivery is required that can ship ground a fifty dollar ($50.00) extra delivery fee is applied. If order
placed after cut-off but can meet CUSTOMERS SCHEDULED DELIVERY a fifty dollar ($50.00) late fee is
applied.
All Will Call (customer pickup) orders will be assessed a one hundred fifty dollar ($150.00) EXPEDITED ORDER
charge regardless of time of request.
Expedited processing charges for HOME PATIENTS are:

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

*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 OFFSCHEDULE DELIVERY and Minimum Order Charges

Effective Date 4/1/12

Vacation Supply Deliveries


Travel orders for destinations within the continental U.S. (excluding all cruises regardless of departure port)
require a lead time of fourteen (14) business days. Less lead time will result in EXPEDITED ORDER charges of
one hundred dollars ($100.00) as outlined in the previous section.
Through the Global Destinations Program, peritoneal dialysis HOME PATIENTS can successfully continue their
therapy while travelling outside of the continental U.S., including Alaska and Hawaii and cruises from any port,
domestic or international. Customer is responsible for the shipping and handling costs associated with the
order delivery. The handling cost for a standard order (>30 days notice) is one hundred dollars ($100.00) while
an EXPEDITED ORDER (<30 days) is two hundred dollars ($200.00). Shipping fees vary and are calculated
based on travel destination. To place an order through the Global Destinations Program, call 1-800-284-4060.
APD EQUIPMENT
A one-time cycler delivery charge of two hundred dollars ($200.00) will apply for new orders.
CUSTOMER assumes the entire risk of loss, damage or failure to return the cycler. In such cases, CUSTOMER
will be invoiced a fee of four thousand dollars ($4,000.00) to cover the costs of such a loss. In the event the
cycler is not returned according to the Returned Goods section of these Terms and Conditions within thirty (30)
days, the fee will be invoiced and be payable to Baxter immediately.
Receipt and Verification
CUSTOMER or HOME PATIENT should verify deliveries to ensure that all items ordered and shipped are
received. All deliveries must be verified within two (2) business days from receipt in order to be eligible for credit
for shortages or to have PRODUCT replaced without incurring delivery charges.
Proof of Delivery
The Baxter invoice and packing list must be retained as proof of delivery. Subject to availability and within thirty
(30) days following the date of shipment, requests for additional documentation of delivery (e.g., carrier delivery
logs) will be subject to a service charge of forty dollars ($40.00).
HD EQUIPMENT Services and Charges
Global Technical Services provides the scheduling and actual on-site service of HD EQUIPMENT by qualified
service engineers. HD EQUIPMENT field service will be performed during Baxters normal business hours at
Baxters then current standard labor rate. Field service performed after Baxters normal business hours and on
weekends and holidays will be charged at a premium labor rate.

10

Effective Date 4/1/12

V. B I L L I N G / P A Y M E N T

Terms of Sale
All orders are subject to credit approval and acceptance at Baxters home office. Standard payment terms are
net thirty (30) from the date of invoice. Payment terms are in effect as of the date of the order. Payment is made
to the remit to address indicated on the invoice. Credit card payments are subject to approval by Credit and
Collections.
Invoices that are not paid according to the payment terms of each sale shall bear interest at the lesser of
18% per annum or the highest rate allowed by applicable law. Additionally, Baxter reserves the right to require
payment in advance of shipment.
Prices
PRODUCT is priced at the amount indicated for the selling unit of measure ordered. Prices and specifications
are subject to change without notice. All shipments are billed at the price in effect on the date of the order.
PRODUCT is billed upon shipment.
Published PRODUCT prices are exclusive of all taxes.
EQUIPMENT service and separately billable PRODUCT processing and delivery charges are priced as
described in these Terms and Conditions.
Discount Disclosure Statement
CUSTOMER and Baxter intend that all purchases of PRODUCT and services made by CUSTOMER shall be
administered in accordance with the provisions of the federal Anti-Kickback Statute (42, U.S.C. 1320a-7b(b)).
Any discounts and rebates received by CUSTOMER with respect to PRODUCT may be considered discounts
or other reductions in price under the Anti-Kickback Statute, Section 1128B(b)(3)(A) of the Social Security Act
[42 U.S.C. 1320a-7b(b)(3)(A)].
To the extent required by the Anti-Kickback Statute or the Discount Safe Harbor regulations, 42 C.F.R
1001.952(h) et seq., CUSTOMER shall fully and accurately disclose such discounts and other reductions in
price in accordance with the applicable state or federal cost reporting requirements, including, without limitation,
disclosing and accurately reflecting where appropriate, and as appropriate, to the applicable reimbursement
methodology. Baxter will provide CUSTOMER with sales and discount information to allow CUSTOMER to
comply with this Section and the Discount Safe Harbor regulation, including sufficient rebate and pricing
information to enable CUSTOMER to accurately report its actual costs for all purchases of PRODUCT and
services. The total charges for PRODUCT and services purchased by CUSTOMER shall be the contract price
less any such discounts, including rebates.
Credit and Disputes
Only amounts which are disputed in good faith may be withheld from payment pending resolution. Any portion
of an invoice not in dispute must be remitted within the payment terms of each sale. All disputes must be
submitted in writing to Credit and Collections within thirty (30) days from the date of invoice. All disputes or
rights are waived unless the CUSTOMERS complaint has been received by Baxter within such thirty (30) day
period.

Effective Date 4/1/12

11

VI. RETURNED GOODS

DISPOSABLES and PARTS


DISPOSABLES and PARTS that have not been stored in a sanitary manner and in accordance with the
package insert cannot be returned or credited. Verification of proper storage may be required for credit.
DISPOSABLES and PARTS must be returned in the original, unopened and undamaged carton or package to
be eligible for credit.
CUSTOMER must notify Baxter and obtain a return goods authorization (RGA) number prior to returning
DISPOSABLES and PARTS. DISPOSABLES and PARTS will not be eligible for credit without prior approval
of the return and unless returned in accordance with this Returned Goods section. Approval to return
DISPOSABLES and PARTS does not guarantee credit. Baxter does not assume liability for DISPOSABLES and
PARTS returned without prior approval. Credit will be issued to the original purchaser only. DISPOSABLE and
PARTS provided at no charge are not eligible for credit but remain subject to the terms of this Returned Goods
section.
A ninety-five dollar ($95.00) pick-up charge will be applied against any credit due on DISPOSABLE returns,
excluding Baxter order/delivery errors. Any portion of the charge that exceeds the credit will be invoiced
separately.
Baxter order/delivery errors must be reported within two (2) business days of receipt and, when applicable,
returned within thirty (30) days of receipt to be eligible for one hundred percent (100%) credit. Examples include
shortages, damages, order entry errors and delivery errors. DISPOSABLES and PARTS returned after thirty (30)
days but within ninety (90) days of receipt may be eligible for credit as excess stock.
CUSTOMER or HOME PATIENT order errors must be reported within two (2) business days of receipt and
returned within thirty (30) days of receipt to be eligible for fifty percent (50%) credit. Peritoneal dialysis solutions
returned from HOME PATIENT are not eligible for credit. DISPOSABLES with a 5K or 5Q prefix are not
returnable.
DISPOSABLES and PARTS returned after thirty (30) days but within ninety (90) days of receipt may be eligible
for credit as excess stock. Excess stock must be returned within ninety (90) days of receipt to be eligible for fifty
percent (50%) credit. Excess stock shall not be eligible for credit under the following circumstances:

returned after ninety (90) days from receipt


returned with less than three (3) months remaining to expiration
returned from HOME PATIENT
returns with a 5K or 5Q prefix
returns sold on a no return basis

EQUIPMENT
Purchased EQUIPMENT is not returnable unless shipped in error by Baxter. Leased, rental, trade-in, and/or
evaluation EQUIPMENT may be returned as governed by the terms of this section.
EQUIPMENT returns are at CUSTOMERS expense, and EQUIPMENT must be in the same condition as when
delivered to CUSTOMER, normal wear and tear expected. CUSTOMER shall deliver the EQUIPMENT to such
place or on board such carrier, packed for shipping, as Baxter may specify. CUSTOMER is responsible for
return of EQUIPMENT including all associated charges with the exception of return due to EQUIPMENT shipped
in error by Baxter. CUSTOMER shall give Baxter prior written notice that it is returning EQUIPMENT.

12

Effective Date 4/1/12

V I I . A P D E Q U I P M E N T R E N T A 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

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

P ER ITO NEAL

DIALYS I S

DIANEAL PD Solution, ULTRABAG System


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
DIANEAL PD-2 and Low Calcium peritoneal dialysis solutions in
ULTRABAG containers are indicated for use in chronic renal
failure patients being maintained on continuous ambulatory peritoneal
dialysis when nondialytic medical therapy is judged to be inadequate.
Important Risk Information for DIANEAL Solutions
n Not for Intravenous Injection.
n Use aseptic technique. Contamination of connector may result in
peritonitis.
n Adverse reactions to peritoneal dialysis include mechanical and
solution related problems as well as the results of
contamination of equipment.
n Solution-related adverse reactions may include peritonitis,
electrolyte and fluid imbalances, hypovolemia, hypervolemia,
hypotension, hypertension, disequilibrium syndrome, allergic
symptoms, and muscle cramping.
n Please see enclosed package inserts for DIANEAL solution full
prescribing information.

DIANEAL Low Calcium PD Solution


Product

Dextrose

Fill Volume (mL)

Container Size (mL)

Pack Factor

Price/Case

5B9765P
1.5%
1500
5B9775P
2.5%
1500
5B9795P
4.25%
1500
5B9766
1.5%
2000
5B9776
2.5%
2000
5B9796 4.25% 2000
5B9768P
1.5%
2500
5B9778P
2.5%
2500
5B9798P
4.25%
2500
5B9757
1.5%
3000
5B9758 2.5% 3000
5B9759
4.25%
3000

2000
2000
2000
2000
2000
2000
3000
3000
3000
5000
5000
5000

8/case
8/case
8/case
6/case
6/case
6/case
5/case
5/case
5/case
4/case
4/case
4/case

$272.57
$280.10
$282.22
$191.07
$213.18
$215.13
$176.73
$181.74
$185.64
$156.37
$159.84
$164.72

D I A N E A L P D - 2 P D S o l u t i o n
5B9866
1.5%
2000
5B9876
2.5%
2000
5B9896 4.25% 2000
5B9868P 1.5% 2500
5B9878P
2.5%
2500
5B9898P 4.25% 2500
5B9857 1.5% 3000
5B9858 2.5% 3000
5B9859 4.25% 3000

2000
2000
2000
3000
3000
3000
5000
5000
5000

6/case
6/case
6/case
5/case
5/case
5/case
4/case
4/case
4/case

$191.07
$213.18
$215.13
$176.73
$181.74
$185.64
$156.37
$159.84
$164.72

Effective Date 4/1/12

PD1

P ER ITO NEAL

DIALYS I S

DIANEAL PD Solution, Single Bag (AMBU-FLEX Container)


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
n

Please see important safety information on page PD1.


Please see enclosed package inserts for DIANEAL solution full prescribing information.

DIANEAL Low Calcium PD Solution, Luer (AMBU-FLEX II Container)


Product

Dextrose

Fill Volume (mL)

Container Size (mL)

L5B4825 1.5% 2000


L5B9727 2.5% 2000
L5B9747 4.25% 2000
L5B9901 1.5% 3000
L5B9902 2.5% 3000
L5B9903 4.25% 3000
L5B4826 1.5% 5000
L5B5202 2.5% 5000
L5B5203 4.25% 5000
L5B9770 1.5% 6000
L5B9771 2.5% 6000
L5B9772 4.25% 6000

3000
3000
3000
3000
3000
3000
6000
6000
6000
6000
6000
6000

Pack Factor

Price/Case

6/case
6/case
6/case
4/case
4/case
4/case
2/case
2/case
2/case
2/case
2/case
2/case

$120.90
$144.92
$146.73
$138.36
$140.30
$143.31
$74.15
$75.88
$77.72
$88.61
$90.54
$93.04

DIANEAL PD-2 PD Solution, Luer (AMBU-FLEX II Container)


Product

Dextrose

Fill Volume (mL)

Container Size (mL)

L5B5163 1.5% 1000


L5B5173 2.5% 1000
L5B5183 4.25% 1000
L5B5166 1.5% 2000
L5B5177
2.5%
2000
L5B5187 4.25% 2000
L5B5169 1.5% 3000
L5B5179 2.5% 3000
L5B5189
4.25%
3000
L5B5193 1.5% 5000
L5B5194
2.5%
5000
L5B5195 4.25% 5000
L5B9710
1.5%
6000
L5B9711 2.5% 6000
L5B9712
4.25%
6000

PD2

1000
1000
1000
3000
3000
3000
3000
3000
3000
6000
6000
6000
6000
6000
6000

Pack Factor

Price/Case

12/case
12/case
12/case
6/case
6/case
6/case
4/case
4/case
4/case
2/case
2/case
2/case
2/case
2/case
2/case

$350.18
$365.35
$376.59
$121.75
$145.60
$148.04
$136.97
$139.92
$143.78
$74.15
$75.87
$77.54
$87.93
$90.24
$92.56

Effective Date 4/1/12

P ER ITO NEAL

DIALYS I S

EXTRANEAL (icodextrin) PD Solution



Na Ca Mg Cl Lactate
Extraneal (icodextrin) PD Solution (mEq/L) 132 3.5 0.5 96
40
Extraneal (icodextrin) Peritoneal Dialysis (PD) solution is indicated for a single daily exchange for the long (8 to16 hour) dwell during Continuous Ambulatory Peritoneal Dialysis
(CAPD) or Automated Peritoneal Dialysis (APD) for the management of End-Stage Renal Disease (ESRD). Extraneal is also indicated to improve (compared to 4.25% dextrose)
long-dwell ultrafiltration and clearance of creatinine and urea nitrogen in patients with high-average or greater transport characteristics, as defined using the Peritoneal
Equilibration Test (PET).
Important Risk Information
Dangerous Drug-Device Interaction
Only use glucose-specific monitors and test strips to measure blood glucose levels in patients using Extraneal (icodextrin) Peritoneal Dialysis Solution. Blood glucose
monitoring devices using glucose dehydrogenase pyrroloquinolinequinone (GDH-PQQ) or glucose-dye-oxidoreductase (GDO)-based methods must not be used. In addition,
some blood glucose monitoring systems using glucose dehydrogenase flavin-adenine dinucleotide (GDH-FAD)-based methods must not be used. Use of GDH-PQQ, GDO, and
GDH-FAD-based glucose monitors and test strips has resulted in falsely elevated glucose readings (due to the presence of maltose, see PRECAUTIONS/Drug/Laboratory
Test Interactions). Falsely elevated glucose readings have led patients or health care providers to withhold treatment of hypoglycemia or to administer insulin inappropriately.
Both of these situations have resulted in unrecognized hypoglycemia, which has led to loss of consciousness, coma, permanent neurological damage, and death. Plasma
levels of Extraneal (icodextrin) and its metabolites return to baseline within approximately 14 days following cessation of Extraneal (icodextrin) administration. Therefore
falsely elevated glucose levels may be measured up to two weeks following cessation of Extraneal (icodextrin) therapy when GDH-PQQ, GDO, and GDH-FAD-based blood
glucose monitors and test strips are used.
Because GDH-PQQ, GDO, and GDH-FAD-based blood glucose monitors may be used in hospital settings, it is important that the health care providers of peritoneal dialysis
patients using Extraneal (icodextrin) carefully review the product information of the blood glucose testing system, including that of test strips, to determine if the system is
appropriate for use with Extraneal (icodextrin).
To avoid improper insulin administration, educate patients to alert health care providers of this interaction whenever they are admitted to the hospital.
The manufacturer(s) of the monitor and test strips should be contacted to determine if icodextrin or maltose causes interference or falsely elevated glucose readings. For a list
of toll free numbers for glucose monitor and test strip manufacturers, please contact the Baxter Renal Clinical Help Line 1-888-RENAL-HELP or visit www.glucosesafety.com.
n Extraneal is contraindicated in patients with a known allergy to cornstarch or icodextrin, in patients with maltose or isomaltose intolerance, in patients with glycogen storage
disease, and in patients with pre-existing severe lactic acidosis
n Extraneal PD solution is intended for intraperitoneal administration only. Not for intravenous injection
n Rarely, serious hypersensitivity reactions to Extraneal have been reported, such as toxic epidermal necrolysis, angioedema, serum sickness, erythema multiforme and
leukocytoclastic vasculitis. If a serious reaction is suspected, discontinue Extraneal and institute appropriate treatment as clinically indicated
n Patients with insulin-dependent diabetes may require modification of insulin dosage following initiation of treatment
n 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 monitored
n In clinical trials, the most frequently reported adverse events occurring in 10% of patients, and more common in Extraneal PD solution patients than in control patients,
were peritonitis, upper respiratory infection, hypertension, and rash. The most common treatment-related adverse event for Extraneal PD solution patients was skin rash.
Additional adverse reactions have been reported in the post-marketing setting and are detailed in the full prescribing information
General Peritoneal Dialysis-Related
n Encapsulating peritoneal sclerosis (EPS) is a known, rare complication of peritoneal dialysis therapy. EPS has been reported in patients using peritoneal dialysis solutions
including Extraneal PD solution. Infrequent but fatal outcomes have been reported
n 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 monitored
periodically. 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 failure
n Please see full prescribing information. Extraneal Product Insert and Extraneal Medication Guide.

EXTRANEAL PD Solution, ULTRABAG System


Product
5B4984
5B4986

Icodextrin
7.5%
7.5%

Fill Volume (mL)

Container Size (mL)

Pack Factor

Price/Case

2000
2500

2000
3000

6/case
5/case

per contract
per contract

EXTRANEAL PD Solution, Single Bag, Luer (AMBU-FLEX II) Container


Product
L5B4974
L5B4976

Effective Date 4/1/12

Icodextrin
7.5%
7.5%

Fill Volume (mL)

Container Size (mL)

Pack Factor

Price/Case

2000
2500

2000
3000

6/case
5/case

per contract
per contract

PD3

P ER ITO NEAL

DIALYS I S

SYSTE M S

Automated Peritoneal Dialysis


HOMECHOICE PRO and HOMECHOICE Automated Peritoneal Systems

HOMECHOICE PRO System


Product

HOMECHOICE System

Description

Pack Factor

Price

Devices
5C4471
5C8310

HOMECHOICE Automated PD System


HOMECHOICE PRO Automated PD System

1/each
1/each

$17,719.67
$20,251.06

L u e r D i s p o s a b l e S e t s
R5C4479C
L5C4531
N5C8305C

Automated PD Set with Cassette - 4 Prong


Integrated APD Set
Low Recirculation Volume APD Set with cassette

30/case
30/case
30/case

$966.63
$1,303.78
$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.

PD4

Effective Date 4/1/12

P ER ITO NEAL

DIALYS I S

SYSTE M S

Automated Peritoneal Dialysis


HOMECHOICE PRO and HOMECHOICE Automated Peritoneal Systems (Cont.)
Product

Description

Pack Factor

Price

Data Cards
R5C4522
4994000449

HOMECHOICE PRO Card


6/case
$327.82
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
5C8346

Carrying Case
Hard Carrying Case with Wheels

1/each
1/each

$153.49
$453.51

E x t e n s i o n L i n e s
5C4480C

12 Foot Patient Extension Line with EASY-LOCK Connector

30/case

$246.60

30/case
30/case
6/case
30/case

$303.44
$170.97
$58.01
$219.79

48/case
30/case
15/case
15/case
1/each

$610.13
$417.61
$228.70
$268.83
$48.18

APD Drain Supplies


5C4145P
15 Liter Drainage Bag
5C4464P
Sterile Drain Extension Line, 12 feet
5C4476
Effluent Sample Bag, 150mL
5C4512
APD Drain Manifold (Connects two 15 liter drain bags)


APD Miscellaneous Supplies
5C4462
5C4426
5C4446
L5C4446
5C4971

Effective Date 4/1/12

Empty Sterile Bag, 3 Liter


5 Prong Manifold Set with Connector Tube
5-Prong Manifold Set (Spike)
5-Prong Manifold Set (Luer)
QUIETCOIL Device

PD5

P ER ITO NEAL

DIALYS I S

SYSTE M S

CAPD
Product

Description

Pack Factor

Price

D i s c o n n e c t Y- S e t s
5C4366P
ULTRASET Disposable Disconnect Y-Set (Spike)
L5C4366
ULTRASET Disposable Disconnect Y-Set (Luer)

M i s c e l l a n e o u s C A P D S u p p l i e s

60/case
30/case

$552.61
$315.07

5C4530
5C4190

48/case
1/each

$586.86
$109.81

Spike Protector II (protective cover for aseptic transfer set spikes)


CAPDDrainage Bracket


Assist Devices
CXD II Compact Exchange Device for APD Patients
Product

Description

Pack Factor Price/Each

Device
5C4275

Compact Exchange Device (CXD II)

1/each

$660.12

1/each

$86.10

C a r r y i n g C a s e

5C4942

Compact Exchange Device Carrying Case

Product

Description

5C4505

EZ-Aide Assist Device

Pack Factor Price/Each

PD6

1/each

$200.91

Effective Date 4/1/12

PERITONEAL DIALYSIS
Product

PATIENT

Description

CONNECTOLOGY
Pack Factor

Price/Case

Transfer Sets
5C4442 Extended Life EASY-LOCK Transfer Set (6)
6/case
$377.56
5C4449 MINICAP Extended Life PD Transfer Set (6) with Roller Clamp 6/case
$377.56
5C4482 MINICAP Extended Life PD Transfer Set (6) with Twist Clamp 6/case
$344.00
5C4483 MINICAP Extended Life PD Transfer Set Extra Short (4)
6/case
$360.39

with Twist Clamp
5C4160 Transfer Set with Spike Connector (48)
12/case
$248.57

Locking Titanium Adapter

FLEXICAP Disconnect Cap

MINICAP Disconnect Cap

Outlet Port Clamp

Transfer Set Adapters


5C4136 EASY-LOCK-to-Spike Adapter Set
12/case
$109.89
5C4137 PD Spike-to-EASY-LOCK Adapter Set
12/case
$109.89
5C4413 Spike/Syringe Adapter (connects spike on patient transfer

set to luer-type syringe)
10/case
$53.12

Transfer Sets For Straight Line CAPD
5C4213P Connection Shield II-K with Povidone-Iodine Solution
60/case
$285.13
5C4215P Locking Connection Shield
60/case
$458.95

Catheter Supplies
5C4129 Locking Titanium Adapter (2 piece)
5/case
$1,172.16
5C4169 Locking cap for Baxter PD Catheter Adapter
25/case
$124.00
5C4319 Immobile catheter and transfer set stabilizing device
30/case
$153.84
5C4381 IMMOBILIZER catheter stabilizing device
30/case
$476.98

Disconnect Caps
5C4212P Disconnect Cap (Walnut Cap)
60/case
$376.16
5C4456 FLEXICAP Disconnect Cap for High Dose Therapy
30/case
$94.52
5C4466P MINICAP Disconnect Cap
60/case
$313.44
Clamps
5C4527 Outlet Port Clamp with Short Nose
12/case
$78.88
5C4957 ULTRACLAMP Clamp (not for use as outlet port clamp)
12/case
$78.88

ULTRACLAMP Clamp

Effective Date 4/1/12 PD7

T RA DEMAR KS
For peritoneal dialysis products listed on pages PD1-PD7
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

PDTM

Effective Date 4/1/12

A CUTE

DIALYSIS

CRRT - Continuous Renal Replacement Therapy - Critical Care Nephrology


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
2
5M3123
HF1200 Hemofilter 1.25m
12/case
$1,736.23
5M3074
HF2000 Hemofilter 1.98m2
12/case
$1,799.77
2
5M3134
MINIFILTER Plus Hemofilter 700cm
4/case
$918.65

Dialysis Solutions for CRRT


Bicarbonate Buffer Solution
Product Description
5B9248
ACCUSOL Dialysis Solution 2.5L 35 Bicarbonate K4
5B9249
ACCUSOL Dialysis Solution 2.5L 35 Bicarbonate K2
5B9250
ACCUSOL Dialysis Solution 2.5L 35 Bicarbonate K0 0 Dextrose
5B9251
ACCUSOL Dialysis Solution 2.5L 30 Bicarbonate K2
5B9252
ACCUSOL Dialysis Solution 2.5L 30 Bicarbonate K2 0 Calcium

Pack Factor Price/Case


4/case
$101.72
4/case
$101.72
4/case
$101.72
4/case
$101.72
4/case
$101.72

Lactate Buffer Solution


5B7860

Premixed Dialysate for Hemodiafiltration-5 liter bag

2/case

$80.12

Acute PD
Catheter Supplies
Product

Description

2C7565

INTERLINK System with Add-On BURETROL

Pack Factor

Price/Case

48/case

$529.92

15/case

$228.70


Disposable Sets
5C4446

5-Prong Manifold Set (Spike)

Effective Date 4/1/12

AC1

T RA DEMAR KS
For acute dialysis products listed on page AC1
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

ACTM

Effective Date 4/1/12

H EMO DI ALYSIS

HEMAVISION Disposable Blood Chamber


Product

Description

Pack Factor

HCT1000B

HEMAVISION Disposable Blood Chamber

Effective Date 4/1/12

HD1

288/case

Price
$1,817.96

H EMO DI ALYSIS

D IA L YZE R S

SINGLE-USE
X E N I U M XPH Dialyzers, High Flux, Synthetic

Product

Description

Pack Factor Price/Case

H25601A
H25602A
H25603A
H25604A
H25605A
H25606A

XENIUM XPH 110 dialyzer (for single-use only)


XENIUM XPH 130 dialyzer (for single-use only)
XENIUM XPH 150 dialyzer (for single-use only)
XENIUM XPH 170 dialyzer (for single-use only)
XENIUM XPH 190 dialyzer (for single-use only)
XENIUM XPH 210 dialyzer (for single-use only)

24/case
24/case
24/case
24/case
24/case
24/case

$748.22
$793.56
$888.46
$943.00
$1,006.96
$1,085.00

X E N I U M Dialyzers, High Flux, Synthetic


Product

Description

Pack Factor Price/Case

5M6400
5M6401
5M6402
5M6403
5M6404
5M6405

XENIUM 110 dialyzer (for single-use only)


XENIUM 130 dialyzer (for single-use only)
XENIUM 150 dialyzer (for single-use only)
XENIUM 170 dialyzer (for single-use only)
XENIUM 190 dialyzer (for single-use only)
XENIUM 210 dialyzer (for single-use only)

24/case
24/case
24/case
24/case
24/case
24/case

$748.22
$793.56
$888.46
$943.00
$1,006.96
$1,085.00

E X E L T R A High Flux Dialyzers, Cellulose Triacetate

Product

Description

5M2119
5M2120
5M2121
5M2132

EXELTRA 150 dialyzer (for single-use only)


EXELTRA 170 dialyzer (for single-use only)
EXELTRA 190 dialyzer (for single-use only)
EXELTRA Plus 210 dialyzer (for single-use only)

Pack Factor

Price/Case

24/case
24/case
24/case
24/case

$1,365.61
$1,405.23
$1,450.22
$1,485.52

D I C E A High Performance Dialyzers, Cellulose Diacetate, High Efficiency

Product

Description

5M2591
5M2592
5M2593
5M2594
5M2595
5M2596

DICEA 90 dialyzer (for single-use only)


DICEA 110 dialyzer (for single-use only)
DICEA 130 dialyzer (for single-use only)
DICEA 150 dialyzer (for single-use only)
DICEA 170 dialyzer (for single-use only)
DICEA 210 dialyzer (for single-use only)

Pack Factor

Price/Case

24/case
24/case
24/case
24/case
24/case
24/case

$1,084.95
$1,200.89
$1,245.92
$1,287.95
$1,360.92
$1,466.75

Rx Only. For safe and proper use refer to Operators Manual.


HD2

Effective Date 4/1/12

H E M O DIALYSIS

D IA L YZE R S

SINGLE-USE
C A Cellulose Acetate Hollow Fiber Dialyzers, Conventional

Product

Description

Pack Factor

5M1729
5M1730

CA 50 dialyzer (for single-use only)


CA 70 dialyzer (for single-use only)

24/case
24/case

Price/Case
$834.39
$834.39

REUSE
C T Cellulose Triacetate Hollow Fiber Dialyzers, High Flux

Product

Description

5M1542
5M1546

CT 110G dialyzer
CT 190G dialyzer

Pack Factor

Price/Case

24/case
24/case

$1,395.68
$1,504.45

C A - H P High Performance Cellulose Diacetate Hollow Fiber Dialyzers, High Efficiency

Effective Date 4/1/12

Product

Description

5M2731
5M2732
5M2733
5M2734
5M2735
5M2736

CA-HP 90 dialyzer
CA-HP 110 dialyzer
CA-HP 130 dialyzer
CA-HP 150 dialyzer
CA-HP 170 dialyzer
CA-HP 210 dialyzer

HD3

Pack Factor

Price/Case

24/case
24/case
24/case
24/case
24/case
24/case

$1,084.95
$1,200.89
$1,245.92
$1,287.95
$1,360.92
$1,466.75

H EMO DI ALYSIS

B L OOD

TU B I N G

S E TS

NIPRO SET Blood Tubing Sets by Nipro Corporation


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
*A201V801 1/4 pump segment, pre-pump arterial chamber
*A203V801 8 mm pump segment, pre-pump arterial chamber
*A204V801 8 mm pump segment, post-pump arterial chamber
A209YV803 8 mm pump segment, pre-pump arterial chamber, Y-port saline set
A210V803 8 mm pump segment, post-pump arterial chamber
A217YV806 8 mm pump segment, post-pump arterial chamber, Y-port saline set

*These tubing sets are compatible with selected Baxter Hemodialysis Instruments.

24/case
24/case
24/case
24/case
24/case
24/case
24/case

$207.77
$207.77
$207.77
$207.77
$207.77
$207.77
$207.77

Please refer to the Recommended Blood Tubing Set Matrix for Baxter Hemodialysis Instruments. Baxter cannot
recommend using sets outside the sets listed in the matrix. Please also refer to the Blood Tubing Set-up Guide for proper
set-up for each recommended blood tubing set. For a copy of either the Blood Tubing Set Matrix or the Blood Tubing
Set-up Guide please contact Renal Technical Support at 1-800-553-6898, Select 1 for English, Prompt 4, Option 1.

HD4

Effective Date 4/1/12

H EMO DI ALYSIS

F ISTU 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
FS1525BC
FS1525BCR
FS1532BC
FS1625BC
FS1625BCR
FS163230BC
FS1725BC
FS173230BC

Safety Fistula 14G x 1, fixed hub 500/case


$876.52
Safety Fistula 15G x 1, fixed hub 500/case
$876.52
Safety Fistula 15G x 1, rotating hub
500/case
$904.65
1
Safety Fistula 15G x 1 4, fixed hub
500/case
$876.52
Safety Fistula 16G x 1, fixed hub 500/case
$876.52
Safety Fistula 16G x 1, rotating hub
500/case
$904.65
Safety Fistula 16G x 114, fixed hub
500/case
$876.52
Safety Fistula 17G x 1, fixed hub 500/case
$876.52
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
FS142530TPR
FS152530TP
FS152530TPR
FS162530TP
FS162530TPR
FS172530TP
FS172530TPR

Safety Fistula 14G x 1, fixed hub


Safety Fistula 14G x 1, rotating hub
Safety Fistula 15G x 1, fixed hub
Safety Fistula 15G x 1, rotating hub
Safety Fistula 16G x 1, fixed hub
Safety Fistula 16G x 1, rotating hub
Safety Fistula 17G x 1, fixed hub
Safety Fistula 17G x 1, rotating hub

250 pair/case
250 pair/case
250 pair/case
250 pair/case
250 pair/case
250 pair/case
250 pair/case
250 pair/case

$876.52
$904.65
$876.52
$904.65
$876.52
$904.65
$876.52
$904.65

Product

Description

Pack Factor

Price/Case

FD152530BC

15G x 1 Fixed Hub w/Backeye

Nipros BIOHOLE Dull Needles

50/case

$93.06

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

Description

Pack Factor

Price/Case

FT152530BC TULIP 15G x 1 Fixed Hub w/Backeye


300/case
$525.91
1
FT153230BC TULIP 15G x 1 /4 Fixed Hub w/Backeye
300/case
$525.91
FT162530BC TULIP 16G x 1 Fixed Hub w/Backeye
300/case
$525.91
FT152530BCR TULIP 15G x 1 Rotating Hub w/Backeye
300/case
$543.22
FT162530BCR TULIP 16G x 1 Rotating Hub w/Backeye
300/case
$543.22

Effective Date 4/1/12

HD5

H EMO DI ALYSIS

F ISTU 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
FT142530TP
FT152530TP
FT162530TP
FT172530TP

Description
TULIP 14G x 1 Fixed Hub Twin Pack
TULIP 15G x 1 Fixed Hub Twin Pack
TULIP 16G x 1 Fixed Hub Twin Pack
TULIP 17G x 1 Fixed Hub Twin Pack

HD6

Pack Factor

Price/Case

120 pair + 10 singles/case


120 pair + 10 singles/case
120 pair + 10 singles/case
120 pair + 10 singles/case

$438.25
$438.25
$438.25
$438.25

Effective Date 4/1/12

HEMODIALYSIS

DISPOSABLE

SUPPLIES

Nipros Disposable DOSE-SAVER Syringes


Product

Description

Pack Factor

JD01D2238 Disposable DOSE-SAVER Syringe 1cc 22G x 1 1/2 1000/case


JD01D2516 Disposable DOSE-SAVER Syringe 1cc 25G x 5/8 1000/case
JD03D2238 Disposable DOSE-SAVER Syringe 3cc 22G x 1 1/2 1000/case

Price/Case
$541.06
$557.29
$546.47

Miscellaneous Nipro Supplies


Product

Description

TPSURE1
PS01

Transducer Protector
Priming Set

Pack Factor
1000/case
200/case

Price/Case
$1,113.95
$200.19


Intravenous Injections In VIAFLEX Plastic Containers (Saline)
Sodium Chloride Injections
Product

Description

2B1321
2B1322Q
2B1323Q
2B1324X

0.9% Sodium Chloride Injection, USP


0.9% Sodium Chloride Injection, USP
0.9% Sodium Chloride Injection, USP
0.9% Sodium Chloride Injection, USP

Container Size (mL)

Pack Factor

150
250
500
1000

36/case
36/case
24/case
14/case

Price/Case
$193.32
$193.32
$128.88
$81.34

Irrigation Solutions in Plastic Containers


Product

Description

2F7112
2F7115
2F7122
2F7124
2F7125

Sterile Water For Irrigation, USP


Sterile Water For Irrigation, USP
0.9% Sodium Chloride Irrigation, USP
0.9% Sodium Chloride Irrigation, USP
0.9% Sodium Chloride Irrigation, USP

Effective Date 4/1/12

Container Size (mL)


250
1500
250
1000
1500

HD7

Pack Factor
24/case
9/case
24/case
12/case
9/case

Price/Case
$146.64
$87.93
$153.12
$89.88
$91.80

H EMO DI ALYSIS

C O N C E N TR A TE S

Acid Concentrate (A-Side) by Minntech Renal Systems


Three Stream (Conventional) Proportioning Systems (36.83x dilution)
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
5M7820 139
5M7821 139
5M7822 143
5M7823 140
5M7824 139
5M7825 139
5M7856 139
5M7857 139

1.00
2.00
1.00
2.00
0.00
2.00
3.00
0.00
3.00

2.50
3.50
3.50
3.00
2.50
2.50
3.00
0.00
2.50

1.00 105.50
1.00 106.50
1.00 105.50
1.00 110.00
1.00 104.50
1.00 105.50
1.00 107.00
1.00 101.00
0.75 106.25

4.0
4.0
4.0
4.5
4.0
4.0
4.0
4.0
4.0

200
200
200
200
200
200
200
200
200

35.0
35.0
35.0
35.5
35.0
35.0
35.0
35.0
35.0

4/case
4/case
4/case
4/case
4/case
4/case
4/case
4/case
4/case

$45.45
$45.45
$45.45
$45.45
$45.45
$45.45
$45.45
$45.45
$45.45

COBE Proportioning Systems (45x dilution)


Product Na
K
Ca
Mg Cl Acetate Dextrose Bicarbonate Pack Price/Case
Factor
5M7901 137
5M7902 137
5M7903 137
5M7904 137
5M7909 137
5M7911 137

0.00
2.00
1.00
2.00
1.00
3.00

2.25
2.50
3.00
3.00
2.25
3.00

0.75 103.00
0.75 105.25
0.75 104.75
0.75 105.75
0.75 104.00
0.75 106.75

5.0
4.0
4.0
4.0
5.0
4.0

200
200
200
200
200
200

32.0
33.0
33.0
33.0
32.0
33.0

4/case
4/case
4/case
4/case
4/case
4/case

$49.78
$49.78
$49.78
$49.78
$49.78
$49.78

Bicarbonate Concentrate (B-Side) by Minntech Renal Systems


Three Stream
Product

Description

Pack Factor

Price/Case

5M7828
5M7829

Bicarbonate Concentrate Powder for Conventional Proportioning Systems - 2.5 gal


Liquid Bicarbonate Concentrate for use with Conventional Proportioning Systems
(1 gal; 3.78 liters)

20 packets/case $104.97
4/case
$58.43

COBE (B-Side)

Product

Description

Pack Factor

5M7905
5M7906

Bicarbonate Concentrate Powder for COBE Proportioning Systems (2.1 gal: 8 liters)
Liquid Bicarbonate Concentrate for use with COBE (45x) Proportioning Systems
(1 gal; 3.78 liters)

20 packets/case $104.97
4/case
$58.43

HD8

Price/Case

Effective Date 4/1/12

T RA DEMAR KS
For hemodialysis products listed on pages HD1-HD8
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

Effective Date 4/1/12

HDTM

S O FTW AR E
Renal Software Suite (for use with HOMECHOICEPRO Automated PD System)
Product

Description

Pack Factor

5M5730
5M5730U

Renal Software Suite, PD Link Single User License


Renal Software Suite, PD Link User License Upgrade

1/each
1/each

RENALSOFT Clinical Software - Medical Record, CKD, PD, HD modules


RENLSFT

RENALSOFT Clinical Software


Contact your Baxter representative for more information

1/each

RENALSOFT Software Interface


5M5720

RENALSOFT Software Interface CD


Contact your Baxter representative for more information

SO1

1/each

Effective Date 4/1/12

T RA DEMAR KS
For software products listed on page SO1
The following is a listing of trademarks of Baxter International Inc:
Baxter
HomeChoice PRO
RenalSoft

Effective Date 4/1/12

SOTM

A NC ILLAR IES
Sponges

Gauze Sponge

Product
5K7458P
5K7407P
5K7424P
5K7505P
5K7416P
5K7426P
5K7425P
5K7567P
5K7559P
5K7589P
5K7428P
5K7543P
5K7427P
5K7525P
5K7430P

IV Sponge

Description
Pack Factor Price/Box
SORB-IT IV Sponge (split) 2 x 2 6-ply Sterile
35/box
$17.48
EXCILON Drain Sponge (split) 4 x 4 6-ply Sterile
25/box
$38.71
CURITY Gauze Sponge 2 x 2 8-ply Sterile
50/box
$9.23
CURITY Gauze Sponge 4 x 4 8-ply Sterile
25/box
$10.41
CURITY Gauze Sponge 4 x 4 12-ply Sterile
25/box
$11.45
CURITY Gauze Sponge 2 x 2 12-ply Non-Sterile
200/box
$11.77
CURITY Gauze Pad 2 x 2 12-ply Sterile
100/box
$28.36
VERSALON All Purpose Sponge 2 x 2 4-ply Sterile 25/box
$4.44
VERSALON All Purpose Sponge 3 x 3 4-ply Sterile 25/box
$8.22
VERSALON All Purpose Sponge 4 x 4 4-ply Sterile 25/box
$10.75
CURITY Cover Sponge 4 x 3 Sterile
25/box
$11.93
CURITY Cover Sponge 4 x 4 Sterile
25/box
$13.35
CURITY Cover Sponge 3 x 3 Non-Sterile
100/box
$10.35
CURITY Cover Sponge 4 x 3 Non-Sterile
100/box
$14.35
CURITY Cover Sponge 4 x 4 Non-Sterile
100/box
$19.79

Dressings
Product
5K7401P
5K7479P
5K7538P
5K7548P
5K7568P
5K7532P
5K7588P
5K7522P
5K7523P
5K7459P
5K7580P
5K7579P
5K7578P

Description
Pack Factor Price/Box
COVERLET Adhesive Bandage, Flexible 1 x 3
100/box
$24.49
BIOPATCH Antimicrobial Dressing - 1 disk w/7.0 mm center hole
10/box
$180.73
PRIMAPORE Adhesive Dressing 4 x 31/8 Sterile
20/box
$47.53
PRIMAPORE Adhesive Dressing 6 x 31/8 Sterile
20/box
$51.88
PRIMAPORE Adhesive Dressing 8 x 4 Sterile
20/box
$66.36
TELFA Adhesive Island Dressing 2 x 31/2 Sterile
50/box
$21.70
TELFA Adhesive Island Dressing 4 x 5 Sterile
25/box
$83.00
VIASORB Wound Dressing 2 x 3 Sterile
20/box
$109.27
VIASORB Wound Dressing 4 x 6 Sterile
20/box
$151.23
1
3
OPSITE Post Op Dressing 6 /8 x 3 /8 Sterile
20/box
$87.89
TEGADERM Transparent Dressing 23/8 x 23/4 Sterile
100/box
$124.97
TEGADERM Transparent Dressing 4 x 43/4 Sterile
50/box
$195.31
TEGADERM Transparent Dressing 6 x 8 Sterile
10/box
$88.98

AN1

Effective Date 4/1/12

A NC ILLAR IES
Tape

Cloth Tape

Product
5K7624
5K7630
5K7639
5K7615
5K7617
5K7660
5K7667
5K7619
5K7627

Description
Cloth Tape 1 x 10 yds
Cloth Tape 2 x 10 yds
Soft Cloth Tape 2 x 10 yds
Paper Tape 1 x 10 yds
Paper Tape 2 x 10 yds
Paper Tape 1 x 10 yds w/Dispenser
Paper Tape 2 x 10 yds w/Dispenser
Plastic Tape 1 x 10 yds
Plastic Tape 2 x 10 yds

Paper Tape

Plastic Tape

Effective Date 4/1/12

AN2

Pack Factor
1/ea
1/ea
1/ea
1/ea
1/ea
1/ea
1/ea
1/ea
1/ea

Price/Box
$2.24
$4.93
$20.91
$1.90
$3.63
$1.87
$3.77
$3.07
$6.97

A NC ILL AR IES
Antiseptics/Chemicals

Surgical Scrub

Product

Description

Pack Factor

5K4075
5K4227
5K4070
5K4066
5K4054P
5K4005
5K4027
5K4001
5K4172P
5K4012P
5K4013P
5K8148P
5K8058P
5K4033P
5K4265P
5K4291P
5K4226
5K4225P
5K4285
5K4286P
5K4077

MANUGEL 85 Antiseptic Hydroalcoholic Gel, 500 mL with Pump


CAL STATPLUS Hand Rub No Rinse - 4 oz.
Liquid Soap Antimicrobial - 16 oz. w/pump
EXSEPT PLUS Skin Antiseptic 500 mL
SHUR-CLENS Skin Wound Cleanser - 20 mL
ALCAVIS 50 - 500 mL
BETASEPT Surgical Scrub 4% - 32oz. with Pump
Alcohol Isopropyl 70% - 16oz.
Alcohol Prep Medium 21/4 x 11/4 2-ply
Povidone-Iodine Swab-aid 13/4 x 11/4
Povidone-Iodine Swabstick 3/pk
SKIN-PREP Protective Dressing
Adhesive Remover Pad
HEMASTIX Reagent Strips
SERIM Cholorine Residual Test Kit
Bleach Wipes
ACTRIL Cold Sterilant for Machine and Surface Disinfectant - Gallon
ACTRIL Residual Test Strips
MINNCARE Cold Sterilant for use on RO Membranes - Quart
MINNCARE Residual Test Strip
Conductivity Standard Solution 14.0 M/HHOS - 32oz.

Price

1 ea
$22.27
1 ea
$11.17
1 ea
$9.36
1 ea
$30.96
25/box
$96.43
1 ea
$20.53
1 ea
$25.52
1 ea
$3.69
200/box
$7.97
100/box $22.44
25/box
$22.68
50/box
$25.06
100/box
$29.78
50/box
$77.58
1 ea
$156.18
50/box
$63.58
1 ea
$47.43
100/bottle
$71.41
1 ea
$86.99
100/box
$88.70
1 ea
$53.62

Gloves

Product

Description

Pack Factor

5K7777P
5K7778P
5K7779P

Latex Free. Non-sterile. Powder Free. Nitrile. Small


Latex Free. Non-sterile. Powder Free. Nitrile. Medium
Latex Free. Non-sterile. Powder Free. Nitrile. Large

AN3

100/box
100/box
100/box

Price/Box
$26.79
$26.79
$26.79

Effective Date 4/1/12

A NC ILLAR IES
Blood Pressure Units
Product

Description

5K3966
5K3967
5K3968

Digital Auto Inflate Blood Pressure Unit w/medium cuff (arm girth 9.4 - 14.2)
Digital Auto Inflate Blood Pressure Unit w/small cuff (arm girth 6.3 - 9.4)
Digital Auto Inflate Blood Pressure Unit w/large cuff (arm girth 14.2 - 17.7)

Product

Description

5K3517
5K3545
5K3575
5K3582
5K3585

Scale Pediatric Digital (Capacity: 44 lbs x 1/2 oz / 20 kg x 0.01 kg)


Scale Digital w/detachable display (Capacity: 400 lbs x 0.2 lbs / 180 kg x 0.1 kg)
Scale Digital 1-1/2 Display (Capacity: 400 lbs x 0.1 lbs / 180 kg x 0.05 kg)
Scale Spring (5000 gm x 100 gm)
Scale Spring Pediatric (250 gm x 10 gm)

Pack Factor

Price/Each

1/each
1/each
1/each

$186.76
$180.36
$203.00

Pack Factor

Price/Each

1/each
1/each
1/each
1/each
1/each

$559.58
$333.94
$116.10
$21.08
$20.65

Pack Factor

Price/Each

Scales

Permanent Equipment
Product

Description

5K3961
5Q3810
5K3572
5K3826
5K8100

Heating Pad - King Size 3 Heat Setting


I.V. Pole Double-Hook Free Standing 47 x 84
Thermometer, Digital
Dialysis Bath Conductivity Meter
PD Simulator and Case Dummy Tummy

Effective Date 4/1/12

AN4

1/each
1/each
1/each
1/each
1/each

$83.61
$117.40
$13.86
$408.91
$1,209.32

A NC ILLAR IES
Miscellaneous Ancillary Supplies
Product

Description

5K7444P
5K7402P
5K4500
5K3739
5K7406P
5K8123P
5K8070P
5K8032P
5K8065P

Underpad Plastic Lined 17 x 24


Sterile Field 18 x 26
BETA-CAP Clamp
Forcep 414 Blue Plastic Dravon A-Clamp Smooth Jaw
Cotton-Tipped Applicator Sterile 6 Long - 2/pkg
Face Mask White Paper Pleated
Face Mask - Yellow Pleated
Face Mask - Blue Molded Fluid Resistant
Can Liner, 33 Gal, Black

Pack Factor

Price/Each

100/box
50/box
1 ea
1 ea
100/box
50/box
50/box
50/box
250/box

$20.87
$48.73
$5.54
$6.04
$22.79
$8.03
$15.42
$27.58
$78.49

Face Mask

AN5

Effective Date 4/1/12

T RA DEMAR KS
For ancillary products listed on pages AN1-AN5
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

Effective Date 4/1/12

ANTM

Non-Diabetic

Type 1 Insulin Dependent

Type 2 Insulin Dependent

Zip
/

State
DOB
/

Zip

State

Phone
Phone

LowCal
L
L
L
L
L
L
L
L

30
30
30
30

R5C4479C 4-Prong APD Cassette


L5C4531 3-Prong Integrated APD Set

5C4480C
5C4464P

Physician:
Signature (Substitution Permitted)

12 Patient Extension Line


12 Drain Extension Line

1
1
1

HOmEcHOIcE cyclers and Disposables:


5C8310R HOmEcHOIcE PRO Cycler
5C4471R HOmEcHOIcE Cycler
5C4406
HOmEcHOIcE Carrying Case

ExTRANEAL (Icodextrin) PD Solution:


L5B
L
ExTRANEAL
5B
L
ExTRANEAL

DIANEAL PD Solution:
L5B
1.5%
L5B
2.5%
L5B
4.25%
5B
5B
5B
5B
5B
PD2

Type 2 Non-Insulin Dependent

(Dispense as Written)

Face Mask, Yellow


Face Mask, White

5K8070P
5K8123P

50
50

1 roll
1 roll
1 roll

Paper Tape 1
Plastic Tape 1
Cloth Tape 1

5K7615
5K7619
5K7624

12
12
25
35
50

Blue Outlet Port Clamp


Red ULTRAcLAmP Clamp

5C4527
5C4957

60
30

Ancillaries:
5K7416P Gauze Sponge 4 x 4 12-ply
5K7458P IV Sponge 2 x 2 6-ply
5K7424P Gauze Sponge 2 x 2 8-ply

mINIcAP Disconnect Cap


FLExIcAP Disconnect Cap

5C4466P
5C4456

HOmEcHOIcE cyclers and Devices (cont.):


5C4145P 15 Liter Drainage Bag
30
5C4512
APD Drain Manifold
30
L5C4366
Disconnect Y-Set
30

Date

State
PO#

Zip

Phone

Max
Qty

Description

Ord
Qty

1
1
1
1

Pack
Factor

Max
Qty

To
To
Clinic Patient

Ord
Qty

PF1

For New York State Prescriptions Only:


PRESCRIPITONS WILL BE FILLED GENERICALLY
UNLESS PRESCRIBER WRITES daw IN THE
BOX BELOW

No IV Pole, Reg BP Cuff


No IV Pole, Lg BP Cuff
w/IV Pole, Reg BP Cuff
w/IV Pole, Lg BP Cuff
No Scale, Sm BP Cuff
Heating Pad, King Size
IV Pole
Scale Spring
BP Unit, Digital (Medium Cuff)
Scale, Digital
Thermometer, Digital

USE AS DIRECTED

VALKITA
VALKITAL
VALKITC
VALKITCL
VALKITP
5K3961
5Q3810
5K3582
5K3966
5K3575
5K3572

valkits/Permanent Equipment:

Ancillaries (cont.):
5K4070
Antimicrobial Soap 16oz.
5K4075
mANUgEL 85 Antiseptic
5K4066
ExSEPT PLUS Antiseptic
5K4005
ALcAvIS 50 (500ml)

Product
Code

Physician Name Printed

Ord
Qty

Days reserve:___________________________ Liters per day: _______________________


Solution Maximum Quantity per delivery cycle: _______________________________________
ONE YEAR REFILL unless otherwise noted _________________________________________

Clinic/Hospital
Address
City
Contact

This ESRD patient has been trained in Home Peritoneal Dialysis and will require the supplies listed below.
Product
% Dextrose
Fill Vol Pack Ord Max
Product
Description
Pack
Code
Factor Qty
Qty
Code
Factor

Diabetic type:

Patient Name
Alternate Contact
Delivery Address
City
Mailing Address (if different)
City
Gender:
Male
Female

APD Prescription Form

Non-Diabetic

Type 1 Insulin Dependent

Type 2 Insulin Dependent

Zip
/

State
DOB
/

Zip

State

Phone
Phone

LowCal
L
L
L
L
L
L

Disconnect Y-Set

Immobile (Velcro)
ImmOBILIzER

L5C4366

5C4319
5C4381

Physician:
Signature (Substitution Permitted)

12
12

Blue Outlet Port Clamp


Red ULTRAcLAmP Clamp

5C4527
5C4957

30
30

30

60

Disposables:
5C4466P mINIcAP Disconnect Cap

ExTRANEAL (Icodextrin) PD Solution:


5B
L
ExTRANEAL

DIANEAL PD Solution ULTRABAg:


5B
1.5%
5B
2.5%
5B
4.25%
5B
5B
5B
PD2

Type 2 Non-Insulin Dependent

Face Mask, Yellow


Face Mask, White

5K8070P
5K8123P

Date

(Dispense as Written)

Antimicrobial Soap 16oz.


mANUgEL 85 Antiseptic
ExSEPT PLUS Antiseptic
ALcAvIS 50 (500ml)

1 roll
1 roll
1 roll

Paper Tape 1
Plastic Tape 1
Cloth Tape 1

5K7615
5K7619
5K7624

1
1
1
1

50
50

25
35
50

Ancillaries:
5K7416P Gauze Sponge 4 x 4 12-ply
5K7458P IV Sponge 2 x 2 6-ply
5K7424P Gauze Sponge 2 x 2 8-ply

5K4070
5K4075
5K4066
5K4005

State
PO#

Zip

Phone

Max
Qty

USE AS DIRECTED

Ord
Qty

Pack
Factor

Max
Qty

To
To
Clinic Patient

Ord
Qty

PF2

For New York State Prescriptions Only:


PRESCRIPITONS WILL BE FILLED GENERICALLY
UNLESS PRESCRIBER WRITES daw IN THE
BOX BELOW

valkits/Permanent Equipment:
No IV Pole, Reg BP Cuff
VALKITA
VALKITAL No IV Pole, Lg BP Cuff
w/IV Pole, Reg BP Cuff
VALKITC
VALKITCL w/IV Pole, Lg BP Cuff
No Scale, Sm BP Cuff
VALKITP
5K3961
Heating Pad, King Size
5Q3810
IV Pole
5K3582
Scale Spring
5K3966
BP Unit, Digital (Medium Cuff)
5K3575
Scale, Digital
5K3572
Thermometer, Digital

Product
Description
Code
Additional Items:

Physician Name Printed

Ord
Qty

Days reserve:___________________________ Liters per day: _______________________


Solution Maximum Quantity per delivery cycle: _______________________________________
ONE YEAR REFILL unless otherwise noted _________________________________________

Clinic/Hospital
Address
City
Contact

This ESRD patient has been trained in Home Peritoneal Dialysis and will require the supplies listed below.
Product
% Dextrose
Fill Vol Pack Ord Max Product
Description
Pack
Code
Factor Qty
Qty
Code
Factor

Diabetic type:

Patient Name
Alternate Contact
Delivery Address
City
Mailing Address (if different)
City
Gender:
Male
Female

CAPD Prescription Form

Non-Diabetic

Dialyzer

5M

50
100
1
1

5K4033P HEmASTIx Reagent Strips


5K4225P AcTRIL Residual Test Strips

5K4077
5K4226

Physician:
Signature (Substitution Permitted)

Conductivity Sol 14.0 M/HHOS


AcTRIL Machine Disinfectant

1000

Blood Tubing Set


TPSURE1 Transducer Protector

Fistula___G x ____

Acid Concentrate
Bicarbonate Concentrate, Liquid
Bicarbonate Concentrate,
Powder

5M
5M
5M

Pack
Factor
14

Ord
Qty

Type 1 Insulin Dependent

Product Description
Code
2B1324X 0.9% Saline Inj., USP 1000mL

Diabetic type:

Patient Name
Alternate Contact
Delivery Address
City
Mailing Address (if different)
City
Gender:
Male
Female

Max
Qty

1 roll
1 roll
1 roll

5K7615
5K7619
5K7624

Date

5K4001
5K4172P
5K4012P
5K4013P

5K4070
5K4075

(Dispense as Written)

Alcohol Isopropyl 70% 16oz.


Alcohol Swabs
Povidone-Iodine Swabs
Povidone-Iodine Swabsticks 3/pk

Antimicrobial Soap 16oz.


mANUgEL 85 Antiseptic

5K8070P Face Mask, Yellow


5K8123P Face Mask, White

1
200
100
25

1
1

50
50

25
35

Pack
Factor

Type 2 Non-Insulin Dependent

Paper Tape 1
Plastic Tape 1
Cloth Tape 1

State
PO#

Zip

Phone

Max
Qty

Gloves

5K77

USE AS DIRECTED

1
1
1
1

100

100

Pack Ord
Factor Qty

Max
Qty

PF3

For New York State Prescriptions Only:


PRESCRIPITONS WILL BE FILLED GENERICALLY
UNLESS PRESCRIBER WRITES daw IN THE
BOX BELOW

Permanent Equipment:
5K3966
BP Unit, Digital (Medium Cuff)
5K3575
Scale, Digital
5K3739
Forceps 4 1/4
5K3826
Dialysis Bath Conductivity Meter

Additional Items:

Underpad, Blue Plastic

5K7444P

Product
Description
Code
Ancillaries (cont.):

Physician Name Printed

Ord
Qty

Treatments per week:_________________________________________________________


ONE YEAR REFILL unless otherwise noted _________________________________________

Clinic/Hospital
Address
City
Contact

Product Description
Code
Ancillaries:
5K7416P Gauze Sponge 4 x 4 12-ply
5K7458P IV Sponge 2 x 2 6-ply

Type 2 Insulin Dependent

Zip
/

State
DOB
/

Zip

State

Phone
Phone

HD Prescription Form

PF4

New Patient

Reactivated Patient

Therapy Change

Transfer Patient

You may be able to avoid this fax by using the DirectAccess online tool. The DirectAccess online tool is the preferred way for you to do business
with Baxter. With the DirectAccess online tool, you can quickly and easily set up or modify patient prescriptions and forward them to doctors for their
eSignature. Work smarter with the DirectAccess online tool.
To learn how, visit the landing page at www.baxter.com/homecareservices to sign up, download a user guide, attend a webinar training, or practice on
your own using our new training environment, the Playground.

SUPPLY ORDER TO THE PATIENT

Patient Name

Requested Delivery Date:


HARDWARE ORDER
(All new APD patients must have a cycler on their
prescription and place a cycler order)

Attending Physician
Clinic Contact

HomeChoice Cycler
HomeChoice PRO Cycler
Carrying Case

Clinic Phone#

Requested Delivery Date:

Clinic Name

To Patient
To Clinic (Address Below)

Billing Information

THERAPY
APD

CAPD

Home HD

56 Days

84 Days

DELIVERY CYCLE
28 Days

FORMER THERAPY (if applicable)


New to dialysis
Failed transplant
From competitive product
From in-center hemodialysis
Other/Misc

VALKITS/PERMANENT EQUIPMENT ORDER


(Per product selected on prescription form)
To Patient

To Clinic

Requested Delivery Date:


NEW PATIENT TRAINING SUPPLIES
(Eligibility may vary by contract)
Requested Delivery Date:
QTY

PRODUCT CODE

TO CLINIC TO PATIENT

COMMENTS

*This is not a legal prescription.


Baxter, DirectAccess, HomeCare Services logo, HomeChoice and HomeChoice PRO are trademarks of Baxter International Inc. AL11180C 09/11

Renal Division | HomeCare Services


Phone: 1-800-284-4060
Fax: 1-800-666-8457

T RA DEMAR KS
For prescription forms listed on pages PF1-PF4
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

PFTM

Effective Date 4/1/12

N UM ER I CAL

INDEX

Code Page

Code Page

Code Page

Code Page

2B1321 HD7

5C4137 PD7

5K3739 AN5

5K7505P AN1

2B1322Q HD7

5C4145P PD5

5K3826 AN4

5K7522P AN1

2B1323Q HD7

5C4160 PD7

5K3961 AN4

5K7523P AN1

2B1324X HD7

5C4169 PD7

5K3966 AN4

5K7525P AN1

2C7565 AC1

5C4190 PD6

5K3967 AN4

5K7532P AN1

2F7112 HD7

5C4212P PD7

5K3968 AN4

5K7538P AN1

2F7115 HD7

5C4213P PD7

5K4001 AN3

5K7543P AN1

2F7122 HD7

5C4215P PD7

5K4005 AN3

5K7548P AN1

2F7124 HD7

5C4275 PD6

5K4012P AN3

5K7559P AN1

2F7125 HD7

5C4319 PD7

5K4013P AN3

5K7567P AN1

5B4984 PD3

5C4366P PD6

5K4027 AN3

5K7568P AN1

5B4986 PD3

5C4381 PD7

5K4033P AN3

5K7578P AN1

5B7860 AC1

5C4406 PD5

5K4054P AN3

5K7579P AN1

5B9248 AC1

5C4413 PD7

5K4066 AN3

5K7580P AN1

5B9249 AC1

5C4426 PD5

5K4070 AN3

5K7588P AN1

5B9250 AC1

5C4442 PD7

5K4075 AN3

5K7589P AN1

5B9251 AC1

5C4446

PD5, AC1

5K4077 AN3

5K7615 AN2

5B9252 AC1

5C4449 PD7

5K4172P AN3

5K7617 AN2

5B9757 PD1

5C4456 PD7

5K4225P AN3

5K7619 AN2

5B9758 PD1

5C4462 PD5

5K4226 AN3

5K7624 AN2

5B9759 PD1

5C4464P PD5

5K4227 AN3

5K7627 AN2

5B9765P PD1

5C4471 PD4

5K4265P AN3

5K7630 AN2

5B9766 PD1

5C4476 PD5

5K4285 AN3

5K7639 AN2

5B9768P PD1

5C4480C PD5

5K4286P AN3

5K7660 AN2

5B9775P PD1

5C4482 PD7

5K4291P AN3

5K7667 AN2

5B9776 PD1

5C4483 PD7

5K4500 AN3

5K7777P AN3

5B9778P PD1

5C4505 PD6

5K7401P AN1

5K7778P AN3

5B9795P PD1

5C4512 PD5

5K7402P AN5

5K7779P AN3

5B9796 PD1

5C4527 PD7

5K7406P AN5

5K8032P AN5

5B9798P PD1

5C4530 PD6

5K7407P AN1

5K8058P AN3

5B9857 PD1

5C4942 PD6

5K7416P AN1

5K8065P AN5

5B9858 PD1

5C4957 PD7

5K7424P AN1

5K8070P AN5

5B9859 PD1

5C4971 PD5

5K7425P AN1

5K8100 AN4

5B9866 PD1

5C8310 PD4

5K7426P AN1

5K8123P AN5

5B9868P PD1

5C8346 PD5

5K7427P AN1

5K8148P AN3

5B9876 PD1

5K3517 AN4

5K7428P AN1

5M1542 HD3

5B9878P PD1

5K3545 AN4

5K7430P AN1

5M1546 HD3

5B9896 PD1

5K3572 AN4

5K7444P AN5

5M1729 HD3

5B9898P PD1

5K3575 AN4

5K7458P AN1

5M1730 HD3

5C4129 PD7

5K3582 AN4

5K7459P AN1

5M2119 HD2

5C4136 PD7

5K3585 AN4

5K7479P AN1

5M2120 HD2

Effective Date 4/1/12

IN1

N UM ER I CAL

INDEX

Code Page

Code Page

Code Page

Code Page

5M2121 HD2

5M7903 HD8

H25601A HD2

L5C4531 PD4

5M2132 HD2

5M7904 HD8

H25602A HD2

N5C8305C PD4

5M2591 HD2

5M7905 HD8

H25603A HD2

R5C4479C PD4

5M2592 HD2

5M7906 HD8

H25604A HD2

PS01 HD7

5M2593 HD2

5M7909 HD8

H25605A HD2

R5C4522 PD5

5M2594 HD2

5M7911 HD8

H25606A HD2

R5C4526 PD5

5M2595 HD2

5M9634 HD4

HCT1000B HD1

RENLSFT SO1

5M2596 HD2

5Q3810 AN4

JD01D2238 HD7

TPSURE1 HD7

5M2731 HD3

A201V801 HD4

JD01D2516 HD7

5M2732 HD3

A203V801 HD4

JD03D2238 HD7

5M2733 HD3

A204V801 HD4

L5B4825 PD2

5M2734 HD3

A209YV803 HD4

L5B4826 PD2

5M2735 HD3

A210V803 HD4

L5B4974 PD3

5M2736 HD3

A217YV806 HD4

L5B4976 PD3

5M3074 AC1

FD152530BC HD5

L5B5163 PD2

5M3121 AC1

FS1425BC HD5

L5B5166 PD2

5M3122 AC1

FS142530TP HD5

L5B5169 PD2

5M3123 AC1

FS142530TPR HD5

L5B5173 PD2

5M3134 AC1

FS1525BC HD5

L5B5177 PD2

5M5720 SO1

FS1525BCR HD5

L5B5179 PD2

5M5730 SO1

FS1532BC HD5

L5B5183 PD2

5M5730U SO1

FS152530TP HD5

L5B5187 PD2

5M6400 HD2

FS152530TPR HD5

L5B5189 PD2

5M6401 HD2

FS1625BC HD5

L5B5193 PD2

5M6402 HD2

FS1625BCR HD5

L5B5194 PD2

5M6403 HD2

FS162530TP HD5

L5B5195 PD2

5M6404 HD2

FS162530TPR HD5

L5B5202 PD2

5M6405 HD2

FS163230BC HD5

L5B5203 PD2

5M7818 HD8

FS1725BC HD5

L5B9710 PD2

5M7820 HD8

FS172530TP HD5

L5B9711 PD2

5M7821 HD8

FS172530TPR HD5

L5B9712 PD2

5M7822 HD8

FS173230BC HD5

L5B9727 PD2

5M7823 HD8

FT152530BC HD5

L5B9747 PD2

5M7824 HD8

FT153230BC HD5

L5B9770 PD2

5M7825 HD8

FT162530BC HD5

L5B9771 PD2

5M7828 HD8

FT152530BCR

HD5

L5B9772 PD2

5M7829 HD8

FT162530BCR

HD5

L5B9901 PD2

5M7856 HD8

FT142530TP HD6

L5B9902 PD2

5M7857 HD8

FT152530TP HD6

L5B9903 PD2

5M7901 HD8

FT162530TP HD6

L5C4366 PD6

5M7902 HD8

FT172530TP HD6

L5C4446 PD5

IN2

Effective Date 4/1/12

Baxter Healthcare Corporation


Renal Business Unit
One Baxter Parkway
Deerfield, IL 60015
1-888-736-2543
www.baxter.com

AL05121X 04/12